Looking for Dr. Right? Get Yours via Speed Date!
Want to find your "Dr. Right"? Now, you can! You can meet your next doctor on a "speed date."
Dne Texas hospital is trying its hand at a method once left to the dating world and to ads in in-flight magazines like "It's Just Lunch".
Texas Health Harris Methodist Hospital outside Fort Worth has created Doc Shop as a way for prospective patients to meet with docs before committing to being a patient, says CNN. It's a way, they say, to see whether patients and doctors click before signing on to that first appointment. How efficient!
According to AMA and AHA, says CNN, Doc Shop is one of a kind. Could it catch on? Maybe.
But should it? Not a chance. From a patient perspective, one could argue that it saves them from wasting all those hours on initial visits only to find out that doctors don't know the current literature or aren't "their type". Of course, Doc Shop won't tell prospective patients how long the wait in the waiting room is at their office, how good or bad the office staff is, or anything else about the practice. And it certainly tells patients nothing about the quality of the physicians charming them across the table.
Even more so, anyone can put on a good face for a minute or two and hide their uglier side. Doc Shop is a totally contrived situation where doctors are selling themselves just a few minutes at a time. They are not under the pressures of daily medical practice--their pager isn't going off, they don't have a call from an angry patient on line one and an even angrier insurance company on line two.
While Doc Shop may seem like a good idea to frustrated patients who can't find a good doctor, I don't think that they are any more likely to find their dream physician any more than someone is likely to find the love of their life from speed-dating around a room of men or women eager to sell themselves off to any one who would have them.
I say if you need a good doctor, ask a friend.
Summer Johnson, PhD
End of Life-ology
William King is dying from MS. His two twenty-something sons, Ennis and Malcolm, already lost their mother to cancer 15 years earlier and now must deal with his slow deterioration. To make matters worse, the King family is poor, or as they put it "broke" and faced with the difficult choices of a generation that is passing, a generation that is looking to take flight and the tension that comes when illness comes between them.
This is the nexus of the play, "Broke-ology", which I had the privilege of watching last night at the Kansas City Reparatory Theater. The story, set in just across the state line Kansas City, Kansas, has come home to roost after first being produced at the Lincoln Center Theater.
I, of course, am no theater critic, but what drew me to this work of art was essentially the story of two young men and their father struggling with the notions of care giving, the end of life, and ultimately letting go.
You cannot understand the King family unless you understand where they live, which is to understand that they are a poor African-American family living in a rundown, dying (what appears to be) exclusively African-American neighborhood in Kansas City, Kansas. The elder son, Ennis', theory about making it in this community "broke-ology" boils down to a simple formula of living on government dole, thriftiness, hard work, and pride in his own family.
But ultimately, "broke-ology" doesn't get you very far when your father is dying of MS. William greets us in the very first scene before Ennis is even born, young and full of vigor, but by scene two, he comes lumbering down the stairs in bathrobe, slippers, and an eye patch (emblematic of his failing vision from MS). In a paradigmatic representation of health disparities in the African-American community, William and his sons understand very little about his condition. They refer to "his doctor" without name, "expensive medicines" without name, and talk openly about their ignorance about William's prognosis, disease progression, and what will come next.
It is the eldest son, however, who has remained in the community (while the younger brother moved off to UConn to earn multiple college degrees), who has become the caregiver for William, giving him his multiple shots per day, reminding him about medications as his memory as failed. Ennis does this even as his own family obligations (a new wife and child on the way) have created his own burdens and struggles. Malcolm represents the paradigmatic son who returns home with much fanfare and glory and who interjects himself with much tumult into medical decision-making. In a gut-wrenching scene, Malcolm and Ennis scream at each other after a visit to an assisted living facility
"Broke-ology" is not a story about being broke, it is a story about dying. The children becoming the parent for their parent is a time old tale, but the nuance added with this African-American family gives the story some richness it might not have had otherwise. Where the play is weakest is in the development of the mother, Sonia, who appears sporadically throughout the play, but who does give William much of his soul. Her death and her life go largely unexamined, however, and this is a real shame.
But ultimately, the end of life-ology is a tale of a family making tough choices and William's the toughest and most definitive of all. He cannot save his family from their broke-ness, but at least they have one last summer together. For most families with parents suffering from terminal illness, that is pretty much all they could ask for.
**SPOILER ALERT***: Broke-ology ends with William making a choice: the choice to end his life with a fatal overdose. The burden upon his caregivers is too much--so ultimately William gives Ennis and Malcolm the freedom to live their lives in the way that he could never could have or give his own wife. He would not condemn his sons to the same fate.
Sadly, what is left unexamined is whether William's suicide and so many of his simultaneously sad and hilarious moments are the result of dementia, depression, or some other side effect of his MS. So many chronically ill patients, as we know, choose to end their own lives, not out of autonomous choice, but as a result of depression. The clinical facts are lacking in this play because the inter-personal drama seems to make them not matter.
Summer Johnson, PhD
If You Are STILL Wondering Why Health Care Reform Is Important...
Check out this statistic from the Chicago Tribune today: "Illinois consumers to pay up to 60% more [for health insurance premiums], data show." When do they pay more? AFTER they have lost their employer-sponsored health care coverage. In other words, just when they can afford to, right?
Oh and this 60% figure is the base rate for insurance premiums (up from 8.5% last year). It doesn't factor in additional increases in the cost of premiums for age, gender or most importantly, health status.
Whether you believe that access to basic health care services is a right (as I do) or whether you believe there is a right to be healthy (I'm less sanguine on that point), it just seems criminal that while so many industries in health care continue to make money hand over fist, some of the most vulnerable among us (children, the recently unemployed) are finding it increasingly difficult to insure themselves.
I don't think there is just a single culprit here. It would be all to easy to just point a figure at the "evil health insurance industry" or "Washington politicians" who have to date have been unable to pass reform. But it isn't that simple.
Unfortunately, the facts are. Those in the individual insurance market, not just in Illinois, but all over the country, are finding themselves priced right out of a market that was supposed to be designed for them. Something can and must be done, whether it will be--in terms of reforming our health care system--remains to be seen.
Summer Johnson, PhD
Glenn McGee and American Catholics in Assisted Reproduction Barfight
First published in the St. Louis Post-Dispatch and then the Washington Post, Glenn McGee makes the provocative claim that American Catholics aren't any more likely to follow the most recent edict from the Vatican that Catholics should not use IVF for reproduction than they are heeding admonitions against using birth control.
The statistics say that only 4% of married Catholic couples use natural family planning--so what do you think the rest of them are using? So to extrapolate, what do you think that Catholic couples having trouble with fertility are going to do? Listen to Rome and not have a child or go see a fertility specialist and use reproductive technologies? What do you think?
I think McGee has it right. The teachings of the Church are out of sync with that American Catholics are likely to do--but hey, it's not the first time.
Summer Johnson
The blog.bioethics.net Archive Rises Like a ...
At last we've found a few minutes to assemble the archive of The American Journal of Bioethics Editors' blog through 2007 and publish them in an accessible venue. If you get nostalgic for the days when we translated documents about the Korean stem cell scandal, or those glorious years of the neocon bioethics movement, drop by and shuffle through thousands of posts on every topic in bioethics. Especially the "this didn't really happen, did it?" chapter in the history of bioethics: who can forget, for example, that sunny morning when the President's Commission on Bioethics' chairman lobbied in the Senate Chambers bearing a paper copy of "the Bush 2nd term agenda for bioethics?"
Back then, everyone else had to identify that they weren't an editor, except, um, the editor. The blog posts that are not signed in the archive were authored by yours truly as Editor-in-Chief.
Glenn McGee PhD
Whistleblowers Everywhere Breathe A Sigh of Relief
Texas nurse Anne Mitchell has won a victory for whistleblowers everywhere after being sued under Texas law for reporting the physician she worked for as being malpracticable using confidential information.
He said that she had ruined his reputation, that she was malicious and had inappropriately used records to which she had access. I mean, how dare she? She's a nurse! What is she doing looking through those medical records?
Apparently this doctor wouldn't know a lot about medical ethics and records. He had previously been dinged by the Texas Medical Board in 2007 for $1,000 and "continuing medical education in the area of ethics, medical records and the treatment of obesity."
Mitchell in her letter had claimed a set of 6 additional, more recent violations. She reported his performing a skin graft, other minor surgical procedures and prescribing herbal medications that the doctor sold on the side.
To boot, he has searched her computer to find her anonymous letter and he fired her after her found it.
Ultimately, if you are a physician working at a weight-loss clinic, do you really need to be performing skin grafts? But more than that, if you have already been fined by the Texas Medical Board and have been told you are not qualified to oversee a physician assistants or nurse practitioners and to get ethics training, you'd better be on your best behavior.
Whether this nurse was an "upstart" isn't the point. Neither is whether nurses generally are saints. This case should never have become the referendum on nurses and whistleblowers it was.
This doctor just seemed to be, and has been for sometime, a not very good one--and the fact that someone had the guts to point it out should be applauded. Thank goodness the Texas courts had the good sense to protect this woman regardless of whether she was a nurse or a good person or anything else. Her right, and everyone else's, to protect patients from quackery has prevailed.
Summer Johnson, PhD
Jacob Appel Takes on the Pope
What do you do when you are a Catholic hospital in value conflict? Ignore the Pope or ignore the indigent, the needs of American Catholics for birth control and abortions, and healthcare generally in conflict with the edicts of Rome?
It's a tough call, but according to Jacob Appel today on the Huffington Post the saving grace is that doctors in these hospitals are still bound by the same ethical guidelines regardless of the kind of hospital they are working in, Catholic or not.
And thank goodness, I would really hate to have the Pope governing my healthcare decisions. So if you have to go to a Catholic healthcare institution, be glad that there are medical ethics guidelines for your healthcare professionals.
Summer Johnson, PhD
Do You Know Why Glenn McGee Wants to Live Forever?
Well, your first answer chould be, "Doesn't everyone?"
But if the actual answer is, "I haven't a clue", then click on this link.
McGee, the John B. Francis Chair in Bioethics at the Center for Practical Bioethics, will discuss how science is giving us an opportunity, if not to actually live forever, to live an additional 25, 50, or 100 years in his inaugural lecture on February 24th at 6 PM.
But before you grab for that stem cell smoothie, McGee will ask his audience to grapple with many of the questions, not only of can we but of ought we extend our lives. Questions both for individuals but also for communities that were addressed in the December 2009 issue of AJOB.
To learn more about the lecture or to register to attend, contact the Center for Practical Bioethics.
Summer Johnson, PhD
Caplan: Zealot's Bad Study Leads Autism Community Astray for A Decade
As Arthur Caplan tells us in this week's MSNBC column, one bad study and a zealot's pursuit of a theory can lead an entire movement and entire generation of parents astray. This is, in effect, what Andrew Wakefield did with his now thoroughly debunked theory about the link between MMR vaccines and autism.
To read the column on the web, click here or read it in its entirety below.
Summer Johnson, PhD
How a zealot's word led us astray on autism
A dozen years ago, a British physician named Dr. Andrew Wakefield published a paper in the prestigious medical journal The Lancet that did immeasurable harm to children.
Wakefield, who back in 1998 was working at London's Royal Free Hospital, claimed in the article that the vaccination of 12 children with measles/mumps/rubella (MMR) vaccine had caused a reaction in their bowels that caused autism.
At a press conference shortly after the paper came out, Wakefield urged parents not to give their children the combination vaccine.
The British press went crazy over the report. The word and the fear quickly spread around the world.
Since the controversial paper was published, British parents abandoned the vaccine in droves, leading to a resurgence of measles. Vaccination rates for measles have never recovered, and there are outbreaks of the disease in the U.K. every year.
And across the globe, millions of parents who choose to follow their own doctors' advice and vaccinate their children have had to face the anxiety of an alleged link to a dread disease.
All this despite the fact that no scientists were ever able to replicate Wakefield's findings.
Yesterday, The Lancet, after years of investigations, lawsuits, press complaints and accusations, took the unprecedented step of withdrawing this 12-year-old article as misleading and false.
Why did The Lancet finally act? Because the British board that licenses doctors recently concluded that Wakefield had "shown callous disregard" for the children in his study and had "abused his position of trust" in doing his research. In language I have almost never seen from a disciplinary body, the General Medical Council added that Wakefield acted "dishonestly," was "misleading" and "irresponsible" in the way he described the findings of his tiny study about the danger of MMR vaccine in The Lancet.
As it turns out, for the study Wakefield took blood samples from children at his son's birthday party, paying them 5 pounds each.
The language was probably not strong enough. The Wakefield paper killed children and left others deaf and disabled from preventable diseases as their parents, in an effort to avoid autism, left them unvaccinated.
Vaccination has always had its critics. Using needles to put things into children's bodies has always left some parents uneasy. And the epidemic of autism has left other parents searching for some cause, some agent, some substance that might be to blame.
Vaccination became a prime suspect because it occurs so close to the time at which autism used to be first diagnosed. And Wakefield's paper was all the ammunition anti-vaccinators needed.
Wakefield's study was both tiny and flawed. Nearly all of his 13 other co-authors eventually bailed out on the article. Still, the press could not resist from spreading the scary news over and over again, even though no one could get the same findings as Wakefield did. And Wakefield himself, supported by a fanatical anti-vaccine lobby that to this day cannot let go of the vaccine-autism connection, continued to spread fear of vaccines right up to the time of his disciplinary hearing.
Some will try to portray Wakefield as a martyr, sacrificed for the profits pharmaceutical companies make from vaccines. But the profit from childhood vaccination has always been a very small part of Big Pharma's big profits. The companies still in the childhood vaccine business generally stay there from a sense of duty to the public health not greed.
Wakefield is no martyr. He is a scientist who would not give up on his theory no matter how much evidence accumulated that vaccines are not linked to autism. And that makes him guilty of letting his zealotry blind him to the harm avoiding effective vaccines did to many vulnerable children.
The bitter lessons of the decision to expunge the Wakefield paper from medical history are clear. No single, small study should ever be taken as the basis for a massive change in anyone's behavior when it comes to your health and that of your family. And the desire to find some reason, any reason, for the plague of autism should not blind us to the fact that the evidence clearly shows that vaccination is not the culprit.
It's My Baby and I'll Smoke If I Want To! Except Florida.
How far can a court, and by extension the state, go to protect the health and well-being of the unborn? In Florida, it would appear--much further than they have ever gone before.
A Florida court crossed the line by forcing Samantha Burton to be hospitalized to prevent her from smoking during her pregnancy. State courts have forced mothers who are pregnant to be involuntarily tested, hospitalized and bedridden to prevent them from engaging in a wide range of unhealthy behaviors in the past--most notably the use of illicit drugs like crack, cocaine, and alcohol.
Burton, who entered the hospital at 25 weeks pregnant for premature labor, was forced by court order to stay in the hospital, on the grounds that "state has a right" to ensure that children receive medical treatment which is necessary for the preservation of life and health", said a Leon Circuit Court judge.
Now, never mind that Burton had two children at home who ALSO needed caring for that this involuntary hospitalization prevented. And never mind that at 25 weeks her fetus is not a CHILD (in my view)--this is Schiavo country, after all. And never mind that bed rest is not medical treatment nor is having a mother go into nicotine withdrawal.
With all of those caveats, Burton claimed she was not a heavy smoker and had been having prenatal care throughout her pregnancy. So exactly, what was the state protecting this fetus from exactly?
Sadly, Burton's baby was stillborn just a few days later. Why? We'll never know.
But this leaves open the real question: with what real evidence did they make this claim? If in fact this case were to set a precedent, then all women who are light to moderate smokers, who are receiving prenatal care who are experiencing premature labor had better steer clear of the hospital for fear of incarceration in their local hospital until their child is born.
Worse yet, if you drink coffee, have eaten a bite of fish, or even looked twice at a piece of blue cheese, you are suspect as well. If you don't live in Florida, don't think you are safe, don't forget that this is just the logical extension of incarcerating women suspected of being on crack to protect "crack babies" which started in South Carolina 11 years ago (see Ferguson v. City of Charleson or Larry Gostin's piece on the subject).
It is clear, at least based on the facts here, that the Florida court exceeded its power to protect the welfare of a child and has set a frightening precedent. Let's hope that the appellate court will overturn the lower court's decision and leave pregnant women free to make their own, albeit healthier, decisions.
Summer Johnson, PhD
