Past Issues
Disclosing Harmful Medical Errors to Patients – An NEJM Current Concepts Article
TH Gallagher et al., NEJM, June 28 2007, Vol 356 (26), 2713-9
Admitting mistakes is always difficult, but it is all the more difficult when one is in a position of trust. Because of this, physicians have a hard time admitting and disclosing errors, for fear of breaking the crucial trust in the doctor-patient relationship. This transparency, however, is crucial, and consequently, policy makers in the US and abroad have been developing different mechanisms to make reporting more standard to the profession. What does this mean for those conditions that we may consider too minor to merit a visit to the doctors? What about privacy?
Communication Between Physicians and Patients in the Era of E-Medicine – An NEJM Perspective Article
JH Stone, NEJM, June 14 2007, Vol 356 (24), 2451-4
Imagine if in addition to chatting to friends, we can chat online with our physicians. Now, that is starting to become a reality. In addition to new was of connecting patients and physicians, information technology, especially the internet, has allowed better connectivity between institutions, between patients and their doctors, and among physicians themselves.
Needlestick Injuries Among Surgeons in Training – An NEJM Original Article
MA Makary et al., NEJM, June 28 2007, Vol 356 (26), 2693-9
Since nearly all residents, by the final year, have been injured with needles, many of them have been exposed to patients with blood-borne infections such as hepatitis B and C and HIV. Of course, the fact that doctors have an occupational hazard is nothing new, but by surveying surgeons-in-training, Dr. Makary and colleagues, have found surprising patterns of reporting–or rather, non-reporting–among health service employees.
Tutorials in Medicine: Models of Healthcare Delivery
In the past fifty years, the practice of medicine has changed quite dramatically, with the advent of HMOs, government medical welfare programs, fee-for-services business models, and so on. The alphabet soup of names continues to grow, however, and so a healthcare management fellow at Harvard University has given us a brief overview of the major ways and business models in which doctors have practiced in the past 100 years.
Patient’s Orders: How Information Technology and the Media are Changing the Patient-Doctor Relationship
The Internet is changing the way patients approach doctors by empowering patients and enabling them to communicate faster and cheaper with doctors, but it is also burying patients in information, often muddying the waters and potentially burning bridges of trust between the doctors and the patients. Emory Hsu looks at how medicine is dealing with the far-reaching influence of this medium.
His “Scrubs” Story
Dr. Jonathan Doris, the “real J.D.” and Medical Advisor for NBC’s “Scrubs”, on medicine and television
Blogging Medicine
On medical blogs, internet resources and the transforming landscape of modern medical communication
Structural Variation in the Human Genome – An NEJM Clinical Implications of Basic Research Article
R Lupski, NEJM, March 15 2007, Vol 356 (11)
Recently, biologists have found that individuals actually have many large-scale rearrangements in their genomes, such as deletions, inversions, or duplications that can affect gene fragments or even entire genes, and not just single point mutations. This “structural variation” affects the regulation of many different genes, and Dr. James Lupski explores the clinical implications of these large rearrangements.
Ethical Challenges Posed by the Solicitation of Deceased and Living Organ Donors – An NEJM Sounding Board Article
DW Hanto, NEJM, March 8 2007, Vol 356 (10)
In exploring the ethics of patients directly soliciting donations of organs from willing strangers, Douglas Hanto advocates the controversial position that organ donors and their families should not be allowed to choose what to do with the organs. Instead, he proposes forcing all donors to donate to the recipient at the top of the organ transplant lists except in those cases where a pre-existing emotional relationship exists (such as between family members).
Cesarean Delivery and the Risk-Benefit Calculus – An NEJM Perspective Article
JL Ecker and FD Frigoletto, Jr., NEJM, March 1 2007, Vol 356 (9)
The authors analyze the possible factors involved in the increasing numbers of physicians who opt for cesarean delivery over the traditional vaginal birth. They examine both the soundness of the reasoning that justifies such a trend as well as the need to educate patients about the real risks and benefits involved in the choice of delivery method.
