Less Medicine, More Health. That’s the contradictory-sounding title of a new book by Dartmouth researcher and Doctor Gilbert Welch. It’s a challenge to the conventional wisdom among patients and providers that more testing and more treatment is always better. Welch says in some cases, you can have too much health care – and can even be harmed by it.
Showing up for work sick is an American affliction…even for doctors. A survey reveals that 80 percent of health care providers admit to treating patients while ill. And, patients want surgeons who are technically skilled, and good communicators. But when it comes to being a good surgeon, does bedside manner really matter? Plus, diagnosis by Skype – a primer on the growing business of telemedicine.
Showing up to work ill is an affliction -- it even plagues doctors. On today's show, we talk about why doctors don't take sick days. But soon, even going to the doctor may become part of the virtual reality lifestyle, as the use of telemedicine increases. Today, we also have an audio postcard from Madison, New Hampshire, from a weekend celebration of E.E. Cummings. Then, screeching fans, long bus rides -- sounds like a boy band on the road. Not exactly. We'll take a look behind the scenes of DigiTour, where stardom is measured not by number of records sold, but by number of followers on Instagram or Vine. And finally, we talk Statute Of Limitation laws to better understand the sexual assault cases against Bill Cosby.
For some people, the day to day grind of the work week can be soul sucking, but for some, a job is more than just a paycheck, it's a passion. On today's show we'll talk to a rare book dealer who found his calling in the pages of antique books. Also today, in the early days of medicine, doctors weren't always revered by their patients. We'll hear about the so-called "Doctors Riot" that happened in 1788 New York City.
Surgery requires years of education, steady hands, extreme confidence, and…kindness? On today's show we ask: when it comes to being a good surgeon, does bedside manner matter? We'll also look into the growing digital house key market and the complicated math behind queue design.
10.1.14: Is Kindness A Virtue In Surgeons & The Evolution Of The House Key
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Here at Word of Mouth, we receive dozens of unsolicited albums each week to be reviewed for potential segments on the show. So what, you may ask, enticed me to pop David Friedenberg's newest album into my computer and give it a good long listen? It may have been the letter enclosed in the CD case, addressed to Laura Knoy, that suggested she might find this new and "more political" album interesting.
Literary journals offer aspiring writers a window into the process of professional publishing and immersion in the community of writers. They are a mainstay of MFA programs, and as well as a number of graduate and post-grad programs in the sciences. We wanted to know more about the creative lives of America’s future practitioners after leafing through Lifelines. That’s Dartmouth Medical School’s arts journal.
We begin with homophobia in American hospitals. A recent, New York Timesop-ed by Dr. Pauline Chencaught our eye. In an era of rapidly expanding acceptance and rights for gays and lesbians, her question, “does medicine discourage gay doctors?” is one we had not yet heard asked. So, we invited Dr. Chen to tell us more.
A recent study in the medical journal Health Affairs found that more than ten percent of doctors admit to not telling patients the complete truth about their medical conditions, with one in five also confessing to not disclosing medical errors. Danielle Ofriis Associate Professer at NYU. She’s also attending physician at New York's Bellevue Hospital, and a regular contributor to The New York Times' Health section.
Nine national medical groups are launching a campaign called Choosing Wisely to get U.S. doctors to back off on 45 diagnostic tests, procedures and treatments that often may do patients no good.
Many involve imaging tests such as CT scans, MRIs and X-rays. Stop doing them, the groups say, for most cases of back pain, or on patients who come into the emergency room with a headache or after a fainting spell, or just because somebody's about to undergo surgery.
New Hampshire has one of the worst prescription drug abuse problems in the country. The state now ranks 5th in the nation for percentage of residents who abuse medications such as percocet, vicodin, and oxycodone, according to the Federal Centers for Disease Control. The problem is especially alarming among young people. New Hampshire has the second highest rate of 18-25 year olds who abuse prescription drugs in the nation.
Danielle Fiore , 24, says she was addicted to painkillers for most of her childhood.
"I had fractured my ankle and I was prescribed vicodin and it felt good. I was ten or eleven," she says. "As time went on I would get something else hurt or a toothache or something and I would get more painkillers. I have a bunch of teeth missing because I would complain and get them pulled so I would get pain killers."
Currently New Hampshire has no prescription drug monitoring program. The program, which is up and running in 48 other states, is initially funded through federal grants. The proposal to create a centralized prescription database that doctors and law enforcement could check to track so called "doctor shoppers" has been defeated several times in the state Legislature. A new bill is now being considered this session and its sponsor Senator Majority Leader Jeb Bradley, R-Wolfeboro, is hopeful that there is enough support for a statewide prescription monitoring program this time. He cites the growing number of overdose deaths in the state from prescription drugs. In the last decade overdose deaths from these medications have more than tripled.
For those who oppose a statewide prescription drug database privacy is a major issue. Rep. Neal Kurk, R-Weare, says such a program goes against the Granite State's core philosophy.
"This is New Hampshire, this is the 'Live Free or Die' state, " says Kurk. "One of the major reasons this bill has not been adopted is because most people feel it’s the independent philosophy, personal responsibility philosophy that prevails and that government should be small and not interfere with people’s lives."
Many of the state's independent pharmacists are also against a monitoring program because they worry they will end up footing the bill. The database would be drawn from pharmacy records. Rick Newman, a lobbyist for the New Hampshire Independent Pharmacy Association, says the small business people he represents will be end up carrying the burden of the costs of such a database.
"I can’t sit here as anyone with any kind of intelligence and disagree that’s there's a problem with people abusing prescription drugs in this country, of course there is," says Newman. "The question becomes whose burden is that? We can’t pass laws to put the burden on the small business person because they happen to be one part of the pipeline."
Emergency room doctors and those that treat pain say they are often confronted by patients who may be faking symptoms to get narcotics for their addiction or to sell on the street.
"I want people who have legitimate pain to get the proper pain medications that they need," say Dr. David Heller, an emergency room physician at Portsmouth Hospital. "But I don’t want to feed somebody’s addiction and I don’t want to write a prescription for drugs that are going to be sold to my kids or my kid's friends."