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 Posted: Mon Jun 23, 2003 12:46 am Post subject: The New Generation of Physicians are Frauds! |
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Howard McCollister
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| Posted: Mon Jun 23, 2003 12:46 am Post subject: Re: The New Generation of Physicians are Frauds! |
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johngohde@naturalhealthperspective.com (N-H-P) wrote in message
news:<16a9b594.0306220356.6b893b0b@posting.google.com>...
[quote]WARNING! That physician examining you may now legally be a fraud
totally unqualified to diagnose. :(
Losing the Touch
http://www.washingtonpost.com/ac2/wp-dyn/A2848-2003Jun16?language=printer
"As Technology and Medical Education Change, Doctors May Lose the
Ability to Perform Physical Exams
By Jennifer Obel
Special to The Washington Post
Tuesday, June 17, 2003; Page HE01
It is 2 o>clock in the morning. So far six patients have been admitted
during my overnight shift. As the resident on call, I am expected to
take a history, perform a physical exam and review lab results and
imaging to diagnose and manage these patients' illnesses. One patient,
a 45-year-old man, complains of sharp abdominal pain. The CT scan of
his abdomen that was done in the emergency room was, as we say in
medicine, "unremarkable."
I am debating whether to perform a complete physical. What more will I
learn from examining his abdomen that the CT has not already gleaned?
While I know that he expects a full exam -- the physician>s trademark
-- I am already running behind. Nurses are paging me with medication
requests for the three other patients I have yet to evaluate. I am
swamped, so I do the bare minimum: a cursory physical exam.
Like many of my fellow residents, I am little trained in the "art" of
medicine. We embarked on our medical careers during an era of dizzying
advances in technology. Unlike our more seasoned attending physicians,
we grew up in the shadow of modern medicine, where imaging has
supplanted clinical skills. An echocardiogram (not the swishing sound
we hear through a stethoscope when the heart>s valves close) tells us
whether a patient has a heart murmur. An MRI (not our neurologic exam)
tells us a patient suffered a stroke. Lab tests (not the patient>s
swollen, warm fingers) tell us that she has rheumatoid arthritis."
[/quote]
At least, totally unqualified to diagnose by physical examination. Maybe
older doctors are totally unqualified to diagnose by modern imaging
techniques? Although, a relative lack of physical exam skills has been true
of resident physicians for many, many years. Those skills improve as they
move farther along in their training
It sounds more like Dr. Obel is maybe a little bit on the lazy side, and
that her medical training up to that point has some serious gaps in it. Not
universally true in my experience since the kind of whining described above
is not something we hear from residents and medical students around here.
HMc |
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Al Hephy
Guest
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| Posted: Mon Jun 23, 2003 12:59 am Post subject: Re: The New Generation of Physicians are Frauds! |
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tintinet <tintinet1@iwon.com> wrote in message news:35f5861e.0306220905.7506a716@posting.google.com...
[quote]johngohde@naturalhealthperspective.com (N-H-P) wrote in message news:<16a9b594.0306220356.6b893b0b@posting.google.com>...
WARNING! That physician examining you may now legally be a fraud
totally unqualified to diagnose. :(
Losing the Touch
http://www.washingtonpost.com/ac2/wp-dyn/A2848-2003Jun16?language=printer
"As Technology and Medical Education Change, Doctors May Lose the
Ability to Perform Physical Exams
By Jennifer Obel
Special to The Washington Post
Tuesday, June 17, 2003; Page HE01
It is 2 o>clock in the morning. So far six patients have been admitted
during my overnight shift. As the resident on call, I am expected to
take a history, perform a physical exam and review lab results and
imaging to diagnose and manage these patients' illnesses. One patient,
a 45-year-old man, complains of sharp abdominal pain. The CT scan of
his abdomen that was done in the emergency room was, as we say in
medicine, "unremarkable."
I am debating whether to perform a complete physical. What more will I
learn from examining his abdomen that the CT has not already gleaned?
While I know that he expects a full exam -- the physician>s trademark
-- I am already running behind. Nurses are paging me with medication
requests for the three other patients I have yet to evaluate. I am
swamped, so I do the bare minimum: a cursory physical exam.
Like many of my fellow residents, I am little trained in the "art" of
medicine. We embarked on our medical careers during an era of dizzying
advances in technology. Unlike our more seasoned attending physicians,
we grew up in the shadow of modern medicine, where imaging has
supplanted clinical skills. An echocardiogram (not the swishing sound
we hear through a stethoscope when the heart>s valves close) tells us
whether a patient has a heart murmur. An MRI (not our neurologic exam)
tells us a patient suffered a stroke. Lab tests (not the patient>s
swollen, warm fingers) tell us that she has rheumatoid arthritis."
A bit harsh, here, John. While I agree medicine ought to focus more on
draining the swamps, those in the best position to effectively provide
preventive medicine are parents, educators, and individuals practicing
upon themselves. Most physicians are left to try to battle the
alligators of fully developed disease.
[/quote]
Actually not harsh enough. Those of us who are old enough observed
the gradual change in the way medicine is practiced. The most abrupt
change was abandoning the 'house call'. Never mind why, it is a milestone
in the change of attitude and emphasis in medicine to eventually reach
the point where we are now, with a primary goal of maximizing the
flow of patients through the doctor>s office and the trend toward
depersonalization.
I get more personal attention when getting my car repaired!
It>s NOT reasonable to expect 'everyone' in the population to learn
'preventive medicine'. When 'everyone' is responsible, then no one
is responsible.
Al |
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Peter Moran
Guest
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| Posted: Mon Jun 23, 2003 1:42 am Post subject: Re: The New Generation of Physicians are Frauds! |
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"N-H-P" <johngohde@naturalhealthperspective.com> wrote in message
news:16a9b594.0306220356.6b893b0b@posting.google.com...
[quote]WARNING! That physician examining you may now legally be a fraud
totally unqualified to diagnose. :(
Losing the Touch
http://www.washingtonpost.com/ac2/wp-dyn/A2848-2003Jun16?language=printer
"As Technology and Medical Education Change, Doctors May Lose the
Ability to Perform Physical Exams
By Jennifer Obel
Special to The Washington Post
Tuesday, June 17, 2003; Page HE01
It is 2 o>clock in the morning. So far six patients have been admitted
during my overnight shift. As the resident on call, I am expected to
take a history, perform a physical exam and review lab results and
imaging to diagnose and manage these patients' illnesses. One patient,
a 45-year-old man, complains of sharp abdominal pain. The CT scan of
his abdomen that was done in the emergency room was, as we say in
medicine, "unremarkable."
I am debating whether to perform a complete physical. What more will I
learn from examining his abdomen that the CT has not already gleaned?
While I know that he expects a full exam -- the physician>s trademark
-- I am already running behind. Nurses are paging me with medication
requests for the three other patients I have yet to evaluate. I am
swamped, so I do the bare minimum: a cursory physical exam.
[/quote]
This is not fraud, this is either poor medical training or malpractice.
There are many causes of abdominal pain which will not show up on an
ordinary CT scan, appendicitis for one.
I otherwise agree that the trend to rely on tests is sad.
Peter Moran |
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N-H-P
Guest
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| Posted: Mon Jun 23, 2003 6:00 am Post subject: Re: The New Generation of Physicians are Frauds! |
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"Howard McCollister" <nospam@nospam.net> wrote
--------------
johngohde@naturalhealthperspective.com (N-H-P) wrote in message
--------------
[quote]WARNING! That physician examining you may now legally be a fraud
totally unqualified to diagnose. :(
Losing the Touch
http://www.washingtonpost.com/ac2/wp-dyn/A2848-2003Jun16?language=printer
"As Technology and Medical Education Change, Doctors May Lose the
Ability to Perform Physical Exams
-------------
At least, totally unqualified to diagnose by physical examination. Maybe
older doctors are totally unqualified to diagnose by modern imaging
techniques? Although, a relative lack of physical exam skills has been true
of resident physicians for many, many years. Those skills improve as they
move farther along in their training
[/quote]
"Maybe older doctors are totally unqualified to diagnose by modern
imaging techniques?"
Let us see now.
The patient pays $1,000 for a CT scan. Then they pay $300-$500 for a
computer program to interpret the CT scan for the Modern Doctor. Then
the patient pays the Modern Doctor to be short with them.
Maybe patients should simply cut out the middle man, otherwise known
as the Modern Physician Scammer, and go straight to the CT Scanner
operator? The price of computers are falling drastically you know.
Why deal with an impersonal buffoon known as the Modern Doctor when
you can deal directly with an impersonal computer?
--
John Gohde,
Achieving good Nutrition is an Art, NOT a Science!
Get started on improving your personal health and fitness, today.
http://www.Tutorials.NaturalHealthPerspective.com/
Offering 14 easy to understand lessons that will change your life. |
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N-H-P
Guest
|
| Posted: Mon Jun 23, 2003 6:17 am Post subject: Re: The New Generation of Physicians are Frauds! |
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"Al Hephy" <ahephy@freewweb.invalid> wrote
------------
[quote]tintinet <tintinet1@iwon.com> wrote in message
------------
johngohde@naturalhealthperspective.com (N-H-P) wrote in message
------------
WARNING! That physician examining you may now legally be a fraud
totally unqualified to diagnose. :(
Losing the Touch
http://www.washingtonpost.com/ac2/wp-dyn/A2848-2003Jun16?language=printer
"As Technology and Medical Education Change, Doctors May Lose the
Ability to Perform Physical Exams
------------
A bit harsh, here, John. While I agree medicine ought to focus more on
draining the swamps, those in the best position to effectively provide
preventive medicine are parents, educators, and individuals practicing
upon themselves. Most physicians are left to try to battle the
alligators of fully developed disease.
------------
Actually not harsh enough. Those of us who are old enough observed
the gradual change in the way medicine is practiced. The most abrupt
change was abandoning the 'house call'. Never mind why, it is a
milestone
in the change of attitude and emphasis in medicine to eventually reach
the point where we are now, with a primary goal of maximizing the
flow of patients through the doctor>s office and the trend toward
depersonalization.
I get more personal attention when getting my car repaired!
[/quote]
Precisely!
We are lead to believe from the assembly line mentality of Modern
Medicine that there is a shortage of doctors, when if anything there
are clearly too many hospitals and too many physicians in the major
metropolitan areas of the US. And, that these wonderfully greedy
people are so desperate for money, eh ... help, that medical residents
routinely work 80 hours weeks. And, that patients should be grateful
for being treated by a sleep deprived person totally unqualified to
diagnose because formerly they were working 120 hour work weeks!
Impersonal treatment by Modern Medicine equates to treating Name Tags,
Medical Charts, and Computer Analyses of test results (aka treating
the diagnose) rather than treating the person standing before them.
This is precisely why there are so many medical errors committed in
hospitals, these days.
--
John Gohde,
Achieving good Nutrition is an Art, NOT a Science!
Get started on improving your personal health and fitness, today.
http://www.Tutorials.NaturalHealthPerspective.com/
Offering 14 easy to understand lessons that will change your life. |
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| Back to top |
tintinet
Guest
|
| Posted: Mon Jun 23, 2003 12:39 pm Post subject: Re: The New Generation of Physicians are Frauds! |
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"Peter Moran" <moringa@gil.com.au> wrote in message news:<3ef614b6_2@news.brisbane.pipenetworks.com>...
[quote]"N-H-P" <johngohde@naturalhealthperspective.com> wrote in message
news:16a9b594.0306220356.6b893b0b@posting.google.com...
WARNING! That physician examining you may now legally be a fraud
totally unqualified to diagnose. :(
Losing the Touch
http://www.washingtonpost.com/ac2/wp-dyn/A2848-2003Jun16?language=printer
"As Technology and Medical Education Change, Doctors May Lose the
Ability to Perform Physical Exams
By Jennifer Obel
Special to The Washington Post
Tuesday, June 17, 2003; Page HE01
It is 2 o>clock in the morning. So far six patients have been admitted
during my overnight shift. As the resident on call, I am expected to
take a history, perform a physical exam and review lab results and
imaging to diagnose and manage these patients' illnesses. One patient,
a 45-year-old man, complains of sharp abdominal pain. The CT scan of
his abdomen that was done in the emergency room was, as we say in
medicine, "unremarkable."
I am debating whether to perform a complete physical. What more will I
learn from examining his abdomen that the CT has not already gleaned?
While I know that he expects a full exam -- the physician>s trademark
-- I am already running behind. Nurses are paging me with medication
requests for the three other patients I have yet to evaluate. I am
swamped, so I do the bare minimum: a cursory physical exam.
This is not fraud, this is either poor medical training or malpractice.
There are many causes of abdominal pain which will not show up on an
ordinary CT scan, appendicitis for one.
[/quote]
Actually, CT scan is a highly sensitive and specific test for appendicitis.
P
[quote]
I otherwise agree that the trend to rely on tests is sad.
Peter Moran[/quote] |
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Lawrence Foard
Guest
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| Posted: Mon Jun 23, 2003 2:26 pm Post subject: Re: The New Generation of Physicians are Frauds! |
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In article <3EF707DF.8080405@want.spam.com>,
Doug Brooks <dont@want.spam.com> wrote:
[quote]N-H-P wrote:
We are lead to believe from the assembly line mentality of Modern
Medicine that there is a shortage of doctors, when if anything there
are clearly too many hospitals and too many physicians in the major
metropolitan areas of the US. And, that these wonderfully greedy
people are so desperate for money, eh ... help, that medical residents
routinely work 80 hours weeks. And, that patients should be grateful
for being treated by a sleep deprived person totally unqualified to
diagnose because formerly they were working 120 hour work weeks!
The plain and simple economic truth is that there IS a shortage of
doctors. The AMA has a de facto monopoly over the supply of doctors,
and it is a field with high barriers to entry. It takes a great
personal investment in both time and money to become a doctor. The
supply is small, and the demand is high, so doctors can charge top dollar.
[/quote]
The most bizarre thing is that not long ago they wanted medical schools
to graduate less doctors claiming a glut. This alone seems like a violation
of the oath. When medical care is suffering through lack of doctors, to
try to tighten the supply even more is simply unethical.
--
Be a counter terrorist perpetrate random senseless acts of kindness
Rave: Immanentization of the Eschaton in a Temporary Autonomous Zone.
We are nothing but sunlight detours, in the road between fusion and eternity. |
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tintinet
Guest
|
| Posted: Mon Jun 23, 2003 10:39 pm Post subject: Re: The New Generation of Physicians are Frauds! |
|
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johngohde@naturalhealthperspective.com (N-H-P) wrote in message news:<16a9b594.0306221717.3edd0608@posting.google.com>...
[quote]"Al Hephy" <ahephy@freewweb.invalid> wrote
------------
tintinet <tintinet1@iwon.com> wrote in message
------------
johngohde@naturalhealthperspective.com (N-H-P) wrote in message
------------
WARNING! That physician examining you may now legally be a fraud
totally unqualified to diagnose. :(
Losing the Touch
http://www.washingtonpost.com/ac2/wp-dyn/A2848-2003Jun16?language=printer
"As Technology and Medical Education Change, Doctors May Lose the
Ability to Perform Physical Exams
------------
A bit harsh, here, John. While I agree medicine ought to focus more on
draining the swamps, those in the best position to effectively provide
preventive medicine are parents, educators, and individuals practicing
upon themselves. Most physicians are left to try to battle the
alligators of fully developed disease.
------------
Actually not harsh enough. Those of us who are old enough observed
the gradual change in the way medicine is practiced. The most abrupt
change was abandoning the 'house call'. Never mind why, it is a
milestone
in the change of attitude and emphasis in medicine to eventually reach
the point where we are now, with a primary goal of maximizing the
flow of patients through the doctor>s office and the trend toward
depersonalization.
I get more personal attention when getting my car repaired!
Precisely!
We are lead to believe from the assembly line mentality of Modern
Medicine that there is a shortage of doctors, when if anything there
are clearly too many hospitals and too many physicians in the major
metropolitan areas of the US. And, that these wonderfully greedy
people are so desperate for money, eh ... help, that medical residents
routinely work 80 hours weeks. And, that patients should be grateful
for being treated by a sleep deprived person totally unqualified to
diagnose because formerly they were working 120 hour work weeks!
Impersonal treatment by Modern Medicine equates to treating Name Tags,
Medical Charts, and Computer Analyses of test results (aka treating
the diagnose) rather than treating the person standing before them.
This is precisely why there are so many medical errors committed in
hospitals, these days.
[/quote]
Actually, there were, quite likely and almost certainly, MORE medical
errors in the past than there are now, decision for decision and
treatment for treatment. We are simply better at recognizing the
errors these days. |
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Al Hephy
Guest
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| Posted: Tue Jun 24, 2003 12:52 am Post subject: Re: The New Generation of Physicians are Frauds! |
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Doug Brooks <dont@want.spam.com> wrote in message news:3EF707DF.8080405@want.spam.com...
[quote]N-H-P wrote:
We are lead to believe from the assembly line mentality of Modern
Medicine that there is a shortage of doctors, when if anything there
are clearly too many hospitals and too many physicians in the major
metropolitan areas of the US. And, that these wonderfully greedy
people are so desperate for money, eh ... help, that medical residents
routinely work 80 hours weeks. And, that patients should be grateful
for being treated by a sleep deprived person totally unqualified to
diagnose because formerly they were working 120 hour work weeks!
The plain and simple economic truth is that there IS a shortage of
doctors. The AMA has a de facto monopoly over the supply of doctors,
and it is a field with high barriers to entry. It takes a great
personal investment in both time and money to become a doctor. The
supply is small, and the demand is high, so doctors can charge top dollar.
In fact, these days, they have to charge top dollar as the costs of
running an office, with sky-high malpractice insurance on top of
secretaries, nurses, PA>s, and highly specialized equipment is enormous.
The assembly-line nature of the business is so that you can actually
afford to get in and see a doctor when you need to.
[/quote]
Want to have a go at WHY malpractice insurance is sky-high?
Al |
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Doug Brooks
Guest
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| Posted: Tue Jun 24, 2003 2:04 am Post subject: Re: The New Generation of Physicians are Frauds! |
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Al Hephy wrote:
[quote]Want to have a go at WHY malpractice insurance is sky-high?
Al
[/quote]
I would say the tort system is the biggest factor. |
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Peter Moran
Guest
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| Posted: Tue Jun 24, 2003 5:35 am Post subject: Re: The New Generation of Physicians are Frauds! |
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"tintinet" <tintinet1@iwon.com> wrote in message
news:35f5861e.0306222339.4b1f458f@posting.google.com...
[quote]"Peter Moran" <moringa@gil.com.au> wrote in message
news:<3ef614b6_2@news.brisbane.pipenetworks.com>...
"N-H-P" <johngohde@naturalhealthperspective.com> wrote in message
news:16a9b594.0306220356.6b893b0b@posting.google.com...
WARNING! That physician examining you may now legally be a fraud
totally unqualified to diagnose. :(
Losing the Touch
http://www.washingtonpost.com/ac2/wp-dyn/A2848-2003Jun16?language=printer
"As Technology and Medical Education Change, Doctors May Lose the
Ability to Perform Physical Exams
By Jennifer Obel
Special to The Washington Post
Tuesday, June 17, 2003; Page HE01
It is 2 o>clock in the morning. So far six patients have been admitted
during my overnight shift. As the resident on call, I am expected to
take a history, perform a physical exam and review lab results and
imaging to diagnose and manage these patients' illnesses. One patient,
a 45-year-old man, complains of sharp abdominal pain. The CT scan of
his abdomen that was done in the emergency room was, as we say in
medicine, "unremarkable."
I am debating whether to perform a complete physical. What more will I
learn from examining his abdomen that the CT has not already gleaned?
While I know that he expects a full exam -- the physician>s trademark
-- I am already running behind. Nurses are paging me with medication
requests for the three other patients I have yet to evaluate. I am
swamped, so I do the bare minimum: a cursory physical exam.
This is not fraud, this is either poor medical training or malpractice.
There are many causes of abdominal pain which will not show up on an
ordinary CT scan, appendicitis for one.
Actually, CT scan is a highly sensitive and specific test for
appendicitis.
P
[/quote]
Only if directly targeted on the appendix using specific techniques. Even
then, I wonder how accurate it is within average radiological practice, or
within the extraordinary range of possible pathologies that appendicitis can
..produce.
Peter Moran |
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Howard McCollister
Guest
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| Posted: Tue Jun 24, 2003 6:16 am Post subject: Re: The New Generation of Physicians are Frauds! |
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"Peter Moran" <moringa@gil.com.au> wrote in message
news:3ef79ce9$1_1@news.brisbane.pipenetworks.com...
[quote]Actually, CT scan is a highly sensitive and specific test for
appendicitis.
P
Only if directly targeted on the appendix using specific techniques.
Even
then, I wonder how accurate it is within average radiological practice, or
within the extraordinary range of possible pathologies that appendicitis
can
.produce.
Peter Moran
[/quote]
It>s true that the optimal way to diagnose appendicitis via CT is with the
use of rectal contrast. If no such contrast is used, the radiologist must
depend on visible inflammation or edema in the tissues around the appendix
and this would lower the accuracy of the CT for diagnosis of appendicitis.
The information from the CT along with a white cell count, a physical exam
(by someone who knows what they>re doing) and a good history should yield an
accuracy better than 90%, compared to the oft-quoted 75% that was considered
standard back in the old days when the diagnosis of appendicitis was made
without the help of CT.
HMc |
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N-H-P
Guest
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| Posted: Tue Jun 24, 2003 9:18 am Post subject: Re: The New Generation of Physicians are Frauds! |
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"Al Hephy" <ahephy@freewweb.invalid> wrote
[quote]Want to have a go at WHY malpractice insurance is sky-high?
[/quote]
Transplanting organs where the blood type does not match.
Operating on the wrong patient.
Surgeons carving initials on the bellies of female patients.
Leaving sponges and other tools inside obese patients after an
operation.
Hospital staff needlessly giving elderly patients pneumonia by
intentionally exposing them to too much air conditioning and other
drafts.
Cutting off the wrong leg, on the correct patient.
Giving a patient the WRONG medication, or the wrong dosage.
Entering the wrong coordinates in the CT scanner.
And, let us not forget physicians making the WRONG diagnoses.
--
John Gohde,
Achieving good Nutrition is an Art, NOT a Science!
Get started on improving your personal health and fitness, today.
http://www.Tutorials.NaturalHealthPerspective.com/
Offering 14 easy to understand lessons that will change your life. |
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| Back to top |
Howard McCollister
Guest
|
| Posted: Tue Jun 24, 2003 9:31 am Post subject: Re: The New Generation of Physicians are Frauds! |
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"N-H-P" <johngohde@naturalhealthperspective.com> wrote in message
news:16a9b594.0306232018.444e4863@posting.google.com...
[quote]"Al Hephy" <ahephy@freewweb.invalid> wrote
Want to have a go at WHY malpractice insurance is sky-high?
Transplanting organs where the blood type does not match.
Operating on the wrong patient.
Surgeons carving initials on the bellies of female patients.
Leaving sponges and other tools inside obese patients after an
operation.
Hospital staff needlessly giving elderly patients pneumonia by
intentionally exposing them to too much air conditioning and other
drafts.
Cutting off the wrong leg, on the correct patient.
Giving a patient the WRONG medication, or the wrong dosage.
Entering the wrong coordinates in the CT scanner.
And, let us not forget physicians making the WRONG diagnoses.
--
[/quote]
What>s your point? Anyone who reads the newspaper could produce a far longer
list than that. But what you need to do is prove your assertion that these
mistakes are more common now than in the past and how that translates to
higher malpractice awards and therefore higher premiums. You can>t just rail
against medical "buffoons" without backing up your claims or you just look
stupid.
HMc |
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