Medical Stories

A Historical Note: I started this section in the summer of 2007 with ambitious plans. But once I was well (thanks to my persistence in challenging medical opnions) my interest in the subject decreased! As I resulted I have not added anything since October 2007. Thus this section will remain a small part of my web site.

Purpose of These Pages

These pages discuss medical issues from the view point of a patient and are intended to help others find their way towards the correct medical diagnosis. While there is a lot of discussion in the media about the cost of the medical care there is little about its quality. And yet, better diagnosis can result in significantly lower cost. Here is an example that shows why this is so.

Suppose you suffer from an ailment that is not common (there may be "only" 100,000 sufferers in the U.S.). Physician A diagnoses it correctly, prescribes the proper treatment and after a month or two you resume your normal life. If you have gone to physician Z though, he would have missed the real cause and come up with several diagnoses (one after the other), subject you to several tests (that are not really needed), and possibly unnecessary surgery. Because your real ailment is not treated, it becomes worse and you end up permanently disabled, or, even, dead. Physician Z will run a much larger health care bill and your insurance company will pay it. In short, good doctors are underpaid and weak doctors are overpaid.

I want to make people aware that there are large differences amongst medical practitioners and that the top ones not only provide better care but often at a lower cost. (Even if their per visit fee may be higher.) Suggestions about how to identify physicians like A (and stay away from physicians like Z) are also provided.

Another goal is to address the misuse of statistics in the medical field and make other people aware of the unreliability of several medical guidelines.

Because the material is based mostly on my own experience it is by no means comprehensive. Please send comments to the address at the top right.

And a final word. If you are not happy with your current doctor, change doctors, but by all means keep seeing a doctor. If your car breaks down you will keep looking for a mechanic that can fix it. You will not abandon it on the road shoulder to rust. Your body deserves at least as much care as your car, especially because you cannot buy another body.

CONTENTS

My Own Essays
Books that I Found Useful
Sites that I Found Useful
From the News Media

My Own Essays

A Patient Looks at Medical Practice

My Medical Adventures (Draft of 10/08/07)

The (Lack of) Science behind the Body Mass Index (BMI)

Books that I Found Useful

JG_2007 Jerome Groopman, MD, How Doctors Think, Houghton Mifflin Company, March 2007 (320pp)
Os_Q M. E. Silverman, MD, T. J. Murray, MD, C. S. Bryan, MD The Quotable OSLER, American College of Physicians, 2003 (283ppp)
Os_I Charles S. Bryan, MD OSLER: Inspirations from a Great Physician, Oxford Univ. Press, 1997.

Sites that I Found Useful

Groopman

Dr. Groopman, the author of the book "How Doctors Think" has a web site that includes a blog. The following is a quote from his blog of April 13, 2007.

The question remains, who is a good doctor, and, moreover, who is the right doctor for any individual? The best answer that I have found for myself and my family is a doctor who thinks with us, explains clearly what is in her mind, how she arrived at her working diagnosis, and why the offered treatment makes sense for us as individuals. She may refer to guidelines and "best practices," but clearly takes into account the spectrum of human biology and customizes our care to fit both our clinical needs as well as our emotional, social, and psychological dimensions.

Ioannidis

Many medical guidelines are based on statistical analysis that, as Ioannidis papers explain, may be flawed.

See paper " Why Most Published Research Findings Are False" by John P. A. Ioannidis (affiliated with the University of Ioannina School of Medicine,Greece, and the Institute for Clinical Research and Health Policy Studies, Department of Medicine, Tufts-New England Medical Center, Boston).

See also the discussions about that article: editorial (Minimizing Mistakes and Embracing Uncertainty), comments by readers, and a long commentary by Ray Hyman.

A non-technical summary of Ioannidis views can be found in To Err is Science.

A more recent study (October 2008) by Neal S. Young, John P. A. Ioannidis, and Omar Al-Ubaydli points out why journals have a tendency to publish studies that may be false: Why Current Publication Practices May Distort Science.

From the News Media

A Health Care Bargain - NY Times Op-Ed piece by Paul O' Neil, October 16, 2007. While the article deals mostly with insurance issues, it also touches on quality issues. A quote "the medical societies would need to finally step up to their responsibility and weed out incompetent providers".

Latest Update: August 15, 2009 (Previous Update: October 31, 2007)

 
theopavlidis.com Site Map