Mea sententia...

Mea Sententia (which translates roughly as 'My Opinion') has been my intermittent blog since 2011. Much of my writing is about medical issues, but my topics range through philosophy, behavioral and decision making, management, humor, and persona/family anecdotes.
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Dragonflies

Beauty is where you find it. Here are some photos of dragonflies…. Click here for the slide show.

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Physician burnout

I see and hear about more and more unhappy physicians, some of whom become happy former-physicians. It makes me reflect on my own circumstances.

Research suggests that the four major underlying contributors to physician dissatisfaction and burnout are

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Screening doesn't save lives.

I received a memo recently from an institution, extolling the virtues of its screening programs. It was entitled:

Screening Saves Lives. 

It was in large block capitals. I call bullshit on this.  Screening does not save lives. FULL. STOP.

This simplistic and self-serving public relations material is a typical example of common screening fallacy, that screening is an action that saves lives. This is worth deconstructing.

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Colorectal Cancer Screening: unFIT for prime time?

It can be amusing when people mistake the map for the territory (sometimes called the reification fallacy). When it harms my patients, though, it pisses me off. And it isn’t just me, or my institution: two physician friends (in other states) tell me they are seeing it as well.

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The ineluctable logic of the child

We couldn’t find her sneakers anywhere. They weren’t in the travel bag, under the bench in the mudroom, in either car,  at friends’ houses, in the closet or under the bed. After two days, we gave up and bought a new pair sneakers.

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Hide problems or fix them?

A recent article in USA Today talked about Regina Holliday’s efforts to make the medical record more easily and promptly available to patients so it becomes as a tool patients use as they engage in co-managing their own care. Her cause is just and her story is compelling, so I was dismayed at the pushback saying: Not so fast.

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Quality versus innovation: a conundrom

"The art of progress is to preserve order amid change and to preserve change amid order. "

(Alfred North Whitehead)

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True North, or 'Has Medicine Lost It's Way?'

What is True North for medicine? Is there an enduring core value that serves as a reliable touchstone across the nearly infinite range of medical activities? Given how medicine and society change, can there even be an enduring True North? If we have one, are we pursuing it faithfully?  

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Why I speak up

I was asked by a colleague at work (someone who frequently but privately agreed with me but never spoke up publicly), “Why do you tilt at windmills?” Many have answered this better than I.

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Doing nothing - but doing it right

It’s always easier to do something than to do nothing. Doctors often offer treatments for things they know are what we call ‘self-limited’ meaning that they will clear up all by themselves.  I think this form of unnecessary treatment reflects an awareness that although many things resolve without intervention, both doctors and patients are driven to DO SOMETHING. Though it is usually tempered by the wish to do something as benign as possible, sometimes doing nothing is the best choice. The trick is knowing how to do nothing properly.

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