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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Humility and medical guidelines

We have LOTS of guidelines and recommendations. We we need is more humility.

The Advisory Committee for Immunization Practices (ACIP) issued a recommendation in September of 2014 that pneumococcal vaccine naive individuals 65 and over get a Prevnar13 followed by a Pneumovax 6-12 months later, and that those who have had a Pneumovax get a Prevnar13 a minimum of 12 months after their Pneumovax.

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System overload

Under stress, including conditions of overload, systems degrade in a predictable manner.  

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Ironing out a diagnosis

Rachel called about her elderly father, Blaine, better known to me as Bucky. She requested a ‘nerve pill’ to calm him down at night and a referral to a neurologist to test for dementia.

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Ironing things out

Rachel called about her elderly father, Blaine, better known to me as Bucky. She requested a ‘nerve pill’ to calm him down at night and a referral to a neurologist to test for dementia.

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My message to healthcare leaders and managers

Our job – though many of us actually see it more as a calling than a job – is to care for patients. 

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Quantum theory and truth

Niels Bohr said: “There is no quantum world. There is only an abstract quantum physical description. It is wrong to think that the task of physics is to find out what nature is. Physics concerns what we can say about nature…”

I think this parallels the enduring human drive to search for Truth. There may or may not be an absolute Truth, but it is wrong to think we can discover Truth or understand what Truth is.  Science, philosophy and religion are merely our endeavors to see what we can say about Truth. 


 

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Cells or selves?

I am both excited and worried about the recent enthusiasm for precision medicine (PM)   

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My ideal healthcare organization

When I envision the ideal health care organization, I picture six characteristics.

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Why bother?

A professional colleague and I were discussing (bemoaning) how hard it is to do quality primary care. She asked why I bothered to keep pushing for change in the face of so much institutional resistance and evidence that it was pointless. I told her, what we put up with is what we end up with.

In return, I asked her why she didn't push back and demand change if she is so unhappy about the way things are?  

Her response:

"Well, I watch you, and I can see that it is pointless."

 


 

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Why bother

A professional colleague and I were discussing (bemoaning) how hard it is to do quality primary care. She asked why I bothered to keep pushing for change in the face of so much institutional resistance and evidence that it was pointless. I told her, what we put up with is what we end up with.

In return, I asked her why she didn't push back and demand change if she is so unhappy about the way things are?  

Her response: "Well, I watch you, and I can see that it is pointless."


 

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