Molecular Biology

Share 
As we attempt to accept the data afforded by genomics, the greatest challenge to health remains nutrition and poverty. While the science accelerates the issues of fresh produce, healthy eating and poverty languish. Why is that?

Wrong Diagnosis

Share |Suprise, surprise, as medical schools scramble to introduce curriculum reform to keep pace with mediocrity, they eliminate the microscope, the doctor's personal lab, the autopsy, and in the name of confidentiality and privacy, bedside teaching is all but forgotten. Sub standard medical schools are a growth industry. Best evidence concentrates so on treatments that we have treatments in search of a diagnosis, particularly expensive highly profitable procedures or drugs. We teach with "standardized patients" a synanym for actors who can never teach the student the reality of a disease or its diagnosis. In our haste to produce alternative providers, we treat health care at the lowest denominator of competence. Any one with a stethescope around their neck is a provider. There are still true physicians, but they are fenw and far between. We still have great medical schools but they are under pressure to make the big bucks, to be self sustaining. Physicians today struggle with commercializations as renasance physicians struggled with the church.  

5 Disasters of the Afordable Care Act, Obama Care

1. It is indeed a tax, progressive fortunately, but inequitably so.

2. There is no provision for autopsy or a physician's own small laboratory, prohibited.

3. There are lots of provisions for providers without adequate medical school training.

4.  The Act allows drug companies to charge what ever they want and prohibits negotiation.

5  it encourages the recording of false or erroneously superfluous diagnosis.

What it has done is acknowledge the need for universal health care,but it needs to morph into a dual system private coverage competing with a universally available single payer system.

Share |

Autopsy

Share
http://www.pbs.org/wgbh/pages/frontline/criminal-justice/post-mortem/without-autopsies-hospitals-bury-their-mistakes/

Four years later and autopsies remain the forgotten basis of scientific medicine. Headlines read, autopsy rates are falling, but they cannot fall from the near zero percent presently undertaken. Some new hospitals do not even provide examining space for autopsies. The NEJM publishes CPCs on living patients. A pity today's epidemic of curriculum reform does not include autopsies, a further sad accommodation to today's reality. Check the PBS link, it's well done.

The renaissance of modern medicine was lead by the microscope and the study of anatomy; it became clinical with the routine practice of autopsy by Marie Francois Bichat in Paris 1793, the stethescope, Rene' Laennec 1822 and the classical bedside teaching of the great Scottish and Irish physicians in the early 1800s. From Bichat, over the door to his autopsy room, "Death comes to the aid of the living." 

Cynically speaking -- we have all but legislated these practices out of existence, the autopsy for money, bedside teaching for privacy, basic science for curriculum reform with greater emphasis on preceptors and, ah the stethescope, it hangs around the neck in color coordinated pastel colors only to pretend to hear something through the patient's clothing. An anatomy professor recently commented, "They have a microscope down in Seattle under glass so students can see what one looks like."