Can We Squeeze the Waste Out Of Medical Education

Patricia Salber

Posted 4/04/12 on The Doctor Weighs In

I had a chance to “moonlight” in the internal medicine “drop-in” clinic at the Kaiser Medical Center in San Francisco while I was finishing my residency and endocrinology fellowship at UCSF. I was superbly trained in in-patient care and there was no IV or PA line that I couldn’t put in with my eyes closed. I was comfortable taking care of really sick people and thrived on complex, acute cases. I knew how to work up a VIPoma (vanishingly rare endocrine tumor), but, I didn’t know how to treat a paronychia (a skin infection around the nails) and I was bored silly by colds and sore throats – the run of the mill cases that filled up the Kaiser clinic. I used to daydream about building a machine that would grab (gently) the patient by the neck, insert a throat swab, and then spit out a prescription for penicillin. Nine years of training for this! What a waste of all that training!

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Surgery Trumps Intensive Medical Therapy for Obese Diabetics

Patricia Salber

Posted 3/26/12 on The Doctor Weighs In

Two back-to-back articles in the March 26, 2012 issue of the New England Journal of Medicine show bariatric surgery to be more effective than intensive medical therapy when it comes to glycemic control. Pardon the pun, but this is BIG.

The studies, one American and one Italian were both randomized, but not blinded (it is hard to blind a surgical versus a non-surgical intervention). Both were relatively small (150 patients in the American study and 60 in the Italian study). And, both were relatively short term (12 months in the American study and 24 months in the Italian study). Nevertheless, the results are dramatic.

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FutureMed: Hanging Out With the Smartest People in Health Care

Patricia Salber

Posted 2/9/12 on The Doctor Weighs In

Last fall, I decided to splurge on tuition for FutureMed (FM), Singularity University’s week long celebration of all things cutting edge in healthcare and bioscience. It is only day four of the six day course and already my brain is stuffed with enough info on innovation to last a life time. Just when I think it can’t get any better, FM rolls out a new speaker on yet another mind-boggling topic: cancer genomics, synthetic biology, robotics, the impact of virtual reality on behavior, exponential thinking, and more. Unbelievable…and fun.

We have had the privilege of being inspired by Peter Diamandis, founder of the X-Prize and co-founder (together with Ray Kurzweil) of Singularity University. Paul Yock, MD shared the experience of the Biodesign Department at Stanford and the work he has been doing with young innovators across the globe. Richard Satava blew our minds with health related technology developed at DARPA (unmanned rescue helicopters, unmanned ORs, and other aspects of the hospital of the future) and Amir Belson chatted about some of the 64 medical device companies he has founded, each one bringing to market innovations that change medical practice for the better (a modular endoscope that takes the curves with ease, a sure-fire catheter to get the IV in the first time).

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Direct Access to Lab Results: Helpful or Harmful

Patricia Salber

Posted 12/19/11 on The Doctor Weighs In

I am a big fan of DIY (do-it-yourself) healthcare, at least for the bulk relatively minor issues that plague people. I think the days when doctors were needed to control, interpret and dole out health data and information are waning. There are simply too many ways, primarily via the internet, to get good, reliable, easy-to-understand information about our own health.

The Quantified Self (QS)people who use sensors, mobile apps, and other devices to collect data on themselves may be taking it to what some would consider extreme, but I think it is the wave of the future.

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Take This Medication, OK? Taking a Look at Emergency Department Discharge Instructions

By Patricia Salber

People seek care in emergency departments for lots of different reasons, including treatment of injuries, evaluation of pain, complications related to chronic illnesses, and fear that a symptom is or could become serious or even deadly. Almost always, people want to know what the problem is and what they should do about it.