"For every complex problem, there is a solution that is simple, neat, and wrong." - HL Mencken
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"I hear and I forget. I see and I remember. I do and I understand." - Confucius
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"The good physician treats the disease; the great physician treats the patient who has the disease" - Sir William Osler
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" The best test of a person's character is how he or she treats those with less power." - Bob Sutton
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"Those are my principles, and if you don't like them - well, I have others." - Groucho Marx
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"The difference between genius and stupidity is that genius has its limits." - Albert Einstein
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"It is hard enough to remember my opinions, without also remembering my reasons for them" - Friedrich Nietzsche
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"Anyone can make the simple complicated. Creativity is making the complicated simple." - Charles Mingus
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"Not everything that can be counted counts, and not everything that counts can be counted." - Albert Einstein
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"A foolish consistency is the hobgoblin of little minds, adored by little statesman and philosophers and divines. With consistency a great soul has simply nothing to do." - Ralph Waldo Emerson
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"This ain't no party, this ain't no disco, this ain't no fooling around." - Talking Heads, Life During Wartime
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"What is hateful to you, do not do to your neighbour. This is the whole Torah; all the rest is commentary. Go and learn it." - Hillel, Talmud, Shabbath 31a
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"You will never understand bureaucracies until you understand that for bureaucrats procedure is everything and outcomes are nothing." - Thomas Sowell
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"An idealist is one who, on noticing that a rose smells better than a cabbage, concludes that it will also make better soup." - HL Mencken
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"If you only have a hammer, you tend to see every problem as a nail." - Abraham Maslow
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"A great teacher is one who realizes that he himself is also a student and whose goal is not to dictate the answers, but to stimulate his students creativity enough so that they go out and find the answers themselves." - Herbie Hancock
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"There are no facts, only interpretations." - Nietzsche
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"An education isn't how much you have committed to memory, or even how much you know. It's being able to differentiate between what you do know and what you don't." - Anatole France
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"In character, in manner, in style, in all things, the supreme excellence is simplicity." - Henry Wadsworth Longfellow
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Workouts by month - Goal 200 from 11/1/09 through 10/31/10
The ACP Advocate Blog by Bob Doherty: "There once was a man named O'Bama ..." http://ow.ly/1nUH3 - HCR limericks and a cold one for BobMarch 18, 2010 5:24
http://ow.ly/1mYi7 - ABIM MOC program - two differing viewpoints - you can guess my voteMarch 16, 2010 5:06
RT @yejnes: My thoughts on the annual exam, etc., final letter ACP Internist, March 2010 http://bit.ly/9FNcXn wel-stated & importantMarch 15, 2010 12:47
A note to the professors, from the "real" world, on the use of ICDs in a fee for service community... http://ow.ly/1jaPy - great postMarch 13, 2010 2:19
RT @paulinechen: New "Doctor and Patient"; Learning to Keep Patients Safe in a Culture of Fear http://nyti.ms/bYA14V - blog post comingMarch 12, 2010 1:35
RT @tom_peters: @kevinmd Spoken like an MD. - true primary care is very complex - it is not simple care -March 11, 2010 12:43
RT @efalchuk: Seriously, what is Nancy Pelosi Talking About? http://bit.ly/9sHSc2 #healthreform #hcr #healthcare think Dazed and ConfusedMarch 10, 2010 7:53
Obama Says Health Overhaul Should Trump Politics - http://nyti.ms/bwKRyo - and he is correctMarch 8, 2010 7:28
Thanks for pointing us to these thought-provoking posts.
To me, part of this revolves around money. Keep in mind that the fiscal woes of academic medical centers has led them to seek other sources of revenue – and, the public has been demanding and consuming more CAM services.
The folks seeking CAM therapies may tend towards the better-off, and since many of these therapies aren’t covered by insurance, centers can charge cash and get what they ask for (as noted in the blog posts describing upfront fees). Acadademic medical centers want in on the uncomplicated and growing pool of money people are willing to put out for these therapies.
The second poster has a good point. Patients are willing to spend money, sometimes a lot of money, on unconventional therapies offered by “alternative medicine” practitioners. Ironically, few will spend on concierge style conventional consultation, I suspect because many think they will get the same service from another physician using their insurance.
When I lived in Florida, I wondered how so many chiropractors were able to survive in practice in the community where I once lived, there were so many of them, yet physical and occupational therapists were leaving town for better opportunities. Obviously they were able to offer something their patients wanted and were willing to pay cash to get. It wasn’t manual spinal adjustment, or nutritional counseling alone, as those services were available elsewhere; it may have been to have someone else listen to them tell about their problem, or even to hear some other proposal to treat a chronic or intractable complaint. I came to believe that part of it was the investment people had made in their therapy by having paid for it and the wish, whether or not that was verifiable, that the therapy was successful and worthwhile.
It was as if the commitment carried a psychological momentum.
The medical schools see this, and they also see the trends in third-party reimbursement and they are trying to cash in. The problem is they are using their institutional reputations–based on excellence in conventional medicine– to seize market share.
It is like hanging the university seal over the door of a rub parlor.
The most frustrating thing for me is when I attempt to explain why this-or-that alternative remedy does not work, … sheesh, … the flack I get is something else. I generally get some look and retort that I just don’t think it works because it is not “traditional” medicine. At that point, no matter what you say is ignored because of my perceived bias and formal education.
If anyone has a reply to that type of logic, I would love to hear it.
I have learned over the years that their are too many patients and those patients who wan’t some type of complementary medicine will need to seek it elsewhere.
My role is to discuss the evidence and science as I know it. If someone want’s anything beyond that then I suggest they try someone else.
5 Responses to Sometimes medical schools are stupid
CHenry
November 17th, 2005 at 11:50 am
Failure of leadership.
Medstudent
November 17th, 2005 at 6:21 pm
Thanks for pointing us to these thought-provoking posts.
To me, part of this revolves around money. Keep in mind that the fiscal woes of academic medical centers has led them to seek other sources of revenue – and, the public has been demanding and consuming more CAM services.
The folks seeking CAM therapies may tend towards the better-off, and since many of these therapies aren’t covered by insurance, centers can charge cash and get what they ask for (as noted in the blog posts describing upfront fees). Acadademic medical centers want in on the uncomplicated and growing pool of money people are willing to put out for these therapies.
CHenry
November 20th, 2005 at 6:53 am
The second poster has a good point. Patients are willing to spend money, sometimes a lot of money, on unconventional therapies offered by “alternative medicine” practitioners. Ironically, few will spend on concierge style conventional consultation, I suspect because many think they will get the same service from another physician using their insurance.
When I lived in Florida, I wondered how so many chiropractors were able to survive in practice in the community where I once lived, there were so many of them, yet physical and occupational therapists were leaving town for better opportunities. Obviously they were able to offer something their patients wanted and were willing to pay cash to get. It wasn’t manual spinal adjustment, or nutritional counseling alone, as those services were available elsewhere; it may have been to have someone else listen to them tell about their problem, or even to hear some other proposal to treat a chronic or intractable complaint. I came to believe that part of it was the investment people had made in their therapy by having paid for it and the wish, whether or not that was verifiable, that the therapy was successful and worthwhile.
It was as if the commitment carried a psychological momentum.
The medical schools see this, and they also see the trends in third-party reimbursement and they are trying to cash in. The problem is they are using their institutional reputations–based on excellence in conventional medicine– to seize market share.
It is like hanging the university seal over the door of a rub parlor.
rwlee
November 22nd, 2005 at 2:05 pm
The most frustrating thing for me is when I attempt to explain why this-or-that alternative remedy does not work, … sheesh, … the flack I get is something else. I generally get some look and retort that I just don’t think it works because it is not “traditional” medicine. At that point, no matter what you say is ignored because of my perceived bias and formal education.
If anyone has a reply to that type of logic, I would love to hear it.
matte
November 26th, 2005 at 8:51 pm
I have learned over the years that their are too many patients and those patients who wan’t some type of complementary medicine will need to seek it elsewhere.
My role is to discuss the evidence and science as I know it. If someone want’s anything beyond that then I suggest they try someone else.