Posted in Uncategorized, tagged best quote in science, ethics in medicine, venkat quotes on June 19, 2021|
Further reading
Here is a book from Dr. Ralf Sundberg, a former general and transplant surgeon, a prolific researcher from the prestigious Karolinska Institue, is trying hard to spill some not-so-sweet truths. A must-read, especially for the heavily biased optimistic scientists.
Posted in Uncategorized, tagged art of healing, best book in medicine, cost effectiveness in medicine, definition of medical care, ethics in medicine, evidence based medicine, harrison principles davidson, medical education, medical science is an art or true science, nursing vs medical profession, principles of practice of medicine on May 30, 2021|
This 90-second video clip is a “perfect provocation”
Allan Savory is a renowned ecologist from Africa. He is a global leader in environment and eco protection. He is making this famous comment, during one of his interviews from the deep forests of Zimbabwe, after years of ground-level work in the field of desertification and climate change. I can understand his feelings, as we also encounter similar situations at ground zero of the health care delivery system. (I wonder if there is anything called peer-reviewed bedside caring)
We realize wide gaps between academia, patient care, and research are the norm, not an exception. One reason for this is, even well-learned medical professionals find it difficult to comprehend, that the practice of medicine is essentially an art, administered with love, care, service-mindedness. A cost-effective infrastructure with an immense amount of teamwork is critical ( Of course, guided by a fair amount of knowledge, expertise based on good scientific principles)
Final message
As Savory says, let us hope, the future looks bright, that welcomes young researchers from the fringes of the scientific community. Let them be conferred with all courage and resources to course-correct medical science from its frequent aberrant and awkward turns.
Posted in bio ethics, Cardiology -Patient page, cardiology -Therapeutics, Clinical cardiology, general medicine, Medical education, Medical ethics, medical quotes, Two line sermons in cardiology, tagged clinical acumen, dr venkat quotes, ethics in medicine, evidence based medicine, guidelines protocols, principles of practice of medicine, rcts in medicine, william osler on March 31, 2021|
Posted in Cardiology quotes, cardiology-ethics, tagged best medical quotes, dr venkatesan quotes, ethics in medicine, evidence based medicine, evidence vs experience based medicine, hippocrates ethics, limitations of ebm, medical education, medical ethics quote, medical industry, principles of practice of medicine on February 13, 2021|
Because . . . its current course is not always in the right direction & not everyone is ready for course correction as well!
Reference
Posted in Uncategorized, tagged best quotes in medicine, dr venkatesan quotes, ethics in medicine, hippocrates, medical education, principles of medical education, quotes in noble profession on January 2, 2021|
Two queries that linger in the medical profession for a long. I am afraid they aren’t addressed specifically by the stakeholders.
Question 1
Foe a moment, let us assume there is no option to answer all three are equally important. Medical colleges are supposedly Godly places where high-quality noble professionals would germinate, let into the community thereupon, to heal the ill and suffering. The teaching faculty has a huge responsibility. They must ensure that students are transformed into responsible caregivers in the first place. They should be made to understand that the knowledge they acquire has a short half-life and medical education is all about continuous learning and unlearning. Unless teaching and research are morally genuine and scientifically perfect, the things we do in the name of patient care is going to be redundant. Hope you got the answer right!
Question 2
Now that, we got the answer to the question 1, here is a more difficult question.
Out of the four, only one addresses the skill and expertise. The rest of the three generally happen away from the bedside. The answer is strikingly clear I guess.
Postamble
I agree the answers to these queries can be extremely sensitive, and contentious for many of us. Little deeper lies the truth. Hope, the quote from the much-stigmatized father of modern medicine “Primum non-nocere” will help find the answer.
Posted in Uncategorized, tagged audit of medical science, bioethics, cleansing of medical literature, Dr. Jhon Loannidhis, ethics in medicine, medical science distillery on October 5, 2020|
If science is considered as a journey towards truth,.. knowledge, data, and statistics are the key companions in this infinite voyage to an unknown destination. While hundreds & thousands of scientists do travel in this turbulent road daily, pursuing their mundane work, there are very few researchers worried about the true purpose of their journey, the quality of the road they travel, the dangerous fault lines they create.
It has become a taboo topic to criticize medical science even after realizing the fact that we are compelled to follow and glorify some of the best nonsense.
Dr. Jhon Loannidhis Professor of statistics and public health from Stanford University is of a different genre. He became so popular after his landmark paper
Loannidis JPA (2005) Why Most Published Research Findings Are False. PLoS Med 2(8): e124.
His lectures are so important to us. Physicians need to listen to his talks, infested with absolute truths, unpalatable though.
Final message
It is my wish there is a need for a new specialty called quality assessment of published medical literature and knowledge distillery.
Posted in Uncategorized, tagged ethics in medicine, hippocrates otth on medical education, Iam documentry Tom Shadyac, medical education, Patch adams, Tom Shadyac on July 1, 2020|
Who is a doctor? Where are they made?
I haven’t clearly understood the true meaning of customary Dr tag, my name carries for more than 3 decades, till I saw this. Wish, this video is played to all young medical students on their graduation day.
I am realizing with guilt, it requires a Holywood movie buff to remind us the true meaning of the famous WHO – definition of Health, done in the most holistic fashion in the year 1948.
Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.
So, technically, whoever serves to improve these three components and alleviate human suffering becomes a doctor.
Happy to share this on July 1st, the official Doctor’s day in India in memory of the Bharat Ratna Dr.B.C.Roy of Bengal.
Reference
The clip is from the movie Patch Adams, Directed by Tom Shadyac. A Hollywood celebrity movie maker, Virginian professor of communication turned philanthropist, now retired to a minimalist life. He is also known for his famous documentary I am that talks about the problems faced by the world. Though his works are much appreciated, I must say, they are underrated. Deserves more than an Oscar for communicating his thoughts on the medical profession perfectly and for social equality.
Posted in Uncategorized, tagged ethics in medicine on May 14, 2020|
I think it is an Invalid question. Whether you like it or not , medical science and philosophy are always bonded together and its relationship is eternal. It doesn’t make sense to separate them. I think we have misunderstood the meaning of philosophy. While science is presumed truths, philosophy is trying to believe in unknown truths. Philosophical truths are built-into every decision a medical professional takes.
If the expected natural history of any disease is science, unexpected deviations are philosophy. (RT PCR testing for diagnosing Corona is science, why 90% of them are not infective and don’t transform disease is philosophy) When something is not seen or quantifiable like human immunity, it is a perfect example of concealed science or manifest philosophy.
Taking about what we think we know is science, Talking about what we really don’t know is philosophy. The term Idiopathic syndrome finds a proud of the place in every specialty in medicine, Isn’t?
What will be your answer when your patient wants an assurance that a stent, you had just implanted will not get occluded in the next 6 months or so.“I don’t know, I cant assure you about that” will be your most likely answer. (Though, we do it in style, hiding behind the scientific hyperbole decorated with numbers, also referred to as statistics) Please realize, this is the expression of medical philosophy in the finest form.
Final message
My Impression is, philosophical truths should be liberally used in a regular fashion right from the first-year medical school to advanced specialty teaching. This seems essential as science in the current times suffers from too much sanctity. This has spilled over to the doctor population as well, and make them appear invincible.
If only we realize science often trails behind the philosophical truths at least by a few decades, our patients will not be injured inappropriately and prematurely. Mixing science with philosophy in the right composition ( a perfect academic cocktail ) will bring out the best from the noble profession.
Postamble
Can anyone guess, why scientists are given a doctorate in Philosophy degree (PhD ) ?
Posted in Uncategorized, tagged ethics in medicine on March 12, 2018| 2 Comments »
Yes, Medicine is a funny science ( some don’t agree , Isn’t Art ?) Many of the noble professionals are silently pursuing their job of saving lives and removing human suffering .Meanwhile, people like this author are needlessly bothered about some Imaginary Issues and write stuff like this one , . . that you are reading now !
Yes, there is an invisible tectonic shift taking place in the name of science.The way we practice medicine currently, it fits in with any of the following descriptions . Divine, Godly,dramatic,miraculous , comical ,cruel or even outright brutal ! (I dare not quantify the weightage of each adjectives used above !)
The field of cardiology as I know personally for the past three decades is challenged by uncontrolled growth (How about proposing 1000 dollar PCSK blocker Evolocumab for a meaningless reduction of few mg of LDL over and above Statin ) Further,the technology goes on to Implode at every corners of wall street ,(Mitra clip for mild MR of DCM ! TAVR for aged Aortic valve ) hijacking commonsense and cost (where is the effectiveness ?) of every stake holder .
In the process ,the critical healing power that resides within every biological system is ignored and ridiculed upon .(You become a fool if you say endothelial tissue plasminogen activator and lytic system will take care of a bulk of the intravascular vascular thrombus if we wait, and we shall permanently defer an Intervention! Current space aged physicians want to invade every existing (or non existing ) problem with multi pronged military strategy and guess what will happen to the humble body which becomes the battle ground.
Coming to the content proper
Sometimes I feel God throws some random truths at an unexpected time through some extraordinary men ! Here is a most unusual study of its kind from the Sanctum sanctorum of Medical science , namely Harvard medical school and Massachusetts General hospital .I think it was presented in ACC Scientific sessions 2018 , Orlando and published in Journal of American heart Association.
Cheers and congratulations to the lead author Dr.Anupam B Jena* , Physician and professor , Department of health care policy , and Health economist
* A video profile of author is in the reference
There is no surprise a paper with such a title had a huge media backlash. USA today reacts . . .
My observations and final message
The paper from MGH, Boston dwells a sensitive area ,of course it has come with a gross conclusion (However, I feel it has hit the bull’s eye.) Still, for the critics, I want to tell one thing , who can deny the fact ? the massive evidence base with 100s and thousands of research papers created by cardiology scientific Industry over the decades is largely a damn squib.
(The problem with acquiring this sort of ready to synthesise knowledge stuff is, It sits right inside our brain and bonds irreversibly , refuse to leave even if these dubious practices are proven dangerous ultimately !)
It might appear , the only option to tackle fake science would be through some dramatic ,less than ideal or mediocre research papers (Or even another fake!) As long as final outcome is good for the public don’t bother about methodology of such studies.(Does it sound in any way I am a supporter of Donald Trump ,! No I am not !)
Reference
Now have a look at this (a long post ) which I wrote some time back. Find out whether these scribblings of mine seem to have grown some scientific backing now .
A brief Info about the author of this unusual paper that has put the field of Interventional cardiology into tail spin and fluttering in cross winds !
Posted in bio ethics, Cardiology Risk assesment, medical quotes, Social medicine, Two line sermons in cardiology, Venkat quotes, tagged cardiology ethics, ethics in medicine, hippocrates, intentional harm, principles of medicine, risk benfiet ratio, unintentional benefit, unintentional harm on November 16, 2013| 1 Comment »
