The PMD Critical List: Medicine's 'Dark Underbelly'

A recent case in Maryland highlighted the problem of bad physician behavior while patients are sedated. Now, an anonymous confessional in a respected medical journal suggests this wasn’t an isolated incident. That story tops this week’s PMD Critical List. Also on the list, a machine that “vomits” and a look at how to streamline your practice.

• Anonymous Essay Unveils Medicine's “Dark Underbelly” (US News & World Report)

An anonymous piece in Annals of Internal Medicine describes bad behavior by physicians around unsuspecting or unconscious patients. Calling the incidents “completely abhorrent," the journal’s top editor, Christine Laine, MD, says: “what makes them especially abhorrent is that they were done in front of trainees. That magnifies the wrong."

• Vomiting Machine Shows How Viruses Spread (NBC News)

Real vomiting is bad enough, now North Carolina State researchers have built a machine that simulates the awful act. By determining “whether norovirus spreads through aerosolized human puke” the “odd machine” could help understand a disease that affects millions.

• 4 Strategies for Improving Medical Practice (Forbes)

Another thoughtful essay from a physician leader on changes to “enhance the rewards of medical practice and minimize the difficulties for patients and physicians.” They are: 1. Invest in public health, 2. Shift from fee-for-service to pay-for-value, 3. Reform the malpractice system, and 4. Unlock access to patient information.

• How Great Leaders Avoid Burnout (Inc.)

It’s major concern for today’s physicians—avoiding the dreaded professional burnout. The solution comes down to two simple actions: “Find a support team of mentors you'll actually listen to” and “Take a break, for at least 20 minutes a day.”

• Cleveland Clinic Boots McDonalds from its Food Court (Cleveland Plain Dealer)

The venerable Ohio healthcare facility ended its lease with the nation’s best-known fast-fast restaurant chain. After 20 years of doing business together, hospital officials want to “reduce the risk factors that contribute significantly to chronic diseases.”

• Seriously, Go to College (US News & World Report)

Despite rising costs, the benefits of a college education are better than ever, according to a new Federal Reserve Bank of St. Louis report. Researchers found that “the lifetime financial benefits of an education have never been so high.”

• Cancer: The New Cure (Barron’s)

Here’s an interesting clinical-financial look at a new class of cancer drugs. “Immuno-oncology strategies arise from understanding the defenses used by cancer cells to evade the normal search-and-destroy operations of our immune system.”

• Schooling Doctors in the Power of Empathy (Boston Globe)

A research and training program engineered to teach doctors empathy, the first such program in the nation offered by a hospital, is now underway in Massachusetts. “Poor people skills displayed by some doctors may stem in part from the rigors of medical school itself.”

• Helping Physicians Predict Suicide Attempts (News-Medical.net)

Indiana University School of Medicine researchers “have developed blood tests and questionnaire instruments that can predict with more than 90% accuracy which of those patients will begin thinking of suicide, or attempt it.”

• Physician Support Key to Successful Weight Loss (Medicalxpress.com)

New research from the Johns Hopkins University School of Medicine shows that patients “who rated their primary care doctor's support as particularly helpful lost about twice as many pounds as those who didn't.” More than one-third of US adults are now obese.

• 9 Novels You Shouldn't Miss Before Summer's Over (Kirkus Reviews)

For today’s stressed-out doctors, one reliable way to reduce weariness can be a summer break spend reading for leisure. Here are a few timely recommendations from one of American’s top book reviewers.