Dokter Blog: from the desk of Rahajeng Tunjungputri

Medicine et cetera by @ajengmd

Commentary: Professor Robot, psychiatrists, and overdosing CT-scans

I will add interesting news I stumble upon this week, and write short commentaries and thoughts about them. The original links to the news are available and I make no attempts to summarize these news.

Professor Robot

Kevin Warwick, a professor of cybernetics at the University of Reading, has a silicon chip implanted into his forearm to fire electrical impulses back to the brain and observe whether human could interpret and respond to stimulus sent by computers. The success of this self-experiment may be revolutionary for development of prosthesis. He basically has turned himself into bionic human purely for the sake of research.

If that sounds fascinating, try other examples of self-experimenting scientists in the article: Stubbins Ffirth drank the blackened vomit of yellow-fever patients in his attempts to prove that the disease was not an infectious one, while James Caroll and Jesse Lazear, US army physicians expose themselves to mosquito bites to prove that these vectors are transmitting the disease. Caroll had long-term complications and Lazear died during the course of this experiment.

These scientists have been regarded as either altruist or extremists. While it’s interesting what this may lead to discover, most research in the world of course are based on strict research protocol and recruit volunteers which safety are ensured.

Psychiatrists

This week, G. Harris on The New York Times brought us the story of how psychiatry is a transformed field. Psychiatrists, due to what they say a systemic shift in psychiatry care provision -that is payment by insurance companies-, now are “forced” to “talk less and prescribe more”. They no longer have the time for talk therapy and instead opt to examine and treat patients with high efficiency. This include only asking close ended questions relevant to their chief complaints, and prescribing drugs to allow them to function. The words “quality of life of patients” was not once mentioned in the article.

While this is perhaps the first time there is such exposure on the profession in US, I have sensed it since a few years ago, and this perhaps is already true for other fields of medicine in a country where doctors are paid on an out-of-pocket basis like Indonesia. You can’t afford a 45-minutes appointments when there are no appointments system, and you’re paid exactly the amount of money no matter how much time you spent on a patient. It’s still however, very much different from the practice of medicine in a well-insured country like The Netherlands for example, where it is mandatory to schedule your doctors appointments, and have longer appointments time for new patients and a fixed minimum time for every following appointments.

The article was closed on the note that a physician said, “I’m concerned that I may be put in a position where I’d be forced to sacrifice patient care to make a living, and I’m hoping to avoid that.”. But that is not the truth. The truth is that they are already in that position, and they know it, and it’s not just to make a living, it’s to make up the lifestyle that they want.

Click here for the original story

Overdosing CT-Scans

Cabell Huntington Hospital in Huntington, West Virginia are under scrutiny after they were found to perform CT-scan with radiation dose of 10x the necessary dose. This result in serious and dangerous medical side effects for patients as a result of over-radiation. The hospital was not responding adequately to this serious events, while the manufacturer of the CT-scan have filed a report to the FDA that this error was caused by medical technician who had manually increased the radiation to obtain sharper image, which was not necessary to detect pathology on the scans.

I can imagine that this events are not being regularly monitored in many parts of the world, and patient safety are relatively neglected. It’s time that we bring more awareness on this matter.

Click here for the original story

Rahajeng. Nijmegen, 7 March 2011

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Disclaimer

Medicine is a growing field, and information presented here is reflective of the time of posting. Please refer to your physician for direct medical consultation. My views do not reflect those of my employers. --
Regards, Rahajeng

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