Comments for Making Medical Decisions http://www.makingmedicaldecisions.com The blog for the forthcoming book "Medical Decision Making: A Physician's Guide" by Alan Schwartz and George Bergus (Cambridge University Press, 2008) Tue, 02 Mar 2010 22:43:16 +0000 http://wordpress.org/?v=2.9.2 hourly 1 Comment on Helping students unlock the mysteries of Bayes by Teresa http://www.makingmedicaldecisions.com/2009/helping-students-unlock-the-mysteries-of-bayes/comment-page-1/#comment-6350 Teresa Tue, 02 Mar 2010 22:43:16 +0000 http://www.makingmedicaldecisions.com/?p=65#comment-6350 Very nice suggestion! We are all subject to fallacies and biases, but sugesting ways to helo it is both helpful and give scientists ideas on the origin of the biases Very nice suggestion! We are all subject to fallacies and biases, but sugesting ways to helo it is both helpful and give scientists ideas on the origin of the biases

]]> Comment on Vaccines and evidence by Alan Schwartz http://www.makingmedicaldecisions.com/2008/vaccines-and-evidence/comment-page-1/#comment-5960 Alan Schwartz Wed, 03 Feb 2010 21:23:07 +0000 http://www.makingmedicaldecisions.com/2008/vaccines-and-evidence/#comment-5960 And, just to resurrect this old post, Lancet today <a href="http://www.npr.org/blogs/health/2010/02/lancet_wakefield_autism_mmr_au.html" rel="nofollow">retracted the 1998 Wakefield article purporting to link vaccines and autism</a>. And, just to resurrect this old post, Lancet today retracted the 1998 Wakefield article purporting to link vaccines and autism.

]]> Comment on Review in Annals of Internal Medicine by Cleo Pappas http://www.makingmedicaldecisions.com/2009/review-in-annals-of-internal-medicine/comment-page-1/#comment-5266 Cleo Pappas Mon, 07 Dec 2009 15:25:19 +0000 http://www.makingmedicaldecisions.com/?p=72#comment-5266 Hooah!!! Hooah!!!

]]> Comment on Lessons outside health care by Bob Harris http://www.makingmedicaldecisions.com/2009/lessons-outside-health-care/comment-page-1/#comment-5130 Bob Harris Fri, 23 Oct 2009 21:21:47 +0000 http://www.makingmedicaldecisions.com/?p=50#comment-5130 When you think about health reform think about this. I live in the UK where healthcare is free to all, however illegal immigration has put such a strain on the system that government spending has nearly doubled and our taxes just keep going up as a result. Drug makers can charge what they want because it is an open ended commitment and we have no choice but to pay. There are no caps, but people die waiting for treatment When you think about health reform think about this. I live in the UK where healthcare is free to all, however illegal immigration has put such a strain on the system that government spending has nearly doubled and our taxes just keep going up as a result. Drug makers can charge what they want because it is an open ended commitment and we have no choice but to pay. There are no caps, but people die waiting for treatment

]]> Comment on GUT decision-making by sameena shah http://www.makingmedicaldecisions.com/2008/gut-decision-making/comment-page-1/#comment-4040 sameena shah Tue, 28 Jul 2009 17:51:51 +0000 http://www.makingmedicaldecisions.com/2008/gut-decision-making/#comment-4040 My 3 words for making medical decision making are: Patient-centered safe Holistic My 3 words for making medical decision making are:

Patient-centered

safe

Holistic

]]> Comment on Lessons outside health care by Health » Making Medical Decisions » Blog Archive » Lessons outside health care http://www.makingmedicaldecisions.com/2009/lessons-outside-health-care/comment-page-1/#comment-3059 Health » Making Medical Decisions » Blog Archive » Lessons outside health care Fri, 19 Jun 2009 08:03:44 +0000 http://www.makingmedicaldecisions.com/?p=50#comment-3059 [...] See the original post:  Making Medical Decisions » Blog Archive » Lessons outside health care [...] [...] See the original post:  Making Medical Decisions » Blog Archive » Lessons outside health care [...]

]]> Comment on FLIP on pharmaceuticals by Making Medical Decisions » Blog Archive » Making Veterinary Decisions http://www.makingmedicaldecisions.com/2007/flip-on-pharmaceuticals/comment-page-1/#comment-1389 Making Medical Decisions » Blog Archive » Making Veterinary Decisions Tue, 10 Mar 2009 19:44:11 +0000 http://www.makingmedicaldecisions.com/2007/flip-on-pharmaceuticals/#comment-1389 [...] for the second course, but agreed. The infection continued to improve on cephalexin. Attention to principles of rational prescribing would have been beneficial [...] [...] for the second course, but agreed. The infection continued to improve on cephalexin. Attention to principles of rational prescribing would have been beneficial [...]

]]> Comment on Choosing doctors, choosing patients by George Bergus http://www.makingmedicaldecisions.com/2008/choosing-doctors-choosing-patients/comment-page-1/#comment-1002 George Bergus Fri, 24 Oct 2008 20:02:19 +0000 http://www.makingmedicaldecisions.com/2008/choosing-doctors-choosing-patients/#comment-1002 I wonder how patient-physician fit changes over time becasue of changes in a patient’s condition. Is a physician who is a good fit for me now when I am health still going to be a good fit for me as I develop chronic diseases? As my needs change in terms of health care perhaps the physician who best fits also changes. A related question to how should patients select a physician is how should a physician select a consulting physician? As a physician I find it difficult to judge the expertise of the consultant. When I send a patient to another physician it is because I realize I need help because I lack the required expertise. I may feel the consultant is doing too much or too little, but am I in a good position to make a valid judgment? Certainly I can assess how well the consultant treats me as a referring physician. Do they send me a report in a timely fashion? Do they treat me with respect? I can also ask my patient whether they liked the consultant. I used to think these were surrogates for quality but then within a few years two consultants I used got into trouble with our state medical board over issues of competence. I was surprised by this and very distressed by this because I had thought I was making good selections. If I am unable to judge the competence of a fellow physician it seems not very likely that a patient can effectively judge the competence of their personal physician. I wonder how patient-physician fit changes over time becasue of changes in a patient’s condition. Is a physician who is a good fit for me now when I am health still going to be a good fit for me as I develop chronic diseases? As my needs change in terms of health care perhaps the physician who best fits also changes.

A related question to how should patients select a physician is how should a physician select a consulting physician? As a physician I find it difficult to judge the expertise of the consultant. When I send a patient to another physician it is because I realize I need help because I lack the required expertise. I may feel the consultant is doing too much or too little, but am I in a good position to make a valid judgment?

Certainly I can assess how well the consultant treats me as a referring physician. Do they send me a report in a timely fashion? Do they treat me with respect? I can also ask my patient whether they liked the consultant. I used to think these were surrogates for quality but then within a few years two consultants I used got into trouble with our state medical board over issues of competence. I was surprised by this and very distressed by this because I had thought I was making good selections. If I am unable to judge the competence of a fellow physician it seems not very likely that a patient can effectively judge the competence of their personal physician.

]]> Comment on Vaccines and evidence by Alan Schwartz http://www.makingmedicaldecisions.com/2008/vaccines-and-evidence/comment-page-1/#comment-851 Alan Schwartz Wed, 01 Oct 2008 14:24:25 +0000 http://www.makingmedicaldecisions.com/2008/vaccines-and-evidence/#comment-851 The Downs, Bruine de Bruin, and Fischhoff study is a really neat piece of work, David. Thanks for calling it to my attention! The Downs, Bruine de Bruin, and Fischhoff study is a really neat piece of work, David. Thanks for calling it to my attention!

]]> Comment on Vaccines and evidence by David Hardman http://www.makingmedicaldecisions.com/2008/vaccines-and-evidence/comment-page-1/#comment-849 David Hardman Wed, 01 Oct 2008 01:54:20 +0000 http://www.makingmedicaldecisions.com/2008/vaccines-and-evidence/#comment-849 The following news item describes how the MMR scare unfolded in the UK. The author, a journalist who is a practising doctor, also notes that vaccination scares often differ between countries. http://www.badscience.net/2008/08/the-medias-mmr-hoax/ A mental models analysis of parents' understanding of vaccination issues has just been published by Julie Downs, Wandi Bruine de Bruin and Baruch Fischhoff: "Parents' vaccination comprehension and decisions", in Vaccine, 26, 1595-1607. The following news item describes how the MMR scare unfolded in the UK. The author, a journalist who is a practising doctor, also notes that vaccination scares often differ between countries.

http://www.badscience.net/2008/08/the-medias-mmr-hoax/

A mental models analysis of parents’ understanding of vaccination issues has just been published by Julie Downs, Wandi Bruine de Bruin and Baruch Fischhoff: “Parents’ vaccination comprehension and decisions”, in Vaccine, 26, 1595-1607.

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