Tag: Doctor-Patient Relationships

Blog Posts (11)

December 28, 2016

Albany Medical College May be the Best Medical School in the Country

I realize that this is not the assessment of the US News and World Report, or other major organizations that rank US medical schools, but I believe it quite possibly is true.  Organizations that rank medical schools look at dollars of research grant funding, or the test scores of the students, but what is really important is the quality of the physician they graduate.  But what do we mean by quality?  And who should be the judge of this?

A survey of patients in a primary care setting revealed that the most important quality that they sought in their physicians was empathy.  More important than even clinical skill or knowledge, they wanted a physician who listened and cared.  This response cut across demographics—the old, young, rich, poor, all ranked empathy as the most important quality of a physician. And shouldn’t patients be the ones to tell us what is most valuable in a physician, and by extension what the most important mission of medical schools must be?

The curriculum of medical schools across the country differs little in terms of the basic sciences taught and clinical rotations of the last two years.  Students from Harvard and Albany need to pass the same standardized tests to graduate, but that doesn’t mean there aren’t differences.  Students at Albany Medical College spend more time learning ethics, and discussing the humanistic aspects of clinical care during their last two years of medical school than any other medical school I have yet discovered.  When Dr Shelton and I discussed our curriculum at a national bioethics conference two years ago, educators from other schools were shocked at how much curriculum time we had with students during their clinical years, and none had anything close to comparable.

I just finished six one-and-a-half hour sessions with third-year students on their internal medical clerkship.  At the end I asked them whether it had helped them.  The fact that I do not grade them at all made their answers less suspect, and to a person they praised the time we had spent together. 

            “A chance to reflect.”

            “Helping me stay human.”

            “I want to keep feeling.”

At that same bioethics conference I listened to a talk on teaching empathy during medical school, and I kept thinking that the speaker had it all wrong.  Our job is to preserve empathy, not teach it, and we preserve it by allowing students the opportunity to share the good, the bad, and the ugly with each other in a safe environment.  We do that. Others should follow our example.  A third-year student told me that the best examples of compassionate patient care came from the residents who had trained at Albany Medical College as medical students, and that she believed it was the ethics curriculum that was making the difference.

NIH grants, and licensing exam scores are not unimportant, and Albany Medical College is a good medical school by any marker chosen.  But by the marker chosen by patients, we may, in fact, be the best.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

December 21, 2016

In Memoriam: John A. Balint, MD

After over three decades of dedicated service to Albany Medical College as a researcher, practicing physician, administrator, and mentor, when some people might consider retirement, John Balint in the early 1990’s was just beginning to redefine his career. It was during this time that I first met John at the University of Chicago, Center for Clinical Medical Ethics, when we were both members of the 1993-1994 Fellowship class. I was privileged to learn about his amazing life up to that point, but what seemed more important at that time, were his high hopes for the future.

John sought out this fellowship opportunity to prepare himself to lead the new Center for Medical Ethics which would be charged with teaching a new course that was being created in the curriculum reform process called Health, Care, and Society (HCS). To say John was excited about the new direction of his life was an understatement. As one of the leaders of this four-year longitudinal course, John was now able to focus on his deepest passion in medicine: the physician-patient relationship and the elements of good doctoring.

Of course I know now that John had been preparing for his new role from the beginning of his life. He often said his interest in the physician-patient relationship was passed along to him from his father, Michael Balint, the prominent physician-psychoanalyst and early thought leader on this topic. As a small boy growing up in Budapest, Hungary, John told me the story of joining his dad on a trip to Vienna to visit Sigmund Freud, where John played under Freud’s desk while the two men talked about their patients. Though John went on to study medicine at Cambridge University in England, and then received advanced training in gastroenterology both in England and the United States, he maintained an interest in his father’s work, which included The Doctor, The Patient, and His Illness originally published in 1957.

John came to Albany Medical College in 1963 to head the new division of gastroenterology and to put an indelible mark on the institution to which he dedicated most of his life. From having leading roles in NIH research grants, to serving as chair of the Department of Medicine and being an invaluable mentor and teacher to many students, residents, and fellows, John was a remarkably well-rounded physician-scientist. But most of all, as those who were around him in the clinical setting know, he was the consummate clinician—a good doctor in the mold of great doctors since Osler. One can hardly imagine better preparation, along with a fellowship in medical ethics, for leading the new program in ethics in Albany.

I was honored and excited when John asked me to join him as his new associate in the Center For Medical Ethics, Education and Research. When I joined him in 1994 our primary mission was to develop HCS throughout the 4 years of undergraduate training ,(the first year had begun in 1993-94), start a new clinical ethics consultation service for the physicians and nurses at Albany Medical Center, and become part of the lifeblood of the institution. John was never interested in purely theoretical pursuits in ethics—he wanted the new focus on ethics to make a positive difference in the lives of the students, patients and staff we served. Within a few years Liva Jacoby and Sheila Otto joined John and me, and together we were making our mission a reality. During our first decade working together I was honored to coauthor a number of papers with John including our 1996 article, Regaining the Initiative: Forging a New Model of the Patient-Physician Relation, which was published in JAMA.

John was a visionary who never stopped dreaming about new possibilities with a great deal of energy and enthusiasm. He was excited to support the joint Albany Medical College/Union Graduate College Master’s of Science in Bioethics as well as the new Distinction in Bioethics for our medical students, both of which began in 2001. By the time John stepped down from the directorship, the Center for Medical Ethics had become the Alden March Bioethics Institute, which has continued to grow and flourish. But it began with John’s passion to make ethics relevant in medical education and in clinical practice, and to train a new generation of young learners to become good doctors.

Though we mourn his loss, we also celebrate his remarkable life and work. He will be greatly missed, but the mission he dedicated himself to and our memory of him will continue.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

 

 

July 21, 2016

Lighting Up New Interest in Teen Smoking Behavior: E-Cigarette Use

Adolescence is known to be a time of experimentation and pushing towards the independence of adulthood. Risk taking, heightened need for social validation, and evolving independent self-hood are hallmarks of this important stage of life. Smoking is often viewed as a behavior that marks adulthood, and is sometimes seen as rebellious against norms (and laws) restricting purchase and use until age 18. Research in discreet regions of the US shows that e-cigarettes are more likely to be the source of nicotine exposure students in 11th and 12 grades, rather than ignited products. This same article elucidates the psychosocial factors linked to e-cigarette use, and finds that some of the determinants correlated with use in teens are prior cigarette use, having a household member using e-cigarettes, and peer endorsement of using e-cigarettes. The study found that current users did not feel there were health risks related to using e-cigarettes.

The question asked in this NY Times blog is what the correlation might be between e-cigarette use and combustible tobacco use. Are e-cigarettes a new pathway to tobacco use, and therefore dangerous by association? Just how dangerous are the vapors inhaled from e-cigarettes themselves? The concern is that there are now simply more teens using smoking products overall, thanks to the e-cigarette. “The numbers suggest that rather than prompting teenagers to replace cigarette smoking with vaping, e-cigarettes instead have enticed an entirely new group of teenagers to use nicotine” according to the NY Times piece, and based on the most recent work by Barrington-Trimis. 

As noted in the various articles linked here, it is unclear what long term health effects will impact e-cigarette users and how use of these products will correlate to combustible tobacco products, though the early data suggests there is a connection. Addressing e-cigarette use may require special, creative initiatives to reach the youths who would not otherwise have exposed themselves to a nicotine smoking product. Healthcare providers caring for adolescents will need to join in the effort to understand the factors influencing the decision to use e-cigarettes in order to address the uncertain health effects and serve as a resource for teens who believe that e-cigarettes pose a lower risk avenue to participate in smoking activities.

July 11, 2016

Does your primary care physician actually provide your primary care?

You’ve just moved to a new city for a new job, and before you can find a primary care practice, you get sick.  So you visit an urgent care center.  The doctor examines you, treats you, and urges you in not-so-subtle (and sometimes judgmental) terms to quickly find and follow up with a PCP.  And so the search begins.

 

Step 1: Consult Google.  Find 150 doctors within 50 miles.  Realize you know nothing about any of the doctors on the list.

Step 2: Ask colleagues for recommendations.  Receive great reviews of 2 doctors.

Step 3: Call the recommended doctors.  None are taking new patients.

Step 4: Realize you have insurance that limits your options.  Scrap your Google search and search on your insurance company’s website for “find available doctors taking new patients.” Results: 3 doctors.

Step 5: Call the doctors listed.  Doctor 1 isn’t taking new patients at all.  Doctor 2 is taking new patients in 4 months.  Doctor 3 may be able to fit you in in two weeks.

Step 6: Give up the search.

Step 7: Symptoms return. Call a PCP office to beg for an earlier visit.  They agree to fit you in in 4 days.  In the meantime, they suggest visiting an urgent care facility for timely treatment. 

 

It has been widely discussed among bioethicists and health care policy experts that emergency departments are overcrowded, urgent care centers are rapidly becoming a substitute for the traditional primary care doctor, and that the number of new physicians specializing in primary care medicine has been declining in favor of other, higher-paying specialties. (See Dr. Wayne Shelton’s blog)  Despite the push for establishing a “medical home” and centralizing care around the primary care physician, demand for urgent care or emergency services is still high.

 

Lack of access to primary care is often blamed on financial issues, especially lack of insurance, but even well-insured patients are affected by the PCP shortage.  A patient may be able to afford the PCP visit, but they either cannot find a practice accepting new patients or, if they are already a patient, may have to wait several days to get a sick visit appointment.  For a patient with strep throat or another easily diagnosable and treatable illness, an extra 4-5 days is too long – the patient suffers longer, risks complications or worsened illness, and must take more time off of work, which can have significant consequences.

 

Faced with this dilemma, why would a patient wait days for their PCP appointment when they could go somewhere else to receive care the same day?  Are patients really to blame for their failure to find a medical home?  If PCPs only see patients for a well visit 1-2 times per year, do they have a comprehensive picture of a patient’s overall health?  Are primary care physicians actually the primary doctors for their patients, or have their offices essentially become a warehouse for patient medical records from other practitioners? 

 

Urgent care centers are rapidly bridging the gap between PCPs and emergency departments, increasing access to care for acute illnesses while avoiding high costs in the ER, but potentially decreasing interactions between patients and PCPs.  Because of this, many patients are left wondering, how can they find comprehensive primary care while still being able to be seen quickly for acute illnesses? Is it reasonable to expect PCPs to be able to provide all primary care for patients, sick and healthy, or do we need to reconsider what is needed for a patient’s “medical home?”

October 22, 2015

Truth Telling In Medicine: Problems Old and New

<p style="font-size: 11.2px; line-height: 19.04px;">The issue of truth telling in medicine was a lively concern in the early days of modern medical ethics during the 1970’s. A new moral awareness had emerge that provided a clear moral rejection of the paternalistic approach taken in the physician-patient relationship that prioritized the traditional values of beneficence and non-maleficence over truth telling. Of course the key development that fueled this new moral perspective as well as the growing passion for medical ethics was the newfound sense that arose beginning in the 1960’s that patients with capacity have a fundamental right both to refuse unwanted treatment and give voluntary informed consent to treatments they were considering. It became obvious to students of medical ethics that if patients are to be able to exercise their right to give voluntary informed consent they must receive a full and accurate disclosure of the relevant information necessary for them to make a decision.</p> <p style="font-size: 11.2px; line-height: 19.04px;">Up to the early 1960’s, patients coming into the health care system very well may not have had an opportunity to give voluntary informed consent. Giving patients this opportunity just wasn’t part of the medical culture. In the early 1960’s it was common for oncologists to not disclose a diagnosis of cancer; by the late 1970’s there was almost universal agreement that full disclosure was the expectation. The full moral force of the principle of respect for patient autonomy happened relatively quickly, especially after the Belmont Report of 1978, which articulated the basic principles of medical ethics (though non-maleficence was subsumed under beneficence). There is no question that the physician-patient relationship has been evolving ever since with new levels of expectations and involvement of patients and their surrogates. There is now universal agreement that physicians are expected to be truthful to patients and accurately disclose their medical condition, including diagnosis and prognosis. Without this first basic step of truth telling in disclosing the medical facts to the patient about their condition, patients cannot exercise their right to express their preferences and wishes about medical treatment and care goals, and specially give voluntary informed consent to medical interventions to treat their condition.</p> <p><span style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.04px;"><strong>The Alden March Bioethics Institute offers a Master of Science in Bioethics, a</strong> </span><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.04px;">Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="color: #000099; text-decoration: underline;" href="/Academic/bioethics/index.cfm">website</a>.</strong></p>
October 5, 2015

Elective or Life-Saving? Catholic Hospitals and the Ban on Tubal Ligation

<p style="font-size: 11.2px; line-height: 19.04px;"><span style="font-size: 11.2px; line-height: 19.04px;">A Catholic hospital </span><a style="font-size: 11.2px; line-height: 19.04px;" href="https://www.rt.com/usa/315359-catholic-hospital-denies-sterilization-request/">came under fire recently</a><span style="font-size: 11.2px; line-height: 19.04px;"> for stating that it would not permit doctors to perform a tubal ligation during a c-section scheduled for October.  According to news reports (including an</span><a style="font-size: 11.2px; line-height: 19.04px;" href="http://www.thedailybeast.com/articles/2015/09/23/a-catholic-hospital-says-it-s-evil-for-me-to-get-my-tubes-tied.html">article written by the patient herself</a><span style="font-size: 11.2px; line-height: 19.04px;">), the pregnant patient has a brain tumor, and her doctor have advised her that another pregnancy could be life-threatening.  Her doctor has recommended that she have a tubal ligation at the time of her c-section.  While my knowledge about this hospital, this case, and the participants is limited to what has been reported in the media, it raises an interesting question: in our pluralistic society, where conscientious objection is respected while maintaining a patient’s right to a certain standard of care, is it ethical to allow a religiously-affiliated health care institution to refuse to provide certain treatments it finds morally objectionable?</span></p> <p style="font-size: 11.2px; line-height: 19.04px;"><span style="font-size: 11.2px; line-height: 19.04px;">As background, the Catholic Church has historically been outspoken on bioethical issues and has a strong and robust bioethical teaching.  Catholic hospitals are governed by the </span><a style="font-size: 11.2px; line-height: 19.04px;" href="http://www.usccb.org/issues-and-action/human-life-and-dignity/health-care/upload/Ethical-Religious-Directives-Catholic-Health-Care-Services-fifth-edition-2009.pdf">Ethical and Religious Directives for Catholic Health Care Services</a><span style="font-size: 11.2px; line-height: 19.04px;"> (ERDs), a document promulgated by the United States Conference of Catholic Bishops (USCCB) that clearly articulates the bioethical policies that must be followed in a health care institution based on the Church’s moral teachings.  It explains the Church’s teaching against direct sterilization as a method of birth control based on the </span><a style="font-size: 11.2px; line-height: 19.04px;" href="http://plato.stanford.edu/entries/double-effect/">principle of double effect</a><span style="font-size: 11.2px; line-height: 19.04px;">.  “Direct sterilization of either men or women, whether permanent or temporary, is not permitted in a Catholic health care institution.  Procedures that induce sterility are permitted when their direct effect is the cure or alleviation of a present and serious pathology and a simpler treatment is not available.” (Directive 53).  In other words, if the sterilization procedure directly treats a pathology, it is licit; if it is used as a form of birth control to prevent a pregnancy, even if that pregnancy would be life-threatening, it is not licit.</span></p> <p><span style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.04px;"><strong>The Alden March Bioethics Institute offers a Master of Science in Bioethics, a</strong> </span><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.04px;">Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="color: #000099; text-decoration: underline;" href="/Academic/bioethics/index.cfm">website</a>.</strong></p>
September 4, 2015

Are Primary Care Providers Providing Primary Care?

<p class="MsoNormal" style="font-size: 11.2px; margin-bottom: 0.0001pt; line-height: normal;"><span style="font-size: 11.2px;">I initially set out to write a post about lack of access to primary care physicians, but the more I explored the topic, the more I realized that the issue is not only that access to PCPs is limited, but that the medical model of primary care itself has changed.</span></p> <p class="MsoNormal" style="font-size: 11.2px; margin-bottom: 0.0001pt; line-height: normal;"><span style="font-size: 11.2px;">It has been widely discussed among bioethicists and health care policy experts that emergency departments are overcrowded, urgent care centers are rapidly</span><a style="font-size: 11.2px;" href="http://registerguard.com/rg/news/local/33331415-75/ccundoctored-sidebar-hedliney-herey.html.csp">becoming a substitute for the traditional primary care doctor</a><span style="font-size: 11.2px;">, and that the number of new physicians specializing in primary care medicine has been declining </span><a style="font-size: 11.2px;" href="/BioethicsBlog/post.cfm/what-we-can-learn-from-medical-students-about-the-need-for-health-care-reform-in-the-u-s">in favor of other, higher-paying specialties</a><span style="font-size: 11.2px;">.</span><span style="font-size: 11.2px;">  </span><span style="font-size: 11.2px;">Still, many insurance plans require regular visits with a PCP and only cover specialty services if the referral is made by the patient’s primary doctor.</span><span style="font-size: 11.2px;">  </span><span style="font-size: 11.2px;">Specialists and urgent care clinicians also insist that patients follow up with their PCP after treatment and make sure that their records are forwarded.</span><span style="font-size: 11.2px;">  </span><span style="font-size: 11.2px;">Despite the push for establishing a “medical home” and centralizing care around the primary care physician, demand for urgent care or emergency services is still high, and getting into a practice or getting a timely appointment with a primary care physician is difficult.</span></p> <p><span style="color: #34405b; font-family: Arial, Helvetica, sans-serif; line-height: 19.04px; font-size: 12px;"><strong>The Alden March Bioethics Institute offers a Master of Science in Bioethics, a</strong> </span><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; line-height: 19.04px; font-size: 12px;">Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="color: #000099; text-decoration: underline;" href="/Academic/bioethics/index.cfm">website</a>.</strong></p>
May 10, 2015

Social Media and Patient Information

<p style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">In the most recent issue of </span><em style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><a href="http://www.clinicalethics.com/">The Journal of Clinical Ethics</a></em><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">, authors Genes and Appel explore the ethical considerations at play when physicians might use the internet to gather patient information</span><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">. They conclude, correctly I believe, that there are circumstances in which accessing information about a patient supports beneficent efforts to provide quality care, even in non-emergent circumstances. Rather than damaging the doctor patient relationship, an informed provider is better equipped to support the patient’s best interests if loved ones can be located, presentation of information can be confirmed as factual or not, and the context of this patient’s needs can be more fully understood by the care team.</span></p> <p class="MsoNormal" style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">Social media, such as the now ubiquitous </span><a style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;" href="http://www.facebook.com">Facebook</a><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">, is often considered a forum where people may express thoughts and feelings they fail to articulate in person. Consider the posts of an angry or despondent partner after the end of a relationship. Should commentary become threatening – to self or others – this is considered cause for concern and these comments are taken as valid expressions that warrant immediate emergency intervention. Text messages carry the same weight as spoken words, and are preserved in electronic format to be shared by the recipient at will. Failing to consider such communications as part of the purview of healthcare providers could lead to harm for the patient or others. While these expressions might not be quickly discoverable by physicians, they can, in some instances, be lifesaving components adding to the overall clinical picture. </span></p> <p style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; line-height: 19.0400009155273px; font-size: 12px;">The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="text-decoration: underline; color: #000099;" href="/Academic/bioethics/index.cfm">website</a>.</strong><span style="color: #34405b; font-family: Arial, Helvetica, sans-serif; line-height: 19.0400009155273px; font-size: 12px;"> </span><span style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 11.1999998092651px; line-height: 19.0400009155273px;"> </span></p>
April 9, 2015

Ideological Struggles Old and New in America: The Inappropriate Use of Coercive State Authority

<p><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">The history of America from the beginning was a struggle of opposing ideological perspectives over the role of the state’s power vis-à-vis the consciences of individual citizens. The 17</span><sup style="line-height: 19.0400009155273px;">th</sup><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"> century Puritans in the Massachusetts Bay Colony basically transported to America the same kind of religious, state intrusion into the lives of individuals they were trying to escape in England by requiring citizens to subscribe to the official state religion. Fortunately, there were courageous individuals there at the time, like Roger Williams (1603-1683), who strongly resisted such requirements. Williams, prior to coming to America, had been educated at Cambridge and worked for Lord Chief Justice </span><a style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;" href="http://en.wikipedia.org/wiki/Edward_Coke">Edward Coke</a><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">. (1552-1634)</span><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">  </span><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">Coke was the famous English jurist whose work provided much of the foundations of the Anglo-American legal system, and who famously “declared the king to be subject to the law, and the laws of Parliament to be void if in violation of "common right and reason”.</span><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">  </span><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">No doubt Williams’ prior education and influences from Coke, and from others like Francis Bacon (1561-1626) who taught him the way of learning through experiment and observation, helped temper his strong theological commitments in relation to his views about the proper relationship between the authority of the state and religion, and the extent to which the state could have control over the consciences of free individuals, what Williams called “soul liberty”. Williams himself did not have theological quarrels with the Puritans; however, he did not believe religious conviction could be coerced. It was on this moral and political basis, that Williams founded Rhode Island, the first state ever to have a constitution guaranteeing expansive freedom of conscience to individual citizens. Fortunately, the thinking of Williams became the mindset of the key founders, particularly Jefferson (1743-1826) and Madison (1751-1836), of the American constitutional system. (For a full account of Roger Williams’ life and influence, see the wonderful book, </span><em style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">Roger Williams and the Creation of the American Soul: Church, State, and the Birth of Liberty</em><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"> by John M. Barry)</span></p> <p><strong style="line-height: 19.0400009155273px; color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px;">The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="text-decoration: underline; color: #000099;" href="/Academic/bioethics/index.cfm">website</a>.</strong><span style="line-height: 19.0400009155273px; color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px;"> </span></p>
January 8, 2015

Some Older Hospitalized Heart Patients May Fare Better During Times Cardiologists Are Away Attending Their National Meetings?

<p><span style="line-height: 22.3999996185303px;">On December 22, 2014, </span><em style="line-height: 22.3999996185303px;">JAMA Internal Medicine</em><span style="line-height: 22.3999996185303px;"> published an article online titled “<a href="http://archinte.jamanetwork.com/article.aspx?articleid=2038979">Mortality and Treatment Patterns Among Patients Hospitalized With Acute Cardiovascular Conditions During Dates of National Cardiology Meetings</a>.” </span><span style="line-height: 22.3999996185303px;">A note by the journal’s editor Rita F. Redberg, MD, MSc, a cardiologist, titled “Cardiac Patient Outcomes During National Cardiology Meetings” appeared the same day. [</span><em style="line-height: 22.3999996185303px;"><span style="color: #262626;">JAMA Intern Med</span></em><span style="line-height: 22.3999996185303px; color: #262626;">. Published online December 22, 2014. doi:10.1001/jamainternmed.2014.6801] Also, the same day press reports appeared – among other news outlets – in <em><a href="http://www.nytimes.com/aponline/2014/12/22/health/ap-us-med-md-meetings-survival.html">The New York Times</a></em></span><span style="line-height: 22.3999996185303px; color: #262626;">, <em><a href="http://www.latimes.com/science/sciencenow/la-sci-sn-cardiology-conventions-20141222-story.html">Los Angeles Times</a></em></span><span style="line-height: 22.3999996185303px; color: #262626;">, and on the Web pages of the <a href="http://hms.harvard.edu/news/startling-benefit-cardiology-meetings">Harvard Medical School</a></span><span style="line-height: 22.3999996185303px; color: #262626;"> commenting on these articles. The newspaper articles and press release titles are more tantalizing: “Do Heart Patients Fare Better When Doctors Away?”; “Some Heart Patients Do Better When the Cardiologist Is Away”; and “Startling Benefit of Cardiology Meetings.”</span></p> <p><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.0400009155273px;">The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="text-decoration: underline; color: #000099;" href="http://www.amc.edu/Academic/bioethics/index.cfm">website</a>.</strong><span style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.0400009155273px;"> </span></p> <p><span style="line-height: 22.3999996185303px; color: #262626;"><br /></span></p>

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