Medical Education I: Super Sexy CPR

As a medical professional, I am always on the lookout for innovative methods of imparting medical knowledge.  Today, we’re blessed with not one but two video tutorials. First,DrHGuy presents this lesson in performing CPR

Medical Education II: Magic Boobs - Breast Exam

Part II of today’s medical education videofest is this virtual hands-on system of teaching breast exam technique. Go here to try it yourself.

The Patient Compliance Commemorative Plaques The plaques feature “Triumph Of Patient Compliance:  A Choreographic Sequence Adapted For Adherence To Post-Hip Pinning Rehabilitative Instructions For Avoidance Of Weight-Bearing On Right Leg With Physician Prescribed Accompaniment By Assistive Walking Device,” which captures the courage, aesthetic integrity, and athletic elegance of DrHGuy’s dynamic adherence to treatment in a compelling charcoal on marble etching.

Mystery Of Medication Noncompliance Solved. According to Science sinks its teeth into 2500 year-old drug problem, a story in the 15 January 2008 online edition of Science Centric, a new device for releasing medication into the body “will mean, finally, an end to the 2500 year-old patient compliance conundrum.” [emphasis mine]

Well, after 2500 years, it’s about time.

There might, however, be one or two teeny-tiny problems with the notion that this is the ultimate solution to patient noncompliance. Or maybe that contention is just sour grapes on my part. Read about it on site.

Check The Fine Print For Noncompliance What’s wrong with this picture?  Well, most of us who are over 55 can’t visualize the print well enough to know  what we're missing. It is difficult to follow written instructions and heed written warnings if you can't read them.

A study quoted at the source found:

The pharmacy name or logo was the most prominent item on 71 (84%) of the labels, with a mean font size of 13.6 point. Font sizes were smaller for medication instructions (9.3 point), medication name (8.9 point), and warning and instruction stickers (6.5 point).

For the non-typographers among us, I’d included a font size chart below.

There is, as one might expect, more to the story, none of it encouraging, at the link.

Cash For Compliance - Benefit or Bribe? | AlignMap The Aetna Foundation is funding a University of Pennsylvania clinical trial to determine if chances to win a daily low-stakes lottery effectively promotes adherence among coumadin patients.

From Mind Your Body: Doctors' Orders—Without Distress The colonoscopy quote in the heading may be my favorite of all the declarations made about improving patient compliance.

My second favorite, also from this article, is

Getting people to do the things they need to do to keep themselves healthy is tricky.

In addition to offering great quotes, this piece is one of the best articles on noncompliance I’ve seen in the lay press. While it is not all-inclusive, it does also offer outstanding advice for patients coping with a difficult medication regimen (e.g., taking meds that produce severe side-effects). Heck, it’s even inspirational.

(via alignmap)

Nobody knows why people lie to their doctors and nurses but we do have an infallible technique for detecting patients who are telling porkies; their lips move.

Lies, lifestyle and longevity - Times Online:  Dr Copperfield, an Essex GP, expounds on the propensity of patients to mislead their clinicians about diet, vices, exercise, and other lifestyle choices and the National Health Service’s response - a plan to add a life check questionnaire to its NHS Choices website.

The Placebo Effect (at Science Based Medicine): Excellent, thoughtful discussion of the Placebo Effect in clinical practice. Check the  Comments as well asthe  post itself.

Excerpt: I do not feel that knowingly prescribing a placebo treatment is effective or ethical medicine. Modern scientific medicine should strive for interventions that physiologically are scientifically plausible and have sufficient evidence for safety and effectiveness. But I do think there are lessons to be learned from the placebo effect – there are aspects of therapy that do go beyond the physiological intervention. Medicine is not only an applied science; it is the art of humans treating other humans. As part of effective treatment it is helpful to try to maximize all those human intangibles that contribute to a good outcome. But we can do this in the context of scientifically valid treatment, and without crossing the ethically dubious line of deception.

Americans Use Excessive Force, or None at All, Battling Diseases: This is a discussion of two studies that look at seemingy irrational healthcare decision-making by patients:

“In one, researchers from Georgia Institute of Technology investigate why some breast cancer patients who could safely opt for limited surgery instead insist on a more radical procedure. In the other, researchers from the University of Michigan found Americans suffering chronic kidney failure are more likely to go off their drug regimen than their counterparts overseas.”