November 7th, 2019
Podcast 241: Talking about guns with patients
Podcast: Play in new window | Download
Subscribe: RSS
Running time: 18 minutes
In California, Garen Wintemute and his group find evidence that people are willing to discuss gun safety with their clinicians, especially when there may be danger of harm present. That willingness extends across gun owners and non-owners. So why aren’t more clinicians doing it?
The findings appear in Health Affairs.
Links to the article & further resources:
Wintemute’s essay in Annals of Internal Medicine on gun violence
Another Annals article on preventing gun-related death and injury
November 1st, 2019
Podcast 240: Overuse of statins for primary prevention of cardiovascular events
Podcast: Play in new window | Download
Subscribe: RSS
Running time: 23 minutes
Paula Byrne set out to understand what the available data tell us about how many people are taking statins for primary prevention — and how much good is it likely doing them?
Also, how do you discuss their possible harms and benefits with patients?
Links:
Paula Byrne and colleagues’ analysis in The BMJ
Kausik Ray meta analysis in JAMA Internal Medicine
Kausik Ray 2010 Clinical Conversations interview
NEJM Journal Watch General Medicine comparison of statin guidelines
October 25th, 2019
Podcast 239: Talking with veterans
Podcast: Play in new window | Download
Subscribe: RSS
Running Time: 18 minutes
Veterans Day will be here soon, and this episode introduces you to Patrick Tripp, a writer and radiation oncologist. He’s taken conversations with some of his patients and published thumbnail profiles of several in a remarkable essay in the London Review of Books (that’s right, it’s not a medical journal).
The patients all happened to be veterans of the war in Vietnam. There are no biomedical insights here — or are there? At the very least, you are reminded that the people in the exam room all have stories to tell, and if you have the luxury of listening to them you may just learn more about their true chief complaint.
Patrick Tripp’s London Review of Books essay
October 18th, 2019
Podcast 238: Preparing for the unthinkable chaos of a mass-casualty event
Podcast: Play in new window | Download
Subscribe: RSS
Running time: 21 minutes
A white paper from the Office of the Assistant Secretary for Preparedness and Response (ASPR) advises clinicians, health planners, and emergency responders that the old ways of responding to mass casualty events no longer hold. Wounded people arrive in Ubers and Lyfts at hospitals that are unprepared to be trauma centers. It’s best to practice (sending out an email to the staff doesn’t count) so that everyone in the hospital knows what to do and where to go when chaos strikes.
Ali Raja and Joe Elia talk with Paul Biddinger, one of the contributors to “Mass Casualty Trauma Triage: Paradigms and Pitfalls.”
And by the way, you may think you know how to use a tourniquet, but you probably don’t. Follow the link (below) to Stop the Bleed.
Links:
- ASPR white paper
- Stop the Bleed home page
- Boston Marathon interviews:
Ron Walls, Brigham & Women’s Hospital
Alasdair Conn, Massachusetts General Hospital
Andrew Ulrich, Boston Medical Center
Brien Barnewolt, Tufts Medical Center - NEJM Journal Watch Emergency Medicine summary of the white paper
October 10th, 2019
Podcast 237: U.S. health spending — where is the outrage?
Podcast: Play in new window | Download
Subscribe: RSS
Running time: 18 minutes
JAMA has just published an analysis of the latest findings regarding waste in the nation’s $3.5 trillion annual health “co-pay.” And with 25% of that — some eight hundred billion dollars — characterized as wasted, you’d think there would be stacks of competing cost-saving proposals to consider, especially regarding administrative costs. There aren’t.
An editorial comment on all this by our guest, Don Berwick, reminds us that one person’s wasteful spending is another’s lavish income. The question is, with all that money left on the table, what are we foregoing as a country?
Dr. Berwick has thoughts, and he kindly agreed to share them with us.
October 4th, 2019
Podcast 236: Is an AI better at diagnosis?
Podcast: Play in new window | Download
Subscribe: RSS
Running time: 20 min.
Recently, Lancet Digital Health ran a meta-analysis concluding — if cautiously — that “deep learning” (more familiarly known as artificial intelligence) can be considered “equivalent to healthcare professionals” in image-based diagnoses.
In an editorial commentary on the analysis, Tessa Cook says, in effect, “not so fast!” And she discusses the reasons behind that caution with us in this episode.
Dr. Cook’s commentary in Lancet Digital Health
The meta-analysis on which she was commenting
About the Podcast
Comments, suggestions, and story ideas welcome. Learn more about Clinical Conversations.
Follow us:
