Jerome Groopman’s bestselling book ‘How Doctors Think’ is about exactly what it means and a bit more, which is how patients can facilitate doctors to think. Doctors are human and are prone to make mistakes. Most of the diagnostic errors result from cognitive / thinking errors rather than technical errors who work under time pressures. Will it be possible for doctors working under such time pressures to think about how they think? There are three cardinal cognitive pitfalls – anchoring, attributing and availability errors. Anchoring is seizing the main presenting symptom and making a snap judgment of a diagnosis. Attributing
Evidence-based medicine for busy clinicians
How to integrate of patients values and expectations with the expertise of the clinicians and the best evidence
Sri Lankan Clinical Practice Guideline Portal - SLCPGP
All Sri Lankan clinical practice guidelines from one website
‘As healthcare professionals we talk about personalised care, person-centred care, personalised medicine, individualised care and precision medicine. These have distinct meanings, but are often confused as the same thing. By confusing these terms, the policy makers, researchers, healthcare workers, and the public miscommunicate. Patients and their doctors need the same lexicon, particularly as patients gain access to their digital personal health records. [BMJ Blog by Dr Jane Wilcock – LINK] Personalised care refers to a wide holistic discussion with the patient, and at times their loved ones, which considers the patient’s context. It requires specific consultation and management skills.
Control of Dengue in Sri Lanka: Are we on the correct path? This is a summary of the important SLMA symposium on Control of Dengue in Sri Lanka on 2019 September 6 There were three expert contributions to this symposium. 1. Dr Hasitha Tissera 2. Dr Ananda Jayawickrama 3 Dr. Lakkumar Fernando
End-stage renal failure is a common sequelae of type 2 diabetes. ACEI and ARBs are the drugs routinely used for renal protection in diabetes. Sodium-glucose cotransporter-2 (SGLT2) inhibitors are a newer class of hypoglycaemic agents that lowers blood glucose in patients with type 2 diabetes by increasing the urinary glucose excretion through the inhibition of SGLT2 in the proximal convoluted tubule where the glucose is reabsorbed. SGLT2 inhibitors reduce the renal threshold of glucose from 180 mg per deciliter (10 mmol per liter) to 40 to 120 mg per deciliter (2 to 7 mmol per liter), thereby effectively lowering blood
In his latest book, ‘Deep Medicine’ Dr. Topol describes how medicine is broken today and how artificial intelligence can help make healthcare human again. In an interview with The Guardian, Dr Topol was asked about the review report he did for the NHS-UK. LINK You were commissioned by Jeremy Hunt in 2018 to carry out a review of how the NHS workforce will need to change “to deliver a digital future”. What was the biggest change you recommended? ‘I think the biggest change was to try and accelerate the incorporation of AI to give the gift of time – to get back the
It can be difficult to approach a colleague if you have concerns about their wellbeing because of a change in their behaviour. Abi Rimmer asks experts how best to handle this situation. Remember a) small gestures make a BIG difference b) Take your doctor hat off c) Don’t be embarrassed to ask Small gestures make a big difference Lucy Warner, chief executive of the NHS Practitioner Health Programme, says, “If you’ve noticed a change, then this situation has probably been around for some time and may already have become a fairly serious problem. Doctors are very good at focusing
A doctors Touch -Abrahim Verghsee
Overdiagnosis occurs when a diagnosis is “correct” according to current professional standards but the diagnosis or associated treatment is unlikely to benefit the person and will not cause symptoms or death. More broadly overdiagnosis refers to the related problems of overmedicalisation and subsequent overtreatment, diagnosis creep, shifting thresholds, and disease mongering, all processes helping to reclassify healthy people with mild problems or at low risk as sick.Read more
Seminar on Overdiagnosis / Too Much Medicine.
Sri Lanka Medical Association 26th March 2019. 12 - 2 PM
"Success is a lousy teacher. It seduces smart people into thinking they can’t lose.”
People think focus means saying yes to the thing you’ve got to focus on. But that’s not what it means at all. It means saying no to the hundred other good ideas that there are. You have to pick carefully. I’m actually as proud of the things we haven’t done as the things I have done. Innovation is saying no to 1,000 things.
Amara's law: We tend to overestimate the effect of a technology in the short run and underestimate the effect in the long run.
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Modern Medicine’s remarkable personalities
Archibald Leman Cochrane CBE was a Scottish doctor noted for his book Effectiveness and Efficiency: Random Reflections on Health Services. which advocated the use of RCTs to make medicine more effective and efficient. This eventually led to the development of the Cochrane Library database of systematic reviews, the establishment of the UK Cochrane Centre in Oxford and the international Cochrane Collaboration.
He is known as one of the fathers of Evidence-Based Medicine. He founded the first department of clinical epidemiology in Canada at McMaster University, and the Oxford Centre for Evidence-Based Medicine. One of his more famous quotes is: “Half of what you learn in medical school is dead wrong”
Abraham Verghese, MD, MACP, is Professor and Vice Chair for the Theory and Practice of Medicine at the School of Medicine at Stanford University. He is also a critically acclaimed, best-selling author and a physician with an international reputation for his focus on healing in an era where technology often overwhelms the human side of medicine. In 2016, Abraham Verghese received a National Humanities Medal, at the White House from President Barack Obama.