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Author: admin, 08.07.2015. Category: Positive Quote Of The Day

In the past year I’ve come to see medical decision making as one of the key crucibles in which participatory medicine plays out. My bottom line: this is a valuable addition for people who want to understand the process of medical decisions, from lifestyle choices to major surgery. It’s not apparent to most lay people that medical decision making is important to learn about. For instance, in my own disease (mestastasized kidney cancer), 3 out of 4 patients never even hear about the treatment I got – high dosage interleukin-2. So I was surprised to see not even a tip of the hat (in the index or skimming) to the 3+ decades of work done by Jack Wennberg and his successors to develop the field of SDM, nor a mention of practice variation. But readers of this blog already know that, so I assess this book for what it adds to our awareness of participatory thinking.
Sharing the decision with a doctor who understands your preferences means sharing the burden of choice, so you lessen your risk for regret. This book adds substantially to our understanding of those issues, not from a data perspective but in understanding the real, raw, human feelings involved. Treating the patient as an individual — and not as a statistic or algorithm to be solved — is vitally important, says Groopman, because the best and safest care might not always be standardized.
From an analysis of 100 best practices put together by committees in internal medicine, Groopman and Hartzband discovered that 14 percent were contradicted within a year.

This is a pretty odd post on which to raise this indictment of Buddhist and Tibetan medicine. Participatory Medicine is a model of cooperative health care that seeks to achieve active involvement by patients, professionals, caregivers, and others across the continuum of care on all issues related to an individual's health.
From Rodney Peppe the author of the outstanding books Automata and Mechanical Toys, Making Mechanical Toys, and Toys and Models: A Sourcebook of Ideas comes this small volume on how to make 10 different paper toys of your own. The book includes details on tumbling acrobats, jumping clowns and revolving pyramids amongst other ideas. We’ve blogged several times about shared decision making (SDM), and by its nature it requires participatory thinking. Our culture expects that all physicians have all the answers, and will pretty much all give the same advice.
Disappointment is an unavoidable aspect of making difficult choices: Sometimes the results fall short of what we had hoped for. From the parts I’ve read, Your Medical Mind is a must read for fully engaged patients and for the health proxies who help others make such decisions.
I particularly enjoyed the story on Fresh Air, Becoming Mindful of Medical Decision Making. Within two years, a quarter of the best practices were contradicted, and by five years, almost half of the rules were overturned.

Participatory medicine is an ethical approach to care that also holds promise to improve outcomes, reduce medical errors, increase patient satisfaction and improve the cost of care.
The reader is given illustrations and photographs to help with the construction of each toy, and a list of the materials which are required. Physicians do indeed save vast numbers of lives, yet a similarly vast amount of literature shows that practice variation (inconsistency) is widespread (our posts here).
The toys themselves should provide hours of fun to use and play with once they have been constructed, and Rodney Peppe makes further suggestions for toys should children ever tire of the numerous ideas in this book. The literature also shows that among a range of choices, the right choice often depends on your preferences – and doctors tend to guess wrong about our preferences. See this two minute CBS News video about practice variation, which links to the famous Dartmouth Atlas of data on variation.

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