What Docs Talked About in 2011

Key Discussions Selected From the Medscape Series

Physicians Are Talking About

The desire to change the past is a common and often frustrating pursuit. In an all-physician discussion, a family practitioner asked, "Do you regret anything in your training?" If it is true, as Thoreau wrote, that "to regret deeply is to live afresh," then virtually all who replied were emphatically alive.

An aggressive campaign to increase handwashing among staff at Presbyterian University Hospital of the University of Pittsburgh had some physicians crying foul. The new measures include hiring independent monitors trained to spot offenses and levying stiff fines for a failure to wash. An internist, posting on an all-physician discussion group, asked fellow physicians how they felt about these this hospital's new rules. A lively discussion of the efficacy and equitability of such a program followed.

No one can be perfectly punctual all the time. The question then is how doctors should handle their own lateness, especially when patients become upset or critical in the face of a delay. In an all-physician discussion, How do you respond to a patient's rudeness?, a general practitioner asked for advice on dealing with the "rudeness" of a patient who "scolds me for being 20 minutes 'late.'" Many responses suggested that the original poster had it backward: A doctor who does not arrive on time for a scheduled appointment is the one who has committed the discourtesy.

Emergencies can arise at any time; this is exactly why there are doctors on call through the night. However, many inconsequential, obvious, and downright bizarre telephone calls can come in the small hours. In an all-physician discussion "After hours phone call of the year," doctors discussed some of the weirdest and most memorable of these consultations.

"How do you counsel patients interested in complementary or alternative therapies?" asked a neurologist, citing a recent study that failed to show a benefit for cranial osteopathy in children with cerebral palsy. This sparked a discussion on an all-physician discussion group, "Counseling patients interested in complementary medicine?" -- and evinced some sharp contrasts in physicians' attitudes and practices concerning treatments that fall outside of the scientific mainstream.

Are scrubs only for the operating room, or are they appropriate for everyday use? Should they be worn to the supermarket or a school board meeting? An all-physician discussion, "Rant: wearing SCRUBS to go shopping?" brought out some strong opinions on where scrubs are appropriate and where they are not -- and on what motivates those who wear them in public.

A recent trend in medical school admissions involves the use of what is called the Multiple Mini-Interview (MMI). In the MMI, a prospective student must navigate a series of interviews, each presenting a difficult hypothetical situation. The purpose of this is not to test an applicant's knowledge of any particular topic, but to gauge an applicant's interpersonal skills and professionalism to think quickly and respond to adversity. The MMI is now used at more than 20 schools in North America, including the medical schools of UCLA and Stanford. Recently in an all-physician discussion, "Newest part of the medical school admissions examination," doctors debated the merits of this new program.

After defeating all comers on the television quiz show Jeopardy!, Watson -- IBM's artificial intelligence system -- is being put to work in healthcare. The first medical application of its massive computational powers will be to aid in diagnosis for the insurance company WellPoint®. In an all-physician discussion group, "The future of medicine," this new use for Watson -- and its implications for the future of medicine -- were vigorously debated.

Last September the first limited provisions of the Affordable Care Act went into effect. They represented the initial wave in a series of new healthcare regulations that have been vigorously championed by President Obama but have seen bitter political opposition and flagging public support. In a posting an all-physician discussion group, Dr. Rick Kulkarni invited MPC members to share their opinions and experiences regarding the new laws. A robust discussion followed, featuring a wide variety of strongly held positions. It would be interesting to revisit this discussion and re-engage to discover if opinions are still held strong or have wavered one way or the other.

Last spring Medscape released its first annual physician compensation report, which you can still view here. Based on its findings, physician median incomes range from $148,000 to $350,000; however, 56% of physicians overall believe that they are not fairly compensated. We opened a discussion on Medscape Connect to find out if physicians in different specialty areas felt they were fairly compensated and whether the median reported income fell in line with their expectations.