More evidence my decision to finish up premed and go to med school is correct

[doc_neuro]

About a month ago Tristan posted this article about a girl with intractable sneezes (12,000 a day roughly) that was baffling doctors. I noticed right away the tic like nature of it and suggested it was a tic disorder related to Tourette Syndrome. They clearly werent proper productive sneezes, were repetitive, waxed and waned in severity throughout

Comments

[gunslnger]

It just means a lot of doctors aren't really thinking very hard. I know very little about rare medical things (aside from what's on Mystery Diagnosis and the like), but I agreed with you after the first paragraph. It's basic logic and analytical thinking. It's hard to get good programmer's in the same fashion. It takes the same kind of thinking.

[doc_neuro]

part of the issue is that a lot of doctors are not aware of the condition itself or its ins and outs. So they end up fumbling around in the dark. The Tourette Syndrome Association puts on CME seminars on it all over the country but while they have made progress it still isnt as common knowledge in the medical community as we would like for it to be.

[gunslnger]

That's what computers are for...

[doc_neuro]

problem is there is a lot of info on the internet, plenty of it bogus, and you have to know what you are looking for. Internet research is no substitute for a CME seminar lectured by the top researchers in the field.

[gunslnger]

I didn't say Internet. There are tools and software that is designed to help doctors diagnose illnesses, they still need to be more widely used and improved to be simple and usable by any doctor, and then cheap enough to be widely adopted. :) Of course with the health care system going down the drain now, I don't think it'll happen any time soon. ;)

[doc_neuro]

well there's things like Epocrates which is a PDA based pharmacopoea that calculates weight-dosage ratios and red flags drug interactions. actual diagnosis, though, particularly of neurological conditions, can be a bit tricky for software based differentials. And frankly even most medical texts for differential diagnosis either gloss over Tourette Syndrome with a very basic summary or leave it out altogether. They consider it to be obscure because it is underdiagnosed and those books and software are designed for disorders that affect a large swath of the population. So while I agree they are useful, they are no substitute for a trained eye and I dont think they would necessarily have helped patients like this girl very much. The Tourette Syndrome Association has been working to get information on the condition to as many physicians as possible, and they've made progress. when I was diagnosed 20 years ago few had ever even heard of it. but they still have a long way to go.

[gunslnger]

I know they have a long way to go, that's what I'm saying. I'm just also saying that doctors do not seem to be taking advantage of current technology very much (or maybe it's not being provided to them, for whatever reason). Just something that I hope you will advocate for as you're closer to that field than I at the moment.

[doc_neuro]

oh certainly. there's a whole lot of medical software available that can do all sorts of fantastic things in terms of improving quality of care and keeping physicians abreast of best medical practices that just havent penetrated deep enough into the medical establishment yet. You see them sometimes in major teaching hospitals but most doctors havent even heard of them. I'm all for promoting that. My next door neighbor is head of tech support for some rural clinics so I've definitely seen how well that sort of thing can increase efficiency and quality while decreasing waste.

dr's thinking hard =oxymoron

[rawmr]

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