MMRI (Mummified Magnetic Resonance Imaging) wait times
Radiologists at the University of Western Ontario recently performed magnetic resonance imaging (MRI) on an Egyptian mummy from the XX Dynasty. 1 An unpublished chart review (“Mummies to mums: wait times for the new millennium”) revealed that the MRI was ordered on Apr. 12, 1191 BC to rule out an aortic aneurysm. The 3200 year wait for this study dramatically reduced the average national waiting time for an MRI.
Blood tests showed that the mummy has iron-deficiency anemia, so a colonoscopy has been scheduled for August of 3512.
Beyond JUPITER
The JUPITER trial (Justification for the Use of statins in Primary prevention: an Intervention Trial Evaluating Rosuvastatin ) showed that statins reduce vascular events in patients with elevated C-reactive protein (CRP). An unpublished follow up trial, PLUTO-CRPs (Pap Lab tests Underutilized by TOo Many CRPers), showed that women with an elevated CRP should undergo routine PAP smears and take folic acid before getting pregnant. MARS (Medical care Access determined by Result of a Suspect test) showed that people with elevated CRP also benefit from vaccinations and routine medical care. The authors stressed that additional large and poorly planned studies are needed. None of these studies will measure levels of CRP after the intervention, just like the JUPITER trial.
Sorry, but I can’t
Apology laws have allayed fears of physicians apologizing to patients for making errors by making such apologies inadmissible in malpractice litigation. 2 A National Physician Politeness bill died on the floor of the House of Commons. The proposed bill would have allowed physicians to make eye contact with patients, allow patients to finish sentences, and pronounce patients’ names correctly without fear litigation for malpractice (failing to provide standard care). Legal associations have advised physicians not to engage in such behaviour until a revised bill is passed.
Guideline guidance
New Hormone Replacement Therapy (HRT) guidelines suggest that the Women’s Health Initiative study misled the public and that, in fact, HRT is safe. An unpublished meta-guideline proposed that future guidelines should be adopted more rapidly so that patients can benefit from them before they are obsolete.
Keeping out the gate keepers
A recent studied showed that, on average, Canadian physicians are getting older. 3 An unpublished secondary analysis showed that doctors are also getting more jaded, less hip, less cool and less young.
The same study showed that there are more specialists than family physicians in Ontario. An unpublished feasibility analysis predicted that this gap will widen. By 2020, Ontarians with lower back pain will receive spinal decompression surgery before being assessed by their family physician. The history and physical examination of a patient with abdominal pain will be informed by a prior exploratory laparotomy. Smoking cessation counselling by a family physician will be undertaken only if a patient fails two lung transplants.
Doubling double speak
The British Medical Association passed a motion urging the term “patient” be used instead of newly popular management-speak terms such as “client” or “service user.” 4 An unpublished commentary discussed several terms that will, however, be retained indefinitely (Table 1).