Clinical “noise” in medicine: it’s not what you think

by Carolyn Thomas   ❤️   Heart Sisters (on Blue Sky)

Noise is getting in the way of good medical practice and better patient outcomes, according to Dr. Kamran Abbasi, Editor-In-Chief of the British Medical Journal (BMJ) in a recent column he called What is Clinical Noise? – and How to Silence It. But he wasn’t referring to annoying loud noises in our environment, but to unwanted distractions in medicine.
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 Dr. Abbasi illustrates that noise by picturing a dart board with darts sprayed all around the bullseye, distracting players from focusing on what matters to dart players: hitting the bullseye.  .

Continue reading “Clinical “noise” in medicine: it’s not what you think”

Survey: how women (and our doctors) respond to early cardiac symptoms

by Carolyn Thomas    ♥   @HeartSisters

I have often written and spoken out about an alarming reality observed among women experiencing their first cardiac symptoms. Researchers call it “treatment-seeking delay behaviour”. One of several interesting studies on this particular tendency in female heart patients was published in The American Journal of Critical Care, for example. Oregon researchers reported that female heart patients are significantly more likely to delay seeking medical treatment compared to our male counterparts – yes, even in mid-heart attack. In fact, study authors identified six common patterns of decision-making delays between the time women first experience serious cardiac symptoms and the time when they go for help.(1)  Those six patterns range from “minimizing symptoms” to “reluctance to ask others for help”.

But just in case these studies seem to suggest that women are to blame for poor cardiac outcomes because we wait too long, let’s look at how prepared our physicians are to assess cardiovascular risks in their female patients. The landmark Women’s Heart Alliance survey asked both female heart patients and physicians for their own perspectives – with surprising results, especially this particular finding:

Physicians may not feel as prepared as you think.      .

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Nine lessons about women’s heart disease that future doctors will learn in med school

by Carolyn Thomas   @HeartSisters

A cardiologist who teaches medical students at a prominent medical school was asked if his students were learning about the known disparities in cardiac research, diagnostics, treatment and outcomes in female heart patients compared to our male counterparts. His answer basically was: “If we start taking up time to talk about women, we’d have to stop teaching one of the equally important subjects in our curriculum.”  See also: Women’s Heart Health: Why it’s NOT a Zero Sum Game

That reluctant conversation-stopper may help to explain what cardiac researchers keep reminding us:  physicians now in practice likely received little if any specific med school training in women’s health aside from reproductive health issues. And as Emergency physician Dr. Alyson McGregor at Brown University reminds her colleagues:

“Women are NOT just men with boobs and tubes.”   

Continue reading “Nine lessons about women’s heart disease that future doctors will learn in med school”

“I’ll give you a hint: the diagnosis is NOT heartburn or anxiety”

by Carolyn Thomas   ♥   @HeartSisters

This recent “What’s the diagnosis?”  ECG challenge on Twitter from Dr. Sam Ghali attracted many online guesses from his healthcare colleagues – including this from a critical care nurse practitioner who astutely wrote:

In today’s healthcare system, she would probably be told ‘it’s all in your head’ or ‘maybe you should lose weight’.”
Continue reading ““I’ll give you a hint: the diagnosis is NOT heartburn or anxiety””