Medicine in Denial Lawrence L Weed Lincoln Weed 9781456417062 Books
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Medicine in Denial Lawrence L Weed Lincoln Weed 9781456417062 Books
A difficult but essential read, not for the answers but for the questions it raises about the future of the profession.Larry Weed famously invented the problem oriented medical record (POMR) back in the sixties. He should be heard in this new read, Medicine in Denial. The Affordable Care Act encourages change in the structure of medical care, much of it coming from the highly subsidized shift towards electronic medical records. This book champions one of those trends; it is a plea for accurate, consistent and standardized medical record.
Weed was born in 1924, graduated from Columbia Medical 1947. He has been prominent in medical education in many teaching positions. I first heard of him at Dartmouth Medical School teaching Family Medicine. He has publications as long as my arm and several books, awards and recognitions. Recently, Weed applied his talents to medical informatics and administrative medicine. Weed founded Problem-Knowledge Coupler Corporation (PKC) of Burlington, VT, a company dedicated to developing the information coupling software and medical information database that the Weeds advocate in their book. Sharecare® of Atlanta, GA, the health and wellness social network acquired PKC June 12, 2012. Dr. Oz, the television host co-founded Sharecare®. Dr Oz plans to make his social technology platform, together with PKC's clinical knowledge management system available to patients and providers to enable clinically informed communications. Weeds version of connecting the vast database of medical knowledge with clinical decision support (CDS) and much of his research may live on in that wellness format.
In the beginning of his book, Doctor Weed and his son Lincoln Weed, an attorney, argue that a lack of complete patient data from the history and physical lead to false assumptions, waste and unnecessary procedures. The Weeds give compelling examples. Here and throughout the book the authors compare the present disorganized medical record keeping and subjective judgment of physicians to the regimented standards of CPAs or airline pilots who follow standard operating procedures. The book is a cry for healthcare reform. Both educationally and clinically Weed would have the standards, the records and decision making dependent on an electronic repository of medical information rather than having the electronic record reflect the judgment and intuition of the provider.
Weed argues that medical information is so vast that it is not possible for the doctor to remember all of the lists associated with sign, symptom and physical finding. The Weeds insist that medical education must change its approach from teaching judgment and diagnostic skills to a more technical training. This would enable the provider to be scrupulously consistent and accurate in developing the clinical database. They further suggest that non-MD providers with this more technical education would be more easily supervised and adherent to standards of procedure devised by experts.
The positive findings in the patient record form a clinical database. This patient data then couples with the vast shared archive of medical terminology matching clinical positives to the criteria for diagnosis in the archive. The result is a differential diagnosis based on matching patterns - much like Google. Two-way communications between the clinical record and medical information, affords both clinical decision support (CDS) for the provider and a graphical representation of the choices for the patient. With the accumulation of sufficient clinical data, the potential for data mining is limitless. It will be a fertile field for research for decades to come. Coupling patient data with the entire electronic database of medical knowledge will presumably mitigate errors and add to patient safety.
The later chapters offer extensive description of the discipline and mechanics of the problem oriented medical record, where better than from the originator.
----------------------------------------
Although not easy reading, this book certainly encourages thought and speculation about the future of medicine. At times one can tell which Weed is doing the writing. A lawyer often views medical practice with skepticism. The number of wrong diagnoses and medication errors do not improve that view. The success of nurse practitioners in the primary care setting, especially in Europe, may lead to an environment dominated by competent NPs in the US as well.
Weed makes a valid argument in favor of collecting the vast sum of medical knowledge in an open scalable, dynamic and accessible database. To whom that data is accessible, becomes a question for our time. Weed appears to favor individual patient autonomy and care with the vast information base available to the patient for shared decisions. One wonders, however, how widely that information should be shared. An old adage suggests that a doctor who treats himself has a fool for a doctor. With the vast store of medical knowledge available to everyone, one indeed risks having a fool for a doctor.
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Tags : Medicine in Denial [Lawrence L. Weed, Lincoln Weed] on Amazon.com. *FREE* shipping on qualifying offers. Deep disorder pervades medical practice. Disguised in euphemisms like "clinical judgment" and "evidence-based medicine,Lawrence L. Weed, Lincoln Weed,Medicine in Denial,CreateSpace Independent Publishing Platform,1456417061,MEDICAL Health Policy
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Medicine in Denial Lawrence L Weed Lincoln Weed 9781456417062 Books Reviews
It was gratifying to read this book which is a pointed indictment of the current state of paper based and computer based medical records. Despite a full generation of physicians that have been exposed to the POMR and many EMR programs that espouse the use of the SOAP format and Problem Lists it was good to see such a detailed critique of current practices. Having worked in this field for over 30 years it is clear to me that in a computer based medical records system having a highly functional Problem List is of central importance. Hopefully this book will provide readers with a better understanding of these issues.
I think this book "hits the nail on the head" As a healthcare provider I thoroughly agree that it is impossible for one doctor to know or remember everything about the human body. I witness on a daily basis misdiagnosis and improper treatment even within university settings and I agree the insurance companies exploit the situation, Kudos for Dr.Weed
from the chicanery of modern socialized meicine.
He is systematic, learned, literate, concise.
A perfect book to go to the medical guillotine with.
Dr Weed has pointed to the central problem in medicine for close to half a century now, and, frankly, nothing has changed. The unwillingness, or incapacity, of doctors and implementers of software for medicine, to understand and act on this message, is breathtaking. To understand what the issues are, I'd recommend watching Dr Weed's lecture from 1971 (search for "Weed", "Internal medicine", "lecture" on youtube), then proceed to reading this book.
I adopted dr Weed's approach to the Medical record in the mid 70's. I had been a city planner for 7 years, and then entered a program to train as a Family Nurse Practitioner at Yale. My job in NYC was the development of computerization of the draft capital budget along with the imput of the areas citizens. I combined this with Dr Weed's medical record approach (which is now used universally), his insistence of the necesssity of computerization, and the announcement of the "Apple 2". Bingo! My thesis was entitled "computer assisted aid in well child care." , where I developed an EMR and "proved" that Dr Weed's approach was correct. We are still struggling to go down this street. Dr. Topol is saying the same thing in slightly different language. Hopefully, we will wake up to this reality in time.
Doctor Weed has always been ahead of his time. He recognized a need to follow a consistent documentation pattern, introduced the "SOAP" note to doctors and improved healthcare. With this book, he and his attorney son, Lincoln, call for us "to open new doors to control our own futures." This is a beautiful read that is felt from the heart for the betterment of patient care.
Michael Warner, D.O., author "Rise of the Patient Advocate - Healthcare in the Digital Age"
This book is the culmination of 50 years of research by Dr. Weed into medical decision-making. His proposal of what he called the "problem-oriented medical record" was considered by the 1970s to be a monumental contribution to the organization and use of medical knowledge. Medical schools throughout the world adopted his recommendations for teaching medical students what was clearly a better way than the standard approach for making a diagnosis or treatment plan. His work is held in the highest esteem to this day. This book, however, may only be accessible to those who are already familiar with this field and actually use the problem-oriented system. The material is dense even for those with experience, but that just reflects the depth of the insights. This book is relevant for all MDs and especially those who have responsibility for curricular design in medical schools.
A difficult but essential read, not for the answers but for the questions it raises about the future of the profession.
Larry Weed famously invented the problem oriented medical record (POMR) back in the sixties. He should be heard in this new read, Medicine in Denial. The Affordable Care Act encourages change in the structure of medical care, much of it coming from the highly subsidized shift towards electronic medical records. This book champions one of those trends; it is a plea for accurate, consistent and standardized medical record.
Weed was born in 1924, graduated from Columbia Medical 1947. He has been prominent in medical education in many teaching positions. I first heard of him at Dartmouth Medical School teaching Family Medicine. He has publications as long as my arm and several books, awards and recognitions. Recently, Weed applied his talents to medical informatics and administrative medicine. Weed founded Problem-Knowledge Coupler Corporation (PKC) of Burlington, VT, a company dedicated to developing the information coupling software and medical information database that the Weeds advocate in their book. Sharecare® of Atlanta, GA, the health and wellness social network acquired PKC June 12, 2012. Dr. Oz, the television host co-founded Sharecare®. Dr Oz plans to make his social technology platform, together with PKC's clinical knowledge management system available to patients and providers to enable clinically informed communications. Weeds version of connecting the vast database of medical knowledge with clinical decision support (CDS) and much of his research may live on in that wellness format.
In the beginning of his book, Doctor Weed and his son Lincoln Weed, an attorney, argue that a lack of complete patient data from the history and physical lead to false assumptions, waste and unnecessary procedures. The Weeds give compelling examples. Here and throughout the book the authors compare the present disorganized medical record keeping and subjective judgment of physicians to the regimented standards of CPAs or airline pilots who follow standard operating procedures. The book is a cry for healthcare reform. Both educationally and clinically Weed would have the standards, the records and decision making dependent on an electronic repository of medical information rather than having the electronic record reflect the judgment and intuition of the provider.
Weed argues that medical information is so vast that it is not possible for the doctor to remember all of the lists associated with sign, symptom and physical finding. The Weeds insist that medical education must change its approach from teaching judgment and diagnostic skills to a more technical training. This would enable the provider to be scrupulously consistent and accurate in developing the clinical database. They further suggest that non-MD providers with this more technical education would be more easily supervised and adherent to standards of procedure devised by experts.
The positive findings in the patient record form a clinical database. This patient data then couples with the vast shared archive of medical terminology matching clinical positives to the criteria for diagnosis in the archive. The result is a differential diagnosis based on matching patterns - much like Google. Two-way communications between the clinical record and medical information, affords both clinical decision support (CDS) for the provider and a graphical representation of the choices for the patient. With the accumulation of sufficient clinical data, the potential for data mining is limitless. It will be a fertile field for research for decades to come. Coupling patient data with the entire electronic database of medical knowledge will presumably mitigate errors and add to patient safety.
The later chapters offer extensive description of the discipline and mechanics of the problem oriented medical record, where better than from the originator.
----------------------------------------
Although not easy reading, this book certainly encourages thought and speculation about the future of medicine. At times one can tell which Weed is doing the writing. A lawyer often views medical practice with skepticism. The number of wrong diagnoses and medication errors do not improve that view. The success of nurse practitioners in the primary care setting, especially in Europe, may lead to an environment dominated by competent NPs in the US as well.
Weed makes a valid argument in favor of collecting the vast sum of medical knowledge in an open scalable, dynamic and accessible database. To whom that data is accessible, becomes a question for our time. Weed appears to favor individual patient autonomy and care with the vast information base available to the patient for shared decisions. One wonders, however, how widely that information should be shared. An old adage suggests that a doctor who treats himself has a fool for a doctor. With the vast store of medical knowledge available to everyone, one indeed risks having a fool for a doctor.
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