Monday, April 9, 2007

End of Life Care in the Blogosphere

Highlights from recent posts on other blogs:

1) In the health care world of blogs, you have bloggers that use pseudonyms and those that use their real names. Basically what it boils down to is credibility you have when you attach your name to something versus the freedom that anonymity gives you to say just about anything. We aim for credibility here but so does Paul Levy. If you do not know who Paul Levy is then you probably don't read a lot of health care blogs or you are not in the Boston health care scene.

Paul is the President and CEO of Beth Israel Deaconess Medical Center in Boston, and he has a blog where he posts his opinions about health care. He recently touched on the Dartmouth Atlas Project which compares resource utilization and cost in various hospitals around the country. This study has been highlighted by many to focus on the over utilization of "limited" resources near the end of life. His post is insightful and candid and a call for how do we fix the mismatch of technology and goals of care in health care. Feel free to check it out and post your comments and opinions. Not every day you get to tell a CEO of a hospital what you think.

2) The Wall Street Journal has started a health blog that has been pretty good, although it focuses a bit too much on pharma for my tastes. They recently highlighted a Boston Globe article noting that not all bed sores are preventable. I think this is something most health care people know, but as we see more decubiti we are learning more about how complex they really are. There is no new definitive study that prompted this article, but it is a balanced news article on a commonly misperceived subject (all bed sores are caused by neglect).

3) A post on Overcoming Bias (a statistics and bias blog) presents predictions as consumable goods. Basically that the prediction is made (verbalized) and consumed (listened too, thought about) and then it is not worth anything, until the next prediction is made. The post is about Friedman Units (6 months) and the war in Iraq, but I found this post interesting in that it reflects a situation that is common in near-death prognostication. When a patient is imminently dying and the family is looking to you for a prognosis, there are many times when a physician may say, "a few more days." But what happens when you say "a few more days" for a few more days?

4) And finally, Hospice Blog has a new address, If you have not checked out Hospice Guy and his Hospice Blog, you should. He has some great posts, like his current one on the dilemma about having hospice in an assisted living facility.

If you think any of these blogs are interesting try subscribing to them or check out the highlights (or at least what I think are the highlights) by scrolling down the left column of Pallimed to 'Christian's Shared Items'. I 'share' the posts and pubmed searches that I think are helpful to the palliative medicine community long before I ever get a moment to blog about them.

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Photo by Rob Lee

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