David Gergen Gets It Oh So Very Wrong

Anderson Cooper is hosting a special on CNN with a panel of familiar CNN faces. At one point, Dr. Sanjay Gupta began discussing tort reform and defensive medicine. Then David Gergen followed up with his own example of what an ENT he talked to calls defensive medicine.

Here's the problem. The example is an absurd one. Unfortunately, Dr. Gupta didn't speak up to point out how asinine the example was. Like an episode of House, the example had that far fetched medical practice sound to it. I'm sure physicians everywhere groaned in disbelief, just as they do when watching House.

I don't know what ENT David Gergen spoke to about defensive medicine, but physicians I work with don't order tests just because the patient asks for them to be done. I certainly don't bend over backwards to appease a patient asking for a test just for the sole purpose of getting the test done.

Let's use the example Gergen gave us.

Patient X comes in and asks for an MRI. Doctor gives the patient the MRI, afraid that the patient will sue him or her for not providing the investigation the patient asked for.

That's not evidence based medicine. If your doctor gives in to that sort of thing, he or she is not a good doctor and cannot seem to muster up the sense to explain to the patient why they do not need the MRI. The patient did not go to medical school. The patient, no matter how informed, cannot just snap their fingers and order any test they'd like.

Here's how the situation should have been handled. Communication! The ENT should have asked the patient why they wanted the MRI. Then, after listening to the patient's own reasoning, the physician should have explained what an MRI would tell them and whether or not the reason is really justified.

An MRI is a peculiar example to use because the patient is not exposed to radiation. Let's twist the story a bit and show you how doctors really behave when it comes to patients who demand tests that could do a little more harm.

Instead of an MRI, let's say the patient is asking for a CT or a chest x-ray. If there is no justification for the test, the doctor is going to expose the patient to an unnecessary dose of radiation. That's malpractice. That's bad medicine. That is something they could be sued for, not denying the patient the CT.

Let's go a little further because the next example is a more common form of defensive medicine. A mother brings her child in to the pediatrician. The child has a cold and the mother says she wants antibiotics. The physician has determined the infection is viral. Antibiotics would not treat the viral infection.

Here are the choices the physician has at this point.

1. Deny the patient antibiotics because it's not evidence based medicine. Tell the mother to treat symptoms, have the child rest, and drink plenty of fluids. No lawsuit.

2. Give the child antibiotics to make the mother happy because they know unhappy mothers tend to complain and want the magic pill to make the infection go away. To avoid confrontation, the physician practices some defensive medicine. It's a bad practice and paves the way for superbugs resistant to antibiotics. Lawsuit.

There are other options if the physician feels the mother is confrontational. Those other options are not relevant to this discussion, although again, an open line of communication would have been the best course of action.

In clinics across America, physicians have regular conversations about the overuse of antibiotics and the rise of bacterial resistance to those antibiotics. Superbugs are the last troublesome obstacle we want to face. Just because a patient demands antibiotics is no reason for a physician to throw those concerns out the window.

Let's give an example of defensive medicine that is also evidence based. For the sake of clarity and understanding, let me skip some of the jargon and clinical details and just go for the basics.

Let's say a patient presents with a set of symptoms. The physician recognizes these symptoms and orders the tests to confirm the diagnosis he or she already suspects. However, these symptoms could also be a sign of a malignancy, something that if missed, could result in a much worse situation for the patient. If missed and the malignancy were to progress to the point where outcomes vary tremendously (surgery, removal, and recovery vs metastatic disease and palliative care for example), you've got a lawsuit on your hands. The physician orders the initial tests for the most likely diagnosis and will probably order the other investigation soon to make sure cancer is not the underlying cause.

In that case, the physician is covering his or her ass, but at the same time, understands that cancer is in the list of differential diagnoses. At some point prior to ordering these tests, the physician would have sat down with the patient and discussed his or her concerns and possible diagnoses which warranted the investigations.

CNN's DNC Coverage SUCKS

They set the stage for what they want to hear while at the same time choosing not to show speakers who actually say those things. They paint a picture so that the viewer holds the same expectations and then if they don't see what they want, they can criticize everything while the viewer lulled into these expectations watches in agreement. If you want to see commentary and not the DNC, watch CNN's coverage. If you want to see people stuck on the idea that Hillary was not picked as Obama's VP, watch CNN. If you want to watch people to tell you to go to a web site to watch DNC speeches, watch CNN. If you want to know that the Pepsi Center is where the Denver Nuggets play, watch CNN. If you want to watch Republicans spout talking points, watch CNN.

MSNBC is not much better. FOX News? Ha! Did they even show any of it?

If you want to watch the DNC without interruption, watch it on C-SPAN.

If you want to watch the DNC with analysis, watch it on PBS. They show each speaker in their entirety and even tape certain speakers (Deval Patrick) to show you if they should deviate and interview someone else (Michelle Obama). If you want to see the fireworks, watch PBS. Some of the best speakers so far were tonight and PBS showed them. PBS had commentary AFTER each one and did not interrupt them in the middle. I'm sure CNN gets far more financial funding than PBS can even dream of, yet PBS is the one able to deliver the goods.

Steny Hoyer gave a magnificent and in your face performance. Did you miss that one? I was able to enjoy Arizona Governor Janet Napolitano take some good jabs at the Senator from Arizona. There is one Arizona tradition she'd like to see continue. Past representatives from Arizona who have campaigned for office failed. I got to see Kathleen Sebelius from Kansas make another joke aimed at McCain. Dorothy from Kansas once said there's no place like home, but McCain says there's no place like home, home, home, home, home, home, or home. Yep. Seven homes. I was able to listen to Governor Mark Warner give an outstanding keynote. Judy Woodruff from PBS even landed an interview with Michelle Obama tonight. Brian Schweitzer from Montana really gave an awesome performance too. Did you happen to catch Lilly Ledbetter from Alabama? The Governor of Massachusetts, Deval Patrick, gave one heck of a direct attack. You missed stories from real Americans and anecdotes about real American struggle and sacrifice. You missed plenty of jabs at Bush and just as many McCain tie-ins to Bush.

If you were watching CNN, you missed the good stuff. Things were said that needed to be out in the open. CNN didn't show it and probably turned around at the end to criticize the lack of such gusto. Pathetic. Who says the media is liberally biased? They have their heads up their asses.

Did you happen to notice Exxon/Mobil was the CNN sponsor?

I think they are killing off a lot of viewers this time. Things have been going downhill for a while now, but they are driving a nail through the coffin. I don't think they care which is troubling.

Outed: Biden, Half Brother

The news was buzzing all evening about who Barack Obama would pick as his running mate. Certain names were crossed off the list and news crews appeared to be camping on front lawns of the rest waiting for any clues. While they were chomping at the bit to find out who was going to be the VP pick, one broadcast decided to bring up something else in the meantime to keep viewers interested. The timing was however, a tad suspicious.

As the eve of the Democratic National Convention approaches, anything showing Obama in the slightest unfavorable light seems to be fair game. CNN had a piece on Obama's Kenyan half brother. The piece seemed to tryand put Obama in an awkward position. It seems like now Obama is expected to take some sort of financial responsibility for a half brother living in a shanty in Kenya. Who cares if his half brother is proud of being Kenyan and is perfectly fine with living in Kenya, right? We're in America where Sally Struthers is supposed to make our hearts bleed for the classic picture of poor Africans walking through dirt streets and shanty towns. How dare Barack Obama not help the spawn of a father who left him and his mother. Looks like his half brother is happy where he is and communication between the two is really none of our damn business. It sounds as though the two have a good understanding, but CNN wants to play "Let's reunite long lost relatives" for ratings and the soap opera Americans who buy into that sort of crap.

If Obama's half brother in far off Kenya is considered newsworthy, then CNN should not have any problem traveling an even shorter distance to blow the history behind McCain's first marriage out of the water. While we're at it, start stirring the pot simmering McCain's feelings towards Asians and see if it boils over. I'm sure the timing of this news piece on Obama's half brother has everything to do with the swiftboating that will continue to taint our televisions in the months to come. Now it has been made to appear as though Obama doesn't want to help his own family. I'm glad I didn't fall for the fake sob story.

By now, you've also forgotten all about whether or not McCain is going to release his VP pick, right? Aren't you glad I gave you this reminder? Who said the media was being a softy when it came to covering Obama? Let's smack McCain around some, shall we?

Obama *was* going to release the name of his VP pick in the morning, but somehow somebody on the Democratic side couldn't keep their lips sealed. Joe Biden appears to be his running mate. I say great choice. I was supporting Biden for President anyway. He's got a great foreign policy stance regarding the Middle East. The man just understands what has been going on over there for decades. He's also a straight talker and will rip you to shreds the way someone deserves to be told off. Now let's just see how many times the media will cover the "articulate" flap between Obama and Biden a while back to try and prove there might be tension between the two guys even though the differences were reconciled shortly after the flap.

Screaming for the Pope???

I'm just watching the coverage of the walking talking freak show they call the Pope. At one point I heard people screaming for him in the background almost like I was watching American Idol. You've got to be joking. He's there to talk about priest sex abuse and people are acting like the Beatles are in town instead of maintaining some kind of serious demeanor. Contain yourselves people.

The dude's name is Joseph Alois Ratzinger. Ratzinger? That's not sexy. Neither is Benedict. Don't scream at him like he's a pop star or a sex symbol. He's not.

I bet there are women in the background holding up signs that read "I want to have your love child." Can you imagine?

Silly Catholics.

I would have considered meeting John Paul both an honorable and memorable experience.

This guy is just too much of an ass in comparison and he just plain looks creepy. Halloween creepy.

(time passes)

Ha!
CNN is discussing how the Pope is connecting with young people at a time when he's talking about sexual abuse of young people. I can't stop laughing. This is a comedian's dream come true. Are you kidding? Too easy to pick these gems up.

By the way, Bushie boy is a Methodist.

As for the priest shortage, it's all about market share. Simple as that.

Utah Teens Texting Nude Pics

Teens send nude photos by text message

Monticello, Utah

Apparently about 25 teens sent shots of body parts, sex acts, sexy dancing, etc to members of the opposite sex. Of course they got caught. So HNN runs the story and asks...

Who's to blame? The options offered by HNN:
Lax parents? Lax parents my ass. Media? Maybe in a round-about way. Remember, it's Utah. Fighting off "sex sex sex" is what people in a red state like Utah do best. Blame the media? What a cop out. Blame the classic rebellious teen mentality. When you try to keep the topic of sex away from youngins with raging hormones, you're going to get stories like this.

A HNN hired shrink says narcissism is the root of the problem. You know, Myspace and Paris Hilton. Me me me? No way chickie. You're way out of touch, especially for a blonde.

It's REBELLION. They live in Utah. I've been to Utah. It's always heartwarming to see goth kids in the malls instead of Mormon kids dressed up covering their magic underwear and refusing to interact with people around them. Yeah. That does happen in Utah. Utah parents try to keep their kids away from sex.

Way to go Utah. It's about damn time you showed us your tits. Granted the tits are jailbait, but it's still good to see the youth of our nation rebelling.

Question:
Where does possession of age appropriate naked photos fit in the kiddie porn legal scheme of things? If you're a 15 year old boy and the 15 year old girl texts you a naked photo, are you in possession of child pornography or age appropriate content? Both are wrong, I'm guessing, but still, it's a relevant question to ask.

And for the perverts who land on this page looking for porn, go get help you creepy old men. While teen rebellion is normal, what you're doing is not. Sicko.