Richard Lehman’s Journal Review – November 2011

BMJ Group blogs: BMJ » Blog Archive » Richard Lehman’s journal review – 7 November 2011.

BMJ Group blogs: BMJ » Blog Archive » Richard Lehman’s journal review – 14 November 2011.

BMJ Group blogs: BMJ » Blog Archive » Richard Lehman’s journal review – 21 November 2011.

BMJ Group blogs: BMJ » Blog Archive » Richard Lehman’s journal review – 28 November 2011.

Bob MacDonald on What’s So Hard about Doing the Right Thing?

In the abstract it is easy to say that doing the right thing is – at the very least – reporting the improper activity. But what if your report seems to be ignored? Are you off the hook and have no further responsibility? Even worse, if you do report it and your boss survives with nothing more than a reprimand, what might this do to your personal well-being and your future with the company? In theory, of course, you could quit your job and find another; but in this economy, is that possible? Is now the right time to put you and your family’s financial future at risk? You could go halfway and say nothing while you look for another job, but is that the right thing to do?  This type of enigma is not an academic exercise. Anyone who has ever been in the business world, with ambitions to be successful and rise up the pyramid and support a family knows this type situation – and a wide variety of others – is more reality than theory. The real questions are: At what point are you willing to dilute or even trade in “doing the right thing,” to protect your career by “going along to get along”? At what point do you break and become willing to rationalize the elements of “doing the right thing?”

via What’s So Hard about Doing the Right Thing?.

Bob’s right.  Read his entire blog post to understand why it is not easy to do the right thing.  Thanks Bob and please keep writing and sharing.

NEJM Resident e-Bulletin Teaching Topics 11.03.11

The next time you get asked by a sales professional why you rated her client for ulcerative colitis pull out this cheat sheet for talking points.

Q. What is the risk of cancer in patients with ulcerative colitis?

A. On the basis of data from referral centers, the cumulative risk of colorectal cancer among patients with chronic ulcerative colitis may reach 20 to 30% at 30 years, but the incidence rate is much lower in population-based series (approximately 2%). Risk factors for cancer include a long duration of disease, regardless of clinical activity; extensive involvement; a young age at onset; severe inflammation; the presence of primary sclerosing cholangitis; and a family history of colorectal cancer.

Richard Lehman’s Journal Review – October 2011

BMJ Group blogs: BMJ » Blog Archive » Richard Lehman’s journal review – 3 October 2011

BMJ Group blogs: BMJ » Blog Archive » Richard Lehman’s journal review – 10 October 2011

BMJ Group blogs: BMJ » Blog Archive » Richard Lehman’s journal review – 17 October 2011

BMJ Group blogs: BMJ » Blog Archive » Richard Lehman’s journal review – 24 October 2011

Here are the links.  Happy reading.

Thought for Today – 09.18.11

New Economic Perspectives: William Black: Why Nobody Went to Jail During the Credit Crisis

We have known for centuries, that if you don’t underwrite loans, or if you don’t underwrite insurance, you’ll get something called “adverse selection”.

This interview answers the question of why nobody went to jail for our recent financial crisis.

For this underwriter, it’s all about prudent underwriting and strong internal controls.

Richard Lehman’s Journal Review – August 2011

BMJ Group blogs: BMJ » Blog Archive » Richard Lehman’s journal review – 8 August 2011

BMJ Group blogs: BMJ » Blog Archive » Richard Lehman’s journal review – 15 August 2011

BMJ Group blogs: BMJ » Blog Archive » Richard Lehman’s journal review – 23 August 2011

BMJ Group blogs: BMJ » Blog Archive » Richard Lehman’s journal review – 30 August 2011

I recently shocked an audience of young doctors by stating that my chance at 61 of having localised prostate cancer stood at about 25%. Since then I have looked at various sources (including Overdiagnosed) and found that according to one study of prostates examined histologically after traumatic death, the true figure may be 60%. So if a urologist decided to do some transrectal biopsies on me and hit the right/wrong spot, I might well have a cancer diagnosis. So what would then be the best nonsurgical management strategy – leave alone, local radiotherapy (brachytherapy), or external beam radiotherapy? The conclusion of this systematic review of different modes of radiotherapy for localised prostate cancer is that nobody actually knows. A most reassuring fact to share with your patients.