ASH Clinical News ACN_4.3_FULL-ISSUE-DIGITAL | Page 79

BACK of the BOOK Heard in the Blogosphere Matthew Might @mattmight 1st rule of Slide Club is you do not ask for my slides in advance. 2nd rule of Slide Club is YOU DO NOT ASK FOR MY SLIDES IN ADVANCE. mcsassymd @mcsassymd If you want to know how pervasive Epic is, I have started putting *** in my writing projects for words/sentences that I need to come back to Aaron Logan, MD, PhD @hemedoc Little known fact: part of the reason clinical trials are so expensive is to pay for all the SIGN HERE stickies. Simple Questions, Difficult Answers “Few simple questions are as difficult to answer as the perennial ‘What did the doctor say?’ … The words spring from our lips, almost of their own accord, whenever a loved one returns from a doctor’s visit. But why should the answer to this question be difficult? The usual suspects – inadequate patient education, differences in cultural perceptions, problems of health literacy – all overlook an important fact: Medicine is a foreign language. It is not foreign because of ‘big words,’ [but] rather, the hedging, equivocation and other linguistic devices that doctors reflexively use obscures the plain meaning of their words. … Can a patient be faulted for not knowing what the doctor said?” —Richard Klasco, MD, and linguist Lewis H. Glinert, PhD, on the linguistic acrobatics that contribute to patient-physician miscommunication, in The Washington Post Patients Versus Paperwork “Like some virulent bacteria doubling on the agar plate, the electronic medical record (EMR) grows more gargantuan with each passing month, requiring ever more (and ever more arduous) documentation to feed the beast. … More and more doctors are concluding that the over- bearing EMR actually jeopardizes patient safety, by pushing patients to the margin of the medical encounter. It’s time, then, to take action, as we do in other areas that harm patients. Health systems should be required to periodically measure the EMR burden, and should be fined when it detracts too much from face-time with patients. … Things might actually change when money is on the table.” —Danielle Ofri, MD, PhD, associate professor of medicine at New York University, discusses the potentially dangerous side effects of the growing documentation burden, in The New York Times Navneet Majhail, MD @BldCancerDoc Discuss hospice with patient/family, then come out of room - hit reset button - go into next room to share good news about disease in remission with next patient/family #DayInLifeOfOncologist Charlie M. Wray, MD @WrayCharles If you want to be a good medical educator, hang out with a toddler. Their incessant ‘whys’ will teach you how to explain complex topics in the most simple manner possible Follow ASH and ASH Clinical News on: @ASH_Hematology, @BloodJournal, @BloodAdvances, and @ASHClinicalNews Facebook.com/AmericanSocietyofHematology @ASH_Hematology ASHClinicalNews.org For Genomic Sequencing in Cancer, More Promise Than Proof Having heard encouraging stories about individualized cancer treatment, people diagnosed with cancer are asking with increasing frequency to have the DNA of their tumors sequenced. But is the precision medicine hype getting too far ahead of the facts? In part of a series of reports for NPR’s Morning Edition, doctors discussed the limitations of using genomic data to guide treatment of a patient with glioblastoma. “We’re getting better, but like many things in life, there’s hope and hype. And that’s also the reality with precision medicine right now. … We have this knowledge [about tumor sequencing data], but it’s not enough. You have to prove that acting on that knowledge – some medical intervention – will actually afford benefit for patients. That’s the trickiest, toughest part about looking at all these types of genomic tests, to really prove that this is making a difference in the lives of our patients.” —Ben Ho Park, MD, PhD, professor of oncology and associate director of the Hematology/Oncology Fellowship Program at Johns Hopkins Sidney Kimmel Comprehensive Cancer Center “There are a few cancers where DNA analysis does make a clear difference, but in other cancers, it’s an open question. At the same time, this testing is available commercially as well as at academic medical centers, and is being done. Patients want it, providers want it. … We think it’s important to capture information [on what treatments patients received] as well, to try to learn from it, because in many cases it’s not going to be effective, but in some it is. It’s important for us to figure that out.” —Josh David Lauring, MD, PhD, assistant professor of oncology at Johns Hopkins University School of Medicine ASH Clinical News s