Medical school applicants face fierce competition; a single point on a MCAT score can make or break a doctor-wannabe's future. So tension was high in April when aspiring physicians across the country were sweating over the day-long, standardized test.
But many test takers moved from tension to agitation when they discovered a passage that was supposed to be about nutrition contained eight questions on black holes. Some were so frustrated they stormed out of the testing room, according to a spokesman for the Association of American Medical Colleges, which administers the test. Others created a significant "commotion."
It turns out a simple printing error caused the mix-up, and the AAMC has said all 2,200 students from the 32 affected sites -- even those who had error-free forms -- may retake the test in August for free.
Apparently, the ability to handle stress and adversity is not a requirement for medical school admission.
Taxing syntax. Technology has its own language and the healthcare sector is no exception. A few phrases bandied about last month at the Toward an Electronic Patient Record convention:
Legacy system: A nice way to refer to a nearly useless computer system, one old enough to be carbon-dated. See also, heritage system, which makes doctors sound like they own the computer Abe Lincoln used to place online orders for theater tickets.
Fully loaded: What vendor test sites are not, according to some consultants. Vendors' EPRs run well with a test 50-patient base, but it's a crap shoot when physicians try to run them with 50,000 patients.
PIA: Officially, a physician's information assistant who inputs clinical data. Unofficially, a pain in the ass -- how colleagues refer to a technophobic doctor.
New mind-set on managed care. Ofer Zur used to be a managed-care believer. Now the Sonoma, Calif., psychotherapist advises M.D.s and other psychotherapists on how to operate a "managed-care free" practice.
Zur thinks doctors must eschew managed care because of the "ethical binds" it creates; for example, insurers having access to patient records.
Zur's solution: Get rid of the insurers, set up shop, market yourself well and watch the patients seeking quality healthcare come in. And they'll pay for it, Zur says to soothe fears about seeing patients who don't have an insurance company attached.
"If you care about your garden and hire a gardener, they don't expect to be paid by a third party," Zur says. "People will pay to be healthy."
Private complaint, public beef. Some folks get a bit, um, sensitive if they believe their medical records are being spread like gossip, folks like Beverly Hills, Calif.-based physician and practice-management consultant Yvonne Mart Fox.
Incensed after receiving a marketing letter from Rite Aid Corp., she sent an angry response to the Harrisburg, Pa.-based company. And the director of the Food and Drug Administration. And the medical societies of all 50 states. And 26 specialty societies. And 23 media representatives, including Dan Rather, Peter Jennings and Ted Koppel.
The Rite Aid letter was a sales pitch for the Bristol Myers Squibb anti-cholesterol drug Pravachol. Apparently Fox got a letter because she is taking Zocor, a similar drug made by Merck. Fox demanded to know how Rite Aid's marketing department got her records, which weren't complete:
"If you had looked at my records more carefully, you would have discovered that I take Zocor because PRAVACHOL MADE ME SICK."
Yeah, and so did Rite Aid's letter.
Dr.com. Americans turn to the Internet for news, entertainment, shopping, sex and -- increasingly -- healthcare information and counseling. Members of online health information and support groups rate their online communities as much more helpful than either specialists or primary-care physicians, according to a survey conducted by Tom Ferguson, M.D., editor and publisher of an online health newsletter, and William Kelly, executive vice president of SHN, a Portland, Ore.-based Internet health information and support service.
The nearly-200 patients surveyed, all members of an Internet service for people with chronic or serious illnesses, ranked their online groups higher than their physicians in areas such as convenience, cost-effectiveness, emotional support and coping advice, and medical referrals. The patients even rated online health communities as the best source for technical medical knowledge.
Physicians may be somewhat heartened to know patients say they still need doctors to perform at least one function: correctly diagnosing a condition.
"The best way for physicians to work with (online communities) is to acknowledge that this (technology) exists and people are going to use it," Kelly says.