July 08, 2009
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Feeling the pain from work hour changes

I'm on service this week, and this is my first week on without the house staff, who were pulled from our service last year, partially for the mandated work hour changes. Now the inpatient oncology service is an elective but is not mandatory, though they are all doing an outpatient oncology rotation, which has increased their viability and participation in the outpatient arena substantially. I won't belabor how I feel about this (you already know), but it has led to some increased anxiety for me about getting anything else accomplished when I am on wards. We'll see how the week goes. But to get you started, here are some interesting topics on cancer issues. Discuss.

  • PSA velocity and PSA doubling time did not predict biochemical recurrence or metastases in this (underpowered) study. More information on the study, including quotes from the authors and editorialist, can be found here. Despite this being a relatively small study with a small number of events, I was surprised that the researchers did not find a more robust association, because clinically, PSA kinetics seem so useful to define disease progression.
  • I have a doctor friend who thinks that no doctor should be paid over $250,000 annually as a way to address the exploding costs of health care. I'm not so sure about that approach, but I do think that fee-for-service provides negative incentives to "do more." What do you think about how doctors should be paid? Vote here at KevinMD's poll.
  • Geri onc is getting some love in the Wall Street Journal health blog, but isn't it a shame they are citing disparities trials from 1999 to make their point?! Why don't more people know about this already (or is this just old news)?
  • Leave it to the Italians to find out that a glass of wine a day may help breast cancer patients make it through radiation!
  • Does the U.S. grants system "undercut major cancer leaps" as reported in the New York Times?