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To: Amy J who wrote (182802)	12/1/2005 5:41:20 AM
From: drjohn	Read Replies (1) \| Respond to of 186894

Well Amy that used to be the case but is no longer the case. Almost all Medical Schools now practise and teach evidence based medicine. Basically this is the application of rigorous statistical analysis to treatment protocols, procedures and new drug therapies. The gold standard is the randomised controlled clinical trial. I agree that many, perhaps most physicians followed cookbook thinking, but the leaders and innovators have always been the ones who applied critical thinking and where able to think outside the box.

To: Amy J who wrote (182802)	12/1/2005 9:04:59 AM
From: GVTucker	Read Replies (2) \| Respond to of 186894

Amy, RE: I really think doctors should be required to attend one year of engineering school to learn critical thinking (and how it's okay to apply it) before being allowed to attend medical school, so they learn how to think critically. Critical thinking and analysis, is not taught in medical school. They tend to purely "following directions", rather than analyze and think. This is bad. For the most part, I agree. But I don't think it's bad. Most of medicine really IS cookie cutter stuff. And as far as critical thinking and analysis are concerned, doctors who are interested in that avenue can pursue a PhD and develop that talent. And there are plenty of MD/PhDs around that spend most of their time in the lab, not the clinic.

To: Amy J who wrote (182802)	12/1/2005 9:12:40 AM
From: Proud_Infidel	Respond to of 186894

Re: Critical thinking and analysis, is not taught in medical school. They tend to purely "following directions", rather than analyze and think. This is bad. Why is this bad? The body is a machine much like a car. Non-linear thinkers who are interested in medicine should probably go into research where new ideas and critical thinking are truly necessary. Re: I actually think Walmart could do a better job at delivering health care treatment because it has efficient distribution channels, efficient practises, etc etc From the 24 hour mastectomy would come the 24 minute mastectomy. I am not sure Walmart is the best company to look to for answers regarding medical care, in fact I am quite sure of it;-) Regards, Brian

To: Amy J who wrote (182802)	12/1/2005 5:54:35 PM
From: d[-_-]b	Respond to of 186894

Amy, Andy Grove basically implied doctors don't investigate, critically think, or pursue, but instead simply follow cookbook procedures they learned from medical school. Doctors are basically mechanics and must keep up on the new diagnostic and repair techniques. Sometimes they don't read all the new material.

To: Amy J who wrote (182802)	12/1/2005 8:00:32 PM
From: Saturn V	Respond to of 186894

doctors don't investigate, critically think, or pursue, but instead simply follow cookbook procedures they learned from medical school I think that the doctors are more intelligent and better trained than what your comments imply, although doctors are clearly not God, which is the way the American society treats them. In the last several years Doctors are trying to base treatments based upon "Evidence Based Medicine" as opposed to an intutive or purely theoretical approach. However the doctors in private practice will not select a treatment based upon their observations alone, due to fear of litigation. Most doctors base the treatment upon published papers and the "Gold Standard" as defined by the AMA, or published studies compiled by medical research institutes. Apparently no one had compiled and published the data on the new procedure selected by Andy to treat his ailment. I have seen similar "holes in medical knowledge" in other specialities as well. Frequently the treatment is also constrained by the insurance companies, which do not approve "new experimental treatments". The AMA does have refresher classes for doctors to bring them up to date. Recently it also requires that doctors have to pass a recertification test every few years to ensure that the doctors "theoretical knowledge" is current. However older doctors are exempt from the recertification procedure by a grandfather clause, and these doctors are the one who need recertification the most. However I see a loophole that the surgical skills on new procedures are not tested. I find older surgeons make more mistakes on new procedures since they lack hands on knowledge of the newer procedures. Personally I have seen several problems in that area, and I recommend that one should question and ask how many such surgeries have been performed by the doctor in question. Based upon my observations we have to question the doctors recommendation like we would question anything else when our lives are at stake. You should seek second opinions and the Internet is also an excellent source of information.It also helps to have doctors in the family and as friends who can give you a quick and dirty second opinion. I also believe that it is safer to have a younger doctor than an older one, but more importantly it is best to check the reputation of the doctor in question. Unfortunately we do not always have the luxury of doing all of the above, and in an emergency we have to go with which ever doctor is available. "Doctors who investigate, critically think, or pursue new avenues" are best found in academia. Typically these doctors have the best and upto date knowledge, but are hard to get hold of. You should try to get hold of them for a second opinion when you are confronted by a critical issue.