Date: June 7, 2013
Who Needs Cadavers?
I read with interest David H. Freedman’s article “Rethinking Anatomy 101” [Winter, 2013]. I started medical school in the summer of 1988, and much to the surprise of many members of my class, we studied anatomy without cadavers. The idea was to learn anatomy with books, anatomic models, and technological aids. I think I learned as much (or as little) anatomy as any other student dissecting cadavers. While it is clear that my specialty is not that dependent on knowledge of anatomy, I have schoolmates who are successful pathologists, surgeons, and radiologists, so I do not see the lack of cadavers as a disadvantage. Of course, anatomy is very important, but contrary to the first half of the 20th century (and before), I see modern medicine as less anatomically based, and more [based] on molecular biology, genetics, and immunology.
I am glad my school in Mexico saw it this way 25 years ago. I am glad Perdana University sees it this way now.
Javier Bolaños-Meade, MD
Associate Professor of Oncology
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Alcoholism: An Underfunded Disease
Rachel Kahn Best [Winter, Second Opinion] touches on a real concern. I fear, however, that the trend she discussed will continue until societal attitudes toward “deserving” and “undeserving” diseases change. I anticipate no such change in the near future.
Despite the space limitations in a one-page essay, I was surprised that the words “alcohol” or “alcoholism” were not mentioned. Measured on a per-patient scale, alcoholism is surely the most underfunded disease in the country. Among several of my conscientious, nonphysician friends who “Walk for Breast Cancer Cure,” and donate time and money to agencies for the homeless and other causes, none has contributed anything for alcoholism research. I personally suggested they consider including ABMRF/The Foundation for Alcohol Research in their next round of contributions. Since it is in Baltimore, and has a strong Hopkins connection (founded in 1982 by Dr. Thomas Turner; current president Dr. Mack Mitchell, MD ’77; and Dr. Frank Iber as consultant), recruiting donors around the Johns Hopkins Hospital should be easier than elsewhere. Using a moderate number of patients and friends as evidence, I long ago concluded that the problem is not “willful misconduct.” Funded research is the sole route to solve it.
Larry R. Kirkland, MD ’64
EMRs: A Cautionary Note
Paul Rothman’s editorial on putting patients and families first [Winter, Post-Op] was exciting to read and continues what I see as Hopkins’ focus on excellence in patient care.
I would add a word of caution about the electronic medical record to be implemented at JHH. EMRs do a great job of making medical information available to all physicians across a system. At KU Medical Center, where we just completed the final stages of implementation, the ability to see other physicians’ notes, look at laboratory values in the exam room, and show patients their X-rays during an exam have been positive steps.
Unfortunately, the EMR has also enormously increased the time spent by physicians with charting and administrative work. I believe it is possible for the EMR to be an overall positive experience, but clinicians need some way to avoid having all their elective time tied up by the demands of the electronic record. This has been a recurrent theme across the country, and the current demand that hospitals and medical systems move now to EMRs has essentially locked in technology that is clumsy and far from convenient—along the lines of an early Windows program.
I hope there will be future updates on Hopkins’ move toward patient- and family-centered care.
Donald B. Milligan, MD ’74
All in the Family
I have just read Dean Rothman’s “Post-Op” column and I applaud his statement: “We are committed to nothing less than becoming the national leader in the science, teaching, and provision of patient- and family-centered care.”
As a retired family physician and medical educator, I can only hope that means Hopkins will now establish a faculty in family medicine and develop training programs for it. It has always disappointed me that my alma mater has not become a complete medical school by leading in my specialty as it has in so many others.
Theodore J. Phillips, MD ’59
Clinical Professor Emeritus, Family Medicine University of Washington School of Medicine
More Good Nutrition
What a pleasure to read about The Patient Promise program developed by Hopkins medical students to urge their peers and other health professionals to adopt personal health habits for themselves and be a role model for their patients.
In addition to the medical school course on nutrition and obesity cited in “Eschewing the Fat” [Winter, p. 5], first- and second-year Hopkins medical students can request a free copy of “Nutrition Guide for Clinicians,” prepared by the Physicians Committee for Responsible Medicine (PCRM) in the fall of 2013. This well-written, pocket-sized book summarizes information on the role of nutrition in health and illness with a focus on preventive and therapeutic measures for more than 80 medical conditions. (http://support.pcrm.org/site/PageServer?pagename=pcrm_membership_med_student_form&AddInterest=2821)
Barbara P. Wasserman, MD ’68
Board of Directors,Physicians Committeefor Responsible Medicine
An Ambassador to China
I was saddened by the recent passing of President Muller [Winter, Editor’s Note]. Like Muller, I have been active in nurturing the mutual understanding of China and America. Along with Dr. Bernard Lown, another Hopkins alumnus, I founded the U.S.-China Physicians Friendship Association in the early 1970s. I was named the Roving Ambassador for Chinese Cardiovascular Science by the editor-in-chief of the International Journal of Cardiology in 2007, and was recently appointed the international consulting editor for China for the journal.
Tsung O. Cheng, MD
Hopkins Fellow in Medicine, 1957-59
Professor of Medicine, George Washington University Medical Center