The PMD Critical List: The NFL's Top Physician Gets the Boot

A rheumatologist with the National Football League (NFL), who led a committee that repeatedly denied the football-concussion link, was reportedly forced to quit. That story tops this week’s PMD Critical List. Also making the list: Old habits die hard when it comes to why physicians tend to favor opioids over marijuana for chronic pain, and seven states are losing doctors.

• Top NFL Physician Forced to Quit (USA Today)

Pro football’s top medical advisor, Dr. Elliot Pellman, is retiring after reportedly being pushed out by Commissioner Roger Goodell. The rheumatologist led the league’s Mild Traumatic Brain Injury committee, which repeatedly denied the link between football, concussions, and long-term brain damage.

• Playing Sick for Young Doctors in Training (New York Post)

“Medical schools and hospitals pay actors like me to play a “standardized patient” because our portrayals teach future doctors how to conduct checkups, diagnose disease and build a bedside manner,” according to this report from New York Hospital Cornell.

• Scribes Giving Doctors Needed Relief (Crain's)

Doctors from a Cleveland hospital’s emergency department “have added one more member to the healthcare roster: the medical scribe, who assists physicians with documentation during patient visits and enters information into the electronic medical record.”

• Out-Of-Control Physicians: Unnecessary Care a Bad Habit? (Forbes)

A report talks about how doctors are performing too many questionable tests and treatments. It’s done not just for money, according to JAMA — “well intentioned physicians often expose their elderly patients to harmful and unnecessary services out of habit.”

• Doctors Are Overprescribing the Pill (Verily)

“Physicians in training during the past 30 years or so have been taught to find any reason to put women on some form of contraception — without mentioning any possible risk associated with these methods,” says Florida FP Dr. John Littell in a strong essay. “Female empowerment comes from knowing all the options.”

• Physicians Have Favorite Patients (Science Daily)

“Physicians like the majority of their patients, but a majority like some patients more than others,” a study in Patient Education and Counseling indicates. “This study is thought to be among the first to explore the positive aspects of physicians' attitudes towards their patients.”

• 53% of Doctors Ration Healthcare (Consumer Affairs)

“A national survey by the Mayo Clinic has found that more than half of US physicians withhold medical interventions from patients due to cost implications — even if the intervention would have benefitted the patient.” It is “particularly prevalent” among solo practitioners.

• More Training for Physicians to Handle Adverse Events (Healthcare Finance)

“New research in JAMA finds that the act of disclosure, combined with stress from the procedure gone wrong, can be an anxious experience for some doctors — and more training is needed to help them engage in these difficult conversations.”

• For Chronic Pain Doctors Love Opioids and Hate Marijuana (Becker’s Hospital Review)

“Physicians favor opioids because of distorted perceptions dating back to the 1960s, which include the belief that opioids are effective for chronic pain of all kinds, while cannabis will lead one to death, debauchery or hopeless insanity," according to a University of Michigan professor of anesthesiology, psychiatry and rheumatology.

• 7 Cities Losing Their Doctors (24/7 Wall St)

“While the number of doctors per capita has been increasing nationwide, in a number of areas across the country, this pattern does not hold. In each of these US cities there are also fewer doctors per capita than there are across the country as a whole.” #1: Jacksonville, NC.