I was just doing some reading yesterday and saw that PandaBear, MD’s blog is now being archived over at SDN. I’ve stayed subscribed to his original site’s feed since he retired just in case he ever popped back in to say anything. As I wandered over to the SDN archive expecting to find a 1:1 copy of his original site, I saw that he actually started writing again on this new site back in March! This just made my day. I’ve got some serious catching up to do! If you’ve never read Panda’s blog, you can start with some things that I thought were notable. Enjoy!
Well after years of writing, it appears that Panda Bear, M.D. is throwing in the towel on his blog. His was one of the few blogs I read regularly, and it’s one that no doubt has left an impact on my past and future as a physician. He says that he’ll be working on a book at some point in the future, and that’s one I’ll definitely look forward to reading. So long, Dr. Bear. Your insight, honesty, and sardonic humor will truly be missed, especially by the up-and-coming who have not yet encountered your work. His “My Personal Statement” is a classic Panda take on the AMCAS Personal Statement for medical school applications.
PandaBear made a good point about the incentives for terminating futile medical care:
My third point is that there is no incentive at any level of the medical industry to use a little common sense. At the high end, physicians risk severe legal consequences for not doing exactly what the family wants no matter how unrealistic. So dangerous is the legal terrain in this area of medicine that most hospitals have an ethics committee part of whose purpose is to spread legal responsibility. In many cases, however, there is no financial incentive to withdraw care as Medicare makes no distinction between the living and the living dead. At the patient end, the families have no financial stake in any of the decisions they make. If we but charged the families a small fraction of the cost for futile care or, more diabolically, had payment garnished from the patient’s estate upon their death, the families would be looking for the plug, especially in the cases where the ICU serves as an expensive funeral home where families can meet to see the body. If the family ever says, “We want to keep Uncle Joe on the ventilator until the rest of the family can fly in from Seattle,” they should be responsible for the full cost of the additional stay. –PandaBear, M.D.
I thought it was important that he emphasized that this is futile medical care and not simply medical care for the elderly as it may seem in some of his other posts. The point being that this is wasting a lot of money!