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The Internet has had a profound effect on clinical practice by providing both physicians and patients with a wealth of information. But with those rewards come risks of incorrect or poorly interpreted information that require that a doctor “never be optional,” warn Harvard physicians Pamela Hartzband and Jerome Groopman, of Beth Israel Deaconess MedicalCenter (BIDMC), in the tomorrow’s edition of the New England Journal of Medicine.“Nothing has changed clinical practice more fundamentally than … the Internet,” the pair write in a commentary, because “its profound effects derive from the fact that while previous technologies have been fully under the doctor’s control, the Internet is equally in the hands of patients.”While applauding the ability of patients to receive test results and communicate with their clinicians electronically – and to search for disease symptoms at numerous web sites – Hartzband, an assistant professor of medicine at Harvard Medical School (HMS), and Groopman, the Dina and Raphael Ricanati Professor of Medicine at HMS and Chief of Experimental Medicine at BIDMC suggest it is a journey no patient should undertake alone.“Material is perceived as factual merely because it is on a computer screen. We sometimes find ourselves in the uncomfortable position of trying to dissuade desperate and vulnerable patients from believing false testimonials,” they write. “Falsehoods are easily and rapidly propagated on the Internet: once you land on a site that asserts a false rumor as truth, hyperlinks direct you to further sites that reinforce the falsehood.”Hartzbandand Groopman cite the example of a neighbor, with a tendency toward hypochondria and with web access, who fretted that a backache was actually an abdominal aortic aneurysm. “After a week of self-palpation, he mustered the courage to call the doctor. With a normal exam and repeated reassurance, the backache resolved.”The physicians warn that secure web portals where patients can remotely view their laboratory, radiology and pathology reports can be a double-edged sword. “This technology is efficient, averts the need for multiple phone calls and the mailing of information. The benefits though, must be weighed against potential negative effects of receiving clinical data without context. Patients and families may be confused by results and worried that minor abnormalities might portend serious consequences.”Most important, however, they contend, is the reality that the Internet simply cannot substitute for human interaction. “It’s impossible to judge the effects on patients of information transmitted through cyberspace: we can’t observe grimaces, tears and looks of uncertainty. And written dialogue is quite different from spoken conversation: replies may be delayed, phrases may be more stilted, tone of voice is absent.”Ultimately, the core relationship between doctor and patient should not change, they write. “Knowledge is said to be power and some of the past imbalance between patient and doctor may be equalized. But information and knowledge do not equal wisdom, and it is too easy for non-experts to take at face value statements made confidently by voices of authority. Physicians are in the best position to weigh information and advise patients …The doctor, in our view, will never be optional.”
“You are going to see me back in the theater in the spring…Nothing’s finalized yet but I feel safe enough to say it, in Night of the Iguana on Broadway, so I’m looking forward to that,” he said at a Times Talks event. The Emmy winner added, “I’m also very excited about something I might be doing in London in September/October.” No theater or dates have been confirmed for the revival. The Night of the Iguana is the story of Rev. Lawrence Shannon (Lewis), a defrocked Episcopal minister, and his fight to keep his personal demons at bay. He leads a bus-load of middle-aged Baptist women on a tour of the Mexican coast and comes to terms with the failure haunting his life. The play was adapted by Williams from his 1948 short story and premiered on Broadway in 1961. It was last revived on the Great White Way in 1996, starring William Peterson, Cherry Jones and Marsha Mason. The 1964 film version was directed by John Huston and starred Richard Burton, Ava Gardner and Deborah Kerr. Lewis frequently spent time on stage before he began his run on Homeland and was recently rumored to be attached to a West End revival of Me and My Girl. He played Laertes in the 1995 Broadway production of Hamlet and the title role of the Shakespeare classic in London. His film and TV credits include Band of Brothers, Your Highness, Life and Dreamcatcher. He will star opposite Tony winner Mark Rylance in the upcoming television adaptation of Hilary Mantel’s Wolf Hall. Former Homeland star Damian Lewis is eyeing his Broadway return. The actor says he’s planning to headline Tennessee Williams’ The Night of the Iguana on the Great White Way in 2015. View Comments Cherry Jones Star Files Mark Rylance
continue reading » ShareShareSharePrintMailGooglePinterestDiggRedditStumbleuponDeliciousBufferTumblr Senate Banking Chairman Mike Crapo (R-Id.) on Tuesday appeared to link legislation allowing marijuana banking to a proposal to outlaw an Obama Administration initiative that he said allowed banks and credit unions to refuse to serve controversial industries, such as gun dealers.Opening a hearing on legislation that would provide financial institutions with a safe harbor if they do business with cannabis-related companies, Crapo did not endorse marijuana banking, although he said that a strong case had been that the issue must be resolved.However, he added that Congress should consider legislation to outlaw initiatives such as the Obama Administration’s Operation Choke Point. That project was intended to hold financial institutions accountable for processing transactions they knew were fraudulent.Critics have said that the program empowered financial institutions to decline to provide services for controversial businesses, such as gun dealers and payday lenders.
Shahid Afridi has pulled out of the Caribbean Premier League 2018 in order to tend to a knee problem that first occurred during the Pakistan Super League, for which he will continue to undergo rehabilitation. Afridi made the announcement through a tweet, expressing his disappointment at missing out on the “biggest party in sport”.After sustaining the injury while playing for Karachi Kings during the PSL, Afridi turned out for Edmonton Royals in the Global T20 Canada league, besides captaining ICC World XI against West Indies in a T20 at Lord’s in July. Afridi’s only previous stint in the CPL was with St Kitts and Nevis Patriots in 2015, during the tournament’s third season.The latest edition of CPL 2018 will commence on August 8, with the Trinbago Knight Riders taking on St Lucia Stars at Port of Spain. Jamaica Tallawahs, led by Andre Russell, will play their first match on August 10, against Knight Riders in the same venue.