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Second Opinion

Readers decry lack of foresight—with respect to loss of vision, eating disorders and the doctor shortage.

Winter 2008
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How thrilling that Patti Jacobs has been able to continue her activities in the face of deteriorating eyesight (“A Life Restored,” Fall 2007). And how distressing that the retinal specialists and general ophthalmologists she consulted were unable to provide the information that would have prepared her for what was to come. She was fortunate that a former colleague tipped her off to a fellow sufferer who was able to assist her.

I had a somewhat similar experience with my father when he lost his vision. By sheer chance he learned of the various technological aids that were available. In turn I was able to assist the dean of a well-known and first-rate medical school whose father suffered from macular degeneration and whose faculty members did not know what was available to assist him.

These are matters that should not be left to chance. If overburdened physicians don’t have the knowledge or the time to assist their patients, so be it. But surely someone can be given that task. Loss of vision is a serious issue, and the medical establishment should not be blind to the problem.

Rashi Fein // Professor of the Economics of Medicine, Emeritus, Harvard Medical School


“Tough to Swallow” (Fall 2007) highlights the significant prevalence of eating disorders in the adolescent and young adult population. Unfortunately, many patients with eating disorders go undetected owing, at least in part, to the relative lack of eating-disorder training for residents in primary care. Studies have shown that early diagnosis and aggressive treatment of patients with anorexia lead to improved outcomes. It’s a challenge for clinicians involved in the care of patients with eating disorders to negotiate comprehensive insurance coverage for the many services these patients require. Isn’t it time that all states include eating disorders in mental health parity laws?

Mark A. Goldstein // Chief, Division of Adolescent and Young Adult Medicine, MassGeneral Hospital for Children

Hurting for Doctors

All you say regarding the doctor shortage (“Are We Running Out of Doctors?” Summer 2007) is quite evident to the aging ICU on-call physician. Replacements for retiring doctors are difficult to find in pulmonary medicine and in many other specialties as well. Medical schools and training programs are unable to meet the demand; soon it will be evident to patients and perhaps even to the government. But how ironic that the same issue of Proto includes an interview with photographer Max Aguilera-Hellweg (“Picturing the Other Side”), who, soon after completing medical training and having been served the privilege of occupying one of the coveted spaces, returned to premedical pursuits after his “great, great adventure.” Sadly, another person might actually have been of service to the profession.

Rex Bolin // Providence St. Peter Hospital, Olympia, Wash.

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