Online dermatology visits for acne can be effective

Physician
May 9, 2010

by Chris Emery

Acne patients who received online treatment from dermatologists had similar outcomes to patients who were treated in the doctor’s office, a new study found.

Patients who participated in “e-visits” with dermatologists experienced similar reductions in inflammatory lesions as those who had office visits, Alice J. Watson, MBChB, MRCP, MPH, of the Center for Connected Health in Boston, and colleagues wrote in the report, published online April 19 in the …

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Online dermatology visits for acne can be effective

How PCOS can be diagnosed and treated in primary care

Conditions and Diseases
May 9, 2010

Hypothetical case scenario

27-year old female presents to the office with a complaint of irregular periods. Menarche was at age 15, and periods occur about 1-2 times a year. Breast development began at age 9, followed shortly by axillary & pubic hair. Growth spurt was at age 13. She’s been trying to get pregnant for the last one year now, and has never been seen before for her irregular periods.

On physical …

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How PCOS can be diagnosed and treated in primary care

MKSAP: A 21-year-old man is evaluated for painful mouth sores

Conditions and Diseases
May 8, 2010

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 21-year-old man is evaluated for painful sores in his mouth. Episodes of these sores have occurred two to three times yearly since he was 16 years old, and he believes they are associated with stress. They usually appear on the inside of his mouth as a single, round, painful lesion, lasting for 5 …

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MKSAP: A 21-year-old man is evaluated for painful mouth sores

Hiatal hernia in women can present with heartburn

Conditions and Diseases
May 8, 2010

by David Edelman, MD

Heartburn and acid reflux disease are common problems affecting women of all ages. The problem develops when acid in the stomach backs up into the esophagus. There is a muscle known as the diaphragm that separates the chest from the abdominal cavity. When you eat or drink, the food goes from the mouth down the esophagus, through the diaphragm and into the stomach. …

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Hiatal hernia in women can present with heartburn

Indoor tanning can be an addictive behavior

Conditions and Diseases
May 8, 2010

by John Gever

“Jersey Shore” wannabes beware: some people crave the indoor tanning experience so much that it qualifies as an addiction, researchers said.

Among 229 college students completing a survey, 39.3% met DSM-IV criteria for addiction, reported Catherine E. Mosher, PhD, of Memorial Sloan-Kettering Cancer Center in New York City, and Sharon Danoff-Burg, PhD, of the State University of New York at Albany, in the April issue of Archives of Dermatology.

Participants …

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Indoor tanning can be an addictive behavior

Dying of old age in the era of modern medicine

Conditions and Diseases
May 8, 2010

He is 93 and has numerous medical problems, most of which involved aging blood vessels, as well as multiple orthopedic issues, including compression fractures and diffuse arthritis. The bony issues have resulted in a severely compromised mobility of late.

Despite ongoing treatment with both aspirin and clopidogrel, he presents after numerous hours of focal neurologic symptoms. A CT scan shows no evidence of bleeding and the diagnosis is a major stroke …

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Dying of old age in the era of modern medicine

Explaining chronic medical treatment to patients

Conditions and Diseases
May 7, 2010

Although some psychiatric conditions are acute and transient, most are chronic. They may wax and wane, but most of them do not go away. Likewise, psychiatric medications can significantly improve people’s functioning and quality of life, but they manage, not cure, mental illness.

It’s therefore not surprising that a common conversation that patients and psychiatrists have revolves around the question, “Do I have to be on this medication ‘forever’?”

I’ve previously written …

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Explaining chronic medical treatment to patients

Autistic enterocolitis may not be real

Conditions and Diseases
May 7, 2010

by Todd Neale

The status of a new inflammatory bowel condition identified in the retracted Lancet paper that linked the MMR vaccine and autism — autistic enterocolitis — appears to be in limbo.

The 1998 paper by Andrew Wakefield, MBBS, and colleagues was fully retracted by The Lancet in February, although the alleged and repeatedly disproven vaccine link was dropped in …

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Autistic enterocolitis may not be real

A pre-medical student writes to her gross anatomy cadaver

Medical Education
May 7, 2010

A letter from a pre-medical student honoring her gross anatomy cadaver.

Letter to the other side
by Hana Low

Thank you for donating your body to science and medical education. It’s so generous to give yourself to those you will never meet. I hope you’re having a good time, up there or wherever you are.

Working with your body has made me acutely conscious of the dangers in my everyday environment. I have to …

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A pre-medical student writes to her gross anatomy cadaver

China medical school and residency training

Medical Education
May 6, 2010

My husband and I recently traveled to Wuhan Medical School in the Hubei Province in central China.

Our medical school has partnered with Wuhan to help inform their curricular reform efforts. We spent 4 days touring the hospitals and teaching facilities, meeting students and faculty, going on rounds, and giving talks. Although the language barrier was challenging, we had incredible translators who worked to translate every slide we spoke …

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China medical school and residency training

Calorie counts in health reform is significant for patients

Health Policy
May 6, 2010

Counting calories as part of health care reform—who knew? But apparently it’s there on page 455 of the health-care reform act, according to Marion Nestle, Professor of Nutrition at NYU, writing in the New England Journal of Medicine. There will now be a national effort at posting calorie counts in chain restaurants.

There are many ways to improve the overall health of Americans, but tackling obesity is surely one of the …

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Calorie counts in health reform is significant for patients

Inhalant abuse remains prevalent in teens

Conditions and Diseases
May 6, 2010

by Todd Neale

Although inhalant abuse has become less prevalent since the early 1990s in all age groups, it remains a source of injury and death, particularly among teenagers, researchers have found.

From 1993 to 2008, intentional exposure to 3,410 different inhalants was reported to U.S. poison control centers, Toby Litovitz, MD, of the National Capital Poison Center in Washington, and colleagues reported in the May issue of Pediatrics.

The highest rate of …

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Inhalant abuse remains prevalent in teens

Social networking impact on patients, doctors, and non-profits

Social Media in Medicine
May 6, 2010

In its current listing of online social networks, Wikipedia presents 156 major, active websites. A neighboring link to view “now-defunct” sites accompanies the listing — a subtle reminder of the Internet’s competitive and volatile environment where promising endeavors rise and fall overnight.

But although the popularity of a specific website may fade with time, the practice of online social networking is here to stay.

In its simplest form, online social networking is …

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Social networking impact on patients, doctors, and non-profits

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How Massachusetts can lead health IT modernization

Health Technology
May 6, 2010

Although healthcare reform has its supporters and detractors, healthcare IT reform – the use of technology to improve the quality, safety and efficiency of healthcare throughout the country – has broad support from all stakeholders.

The passage of last year’s $787 billion economic stimulus bill brought with it a healthcare IT modernization program that could inject about $30 billion into the economy. Since Massachusetts is a leader both in the use …

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How Massachusetts can lead health IT modernization

Family comes first for some who have finished residency

Medical Education
May 5, 2010

by Dr. Whoo, MD

I have met several women who have completed residency and maybe even practiced beyond that, but decide to quit and stay at home with kids. I wonder – why would a woman who has gone through all of that training just quit? It would seem like the hard part is behind them and I am perplexed by their decision but, of course, I …

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Family comes first for some who have finished residency

How Massachusetts controls health costs should be closely watched

Health Policy
May 5, 2010

A major criticism leveled at the health reform law is that it doesn’t do enough to control costs. Yet experience with a similar breed of health reform in Massachusetts indicates that the cost control issue will come to the fore sooner rather than later.

Recent stories have reinforced my conviction about this:

Massachusetts health plans have sued the state and stopped issuing new policies to small businesses and individuals after the …

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How Massachusetts controls health costs should be closely watched

Maternal death rates improve but hurts fund raising

Health Policy
May 5, 2010

by Mike Himowitz

When you’re advocating for a health cause, can good news be bad news?

It’s entirely possible — when science threatens fund-raising, and at the worst possible time.

Consider a study of worldwide maternal death rates by a team from the University of Washington that appeared online recently in The Lancet.

The group, led by Christopher Murray, of the school’s Institute for …

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Maternal death rates improve but hurts fund raising

Quality hospital care deserves to be celebrated

Physician
May 5, 2010

Last week my wife and best friend, Elaine, had massive abdominal surgery. We fully expected her to be an inpatient for a week, but she was home in four and half days. To watch her recover was to see what happens when everything converges: the deep knowledge and skills of excellent, humane physicians; a capable, caring clinical staff; wonderful new technologies; and a lifetime of eating right, being fit and …

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Quality hospital care deserves to be celebrated

Health reform may mean meaningful changes for physicians

Health Policy
May 4, 2010

Jim called me late on a fall afternoon to report our mutual friend was in the local emergency room. “It looks like he had a stroke”. I immediately asked to speak to the ER doctor for the results of the CAT scan I knew would have been done. There were two metastatic tumors in the brain.

It has been over two years since my friend died. He was among the millions …

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Health reform may mean meaningful changes for physicians

Problem list problems with electronic medical records

Health Technology
May 4, 2010

In family medicine it has been common to keep a “Problem List” in patients’ paper charts. Usually placed on the left hand side, on top of the Medication List, it has given doctors like me an instant thumbnail sketch before considering the specifics of each patient’s visit for that day.

A typical Problem List would include diagnoses like diabetes, hypertension, high cholesterol or rheumatoid arthritis. It would list prior surgeries, like …

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Problem list problems with electronic medical records

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