Originally published in MedPage Today
by Joyce Frieden, MedPage Today News Editor
Almost 40 years and 100 billion federal dollars have been invested in the “War On Cancer” since President Richard M. Nixon declared it, but the campaign is far from over, two researchers concluded this week in the Journal of the American Medical Association.
“These funds have been more than matched by …
Cancer deaths are improving, but a cure remains distant
My daughter, who turns two years old in June, is becoming something of a medical rarity. This isn’t because she is showing signs of a late-developing handicap or extraordinary ability for her age – it’s because she came into the world as a vaginal birth after Cesarean section (VBAC), delivered by a certified nurse midwife.
Although more than three-quarters of women who choose a trial of labor over a repeat Cesarean …
VBAC rates are low, but are obstetricians to blame?
VBAC activists are clinging to their resentment and aggressively ignoring reality.
Amy Romano at Science & Sensibility asks the bizarre question: Do women need to know the uterine rupture rate to make informed choices about VBAC? It’s bizarre because she implies that this is a medical question and that the answer is unknown. However, this is a legal question and the answer has been clearly established by the courts. Not …
VBAC should not be a woman’s right
Originally published in MedPage Today
by John Gever, MedPage Today Senior Editor
When the mainstream media report on cancer treatments, they seldom note that aggressive therapies may fail or cause severe side effects, researchers said.
Analyzing more than 400 articles about cancer in major newspapers and magazines, investigators at the University of Pennsylvania found that adverse outcomes or palliative care were hardly …
Cancer side effects are being ignored by the media
During President Obama’s final push for “universal health care” legislation, his biggest obstacle was not Republicans but rather anti-abortion Democrats let by Congressman Bart Stupak (D-Michigan).
Stupak eventually reached a last-minute deal with the White House on federal funding of abortion services. But no one should be surprised that under government-controlled health insurance, medical coverage decisions will be based on political considerations. Rather, the recent wrangling over abortion will be …
Government-controlled health insurance may politicize health
Whether we like it or not, the lines between allopathic and alternative medicine continue to blur. Just last week I recommended glucosamine-chondroitin to a patient who suffers from osteoarthritis and wrote a prescription for Lovaza, a prescription-strength preparation of fish oil. And today I was asked about red yeast rice from a patient interested in controlling her cholesterol through “natural means.”
Like nutrition, complementary and alternative medicine, or CAM, is somewhat …
Allopathic medicine has alternative medicine roots
Let’s get one thing out of the way.
The health care reform bill that passed the House this past Sunday, and will be fixed via reconciliation in the Senate, is a moderate, relatively incremental approach to fixing our health care system.
Conservatives are up in arms, as they have been during the entire process, and are lining up lawsuits and trying to gather momentum to repeal the bill.
And I’m asking myself, …
Health reform should make conservatives very happy
Originally published in MedPage Today
by Joyce Frieden, MedPage Today News Editor
Patients with erectile dysfunction (ED) who were treated with telmisartan, ramipril, or both were at greater risk for cardiovascular events than other patients on the same medications, researchers found.
In men who reported ED at baseline, all-cause mortality during a median follow-up of four years was double that seen …
I’m becoming an amateur archeologist. The hilltop where we live is strewn with arrowheads and bits of Native American pottery shards. I have slowly, surely, trained my eye to find them. There is little flint here; so most of the pieces I find were made of quartz. (Hard to work with, but remarkably beautiful and almost always a brilliant white.)
My kids and I walk the red-clay paths and look down …
Archeology skills work in medicine
by Robin Tang
Sunday, March 22, 2010, marked the passage of the Health Care and Education Affordability Reconciliation Act (H.R. 4872) by the House by a narrow 219-212 margin, with no Republicans voting in favor. Whether you think the bill is good, bad, sustainable, or even constitutional, we can agree this was a historic day.
Putting politics aside, I want to highlight two parts of the bill that aren’t getting enough …
Tax credits and new patient care models in health reform
by Patrice Villars
The best learning experiences for me have been times when I come away questioning core assumptions about the work I/we do. As palliative care folks, we try to help people understand where they are in relation to their disease and what their hopes and goals are for care. We offer treatments and resources to match those needs through, in part, supportive communication.
What if, in our kind, well-meaning …
Palliative care shows the importance of language
Originally published in MedPage Today
by Joyce Frieden, MedPage Today News Editor
With the House and Senate now in basic agreement on healthcare reform and President Barack Obama about to sign the underlying bill into law, opponents are gearing up to challenge the legislation on a variety of fronts.
This effort was beginning even before Sunday’s House vote sent the Senate …
Healthcare reform will be challenged in states
Thanks all who responded to my recent USA Today piece, Patient-satisfaction surveys have drawbacks.
But in a letter published in the paper yesterday, a reader from Oklahoma City was quite unhappy with my take.
Mark R. Heaton writes, somewhat angrily:
Dr. Kevin Pho’s recent opinion piece was not only arrogant but also grossly naive.
His basic premise was twofold:
• Doctors know best and should therefore ignore patient feedback regarding possible tests and treatments.
• …
Patient input in their treatment should be valued by doctors
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The following is part of a series of original guest columns by the American College of Physicians.
by Steven Weinberger, MD, FACP
The New England Journal of Medicine‘s March 11 issue included an interesting “Clinical Decisions” article. Looking at a hypothetical case of an endocrinologist with time-unlimited board certification, the editors posed the question of whether he should voluntarily …
ACP: To whom are physicians accountable?
I haven’t ever saved a life. No doctor has. We may prolong the inevitable, but we don’t save anyone. We aren’t immortal, and weren’t meant to be. We die. All things do. Plants, animals, even stars. Death is as much a part of life as birth. And yet, at times people chase medical science as if we have immortality in all our gadgets and pills.
Why am I writing this?
A few …
Futile care has human and financial costs
Originally published in MedPage Today
After a year-long struggle and often-raucous partisan debate, the House of Representatives passed an historic health care reform package late Sunday night.
The vote on the last of the two bills in the package was 220-211. All 178 Republicans, along with 33 Democrats, voted against the measure. The margin was similar on the other measure; both …
Health care reform passes the House in a historic vote
Originally published in MedPage Today
by Kristina Fiore, MedPage Today Staff Writer
Earlier this year, Harvard’s Partners Healthcare put a cap on payments its physicians can receive for serving on corporate boards at $5,000 a day.
Although the cap primarily affects top researchers and executives, it is by far the stiffest limit imposed by any academic medical center, and drives deeper the …
Industry relationships with physicians are coming under fire
Heading into the final weekend of Mr. Toad’s Wild Ride, who could have guessed that in a year that brought us Death Panels, Pickup Trucks, “You Lie”, The Cornhusker Compromise, Bart Stupak (boy, that must have been a tough name to grow up with), and the Senate Parliamentarian-as-Rock-Star, we would be on the cusp of passing a perfectly …
Healthcare reform is an achievement but isn’t perfect
Originally published in MedPage Today
by John Gever
This meditation was evoked by the prospect that my basement could be filled with E. coli-laden mud next week.
I live within a few yards of Wheeling Creek, a tributary of the Ohio River that drains about 250 square miles of northern West Virginia and southwestern Pennsylvania. This week has brought temperatures near 70 degrees, …
Flood insurance by the government, but no public option
Middle age introduces itself in many ways; one is atrial fibrillation. Youth, vigor and a medically-problem free life was seemingly right there in the recent past. A rhythm doctor often hears this suddenness of onset described as “Doc, yesterday, I was fine.” As is always the case for a first episode of an arrhythmia, yesterday, you were fine, but today is indeed a new day.
It happened during a bike ride. …
Atrial fibrillation as experienced by an electrophysiologist
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