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Beware of predatory journals when it comes to homeopathy studies

Medications

November 9, 2015

An August, 2015 study in Multidisciplinary Respiratory Medicine is being touted as evidence that homeopathy is as effective as antibiotics for respiratory infections in children. It doesn’t show that at all — in fact, it doesn’t show anything, except that crappy studies in crappy journals can nonetheless be used to manipulate opinion. Beware.

First, the study itself. Researchers in Italy looked at about 90 children with ordinary …

The FDA’s epic regulatory failure

Brian Klepper, PhD

Medications

November 9, 2015

A new study in JAMA Internal Medicine finds that two-thirds of cancer drugs considered by the U.S. Food and Drug Administration (FDA) over the past five years were approved without evidence that they improve health outcomes or length of life. (This study closely corroborates and acknowledges the findings published last year by John Fauber of the Milwaukee Journal Sentinel and Elbert Chu of MedPage Today.)

Follow-up …

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The FDA’s epic regulatory failure

Why male physicians should care about maternity leave

Jamie Coleman, MD

Physician

November 9, 2015

You all have prostates.

Seriously. But let me explain further to those people who simply can not fathom as to how a woman could dare ask for maternity leave and expect her other team members to “pick up her slack, because she chose to get pregnant.” (Yep, check the comments section on my last post. Pretty entertaining, in fact!)

Life happens to everyone.

If my profession as a trauma surgeon has taught me …

Smoking is the ultimate thief of time

Samuel M. Chen, MD

Physician

November 8, 2015

I sit at my desk in a cubicle with high ceilings and an open entryway. It is dark except for the somewhat eerie glow of light emitted by CRT monitors. With concentration and some sense of urgency, I methodically plow through the queue of studies to be interpreted. Some are marked STAT, some not. I address the former first.

Our ER is a busy one. Many cases come from that department. …

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Smoking is the ultimate thief of time

A physician’s life with epilepsy

Kristin Seaborg, MD

Conditions and Diseases

November 8, 2015

In May 2003, during my second year of pediatric residency, I had a right temporal lobectomy to remove a seizure focus in my right hippocampus. Although the surgery proceeded without complications, I was unable to walk unsupported for several weeks after the operation. My experiences taught me what makes an exceptional physician.

An excerpt from The Sacred Disease: My Life with Epilepsy.

The day after my surgery, Nancy was my new …

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A physician’s life with epilepsy

The patient experience: 4 observations from a physician

Thomas D. Guastavino, MD

Physician

November 8, 2015

Last year, I retired from full-time practice and moved to a new area. At about the same time, my wife was diagnosed with breast cancer, and because she was in good health prior, she had relatively little contact with the health care system as a patient.

Before our move she worked as a part-time school nurse, so we were able to share provider horror stories from different perspectives. Since we moved …

It’s dangerous. It can kill. But physicians don’t want to talk about it.

Tehreem Rehman

Conditions and Diseases

November 8, 2015

“You need to come to the ED ASAP.”

A new patient was admitted at 2 a.m. and requested for a crisis counselor. Unlike with cases of sexual assault, survivors of domestic violence had to specifically request for the presence of an advocate when I was volunteering in NYC back in 2009. This woman, I’ll call her Sadie, had already taken the first courageous step to seek help.

I briskly walked past …

In medicine, too many disruptors disrupt disruption

Dr. Saurabh Jha

Health Technology

November 7, 2015

Recently, I was dining with elite radiologists. In that uncomfortable silence between dessert and the check, I said, “radiology must shift the traditional paradigm by creating value streams using disruptive innovation to leverage population health to build strong ecosystems and a robust ectoplasm.”

I was experimenting if excreted verbiage hastens the check. Instead, it sparked a vigorous conversation about disruptive innovation, compelling me to drink more cognac.

In health care, no two …

Mental health in America requires a collaborative solution

Jeffrey A. Katz, PA-C and James Cannon, PA-C

Conditions and Diseases

November 7, 2015

Getting mental health right for all Americans is a huge undertaking. For the last 150 years, our “solutions” to mental illness can, at best, be characterized as a series of good intentions that were poorly, if not disastrously, implemented. But while there may be a conversation that needs to happen about how we got here, what’s important right now is how we go about shoring up a system that is …

Test your medicine knowledge: 59-year-old man with gout

mksap

Conditions and Diseases

November 7, 2015

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

A 59-year-old man is evaluated for a 6-month history of gout. He was doing well on colchicine and allopurinol but developed hypersensitivity to allopurinol, which resolved with cessation of the agent. He then began to have more frequent gout flares; two flares occurred in the past month and were treated with prednisone. History is also …

Physician, heal thyself. A reflection on physician self-care.

Chiduzie Madubata, MD

Physician

November 6, 2015

Another workday comes to an end. 11 a.m. rolls around and freedom from the hospital beckons after another 24-hour call is finished. In the span of the preceding day, it is likely that numerous important decisions had to be made with the expectation that all of your mental faculties would be used, irrespective of what time of day it was or how much sleep was obtained. It is a day …

Failure to communicate is a patient safety issue

Steven Reznick, MD

Physician

November 6, 2015

My 66-year-old professional athletic patient had a history of a scar tissue related small bowel obstruction seven years ago related to a previous appendectomy. He now had similar symptoms with cramping, lower abdominal pain, and some nausea.

Since his office was next door to his longtime friend and gastroenterologist, he called over there. He was given an appointment with the junior partner since his buddy was out of town. Thirty years …

Why a doctor stopped taking a particular health insurer

Lucy Hornstein, MD

Physician

November 6, 2015

For the moment, I still take almost all insurances in my practice. And as long as I see enough patients (i.e., as long as the phone rings) I’m doing OK. I’ve been billing electronically with a free clearinghouse for about five years now, and things are pretty good.

Over all these years, I’ve only dropped one insurance company. It covered a fair number of patients, including many of my …

We are morally scarring our future physicians

Alex Smith, MD

Medical Education

November 6, 2015

Have you ever had that experience when you think what you’re doing is futile, and that thought goes through your mind:

“Why am I doing this?”

“I’m torturing him.”

“This feels wrong.”

For those of us that are physicians, think back to your internship and residency training. I think we can all remember at least one of these situations, if not more.

I remember being in the ICU as a third-year internal medicine resident, being sent …

The geriatrician shortage: The problem isn’t what you think

Richard Young, MD

Physician

November 5, 2015

I’ve read several articles recently reporting on a shortage of geriatricians. The writers have some clear misunderstandings of who actually cares for our elderly and where they come from.

Susan Jaffe writing for Kaiser Health News stated that the American Geriatrics Society (AGS) estimates that the nation will require 30,000 geriatricians by 2030 to serve our aging population. This is probably true, what the AGS believes. She goes on …

Is routine home blood pressure monitoring really such a good idea?

Rocky Bilhartz, MD

Conditions and Diseases

November 5, 2015

It has occurred to me that this is a terrible idea.

In fact, it’s possibly the least beneficial thing for the general health of a population to have gained momentum in recent years. I’m not discussing cigarettes or e-cigarettes or low-yield cancer screening procedures. I’m not talking about diet drinks or sugary drinks.

I’m talking about home blood pressure monitoring.

It’s a terrible idea.

OK, I get it. The idea sounds benign. Buy your own …

Here are 10 patient suggestions for hospitals. Let’s make them happen.

Peter Pronovost, MD, PhD

Physician

November 5, 2015

Since undergoing a double-lung transplant at the Johns Hopkins Hospital in December 2011, Podge Reed Jr. has had four medical admissions, two surgical admissions, eight outpatient procedures requiring anesthesia, more than 100 outpatient appointments, and 700 labs and other tests. He’s amassed enough experiences with the health care system to write a book. So far, though, he’s mostly kept it to two letters, totaling 12 pages, to our patient relations …

Physicians are not providers: It’s time to wake the sleeping giant

Suneel Dhand, MD

Physician

November 5, 2015

I wrote a piece about the word “provider,” and how physicians have been a bit blindsided to what’s fast becoming their new title. It started something of a social media wave. It was good to see the article encouraging lots of healthy debate, and I was also grateful for the large volume of supportive messages.

As we continue this important discussion, I wanted to specifically address five follow-up issues:

1. This …

Pain management is personal

Val Jones, MD

Medications

November 4, 2015

Most of my patients think about pain medicines in terms of the symptoms they treat. “This is my headache medicine, and this is my arthritis medicine,” they often say. Health care providers are more likely to categorize pain medicines by the way they work: some are anti-inflammatory, some affect nerve endings, and others influence how the brain perceives pain. But the truth is that no matter how you classify pain …

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Pain management is personal

Playing a little game in the nursing home

Jordan Grumet, MD

Physician

November 4, 2015

It was a little game we played.

My shoes squeaked quietly down the hallway of the nursing home as I approached her room. I knocked gently trying to avoid any particular rhythm or dissonance.

Go away!

Her voice was at once stern, and then followed by peels of laughter. She only saved such greetings for me. And I tried to trip her up. I varied my visits by time and pattern. Sometimes I …

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