In my interactions with patients, I always ask them to tell me when their weight problems began and what they believe contributed to their weight gain.
Broadly speaking, there are two categories: people, who were big (or were considered big by others) as long as they can remember and those, who can often clearly pinpoint when their weight …
Themes explaining why people are obese
The following deceptive advertisement appeared in my church’s bulletin yesterday:
Life Line Screening, the nation’s leading provider of preventive health screenings, will offer their affordable, non-invasive, painless health screenings [in the church cafeteria] on April 9th. Five screenings will be offered that scan for potential health problems related to: blocked arteries, which is a leading cause of stroke; abdominal aortic aneurysms, which can lead to a ruptured aorta; hardening of the …
Examining the evidence behind a community health screening
Comparative effectiveness research — investigations that determine which treatments are best — has attracted attention in the health care debate. Critics charge that these studies are designed to restrict choice. The Center for Medicine in the Public Interest released a report that suggested that they would stifle innovation. Often they are framed as studies to support efforts to keep useful but expensive …
Niaspan and how comparative effectiveness research was done well
by Mike Cadogan, MB ChB
Crossing multiple time zones can produce a constellation of symptoms known as jet lag.
Jet lag is most noticeable in the first 24-48 hours following travel and can last for up to 5 days before individuals return to normal functioning. Symptoms are closely affected by both the length and direction of travel. Symptoms include: reduced alertness, night-time insomnia, loss of appetite, depressed mood, poor …
The science and treatment of jet lag
In a thoughtful posting in the New York Times, Dr. Pauline Chen, a well respected observer of the doctor-patient relationship, points out an ethical dilemma that faces cancer researchers working in drug development conducting early phase (I) new drug studies. Ethicists have identified that patients in these studies often have unrealistic optimism about their personal outcomes despite …
Unrealistic optimism in early phase new drug studies
Have you noticed the recent trend against specialty physicians? Policy experts have determined that primary care needs incentives to attract medical students away from those “highly lucrative” specialties such as plastic surgery, orthopedic surgery, interventional cardiology, and neurosurgery.
Our federal government believes in equal opportunity — if you wish to become a family doctor. There are incentives sponsored …
Health reform’s prejudice against specialist physicians
Stem cell therapies promise to be one of those scientific breakthroughs that will have an enormous impact on health care in the future.
Stem cells will bring us closer to the goal of personalized medicine, just as genomics is doing. The course of a disease will change once we have the technology to develop and then insert stem …
Stem cells will bring us closer to personalized medicine
Ready to learn more about nurses who work beyond the bedside? Nurses who work in the Cardiac Catheterization Lab (CCL) play an important role in cardiac care. Amy Sellers, RN blogs at Nursing Influence and graciously agreed to give us a peek at what a nurse is responsible for doing in the CCL.
Amy has worked in the Cath Lab for about 6 months now. She previously worked in cardiovascular intensive …
Nurses who work in the cardiac catheterization lab
I find that it takes more effort for me to talk patients out of doing tests than it takes to get them to submit. It doesn’t seem like it should be that way:
I need you to undergo a test where you fast for 12 hours, show up to the hospital 3 hours before the sun comes up, strip down and slide into a breezy hospital …
Talking patients out of doing tests takes effort and time
Everybody has a theory of what’s wrong with American health care and why costs are high.
I have my own theory – talk is cheap. By this, I mean Americans and third party payers are unwilling to pay more for what mere talk is worth.
They do not want to pay more for a visit to the family doctor, …
Why cognitive doctors need to be paid more
8,000 patients will no longer be able to receive care from UNC Hospitals and their affiliated physician practices because of a dispute between UNC and the insurance company Aetna.
The bottom line is that Aetna does not want to pay as much for care provided by UNC as UNC wants to be paid for providing this care. No surprise there, as the interests of the two parties (health care provider and …
How a dispute with an insurance company can affect patients
“I just want to learn the abdomen and the pelvis”, I thought to myself, while staring at our donor’s metastasized body. Nothing looked normal, tumor was everywhere, and for the 4th lab my group looked at each other, looked at the lab steps, and concluded it was going to be “just another day where we just … found what we could find and did … …
Cancer in the gross anatomy lab
Ok, I confess. I have contributed to the $2.3 trillion that our country spends on health care every year. As a patient I want the best possible care for my family and me. As a physician I am the gatekeeper to expensive procedures, medications, and diagnostic tests. However, by several indices including life expectancy, infant mortality rate, and satisfaction with the health care system, we are not getting our money’s …
How primary care physicians can improve health and lower costs
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Part two of the three-part series, Let’s Pay Popular People More!
Take a moment to ask yourself whether any of these categories describe you or someone you love:
If any of these terms describes you or a loved one, then you are statistically more likely to give a doctor a lower Read more…
How paying doctors for patient satisfaction is racist
I recently had quite a long conversation with a college senior that was just accepted into medical school for this coming fall.
As a rising fourth year medical student myself, I would like to think that I have navigated the waters of academia and figured out both efficient paths to success and avoidance of roadblocks and setbacks. …
5 easy steps to become a better medical student
Do you spend 8 hours in front of a screen at work? Do you then spend your free time watching TV or poking around the internet when you get home? How much time are you spending cooking healthy meals to eat with friends and family? How much time are you doing physical activities that make you happy?
A recent study in the Journal of the American College of Cardiology entitled, Screen-Based …
Work should be about optimizing your productivity and health
When I was called to see the patient after a motorcycle accident I expected the worst. The patient sustained a thoracic spine injury with cord transection at T5 level as well as significant chest wall injury on the right side.
Multiple ribs were broken; some with a significant displacement. Managing patients with a significant chest wall trauma could be a nightmare. Pain control is only one of the challenges.
Read more…
Pain control in a patient with rib fractures and a spinal cord transection
Here’s some advice to think about before starting clinical rotations during the third year of medical school.
Don’t sit in the back of the plane
The basic sciences are important to learn the vocabulary and grammar of medicine. Clinical rotations are different – it’s where you actually learn to be a physician. If you use the analogy of learning to fly, …
Practical advice for medical students starting clinical rotations
by Jeffrey L. Cohen and Albert R. Meyer
Chiropractors and medical doctors (or D.O.s) have had a long and somewhat complex relationship.
Though they approach healthcare issues differently, there are many instances where they share care or even work together. Such “M.D./D.C.” relationships are legally complex, but often prove to be rewarding in many respects. Properly constructing the arrangements is critical, especially since government regulators and payers tend …
The legal issues of doctors and chiropractors working together
by Alison McKnight
I have been in and out of the doctor’s office ever since I was little, and I have had my share of good and bad experiences during this time.
These experiences can shape the expectations of both the physician and the patient, in both negative and positive ways. While the perfect relationship between …
When communication is broken, the quality of care is diminished
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