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Exploring the Angelina Jolie effect in breast cancer screening

Alan Cassels

Conditions and Diseases

September 26, 2014

Up to this point, it had only been a hypothesis: That celebrity firepower can definitively drive consumer health behavior in a certain direction. The case here concerns whether women wish to embark on a genetic hunting expedition to see if they are at high risk of developing a particular disease such as breast cancer, and the motivator in this case is Angelina Jolie.

The actress underwent genetic testing for mutations related …

A palliative care dilemma on the first day of the job

Jessica Nutik Zitter, MD

Physician

September 25, 2014

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It was my first day at my new job, practicing a new specialty. Having spent fourteen years as an ICU physician — including a four-year pulmonary/critical-care fellowship in this very hospital — I had just completed a palliative care fellowship. Now I was the hospital’s palliative care consult attending.

When I set eyes on the patient in room 1407, my first thought …

Lessons from the first month of residency

Pramod Theetha Kariyanna, MD

Medical Education

September 25, 2014

Where there is love there is life.
– Mahatma Gandhi

In this first month there is a lot I saw, learned and experienced. Love tops the list. I became an expert in arterial punctures as I did 4 to 5 of them each day in the floors. Each time I headed for an arterial puncture, many things automatically came to my mind: collect all of the required supplies, talk to and comfort …

Health care fails to adopt technology. Here are 5 reasons why.

Robert Pearl, MD

Health Technology

September 25, 2014

Why do so many seemingly great technologies fail to penetrate the health care system?

I hope the following five answers shed some light on the realities of technology adoption in health care.

1. Many new technologies don’t address the real problem

Tech entrepreneurs often take a backward approach to invention. They start by discovering a nifty technology. Later, they figure out how people can use it.

This technique often teaches entrepreneurs a tough lesson: Technology …

A twisted argument against end-of-life care

James C. Salwitz, MD

Physician

September 25, 2014

“All your patients will die. Maybe not today, but someday. The defining fact of life is that it ends. Only a fool would dedicate their career to fighting something that can never be beaten. Therefore, a doctor’s task cannot be to fight death. A doctor’s task is to heal when possible and prevent suffering always. Our calling is to support life. Fighting death may deprive patients of the opportunity to …

5 examples of what health care IT should look like

Suneel Dhand, MD

Health Technology

September 25, 2014

Over the last year I’ve written a lot about the problems with health care IT and how we need to get better. Unfortunately, unlike other aspects of our life where information technology has actually made life easier, in health care the user experience been nowhere near as smooth. IT solutions, including electronic medical records, are for the most part slow, inefficient and cumbersome. They cause a great deal of frustration …

Domestic violence and the NFL: We all need to change

Jennifer Gunter, MD

Physician

September 24, 2014

If I were punched by an unknown man in an elevator there would be little doubt that my assailant would be prosecuted. If the trauma were enough to cause me to lose consciousness, meaning I suffered brain trauma, my attacker would likely be charged with aggravated assault. No one would be surprised if he received jail time. No one would think twice if he lost his job. However, if I …

The long road to a blockbuster drug

Vern L. Schramm, PhD

Medications

September 24, 2014

One thousand dollars per pill?

A single treatment course for hepatitis C virus to cost $83,000?

How can those prices be justified?

The drug-discovery process is a long one, fraught with disappointments and massive investment, no matter what the outcome. Some pharmaceutical companies argue that the high prices charged for their rare “blockbuster” drugs help them recover research and development costs.

While drug pricing and drug access are contentious and controversial issues — ones …

Read more…

The long road to a blockbuster drug

Why health apps fall short and how to fix them

Samir Damani, MD

Health Technology

September 24, 2014

Searching for health and fitness apps on the iTunes app store turns up approximately 2,200 results. There are calorie counters, activity trackers, heart rate monitors, virtual fitness coaches and every other conceivable permutation.

The quantity should grow even larger thanks to Apple’s latest product release, the Apple Watch, a wrist wearable computer that tracks health and fitness information. One question, though: Are the users of these apps any healthier as a …

Don’t spank your children. Do these 5 things instead.

Wendy Sue Swanson, MD

Conditions and Diseases

September 24, 2014

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In my mind it’s no wonder the American Academy of Pediatrics has a statement against spanking. Spanking, in the simplest form, is the act of hitting a child, using physical force to try to get a different outcome. Thing is, spanking is an ineffective discipline tool in the long run and research shows it’s damaging to a child’s mental health. Most parents don’t want …

The uninsured rate has fallen, but it may soon rise

Brad Wright, PhD

Health Policy

September 24, 2014

While there are plenty of valid reasons to be skeptical about the Affordable Care Act, regardless of where you fall on the political spectrum, it’s hard to argue that imposing an individual mandate to purchase insurance won’t result in more people obtaining coverage. According to the results of a recent survey conducted by the Centers for Disease Control and Prevention (CDC), that’s precisely what’s happened.

Based on results of the National …

“I want to give up my son”: Is that child abuse?

Alberto Hazan, MD

Physician

September 24, 2014

The case

A thirty-five-year-old female presents to the emergency department on a weekend afternoon with the following chief complaint: “I want to give up custody of my son.”

The patient is well dressed — and so is her four-year-old son, who is sitting comfortably on the bed playing a video game on his mother’s cell phone.

According to the patient, she is a single mother with no support system. Her son’s father deserted …

Employer-sponsored primary care: An explanation

Stephen C. Schimpff, MD

Health Policy

September 23, 2014

Part of a series.

Patients need doctors that take time to listen which means a limited number of patients under care. Employers need programs that reduce costs and ideally improve the health of their staff. These apparently disparate needs can come together in a new model for effective company-sponsored primary care programs.

Those of you who have followed this series know that I am an advocate for PCPs finding ways to …

Our value judgments are often psychologically frail

Peter Ubel, MD

Health Policy

September 23, 2014

In health policy circles (yes, those exist!), experts often refer to three aims for a modern health care system: to offer 1) universal access to 2) high quality medical care at 3) an affordable cost. Access, quality, and cost: a possibly unachievable set of goals, certainly in the U.S., where the quality of our care is decent (but uneven), while access to care and the high cost of our care compare dismally to …

What does this retired doctor miss about medicine?

David Mann, MD

Physician

September 23, 2014

As a recently retired physician, I still maintain an interest in medical research, though I have to ask myself: Why? Surely not just from the point of view of a potential future patient. But not from the point of view of a practicing physician either. Perhaps I keep up just from a lifetime of habit? Or is there something I miss about my old job?

These thoughts came to mind as …

Responding to a medical student in pain

Abigail Schildcrout, MD

Medical Education

September 23, 2014

This evening, I read a post written by a woman who finds herself feeling alone, depressed, desperate, and afraid of losing herself as she goes through medical school.

This post is my response to that woman.

Dear colleague and friend,

You are not alone.

You are far from home. You are far from your family. You are far from the desert, the open …

Read more…

Responding to a medical student in pain

Surgery is one of the biggest barriers to space travel

Skeptical Scalpel, MD

Physician

September 23, 2014

The astronauts are halfway to Mars when suddenly one of them develops abdominal pain and requires surgery. What will they do?

According to NASA, a miniature robot capable of assisting in surgery has been developed, tested in pigs, and is soon to be trialed in a weightless environment. The robot, which weighs less than 1 pound, can be inserted into the abdomen via the umbilicus and controlled remotely.

The press release from …

Behind the scenes: The magic of medicine

Adrianne Westmoreland, DO

Physician

September 23, 2014

Let’s talk about expectations. And I’m talking the Dickens’ kind. When you watch television, the food flaunts itself before you. Tempting you with golden buns and perfectly placed pickles. The models eating those perfectly styled burgers are the same — airbrushed to perfection. Most often, limbs are stretched to unrealistic proportions and curves are molded and erased to fit someone’s view of beauty.

When someone first takes the baby steps to venture into …

Handshakes transmit germs: What are doctors to do?

Alex Smith, MD

Physician

September 22, 2014

In a study in the American Journal of Infection Control, researchers coated a gloved hand in E. coli. One person with the E. coli glove then they shook hands, high-fived, and fist bumped another person with a sterile glove. Transfer of E. coli to the sterile glove was measured.

Results:

highest transfer of bacteria: handshake
lowest transfer of bacteria: fist bump (high five was in the middle)
difference: fist bump less than 10% of …
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Handshakes transmit germs: What are doctors to do?

Get rid of the trolls in medicine

Petr Rholls

Medical Education

September 22, 2014

Scientist J. Robert Oppenheimer once said, “There are children playing in the streets who could solve some of my top problems in physics, because they have modes of sensory perception that I lost long ago.”

Like physics, medicine has its share of problems, namely cost control.

Like children, we must open our perception to the problem of cost control to consider other possibilities that better account for the issue than the theories …

Read more…

Get rid of the trolls in medicine

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