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Does your doctor really know what you should be eating?

Conditions and Diseases

October 28, 2011

For years, it has been widely known throughout the medical profession that basic education in nutrition for training physicians has simply been ineffective. And whether this failure was due to a lack of time or simply a failure of emphasis, the point remains that the medical profession in general is woefully inadequate when it comes to a sound knowledge base related to nutrition and its effects on optimal health. …

Non-judgmental regard can show the best of humanity

Reflex Hammer

Patient

October 28, 2011

On July 24, 1998, a psychotic schizophrenic gunman entered a side entrance at the U.S. Capitol. As he approached Rep. John DeLay’s office, he exchanged fire with two Capitol Police officers who later died of their wounds. The gunman was badly wounded as well.

Senator Bill Frist, a cardiologist, was leaving the Capitol when Congressional aides informed him that some men needed urgent medical assistance.

A New York Times article tells …

The fiscal realities of health care are demoralizing

Maria Yang, MD

Physician

October 28, 2011

In New York, I worked for an organization called Project for Psychiatric Outreach to the Homeless (PPOH). It has a humble history: Over 20 years ago, a group of psychiatrists were sitting around and discussing the need for psychiatric services for the homeless. They decided to volunteer their time and skills to this population.

The organization grew and, for both administrative and financial reasons, eventually became part of another social …

Why hospitals and physicians should get serious about patient-centered care

Steve Wilkins, MPH

Patient

October 28, 2011

Health care professionals are a cynical lot. We joke about the “fad or buzzword of the month,” usually some vague concept heralded by the powers on high. Our job is to promote the idea, knowing full well that the “next big thing” is probably right around the corner.

Take “patient-centered.” It sure feels like a buzz word. I suspect most hospital and physician executives, and their ad agency partners, …

Judging a guideline just by financial interest is intellectually lazy

Robert Donnell, MD

Physician

October 27, 2011

Tom Sullivan, blogging over at Policy and Medicine, recently noticed another flurry of activity in the long running debate about conflicts of interest. His post is titled Coordinated Ad Hominem Attacks on Physician-Industry Relationships in Guideline Development: The Next Frontier?

He opens, saying, “Recently, we saw concerted attacks on clinical guidelines committees, but interestingly, not on the science coming out of them. Instead, the attacks were focused on whether the writers …

Stop paying for tests that don’t improve health

Rosemary Gibson

Health Policy

October 27, 2011

The October 19 Health Affairs briefing entitled “Saving Medicare Dollars and Improving Care,” sponsored by the ABIM Foundation and other funders, was a watershed moment in which ideas that would require less spending on health care that would actually improve care for patients were discussed on K Street. This is a great message for patients and, it so happens, for the super committee deliberations a few miles away.

Dr. Nancy Morioka-Douglas, Clinical Professor of Medicine/Family and Community Medicine …

Quality care is dependent on the total engagement of nurses

Harvey V. Fineberg, MD, PhD and John W. Rowe, MD

Health Policy

October 27, 2011

Six months after Congress passed the health reform law last year, the Institute of Medicine of the National Academy of Sciences issued a landmark report on nursing. Although seemingly separate events at the time, it’s clear now that they are integrally linked: Never has quality care been more dependent on the total engagement of nurses as well as other health professionals.

At its core, the Affordable Care Act is about …

Compassionate care is a crucial component of care

Joyce Hyam, RN

Patient

October 27, 2011

I remember when my best friend was in the hospital thirty years ago and I brought her 3 year old daughter to visit. My friend could not speak. She could only blink one eye and was paralyzed on one side. How she was able to communicate was through the blink of her one eye. I felt her energy of wanting to spend time with those she loved. It was Christmastime …

Targeted therapies improve cancer treatment

Stephen C. Schimpff, MD

Medications

October 26, 2011

The revolution in medicine brought about by greater understanding of genomics has led to a number of targeted therapies in cancer care.

The basic concept is to first find the genomic change or mutation that leads to a disease, then learn its gene product and then develop a drug that inhibits the action of the aberrant gene product. The first was imatinib (Gleevec) for chromic myelocytic leukemia (CML.) When a …

I wish House, MD was here

Dr. Ashley Jacobs

Patient

October 26, 2011

The wards had an odd sanguine feeling that day. The large glass pane doors were streaming a glow from the summer outside, and all was right because I had actually managed to have a lunch break. The High Care Ward is where the most intense monitoring is done so that we doctors can observe suffering in slow motion. I can’t remember what brought me there but in the first bed …

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I wish House, MD was here

Discussing end of life issues with a teenager

Jim deMaine, MD

Patient

October 26, 2011

Marcie transitioned to my care when she turned sixteen. She felt too grown up now to be in the same waiting room with “kids” at the children’s clinic. But she wasn’t doing well.

Her pediatrician had suspected the problem shortly after birth. She wasn’t growing normally, had nasal congestion, and more respiratory infections than usual. A sweat chloride test was ordered which was positive. The diagnosis was cystic fibrosis (CF). The …

PSA testing: Information is better than ignorance

David B. Samadi, MD

Conditions and Diseases

October 26, 2011

With just a few minutes of research on prostate cancer, you will find that it is the most common cancer in men; approximately 1 in 6 men will develop prostate cancer in their lifetime. In these few minutes you will also identify the only two methods available for prostate cancer screening: PSA tests and digital rectal exams (DRE). Alone, these exams are not very sensitive in detecting prostate cancer, …

Direct to consumer advertising works in correction facilities

Jeffrey Knuppel, MD

Medications

October 25, 2011

One might assume that inmates in correctional facilities would not be influenced by big pharma’s direct-to-consumer advertising (DTCA) strategies. After all, their communication channels with the outside world have largely been silenced.

However, many do have access to television. And despite an increase in online pharmaceutical marketing, TV remains a common medium for trying to persuade patients to “ask your doctor” about drug X. Inmates also read magazines, another common …

5 tips to evaluate medical websites

Jill of All Trades, MD

Patient

October 25, 2011

During my transition from public to private health, I have indeed noticed some interesting differences that have forced me to practice medicine a perhaps a tad differently. One big surprise: in private health, I have to admit that I have been pretty astounded to see that my patients quite heavily rely on the Internet before they even come to see me for their given ailments.

In public health, some of my …

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5 tips to evaluate medical websites

The challenges of living with invisible pain or illness

Toni Bernhard, JD

Patient

October 25, 2011

In May of 2001, I got sick with what the doctors thought was an acute viral infection. But I didn’t recover. As the months went by and I didn’t get better, I felt as if I’d entered a parallel universe that I didn’t know existed. One reason this universe is largely invisible is that many people living with chronic pain or illness don’t look any different from those around …

The power of gut feeling in cancer screening

Kevin Pho, MD

KevinMD

October 25, 2011

Cancer screening has always been an emotional topic.

In recent years, both prostate and breast cancer screening have come under increasing scrutiny. Studies are beginning to question the benefits of early detection, and, in the case of prostate cancer screening, whether more harm is done than good.

In fact, the USPSTF recently downgraded their prostate cancer screening recommendation.

In a recent study from …

Evidence based medicine removes a physician’s autonomy

Angry Orthopod, MD

Health Policy

October 24, 2011

Evidence based medicine.

Just think about it for a second. This means now we actually practice medicine based on bona fide evidence? What the hell have I been doing for the past 25 years? Making it all up? And who wrote those thousands of articles I’ve read? Dr. Seuss?

Evidence based medicine, or EBM, may be just another way to remove a physician’s autonomy. This trend has marched on for years, …

Aggressive care at the end of life continues to grow

John Mandrola, MD

Physician

October 24, 2011

There are important medical studies, and then there are landmark studies–the kind of science that disrupts the entire medical community. The most recent game-changer was published recently in the Lancet.

Well known surgeon and author, Dr. Atul Gawande and colleagues published this important look-back study on the intensity and variation of surgical care of 1.8 million elderly patients in the US. They put numbers to the well-known and ever-expanding problem of …

Physicians who cash in on a woman’s desire to be beautiful

Linda Burke, MD

Physician

October 24, 2011

Three young mothers under the age of 40 are dead because they wanted to be beautiful. Kellee Lee-Howard wanted a slimmer body. Ditto Maria Shortall and Rohie Kah-Orukatan. Shortall worked as a housekeeper; Lee-Howard was the mother of six kids and Kah-Orukotan died at the same place where she received manicures. What do these women have in common besides being minorities? They had liposuction procedures performed by men who offered …

Waiting is the bane of the medical system

Lisa Gualtieri, PhD

Patient

October 24, 2011

“By the time you see the doctor, you’re either dead or you’re better,” my mother-in-law told me. She had to have multiple tests, all with long waits to get the appointments and the results, before her health insurer would allow her to make an appointment with a specialist.

“Waiting is the bane of the medical system,” a former student, an R.N., concurred. Advances in medicine and technology have improved medical outcomes, …

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