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Observing the Primatene Mist controversy as an asthma specialist

Medications

October 8, 2011

As the clock ticks away on Primatene Mist, the only over-the-counter asthma inhaler left on the market, it is being ginned up as an argument against regulatory overreach by the Obama administration. I have been observing the Primatene controversy for decades as an asthma specialist. I have to say that there’s blame enough on many sides of this discussion, not just pro and con government regulation, but both the pharmaceutical …

Time to put a little bit of Disney into medicine

Anonymous

Physician

October 8, 2011

Why is a trip to the doctor’s office more like going to the DMV than to Disney World? Both the DMV and Disney World involve waiting in long lines, but Disney has made the entire experience fun and exciting, while the DMV has made it cold and frustrating.

“But medicine is different,” you may say. After all, seeing the doctor was never meant to be a fun or exciting experience. When …

MKSAP: 72-year-old woman with fatigue and decreased exercise capacity

mksap

Conditions and Diseases

October 8, 2011

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

A 72-year-old woman is evaluated for fatigue and decreased exercise capacity. The patient has severe chronic obstructive pulmonary disease, which was first diagnosed 10 years ago, and was hospitalized for her second exacerbation 1 month ago. She is a former smoker, having stopped smoking 5 years …

Why medical scientists should share data

George Lundberg, MD and Eugen Tarnow, PhD

Physician

October 7, 2011

Our kindergarten teachers and Hippocrates taught us to share. But after school, capitalism takes over among American medical researchers.

Eric Campbell writes in “Data Withholding in Academic Genetics” that it was frequent for investigators to be denied access to data. The reasons for denials include “too much effort” and protecting potential publications of students and themselves.

The respondents expressed only a little worry about protecting the commercial value of results: …

Psychiatry should not be a tool for social justice

Steve Balt, MD

Physician

October 7, 2011

A doctor’s primary responsibility is to heal, and all of our efforts and resources should be devoted to that goal. At times, it is impossible to restore a patient to perfect health and he or she must unfortunately deal with some degree of chronic disability. Still other times, though, the line between “perfect health” and “disability” is blurred, and nowhere is this more problematic than in psychiatry.

To illustrate, consider …

Palliative care physicians can enhance patient decision making

Mark Novotny, MD

Health Policy

October 7, 2011

Data from the Dartmouth Atlas show patients with chronic illness in their last two years of life account for about 32 percent of total Medicare spending, with much of that expense going toward physician and hospital fees associated with repeated hospitalizations.

Opportunities to reduce medical expenditures during the last 2 years of life are often looked upon as a way to reduce the cost of healthcare while actually improving the …

USPSTF prostate cancer screening guidelines need emotion to resonate

Kevin Pho, MD

KevinMD

October 7, 2011

Prostate cancer screening has always been controversial.

Now, with the USPSTF is recommending against screening for prostate cancer, gas is about to be poured on the proverbial fire.

Recently, the New York Times Magazine published a lengthy piece on the issue, perhaps not coincidentally, perfectly timed with the Task Force’s announcement.

In 2009, advocates for breast cancer screening were up …

5 ways to cut breast cancer risk

Therese B. Bevers, MD

Conditions and Diseases

October 7, 2011

Breast cancer may be the most common cancer among women. But, that doesn’t mean you can’t do something to help prevent it.

Researchers have found certain risk factors that increase a woman’s chances of getting breast cancer. We can’t change some of these factors, like age or race. But we can try to control others, like weight gain and alcohol use.

And, taking responsibility for the things you can control may …

Read more…

5 ways to cut breast cancer risk

Is teaching bedside manner a thing of the past?

Jackie Fox

Patient

October 6, 2011

I caught the tail end of a recent #hcsm (health-care social media) tweetchat and it looked to be a good one. I saw a few comments about teaching bedside manner and whether it’s a thing of the past (oh, how I hope not). It occurred to me that sharing a real-life story could be instructive.

I put on a brave face when I got a mastectomy for stage 0 DCIS …

Physicians need to understand data to provide better and safer care

Donald Tex Bryant

Physician

October 6, 2011

Patients expect excellent care from their physicians. Unfortunately, not all receive such care and most of us realize this. Many who do understand the wide variation in patient care probably believe it is due to the clinical knowledge and attitude of the provider—a very knowledgeable physician or nurse who is passionate about his or her job will deliver the best care. Although these ingredients are necessary for excellent patient …

Practical tips for a more comfortable mammogram

Stacey Vitiello, MD

Patient

October 6, 2011

By now you’ve probably seen the internet jokes that compare the mammogram experience to having your breast squashed in a refrigerator door. A few years back, I joined the club of women who have our annual mammograms, and I can’t say that I disagree with the imagery of the jokes. However, the benefits of early detection far outweigh the discomfort, so I’m willing to put up with it.

I’d like to …

Preventing deaths from food allergy

Scott H. Sicherer, MD

Conditions and Diseases

October 6, 2011

Sadly, recent news reports described two food allergy-related deaths in a single week. Although the details are scant, the victims were a 15 year old and a 20 year old, who apparently ingested unsafe foods and were not treated promptly. These preventable tragedies behoove us to learn how to better manage our food-allergic patients and advocate for them as well.

The Centers for Disease Control and Prevention (CDC) estimated that approximately …

Read more…

Preventing deaths from food allergy

When to see a doctor if you have a new symptom

Rick Donahue, MD

Patient

October 6, 2011

Patients and friends tell me it’s sometimes difficult to decide exactly what symptoms merit a doctor’s appointment. I find that it helps to think of three basic categories of visits. One category is the all-important annual checkup, which assesses and promotes overall health and can detect signs of early disease. Another category is the follow-up appointment to track chronic conditions or recovery from a major illness.

But the third category …

A doctor cannot be on time and take care of your needs

Stewart Segal, MD

Physician

October 6, 2011

Today’s article addresses a common complaint about physicians.

“Freewheel” responded to a previous article by writing the following, “you will not make me wait more than 10 minutes. My time is important, too.” One of the most common complaints I hear is “I waited over an hour to see you!” Waiting for an appointment, particularly when you are sick, is frustrating. Once you have that appointment, waiting for a doc who …

How Steve Jobs mentored a physician and changed health care

Davis Liu, MD

Health Technology

October 6, 2011

I’ve been reading A Game Plan for Life: The Power of Mentoring written by famed UCLA basketball coach John Wooden. Wooden spends half of his book thanking the people who had a powerful influence on his life, coaching, philosophy, and outlook on life. Important people included his father, coaches, President Abraham Lincoln, and Mother Theresa.

Yes, President Abraham Lincoln and Mother Theresa.

Though …

Healthcare professionals need to get an annual flu shot

Norman H. Edelman, MD

Conditions and Diseases

October 6, 2011

Whether you are a physician, nurse, physician assistant, pharmacist, or someone else who cares for sick or disabled people, your job as a healthcare professional is an important one. Healthcare professionals are expected to provide services to individuals in need and to do so with quality and care.

One way we can help ensure that we are doing our job the best way possible is to get our annual flu …

The Haiti cholera outbreak is a repeat of history

Christopher Hamlin, PhD

Conditions and Diseases

October 5, 2011

The Cholera outbreak in Haiti reminded us that this is not simply a disease of the distant and unsanitary past. The outbreak was both unique and typical. Caused by a disease that has a long and devastating history, this Haiti outbreak has much in common with the outbreaks of the nineteenth century and twentieth century. History helps us keep in mind five key factors.

1. The role of media coverage …

Depression causes a drop in productivity at work

Dheeraj Raina, MD

Conditions and Diseases

October 5, 2011

According to a recent study, depression causes an 23% drop in productivity at work. The drop is almost 45% for treatment resistant depression, defined in that study as depression that has not responded to 2 adequate trials (i.e. adequate dosage for adequate duration) of antidepressants.

My gut, based on clinical experience, tells me that even when depressed, people devote lot more of their emotional resources to trying to not let …

Calling yourself Doctor and what that now means

Bradley Flansbaum, DO

Physician

October 5, 2011

In New York State, the issue of scope of practice is at the fore. Mainly, what activities can non-physicians (NP’s) engage in, with or without physician supervision? It is a heated subject here where I reside, but not the one I will address below.

The New York Times discusses a similar matter, although altogether more controversial. Many of you are aware nurses are obtaining doctorate degrees and advancing their training.

The divisive …

Cancer screening is plagued by dissonance

Kevin Pho, MD

KevinMD

October 5, 2011

Last year, the USPSTF was poised to meet regarding its prostate cancer screening guidelines.

According the Kenny Lin, a physician who was with the Task Force at the time, the meeting was cancelled for political reasons. He points us to a New York Times story on the dueling narratives of prostate cancer screening.

It’s a topic that often appears here …

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