Cannabis use and medicine, the debate over benefits and harms

Medications
March 22, 2011

An excerpt from Uses and Abuses of Plant-Derived Smoke: Its Ethnobotany as Hallucinogen, Perfume, Incense, and Medicine.

by Marcello Pennacchio, PhD

Few plants have generated as much debate and controversy as cannabis (Cannabis sativa).

Throughout the ages, it has been labelled both a dangerous drug and potent medicine. Where the former is concerned, law-enforcement agents and governments spend millions …

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Cannabis use and medicine, the debate over benefits and harms

What to do with a prescription bottle with the wrong pills inside

Medications
March 22, 2011

Have you ever opened a prescription bottle to find the wrong pills inside? If so, you may have found it to be an expensive mistake.

Whatever the reason for the error (and there are numerous possible causes), here is how to best handle the situation.

Of course, it is always smart to confirm the medications, quantities and dosages at the pharmacy checkout.  A mistake recognized at the time of purchase can be easily …

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What to do with a prescription bottle with the wrong pills inside

Accountable care organizations: The lost art of medicine?

Health Policy
March 22, 2011

by Sharolyn Rhees Medina, MD

It’s no secret that healthcare’s inevitable move toward accountable care organizations (ACOs) has many physicians feeling a bit …nervous. Admittedly, most physicians are creatures of habit who fiercely defend their individual approach to patient care, focus on cures not cost, and dread the concept of “cookbook medicine.”

And under the ACO model, physicians …

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Accountable care organizations: The lost art of medicine?

Doctors should ask the people what they want for health care

Patient
March 22, 2011

Americans typically rely on elected officials to uphold the will of the people. Now physicians—traditionally confined to exam rooms—are taking direct action to fulfill community needs.

In 2004 I decided to meet face to face with citizens in my hometown. I thought, “Why wait for legislation? I’m a board-certified physician. What’s stopping me from serving the public?”

So I led town hall meetings and invited ordinary citizens to create the clinic of …

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Doctors should ask the people what they want for health care

A surgeon on those who understand murderers, rapists and child molesters

Physician
March 21, 2011

(Editor’s note: reader discretion advised)

Recently I was involved in a discussion with a guy that was explaining how we should understand criminals. The emphasis was on farm murders but we touched on murderers in general, rapists and child molesters. My point of view was that I did not understand them and felt that he was justifying their actions. In the end I was informed that I was smug. Apparently that …

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A surgeon on those who understand murderers, rapists and child molesters

Family physicians who care for underserved patients

Physician
March 21, 2011

One of the ugliest incidents in my career occurred during my faculty development fellowship year, when I spent two days each week seeing patients at several federally qualified community health centers in inner city Washington, DC. Midway through the year, I was transferred from a health center that served an African-American population to one serving a mostly Spanish-speaking clientele.

Nearly all of the permanent Read more…

Family physicians who care for underserved patients

How obesity is like alcoholism

Conditions and Diseases
March 21, 2011

Recently, I attended a scientific symposium on addictions.

One of the books I picked up at that conference, and read on my flight to Montreal, is A. J. Adams’ Undrunk: A Skeptic’s Guide to AA.

While this book is a very quick and highly readable introduction to AA (Alcoholics Anonymous), about which I knew very little, today’s post is not about this book.

The definition reads as follows:

Alcoholism is a primary chronic disease …

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How obesity is like alcoholism

Prostate cancer from a patient perspective

Conditions and Diseases
March 21, 2011

by Dan Zenka

As a patient, I feel for anyone who is given a diagnosis of prostate cancer.  Hearing the “Big-C” word can be upsetting enough. But the complexity of the disease—diagnosing it, trying to characterize it and selecting the appropriate treatment—can feel like insult upon injury.  We need to talk about prostate cancers. With 24 known sub-types of this cancer—from …

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Prostate cancer from a patient perspective

Concierge and primary care medical home hybrid model of care

Health Policy
March 21, 2011

As a consultant, I spend a lot of time on airplanes and subsequently get to meet a new “person in the next seat” almost every week. Once the small talk is over, the conversation is nearly the same every time. “Oh, you work in healthcare! What do you think about all of this reform stuff anyway? Is there an answer?” I’m always very cautious how I frame my answer. As those …

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Concierge and primary care medical home hybrid model of care

Evaluating dizziness in the cardiologist’s office

Conditions and Diseases
March 20, 2011

I see a lot of patients who are sent to me for evaluation of dizziness.  On the surface you wouldn’t think a cardiologist would have much to do with a symptom that relates more to the head than the heart, but there is some logic to it—poor blood flow to the brain could lead to dizziness and, since blood flow starts in …

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Evaluating dizziness in the cardiologist’s office

Uncertainty in the diagnostic methods of the obstetrician

Physician
March 20, 2011

by Henry Dorn, MD

In 1974, the noted obstetrician Marcus Filshie published a review of the relatively new electronic fetal monitoring in the British Journal of Hospital Medicine. He stated, somewhat fatefully:

Now that the appropriate technology is available, the obstetrician may virtually eliminate intrapartum stillbirths and reduce morbidity to a minimum.

Similar statements were made in the United States by leaders in the obstetrical …

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Uncertainty in the diagnostic methods of the obstetrician

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Slowing health costs requires answering 3 simple questions

Health Policy
March 19, 2011

If we ever slow health care cost inflation to a sustainable pace, it will be because we learn how to ask 3 simple questions when thinking about a medical treatment.

  • Does it improve quality of life for the patient?
  • Does it extend the patient’s life?
  • How much does it cost?

Asking the questions are of course much simpler than figuring out the …

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Slowing health costs requires answering 3 simple questions

A global view on effectiveness research

Health Policy
March 18, 2011

We badly need effectiveness research — which medical treatments work and which ones don’t. After all, some reasonable estimates are that a third or so what we spend on medical treatments is for things that aren’t known to work, or worse, don’t work. Effectiveness research means comparing two competing therapies to see which works better; if both work the same, our preference …

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A global view on effectiveness research

Osteopathic medicine and the growth of D.O. graduates as physicians

Physician
March 18, 2011

by Tayson DeLengocky, DO

The landscape of healthcare delivery has changed so drastically over the past three decades with the proliferation of allied health professions, increased in medical specialization, managed health care, and technology advancement.

The direct doctor-patient relations have been relegated to the relations between healthcare providers and patients, in which doctors are only participants among other healthcare givers. A healthcare consumer, patient, can be easily further confused when visiting medical …

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Osteopathic medicine and the growth of D.O. graduates as physicians

Emotional issues that come with cancer during the teenage years

Patient
March 18, 2011

When Clarissa was 13 she entered Johns Hopkins Hospital to be treated for relapsed acute leukemia knowing full well that she had only a 40% chance of survival. Today she is 16 and in excellent health. But it took 2 1/2 years of incredibly rigorous treatments to get there. Equally importantly it meant riding an emotional roller coaster for her and her parents.

Clarissa had …

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Emotional issues that come with cancer during the teenage years

Supportive physicians and management to implement an EHR

Health Technology
March 18, 2011

From Medicare/Medicaid incentives to EHR industry ads, it is hard to cut through the hype and determine if your practice is even ready to try to select and implement an EHR.

Implementing an EHR is a transformational exercise for any practice that requires redesigning every aspect of charting, clinical workflow and interaction with patients.  However, in too many cases, practices  approach EHR …

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Supportive physicians and management to implement an EHR

Cancer patients get better care than patients in primary care

Physician
March 17, 2011

Why do my patients with cancer get better care than my patients in primary care? As the senior resident on my hospital’s inpatient leukemia service recently, this question troubled and intrigued me daily.

Despite the sheer complexity of treating leukemia (administration of chemotherapy, bone marrow biopsies, stem cell transplantation), the resources required (transplantation routinely costs $1 million), and the severity of the illness …

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Cancer patients get better care than patients in primary care

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