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Unnecessary screening tests for asymptomatic adults

Daniel Wolfson

June 16, 2011Jun 16, 201117

I rarely get sick and have no known disease. I’m fit as a fiddle for an aging male. I jog four times a week and have strong vital signs (blood pressure is 120/70). I have no family history of heart…

Besides complying with adult screening recommendations and vaccines, I only see a doctor when I have a persistent cold or sore throat. I fear going to a doctor because …

Docs vs Glocks, and the slippery slope of HB 155

Mona Mangat, MD

June 16, 2011Jun 16, 201139

by Mona Mangat, MD "We take our children to pediatricians for medical care — not moral judgment, not privacy intrusions." This quote by an NRA lobbyist troubles me. The statement reveals degradation in a sacred relationship – the physician-patient relationship.…

by Mona Mangat, MD

“We take our children to pediatricians for medical care — not moral judgment, not privacy intrusions.”

This quote by an NRA lobbyist troubles me. The statement reveals degradation in a sacred relationship – the physician-patient relationship.

This sentiment was prompted by a Florida pediatrician that refused to continue seeing a child after the parents refused to answer whether they kept firearms in the home. Governor …

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How switching from brand name drugs to generics is sometimes absurd

Paul Sax, MD

June 16, 2011Jun 16, 201112

I had an interesting exchange with one of our nurses recently about a long-term patient of ours. The e-mails went something like this: Got a fax from —-’s insurance that his Lipitor won’t be covered anymore. They will cover simvastatin,…

I had an interesting exchange with one of our nurses recently about a long-term patient of ours.

The e-mails went something like this:

Got a fax from —-’s insurance that his Lipitor won’t be covered anymore. They will cover simvastatin, lovastatin, and pravastatin. Let me know what you want to do.
Charlie

He’s on darunavir, and all three of those statins are contraindicated because of drug-drug interactions. Rosuvastatin?
Paul

Checked with them — rosuvastatin needs

…

Jennifer Adaeze Anyaegbunam & Jennifer Sotsky

The accidental genius of homeopathy thrives

George Lundberg, MD

June 16, 2011Jun 16, 201137

All thoughtful physicians I know consider the historical theory and philosophy of homeopathy to be rubbish, balderdash, preposterous, BS, or, politely, NOT PLAUSIBLE; thus, not even worth testing for safety and efficacy. Then, why, when one asks Mr. Google by…

Then, why, when one asks Mr. Google by entering … Homeopathy … and clicking, does one receive 9.9 million results?

And, why does the National Health Service of the U.K. continue to fund homeopathic hospitals, clinics, and treatments?

And why are …

Patient voices

Narrative medicine means more effective healthcare

June 16, 2011Jun 16, 20113

As undergraduate premedical students, we learned about narrative medicine by chance in a New York Times article titled "Learning to Listen." After exploring the research of Dr. Rita Charon, we were both drawn to the new field and what it…

As undergraduate premedical students, we learned about narrative medicine by chance in a New York Times article titled “Learning to Listen.”

After exploring the research of Dr. Rita Charon, we were both drawn to the new field and what it had to offer us as future medical professionals. The Times article explains, “Through literature, [Dr. Charon] learned how stories are built and told, and translated that …

We want our doctors to be perfect, but they’re human too

Michelle Au, MD, MPH

June 16, 2011Jun 16, 20117

Though there are few subjects as immediate to my experience as that described in Gardiner Harris's article in The New York Times, "More Doctors Say No to Endless Workdays," perhaps the truest indication of my opinion on the matter may…

Though there are few subjects as immediate to my experience as that described in Gardiner Harris’s article in The New York Times, “More Doctors Say No to Endless Workdays,” perhaps the truest indication of my opinion on the matter may be the fact that, upon first glance at the headline, I didn’t feel much need to read the rest of the article. More doctors say no …

Before getting a CT scan, ask your doctor if its really needed

John Schumann, MD

June 15, 2011Jun 15, 20112

How and when do new medical technologies become the standard of care? A recent study showed that the use of CT scans in hospital emergency departments rose sixteen percent between 1995 and 2007. Looks a bit like a medieval torture…

How and when do new medical technologies become the standard of care?

A recent study showed that the use of CT scans in hospital emergency departments rose sixteen percent between 1995 and 2007.

Looks a bit like a medieval torture doughnut.

The only thing that surprises me about this is that it’s not more.

Way more.

I remember the first time I actually ordered a CT scan on a patient all by myself, in …

Medical education

Is First do no harm really part of the Hippocratic Oath?

Jessica Gold

June 15, 2011Jun 15, 201110

When Professional Responsibility class began, I was most excited at the idea of not having to sit through another lecture on proteins and cell transport. I was also looking forward to the class where we would be using clickers from…

When Professional Responsibility class began, I was most excited at the idea of not having to sit through another lecture on proteins and cell transport.

I was also looking forward to the class where we would be using clickers from the Library to poll audience responses during the lecture, as doing something while listening to someone talking has a much higher success rate in getting …

How a pediatrician advises parents on sleep training their children

Michael Gonzalez, MD

June 15, 2011Jun 15, 201113

At some point, the novelty of a new baby wears off. Waking up at two in the morning loses some of its appeal. Parents often tell me that their baby does not sleep well. I tell them how they can…

At some point, the novelty of a new baby wears off.

Waking up at two in the morning loses some of its appeal. Parents often tell me that their baby does not sleep well. I tell them how they can get their child to sleep through the night in just three nights. I explain that learning to sleep is a training process, either …

Can xenotransplantation help with the organ shortage?

Stephen C. Schimpff, MD

June 15, 2011Jun 15, 20112

There are many more individuals with end stage kidney failure, heart failure, chronic lung disease, or liver failure who would benefit from a transplanted kidney, heart, lung or liver than are available. Similarly, there are many people with unstable, difficult…

Today the only option for more organs available for transplant …

Health technology

How technology intersects with medicine and its impact on patients

Alison McKnight

June 15, 2011Jun 15, 20113

We are surrounded by technology. No matter where you go, you will find technology rearing its face, whether ugly and ungodly or tempting and beautiful. These advances have brought both good and evil to many professions, especially healthcare. Twenty years…

Twenty years ago, you would not have found signs instructing people to turn off their cell phones in physician offices. Now these signs litter both the reception …

Should academic physicians have the final word on acceptable practice?

Michel Accad, MD

June 15, 2011Jun 15, 20118

The New York Times recently published an opinion editorial entitled "Squandering Medicare’s Money"in which Dr. Rita Redberg, professor of cardiology at UCSF, proposes that much of Medicare’s financial deficit could be reduced if the government did not spend "a fortune…

The New York Times recently published an opinion editorial entitled “Squandering Medicare’s Money“in which Dr. Rita Redberg, professor of cardiology at UCSF, proposes that much of Medicare’s financial deficit could be reduced if the government did not spend “a fortune each year on procedures that have no proven benefit.”

To support her contention, Redberg cites several studies which indicate that many routinely performed tests and treatments …

Medication reconciliation brings the ER back to 1960

Chris Rangel, MD

June 14, 2011Jun 14, 201110

What a blessing and a curse it must have been to practice medicine fifty years ago. Most internists had only about twenty or so medications that they used regularly. It was a curse not to have effective medications to treat…

What a blessing and a curse it must have been to practice medicine fifty years ago.

Most internists had only about twenty or so medications that they used regularly. It was a curse not to have effective medications to treat many common ailments but somewhat of a blessing not to have the modern medical nightmare of having patients on 15-20 chronic medications with all the logistical problems of keeping track of …

Why the word “drug” promotes a public bias in chronic pain treatment

Jack Cain

June 14, 2011Jun 14, 20116

by Jack Cain In the United States, there is a heated debate at all levels over the increased use of narcotic pain relievers, especially as part of a long-term treatment regimen for chronic pain. Part of that debate is fueled…

by Jack Cain

In the United States, there is a heated debate at all levels over the increased use of narcotic pain relievers, especially as part of a long-term treatment regimen for chronic pain. Part of that debate is fueled by the pejorative use of the term “drug” instead of “medication” in conjunction with the legal prescribing, dispensing and consumption of these substances.

Bias is …

A history of smallpox in America

A history of smallpox in America

Michele R. Berman, MD

June 14, 2011Jun 14, 2011

This past Presidents’ Day, I thought it would be a good idea to talk briefly about the role that smallpox played in the life of our first president and it’s important role in the American Revolution. For those who would like to learn about this in greater detail, I would highly recommend the book, Pox Americana: The Great Smallpox Epidemic of 1775-82, written by Elizabeth A. Fenn.

In 1751, when George …

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Insurance companies cutting corners puts patients at risk

Vipan Nikore, MD

June 14, 2011Jun 14, 201114

My patient, whom I’ll call Jane, had a neurologic disorder that prevented her from emptying her bladder properly. She required a permanent urinary foley catheter to help her urinate. Jane landed back at the hospital with yet another urinary tract…

My patient, whom I’ll call Jane, had a neurologic disorder that prevented her from emptying her bladder properly.

She required a permanent urinary foley catheter to help her urinate. Jane landed back at the hospital with yet another urinary tract infection – her third in one month. She had pus draining from her catheter and was infected with a multi-drug resistant strain of the bacteria Proteus. Our lab ran tests (sensitivities) …

Health technology

Hospital inefficiencies observed during a surgery rotation

Anar Mikailov

June 14, 2011Jun 14, 2011

I recently finished my surgery rotation at a Level 1 Trauma Hospital in Philadelphia and amidst the ephemeral eight weeks I quickly realized the immense demands of a surgical residency. So, as an avid technology enthusiast and a team member, I took note of inefficient workflows with potential for technology driven solutions. By discussing the observed inefficiencies and potential solutions I hope to inspire …