Have you ever wondered by some people never get colds? Why do other people get colds at the drop of a sneeze?
An opinion piece recently published in the New York Times explains away a common myth—that you have to strengthen your immune system to fight a cold. His argument is that your symptoms of a cold are actually your immune system over-reacting to harmless viruses. This is …
Sleep-breathing, your immune system, and colds
by Ray Carlson
As we all know, this past March Congress passed and the President signed The Affordable Care Act. One component of the new legislation was the creation of a program called the Pre-Existing Condition Insurance Plan (PCIP). This is a federally funded high risk pool for state residents who – having been denied individual insurance coverage within the past 12 months for a pre-existing condition – would now, theoretically, …
Why the Pre-Existing Condition Insurance Plan (PCIP) fails
Year: 1993
Setting: Mendi Hospital, Southern Highlands province, Papua New Guinea
Position: Chief medical officer for Chevron
Chevron is contributing to the budget of Mendi Hospital in the capital city of the Southern Highlands province. Each year, the hospital director sends a financial request to the company’s medical department, and this is my first time to review and approve it. Curious about how the money will be used, I phone the director to …
Waste at hospitals in developing countries
Recently, medical writer and pediatrician Perri Klass wrote in the New York Times about evolving issues regarding the diagnosis of appendicitis in children, which are also applicable to adults. There is well-documented concern regarding the excessive radiation exposure associated with CT scans.
For example, a recent paper reported that a single abdominal CT scan with contrast delivers a radiation dose equal to undergoing more than 200 regular …
Appendicitis in children and radiation exposure from CT scans
What’s happened to psychiatry over the last 15 to 20 years? That’s a big subject, discussed in many recent and excellent books. One of those books is by Daniel Carlat, author of Unhinged: The Trouble with Psychiatry – A Doctor’s Revelations about a Profession in Crisis
One of the problems Carlat readily acknowledges is that psychiatry is excessively focused on psychopharmaceuticals at the …
How the pharmaceutical industry changed psychiatry
Have you ever discharged a patient from the hospital and had a gnawing feeling that maybe you could have done more to educate the patient about their disease, medications, and plan of care?
Probably so. A recent survey published in the Archives of Internal Medicine tells us that this feeling is based in reality (I’m guessing that you already knew this) and that you are not alone.
The …
Educate the patient about their disease and discharge plan
Five years ago my associate and I invested sixty thousand dollars to purchase and set up an electronic health record system and eliminate extensive paper use.
We researched all available systems and decided upon MediNotes because it was a large company with an excellent record of service and their system met all the national requirements for certification. We worked through our local computer vendor’s family …
A better system is needed to migrate to electronic health records
We’re learning a lot from Massachusetts’ experiment in universal coverage – and some of the lessons are rather enlightening.
According to Bestwire, Lora Pellegrini, president of the Massachusetts Association of Health Plans, said something along the lines of “That’s the problem with the new U.S. health care reform law … it offers millions of uninsured Americans access to health insurance but doesn’t address underlying medical costs, which are contributing to costly …
Learning from the Massachusetts experiment in universal coverage
They are coming in fast under the radar, out of peripheral vision, in the magician’s other hand—and they will change everything. New ideas, surprising networks, stealth business models that may change health care profoundly, are bubbling up in pilot programs, experiments and full-on corporate transformations. There is something here that does not yet have a name, that no one is yet calling a movement, that no one is yet seeing …
Integration and virtual accountable care organizations in health reform
Medical students today consider lifestyle an essential criteria when choosing a specialty.
It’s become a cliche that most are looking towards the ROAD (radiology, ophthalmology, anesthesiology and dermatology) to happiness.
There’s been some recent media attention at how women are lured to specialties that offer a greater balance between their family lifestyle and professional demands.
Claudia Golden, a Harvard economics professor, recently noted that,
high-paying careers that offer more help in balancing work …
Lifestyle matters for specialties that want to survive
by Shelley Carson, PhD
Both highly creative individuals and ADHD-diagnosed individuals often report feeling out of place, like a square peg in a round hole.
(In fact, in my creativity research questionnaires I actually ask the question “Do you often feel like a square peg in a round hole?” Participants who score high on the Creative …
Creativity and ADHD may share some common genetic vulnerabilities
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 70-year-old woman with hypothyroidism fell and fractured her hip. During preoperative evaluation for hip fracture repair, she mentions recent mild fatigue, which has not significantly limited performance of her daily activities, and ongoing right upper-quadrant abdominal pain after eating. She takes levothyroxine, 0.075 …
MKSAP: 70-year-old woman with hypothyroidism and a fractured hip
I’ve made some fairly outrageous claims about the workload of a neurosurgical resident recently. Seems like a reasonable time to lay out exactly what a day on call can be like for me and my fellow residents.
To be fair an average experience may be hard to articulate. Different rotations and different days yield different … adventures. Right now I’m on a service that could hardly be called grueling, but I …
A neurosurgical resident’s typical day
ADVERTISEMENT
How did the idea that vaccines are dangerous, toxin-filled CDC experiments metastasize so quickly from the fringe to the mainstream?
Keep in mind that not only have vaccines been scientifically proven to be safe, but that some of the arguments against vaccines are so scientifically incredulous they are the equivalent of saying there is a UFO sitting in Central Park right now.
So let’s begin at the beginning. In 1998 Andrew Wakefield …
Conspiracies against vaccines: Blame the media
I have been genuinely blessed by my career in medicine.
When I started medical school, I was living through a very rocky time, dealing with severe, at times suicidal depression. I was working through an outpatient alcohol and drug rehabilitation program, and I was about 40 pounds overweight. I had grown up with a very negative and fatalistic attitude toward life which resulted in chronic misery and a number of personal …
A community of healthy seniors inspires this physician
With the darker days upon us, it may be tempting to try to fight fatigue with energy drinks.
Ever wonder what’s really in them and what they might be doing to you? I just came across an article in the November issue of the Mayo Clinic Proceedings that broke it down nicely.
Here’s the summary.
Caffeine. No brainer. Interestingly, it is on the list of substances banned by the International Olympic Committee (which is …
Energy drinks are unregulated and can be dangerous
So there was a neurosurgeon who called a plumber for a house visit.
The plumber arrived and after spending an hour bestowed the neurosurgeon a bill of $500. The surgeon was stunned; he said, “Even I don’t charge this much after a surgery.” The plumber stood up, gave him a sly look and said, “well that is why I am a plumber now; I used to be a neurosurgeon.”
I mention this …
How a plumber charges more than a neurosurgeon
The official ESC journal Europace publishes an online case report by Dr. Martin Hudec about the extremely rare and spectacular failure of a recently implanted Biotronik 340 VR-T ICD in a 46-year-old man. The battery of the device apparently overheated, causing the device to malfunction and leading to severe internal burning.
On Wednesday, October 6, US electrophysiologist Westby Fisher summarizes the Europace article on his blog and reprints several extremely gruesome …
Suspicious withdrawal of a publication from an academic journal
by Brian Loew
Travelers with medical conditions hope that the TSA pat-down incidents involving bladder cancer survivor Thomas “Tom” Sawyer, at Detroit Metro Airport, and to breast cancer survivor Cathy Bossi, at Dulles Airport, are isolated incidents. But these reports are already creating a chilling effect on air travel for people with medical conditions and disabilities.
This group of travelers could benefit the most from holiday …
Travelers with medical conditions fear increased TSA security procedures
This is a topic close to home.
My wife was diagnosed with stage 3C cancer of the ovary a bit over a year ago. She was a chemotherapy superstar, had few complications, and has been in remission since her treatment finished last October. Still we know her chances of a cure are fairly low.
Understanding statistics is a mixed blessing. Even though her chances of this cancer never recurring are pretty low, …
Living with cancer is different from living after cancer
Get free updates delivered free to your inbox.
