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Colds teach the immune system how to fight future viruses

Conditions and Diseases

November 27, 2010

Viral upper respiratory illnesses, or common colds, are by far the most frequent illness I see in my office.

It is called the common cold because it is, well, common. I typically can make the diagnosis with a high degree of certainty based on the pattern and the timing of the symptoms. Deciphering cold symptoms and knowing when to worry is what a pediatrician does more often than anything else, and …

Ethics of placebo in cancer treatment clinical trials

Wendy S. Harpham, MD

Conditions and Diseases

November 27, 2010

The New York Times recently ran an article tackling a complex ethical dilemma in cancer care: the withholding of treatment in clinical trials. Because I was treated in 3 clinical trials in the 1990s, the topic is close to my heart.

Scientists have advanced the treatment of disease using the scientific method. By that, I mean they have tested a theory using rigorous methods that give a reliable and reproducible answer. This …

Travel tips for a panic free vacation

Kevin

Conditions and Diseases

November 27, 2010

by Stephen R. Blumberg, PhD

If you are like many Americans, you are planning or getting ready to take a summer vacation. Sounds very exciting. Aruba. A cross-country jaunt. Or a short trip overnight to the coast!

What is exciting for the panic-free community can be agony for a panic sufferer. Why?

The core fear is being trapped far from safety

Whether it is traveling on a cruise ship, airplane, highway driving, …

Read more…

Travel tips for a panic free vacation

Concerns about long term acid suppressive therapy

Chris Rangel, MD

Medications

November 26, 2010

Physicians hate acid. But, hey, who doesn’t hate acid? It burns things. It corrodes. It’s that after-pizza punishment.

We prescribe antacid medications by the ton in this country, not because people’s stomachs have developed increased acidity, but because people in our modern society are generally overweight, like to eat large meals, and prefer fatty foods and things like alcohol, chocolate, and tobacco, all of which tend to worsen acid reflux.

Physicians like …

Should patients be charged for no shows?

Brandon Betancourt

Physician

November 26, 2010

No shows. It seems that no matter what we do, we always have them.

Despite the fact that we call every single person on the schedule to remind them of their appointment the day before (the staff personally makes the call. We don’t use an automated system) we found that in 2009, we had 389 no-shows.

Slicing the data

Is 389 a high number of no-shows? I guess it depends on the size …

How small private practices can still thrive

Susan Giurleo, PhD

Physician

November 26, 2010

Health care is changing at lighting speed. If you don’t know this, or worse, don’t accept it you’re doomed. No. Really. It’s change or close shop. Whether you like it or not, health care reform is going to change the way we practice from now on.

Many physicians are choosing to work for large group practices to buffer themselves from directly dealing with change. Mental health providers could do the same, …

Talk with your family about their end of life wishes

Kevin

Potpourri

November 25, 2010

by Alexandra Drane and the Engage With Grace team

For three years running now, many of us bloggers have participated in what we’ve called a “blog rally” to promote Engage With Grace – a movement aimed at making sure all of us understand, communicate, and have honored our end-of-life wishes.

The rally is timed to coincide with a weekend when most of us are with the very people with whom we should …

Bedbug rashes, and how to prevent and get rid of bedbugs

Michele R. Berman, MD

Conditions and Diseases

November 24, 2010

There’s a new bunch of bloodsuckers running rampant in cities all over the country.

No, they’re not on a new vampire TV show or in a Twilight sequel. They’re bedbugs, and they’ve been showing up in droves in more and more cities across America. And despite what is commonly thought about them, bedbugs do not exist only in the poorest sections of town, they are showing up at 5-star hotels.

That means …

Never forget to advocate for your patient

Anesthesioboist T., MD

Patient

November 24, 2010

There are some lessons we learn and keep re-learning in medicine. For me some of these recurring lessons are,

Listen to your “gut.”
Pay attention to the clues.
Listen to your team.
Don’t be afraid to call for help.

and

Stick to your guns when advocating for your patient.

I encountered a young patient recently, just at the cusp of adolescence and adulthood, who had undergone a procedure related to a sports injury. Other people had been …

Penicillin and the Cocoanut Grove fire in Boston

MedPage Today

Medications

November 24, 2010

by Nancy Walsh

The recent report of the deliberate infection of Guatemalans with syphilis in the 1940s to see if penicillin could cure and prevent transmission of the disease was a reminder of just how short the time has been since most infectious diseases were untreatable. Penicillin — discovered by Scottish biologist Alexander Fleming in 1928 but not available for clinical use until the 1940s — …

Drug reps know what doctors are prescribing

Kevin

Medications

November 24, 2010

An excerpt from White Coat, Black Hat.

by Carl Elliott

[Michael] Oldani worked as a rep in the late 1980s and the 1990s, a period when the drug industry was undergoing key transformations. Its ethos was changing from that of the country-club establishment to the aggressive, new-money entrepreneur.

Impressed by the success of AIDS activists in pushing for faster drug approvals, the drug industry increased pressure …

Why comparing healthcare access to food is a false analogy

Marya Zilberberg, MD, MPH

Health Policy

November 23, 2010

When I was in training as a resident and a fellow, I remember taking only a couple of sick days over the entire 6-year period.

And I had to stay home because I could not stop praying to the porcelain Goddess during a bout of a particularly nasty flu, despite a vaccination. I actually took pride in my health record, and attributed it directly to being rather sickly as a child. …

There is no routine procedure in general surgery

Jeffrey Parks, MD

Physician

November 23, 2010

The life of a general surgeon is one fraught with contingency, soul-crushing doubt, unexpected disaster, and overwhelming stress. I wouldn’t wish it upon my worst enemy. Fortunately, I was brainwashed to a sufficient degree during residency such that I actually don’t mind my job.

One of the reasons general surgery is so tough is that it is nearly impossible to map out your week according to a strict schedule. Maybe at …

Diabetes and leg amputations in McAllen, Texas

Merrill Goozner

Conditions and Diseases

November 23, 2010

The Dartmouth Atlas of Health is once again throwing a harsh spotlight on McAllen, Texas.

This time the Mexican border town has the highest rate of leg amputations in the nation, a new report released recently showed. McAllen’s rate was ten times the rate of Provo, Utah, which had the lowest rate of leg amputations among the Medicare eligible population. The national average was one-third of McAllen’s rate.

McAllen became notorious earlier …

ACP: Health care innovation in the Affordable Care Act

American College of Physicians

Health Policy

November 23, 2010

A guest column by the American College of Physicians, exclusive to KevinMD.com.

by John Tooker, MD, MBA, MACP

The Patient Protection and Affordable Care Act (PPACA) has important provisions – improved access, safety and quality among them – that have the real potential to improve health and health care and, lower costs.

Two recent reports remind us of the …

Noninvasive fat removal in plastic surgery

Anthony Youn, MD

Conditions and Diseases

November 23, 2010

One of the hottest things in plastic surgery is noninvasive fat removal.

I’ve mentioned on Rachael Ray Showthat fat removal without any invasiveness is the ‘holy grail’ of plastic surgery, and I still stand by it. I’ve gone over the Zerona a few times, but what about Zeltiq, a.k.a. Cryolipolysis? Does this device actually remove fat without surgery or needles?

Well, let’s review the different fat removing technologies:

1. Diet and exercise. The …

Why you should care about prison healthcare

Jan Gurley, MD

Patient

November 22, 2010

It was kind of amazing how little coverage the recent report on healthcare in our prison systems got. Heck, you may be thinking, I don’t think that’s amazing – why waste airtime on that topic – why should I fret and worry about the healthcare that prisoners get when my child is burning up with fever and coughing up a lung and I can’t even afford to take her to …

Breast cancer transforms a doctor in training to patient in an instant

Kevin

Conditions and Diseases

November 22, 2010

by Jessica Tekla Les, MD

During my third year of medical school I was performing a routine breast exam, more for practice than anything else. I was trying the concentric-circles-around-the-nipple technique, one of several I’d been taught. About halfway through the right breast I found a lima-bean-sized lump, not far from the breastbone. I took liberties with this particular exam. I poked the lump, tried to …

Will primary care be saved by the community health center?

Allen Perkins, MD

Physician

November 22, 2010

As I have written before, the Teaching Health Center is seen as a way to move education into the community (using Community Health Centers as a training resource) and out of the Academic Health Center.

Currently, 20 million Americans receive care in a CHC. They serve Americans who are unable to obtain access through more traditional means, either because of location (the community will not support traditional healthcare) or socioeconomic …

Do online physician rating sites help patients to choose a good doctor?

Kevin Pho, MD

KevinMD

November 22, 2010

The following op-ed was published on October 27th, 2010 in USA Today.

When I ask new patients how they found me, frequently they say on the Internet through search engines such as Google.

Out of curiosity, I recently Googled myself. Numerous ads appeared, promising readers a “detailed background report” or a “profile” of me. Among the search results was information about my practice, whether I was board certified, had any lawsuits against …

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