KevinMD.com

January 25, 2011Jan 25, 20112

You are a new parent. Your infant is gassy, fussy, spitty, and does not sleep much. In other words your infant is a normal baby. You are stressed, and like any good parent, you want to fix what “ails” your infant. As you stroll down the baby aisle at the grocery store, you see labels that tout words like gentle, comfort, and restful. Formula manufacturers are brilliant. They know their …

Physician voices

Depersonalization of the patient and the loss of compassion

Wendy S. Harpham, MD

January 25, 2011Jan 25, 20113

A common complaint about modern medicine is the depersonalization of the patient and the loss of compassion. So let's take a look at compassion. Compassion is derived from the Latin "cum" (together with) and "patior" (suffer). From the perspective of…

A common complaint about modern medicine is the depersonalization of the patient and the loss of compassion.

So let’s take a look at compassion.

Compassion is derived from the Latin “cum” (together with) and “patior” (suffer). From the perspective of clinicians, compassion is defined by two concurrent emotions: (1) a feeling of deep sympathy and sorrow for another who is stricken by medical misfortune accompanied by (2) a strong desire to relieve that …

Health policy

How repeal and replace will affect patients

Rishi Manchanda, MD, MPH

January 25, 2011Jan 25, 20112

by Rishi Manchanda, MD As a primary care doctor for working families, I am interested in anything that can tangibly address my patients' health problems. But how do I prescribe repeal? The House effort to repeal and replace last year's…

by Rishi Manchanda, MD

As a primary care doctor for working families, I am interested in anything that can tangibly address my patients’ health problems. But how do I prescribe repeal?

The House effort to repeal and replace last year’s health care law is not just an untested placebo with major potential side effects, like increasing the number of Americans without health coverage. For those of us on …

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Drugs and prescribing

Nicotine vaccine to treat tobacco abuse and nicotine addiction

Chris Rangel, MD

January 25, 2011Jan 25, 20112

Antibodies are complex proteins created by immune cells that are targeted to very specific parts of other large and complex molecules called antigens. Much smaller molecules like nicotine, called haptens, do not normally induce any significant immunologic response so researchers…

Antibodies are complex proteins created by immune cells that are targeted to very specific parts of other large and complex molecules called antigens.

Much smaller molecules like nicotine, called haptens, do not normally induce any significant immunologic response so researchers chemically bound several nicotine molecules to a large protein to form an adduct. This combined molecule does induce an immune response, i.e, causes immune cells to produce antibodies targeted to the …

Physician voices

What your medical office can learn from Norman Rockwell

Brandon Betancourt

January 24, 2011Jan 24, 2011

This past summer I got a chance to visit Washington DC. While I was there, I saw a Norman Rockwell exhibition at the Smithsonian American Art Museum. As it turned out, the exhibition was the private collection of George Lucas…

I didn’t know much about Norman Rockwell before that day. I knew he was a famous American painter and I had seen …

Patient voices

Adherence to HIV treatment in Africa

Paul Sax, MD

January 24, 2011Jan 24, 2011

There has been an irresistible urge for people — doctors, public health officers, politicians, journalists, the usual pundits — to compare adherence to HIV treatment in resource-rich vs. resource-limited setting. I suspect this is because the whole issue got off…

I suspect this is because the whole issue got off to a famously bad start in 2001, when then-head of the U.S. Agency for International Development (USAID) Andrew Natsios said in an interview with the Boston Globe that Africans,

don’t know what Western time

…

Read more…

Adherence to HIV treatment in Africa

Health policy

Guns and why doctors should partner with the National Rifle Association

George Lundberg, MD

January 24, 2011Jan 24, 201162

Is there anything that we physicians can and should be doing to help with the huge problem of gun violence in America? We all know it is nuts to sell guns and ammo to nuts, yet as a country we…

Is there anything that we physicians can and should be doing to help with the huge problem of gun violence in America?

We all know it is nuts to sell guns and ammo to nuts, yet as a country we do it every day.

We all know that, in contrast to rifles and shotguns, the only moving targets for hand guns are people; that the Congress and president in this century legislated …

Drugs and prescribing

Create a disease to market a new drug

Carl Elliott, MD, PhD

January 24, 2011Jan 24, 201111

An excerpt from White Coat, Black Hat. by Carl Elliott Many of us have a relatively simple, commonsense view of the way that drug development and marketing work. People get diseases; scientists develop drugs to treat those diseases; and marketers…

An excerpt from White Coat, Black Hat.

by Carl Elliott

Many of us have a relatively simple, commonsense view of the way that drug development and marketing work.

People get diseases; scientists develop drugs to treat those diseases; and marketers sell the drugs by showing that the drugs work better than their competitors. Sometimes, however, this pattern works in reverse. Drug company scientists develop a …

Read more…

Create a disease to market a new drug

Physician voices

Can a doctor and a nurse be friends in the OR?

Anesthesioboist T., MD

January 23, 2011Jan 23, 20114

One of my best friends in med school was an O.B. nurse. Though she has moved almost all the way across the country and I haven't seen her since I was in school, we're still in touch and expect to…

One of my best friends in med school was an O.B. nurse. Though she has moved almost all the way across the country and I haven’t seen her since I was in school, we’re still in touch and expect to be seeing each other at last in a couple of months.

By some coincidence one of my best friends now is also an O.B. nurse. I’ll call her Ziva (yes, I …

Conditions and diseases

Should obesity be classified as a brain disease?

Michele R. Berman, MD

January 23, 2011Jan 23, 201115

Many of our most popular stories are about diets and weight management. Did you know that some psychologists and psychiatrists would like to classify obesity as a brain disease? The reason for this is that there is mounting evidence that…

Many of our most popular stories are about diets and weight management.

Did you know that some psychologists and psychiatrists would like to classify obesity as a brain disease? The reason for this is that there is mounting evidence that food, or certain types of food, can trigger the same addictive effects in the brain as drugs like heroin and cocaine. There is also substantial evidence that some people lose control over …

Physician voices

How MD anesthesiologists have become victims of their own excellence

Jeffrey Parks, MD

January 22, 2011Jan 22, 201124

The New York Times has jumped all over a couple of recent scientific articles asserting that certified registered nurse anesthetists (CRNA's) provide equivalent care as MD anesthesiologists. Already, it is legal in 15 states for CRNA's to dispense anesthesia without…

The New York Times has jumped all over a couple of recent scientific articles asserting that certified registered nurse anesthetists (CRNA’s) provide equivalent care as MD anesthesiologists. Already, it is legal in 15 states for CRNA’s to dispense anesthesia without the overarching supervision of a physician.

Furthermore, a study from the Lewin Group in California has demonstrated that CRNA-only models of anesthesia provision are far more cost effective that …

Drugs and prescribing

Problems with the connection between thimerosal and autism

Kevin

January 22, 2011Jan 22, 201110

An excerpt from Tabloid Medicine: How the Internet is Being Used to Hijack Medical Science for Fear and Profit. by Robert Goldberg, PhD From the beginning, there were two problems with the connection between thimerosal and autism. The first problem…

An excerpt from Tabloid Medicine: How the Internet is Being Used to Hijack Medical Science for Fear and Profit.

by Robert Goldberg, PhD

From the beginning, there were two problems with the connection between thimerosal and autism. The first problem with was that thimerosal, while about half mercury, contains ethyl mercury, for which there were no exposure guidelines. So the scientists used the ones for methyl mercury. However, the ethyl mercury …

Health policy

Payment systems must take into account the art of medicine

Marya Zilberberg, MD, MPH

January 22, 2011Jan 22, 20115

You know that joke about the farmer whose cows are not producing enough milk? A university panel gathers under the leadership of a theoretical physicist. They analyze each aspect of the problem thoroughly and carefully, and after much deliberation produce…

This joke has become short-hand for some of the reductionist thinking in theoretical physics, but …

Physician voices

Malpractice fails when it comes to medical errors

Jan Gurley, MD

January 21, 2011Jan 21, 201146

Here’s your multiple choice question to set the stage: what percentage of all physicians do you think should be sued for malpractice? Would you say one-in-ten doctors ought to be sued? Or one-third? How about every single one of them?…

Here’s your multiple choice question to set the stage: what percentage of all physicians do you think should be sued for malpractice?

Would you say one-in-ten doctors ought to be sued? Or one-third? How about every single one of them? Let’s make it one claim per doctor, nationwide. Does that sound reasonable? Keep in mind that even defending yourself against a suit will cost on average $40,649 per claim, ranging from …

Patient voices

Are parents to blame for childhood obesity?

Dr. Joe Kosterich

January 21, 2011Jan 21, 201112

Childhood obesity is a problem. It is a function of the foods children eat both at home and at school. The people responsible for feeding children are parents not advertisers. Running the line that it is all to do with advertising allows adults to run a “Johnny told me to” line, which would not be accepted as an excuse from a child.

It is not about blaming parents. It is about …

Health policy

How effective will the physician payment national database be?

Merrill Goozner

January 21, 2011Jan 21, 20114

ProPublica.org did some interesting frontrunning on the physician payment national database that will become operable sometime around 2013 as part of health care reform. In the first of a series of stories that has been picked up by several mainstream…

ProPublica.org did some interesting frontrunning on the physician payment national database that will become operable sometime around 2013 as part of health care reform.

In the first of a series of stories that has been picked up by several mainstream media outlets, the New York-based investigative journalism non-profit culled all the physician payments that have been publicly posted by seven drug companies to date. It aggregated the dollars …

Conditions and diseases

Menopause and cancer: What women should know

Therese B. Bevers, MD

January 21, 2011Jan 21, 20115

Menopause often brings more than physical changes. It also may bring uncertainty about cancer risks and cancer prevention. Below, I’ve compiled some of the questions I frequently hear from patients about menopause and cancer. I hope these answers will help…

Menopause often brings more than physical changes. It also may bring uncertainty about cancer risks and cancer prevention.

Below, I’ve compiled some of the questions I frequently hear from patients about menopause and cancer. I hope these answers will help other women start informed conversations with their doctors about menopause-related concerns.

How does menopause affect a woman’s cancer risk?

Menopause does not cause cancer. But your risk of developing cancer increases …

Conditions and diseases

Mental illness in the college student

Emily Gibson, MD

January 21, 2011Jan 21, 20119

Along with millions of Americans, I've tried to comprehend the tragic shootings in Tucson, reaching deep within myself to find compassion for a young man who has forever changed the world for himself and so many others through his actions.…

Along with millions of Americans, I’ve tried to comprehend the tragic shootings in Tucson, reaching deep within myself to find compassion for a young man who has forever changed the world for himself and so many others through his actions.

For those of us who assess, diagnose and treat college students struggling with mental illness while trying to succeed in their academic pursuits, the events leading up to his impulsive killings …

Read more…

Mental illness in the college student

Patient voices

Compassion and decency overwhelmed by fear

Eileen M.K. Bobek, MD

January 20, 2011Jan 20, 2011

The year after I finished my emergency medicine residency, I had all four of my wisdom teeth pulled. Afterwards, I looked as if I had taken several punches to my face. My jaw was swollen, my skin a cornucopia of…

The year after I finished my emergency medicine residency, I had all four of my wisdom teeth pulled.

Afterwards, I looked as if I had taken several punches to my face. My jaw was swollen, my skin a cornucopia of muddied blues, purples, greens, yellows and reds. If people didn’t know better, I told my husband with a laugh, they might think that I’d been beaten.

It took weeks …

Real physician voices, twice a week

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