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Why abstinence only sex education is a waste of money

Patient

June 18, 2010

Since 1992, the federal government has spent close to $1 billion on abstinence-only sex education, despite growing evidence that these ideology-based programs are ineffective in delaying the onset of sexual activity, preventing teen pregnancy and the spread of sexually-transmitted disease among teens.

Meanwhile, comprehensive sex education—the kind where teens are given information about both abstinence and contraceptives—has received virtually no federal funding.

That’s why it was so encouraging when President Obama released …

Tips for students who want to shadow doctors

Vineet Arora, MD

Medical Education

June 17, 2010

On a recent Saturday, I rounded in the hospital. I met up with Zainab, the president of the minority premed association for the University of Chicago, who asked to shadow me. While she was doing research at the hospital, she had not ever rounded in the hospital before. It was Saturday so our team was mostly off so it was just me and my very capable resident who is about …

Measles from rejecting vaccines, and the price society pays

Amy Tuteur, MD

Physician

June 17, 2010

Vaccine rejectionism is based on a profound lack of knowledge about immunology, statistics and science. Virtually every single empirical claim of vaccine rejectionism is factually false, but parents who lack even the most basic understanding of immunology are often incapable of evaluating those empirical claims.

Indeed, those parents most likely to proclaim themselves “educated” on the topic are generally the most ignorant.

A new paper on a recent measles outbreak, Measles Outbreak …

E-mail can screen college students for depression

Kristina Fiore

Patient

June 17, 2010

by Kristina Fiore

E-mail may be a simple and cheap way to screen college students for depression, but it’s not likely to motivate them to seek treatment, researchers said.

A commonly-used depression screening tool sent in e-mail blasts to students at four colleges put the prevalence of major depressive disorder at 14.5%, Irene Shyu, MD, of Massachusetts General Hospital in Boston, and colleagues reported at a poster session at the American Psychiatric …

Physicians need to focus on wellness to prevent burnout

Aldebra Schroll, MD

Physician

June 16, 2010

I recently received a bulletin from one of the medical societies to which I belong: the topic was on promoting physician wellness.

My first reaction, “It’s about time “. Historically physicians have struggled with multiple health impacts from the demands of their work, with higher rates of depression, anxiety and suicide than in the general population. Physicians train under circumstances of extreme stress often resulting in unhealthy coping strategies; strategies frequently …

Why a doctor chose OB over family practice

Kevin

Physician

June 16, 2010

by RH+, MD

More than anything in life I wanted to be a family practitioner (FP).

Going into medical school there was little doubt in my mind that this was my chosen path. I chose a school that had a significant focus on primary care and was president of the Family Practice Club my second year. I had shadowed several FPs and truly enjoyed the continuity of care that went into FP.

When …

Multiple vaccines in infants are harmful, a theory disproved

MedPage Today

Medications

June 16, 2010

by John Gever

Worries that cramming multiple vaccinations into the first months of life slows brain development have no basis in fact, researchers said.

There was no evidence of neurodevelopmental delays or deficits associated with on-time vaccination in an intensively studied cohort of more than 1,000 children, according to Michael J. Smith, MD, and Charles R. Woods, MD, of the University of Louisville, in the June issue of Pediatrics.

“These data may reassure …

Do large hospital systems increase healthcare costs?

Roy Poses, MD

Health Policy

June 16, 2010

In Rhode Island, hospitals that are part of hospital systems were paid more for the same services than independent hospitals.

The price differences could not be explained by quality of care or severity of illness. The results suggested that market power determines the price of hospital services, and that increasing concentration of power in hospital networks is likely to further increase costs, without improving quality of care.

Recently, a similar report out of the neighboring state …

Who really benefits from President Obama’s health reform plan?

Erin Marcus, MD

Health Policy

June 15, 2010

I don’t know about you, but as I watched coverage of President Obama signing the health care bill three months ago, it was hard not to notice the constant ads for power wheelchairs. Emblazoned across the ads was a flashing notice reminding viewers: Medicare may cover this!

Don’t get me wrong. As a primary care doctor who takes care of low-income patients, I was glad to see something being done to …

Why the medical chart may not improve patient care

Edwin Leap, MD

Physician

June 15, 2010

Why do we physicians chart the way we do? Hopefully, you do it perfectly well and have no concerns at all. But where I practice emergency medicine, we are approaching maximum inefficiency in charting.

It all became much clearer when we started using our new EMR system. Let me make it clear, I’m not against EMR. In fact, typing and templates work better for me than dictating. My dictations were usually …

iPhone app that empowers patients may be harmful instead

Satish Misra, MD

Health Technology

June 15, 2010

Unless you spent the last two years in a Himalayan monastery, you are certainly aware of the bitter healthcare battle that unfolded in Washington.

Underlying the nonsense about death panels from the right and claims of impending doom from the left lies a far more legitimate conflict about how we view healthcare – as a basic human right or as a market service. Conservatives generally ascribe to the latter, viewing non-emergent …

Doctors make far less money than most people think

Kevin

Health Policy

June 15, 2010

A video excerpt from The Vanishing Oath, a film directed by Ryan Flesher, MD.

The average physician salary in the United States is $146,000 — which is undeniably a lot of money at face value.

But it’s a lot less when you factor in the overhead costs that doctors incur. And that’s not including the medical school debt which, on average, exceeds $150,000.

This clip shows how the take home pay of …

Medical loss ratios is not all about health insurance profits

David Williams

Health Policy

June 14, 2010

The new health insurance reform law will generally require health plans to pay out at least 80 or 85 percent of premiums in medical expenses, depending on whether they are selling to individuals/small groups or to large groups. Intuitively it makes sense that purchasers would want the medical loss ratio to be as close to 100 percent as possible –- since the purchaser doesn’t derive utility a plan’s administrative expenses …

Prescription drugs and its copycats contribute to health waste

Roy Benaroch, MD

Medications

June 14, 2010

I’ve recently posted about the insane costs of health care, and about how defensive medicine is a big contributor. Prescription drugs are another huge cost, accounting for about 11% of the 2 trillion spent each year on health care in The United States. And it turns out that the marketplace for prescriptions is also rife with bizarre sources of waste and sneakery.

First, some good news: prescription medications are …

Statins do not decrease the risk of many cancers

Kristina Fiore

Medications

June 14, 2010

by Kristina Fiore

Claims of unintended benefits of statins appear to be largely unsubstantiated and known risks — including liver and renal problems and myopathy — confirmed, British researchers concluded based on findings from a large prospective open cohort study.

The study involving more than two million people, “largely confirmed other studies that reported no clear association between statins and risk of cancers,” Julia Hippisley-Cox, MD, and Carol Coupland, MD, of the …

Primary care is more than just office visits

Robert Wachter, MD

Physician

June 13, 2010

If you’ve ever been on a diet, you know that it really helps to keep a food log. Seeing your consumption chronicled in one place is illuminating – and often explains why those love handles aren’t melting away despite two hours on the treadmill each week.

In a recent issue of the New England Journal of Medicine, internist Rich Baron Rich Baron chronicles the work of his 5-person Philadelphia office practice …

Government and marathon runner motivation

Jeffrey Hall Dobken, MD, MPH

Health Policy

June 13, 2010

Giving advice is usually a thankless business. I have always been mindful of the unconsciously profound summation given by a six-year-old when she was asked to identify Socrates. “Socrates,” she stated, “was a really old Greek guy who went around giving people good advice. They poisoned him.”

But here goes: We do not need government intervention to improve our health, and, by extension, the quality of our lots in life.

This essay …

Primary care doctors at a competitive disadvantage to midlevels

Hans Duvefelt, MD

Physician

June 13, 2010

A primary care resident wrote in one of the journals recently about making the limited time she has with each patient matter the most.

How refreshing, I thought when she concluded that time ultimately is an absolute and finite resource. We often feel as if we are battling time as much as we are battling disease, and we sometimes have trouble admitting when we are losing either one of those battles. …

Don’t let a doctor make you feel uncomfortable

Diana E. Lee

Physician

June 12, 2010

by Diana E. Lee

One member of my health care team is a migraine specialist in another state. Since we don’t have many opportunities to work together in person, we generally try to pack a lot into my periodic two-day visits.

Last time I was there I had an experience that has left me feeling guilty all these months later.

My doctor, who I respect and admire greatly, asked if I was interested …