KevinMD.com

July 6, 2010Jul 6, 20106

The following op-ed was published on June 7th, 2010 in CNN.com. "I read all about my condition on the Internet," a recent patient proudly told me. Like other doctors, I'm seeing more patients research their symptoms thoroughly before setting foot…

The following op-ed was published on June 7th, 2010 in CNN.com.

“I read all about my condition on the Internet,” a recent patient proudly told me. Like other doctors, I’m seeing more patients research their symptoms thoroughly before setting foot in the exam room.

Patients are using the Web in unprecedented ways for their own health empowerment. According to the Pew Internet & American Life Project, 61 percent of American adults …

Conditions and diseases

Physical features of autism spectrum disorder (ASD)

William R. Yates, MD

July 6, 2010Jul 6, 2010

Social and language issues dominate most of the discussion about the features of autism spectrum disorder (ASD). A neglected area of study are the physical feature characteristics that have been known to be associated with ASD. Unlike some of the…

Social and language issues dominate most of the discussion about the features of autism spectrum disorder (ASD).

A neglected area of study are the physical feature characteristics that have been known to be associated with ASD. Unlike some of the diagnostic physical changes in disorders such as Down Syndrome, physical features found in ASD are often subtle and missed by most clinicians.

Ozgen and colleagues from the Netherlands, UCLA and the UK …

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Conditions and diseases

Oil spill got you down? Here’s what to do about it

Jeffrey Knuppel, MD

July 6, 2010Jul 6, 20104

As I've watched all of the media reports and videos of the oil uncontrollably gushing into the sea, the decaying marshlands, and the suffering or dead wildlife, the profound sense of sadness, anger, helplessness, and disappointment that I felt after…

As I’ve watched all of the media reports and videos of the oil uncontrollably gushing into the sea, the decaying marshlands, and the suffering or dead wildlife, the profound sense of sadness, anger, helplessness, and disappointment that I felt after 9/11 returned.

I don’t feel it all the time—it’s not clinical depression. It’s just strong negative emotion associated with the fact that both 9/11 and the oil spill were man-made disasters …

Health policy

Does prevention improve health care outcomes and lower costs?

Joseph W. Stubbs, MD

July 5, 2010Jul 5, 20108

by Joseph W. Stubbs, MD, FACP The eighth paragraph of the modern Hippocratic Oath reads: “I will prevent disease whenever I can, for prevention is preferable to cure.” Support and encouragement of prevention are deeply rooted among physicians. Intuitively, to…

by Joseph W. Stubbs, MD, FACP

The eighth paragraph of the modern Hippocratic Oath reads: “I will prevent disease whenever I can, for prevention is preferable to cure.”

Support and encouragement of prevention are deeply rooted among physicians. Intuitively, to prevent a deadly or disabling disease from occurring or stop it at an early stage seems like a bread-and-butter concept with obvious health benefits.

But it should also accrue cost savings by avoiding …

Conditions and diseases

PTSD frequency in National Guard soldiers

MedPage Today

July 5, 2010Jul 5, 20102

by Kristina Fiore After combat duty in Iraq, members of the National Guard appear to have higher rates of mental health problems than soldiers in the Active Component, researchers have found. Rates of post-traumatic stress disorder (PTSD) with serious functional…

by Kristina Fiore

After combat duty in Iraq, members of the National Guard appear to have higher rates of mental health problems than soldiers in the Active Component, researchers have found.

Rates of post-traumatic stress disorder (PTSD) with serious functional impairment increased from about 7% to more than 12% over a nine-month period, compared with only about a 1% increase among those in the Active Component, according to Jeffrey L. Thomas, PhD, …

Conditions and diseases

Kidney stone pain, as experienced by a man and a woman

StorytellERdoc, MD

July 5, 2010Jul 5, 201013

As a typical guy, there are several painful illnesses that can hit our brotherhood in an instant. No warning was given. No "Get out of jail free" pass, either. Just cruising along, having another fine, healthy day, and bam! --…

As a typical guy, there are several painful illnesses that can hit our brotherhood in an instant. No warning was given. No “Get out of jail free” pass, either. Just cruising along, having another fine, healthy day, and bam! — suddenly, you are lying on the floor in severe distress.

The most feared? A testicular torsion. It can happen spontaneously. It can …

Conditions and diseases

Anal cancer screening in HIV+ men

Paul Sax, MD

July 4, 2010Jul 4, 2010

In Journal Watch AIDS Clinical Care, we published a simple case: Clinically stable HIV+ gay man, on HIV treatment; anal pap comes back with “atypical squamous cells of undetermined significance” (ASCUS). What to do with this result? Two experts weighed…

In Journal Watch AIDS Clinical Care, we published a simple case: Clinically stable HIV+ gay man, on HIV treatment; anal pap comes back with “atypical squamous cells of undetermined significance” (ASCUS).

What to do with this result? Two experts weighed in, Howard Libman and Joel Gallant. In Howard’s thoughtful response, he acknowledges the limitations of the data thus far, but said he would refer the patient for high-resolution anoscopy (HRA) and …

Read more…

Anal cancer screening in HIV+ men

Physician voices

Abuse is linked to obesity in children

MedPage Today

July 4, 2010Jul 4, 2010

by Todd Neale Children whose mothers reported chronic abuse at the hands of an intimate partner were more likely to be obese at age 5 than those from violence-free families, researchers found. After controlling for several potential confounders, including maternal…

by Todd Neale

Children whose mothers reported chronic abuse at the hands of an intimate partner were more likely to be obese at age 5 than those from violence-free families, researchers found.

After controlling for several potential confounders, including maternal obesity and depression, children whose mothers reported chronic violence had 1.8 times the odds of being obese, according to Renée Boynton-Jarrett, MD, ScD, of Boston University, and colleagues.

The association appeared to be …

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Abuse is linked to obesity in children

Conditions and diseases

Ranking prestige of medical diseases

Jan Henderson, PhD

July 4, 2010Jul 4, 201015

Among medical specialties, some are more prestigious than others. You can generally tell which ones are more prestigious by how well they pay. Surgery and cardiology, for example, rank at the top of the prestige scale. Psychiatry and dermatology are…

One can also ask if some diseases are considered more prestigious than others, in the opinion of doctors.

A Norwegian doctor, Dag Album, has been investigating the prestige …

Read more…

Ranking prestige of medical diseases

Patient voices

How to treat patients who want everything

Lyle Fettig, MD

July 3, 2010Jul 3, 20102

The Annals of Internal Medicine had a perspective article by palliative medicine communication gurus Drs. Tim Quill, Bob Arnold, and Tony Back which details an approach to discussing treatment preferences with patients who want "everything." When I think of a…

The Annals of Internal Medicine had a perspective article by palliative medicine communication gurus Drs. Tim Quill, Bob Arnold, and Tony Back which details an approach to discussing treatment preferences with patients who want “everything.”

When I think of a patient requesting “everything,” I typically think of it as a response to a physician who offers the patient the choice of “doing nothing” if the patient’s heart should stop or …

Conditions and diseases

Post-traumatic stress disorder (PTSD) may increase dementia risk

MedPage Today

July 3, 2010Jul 3, 20103

by Todd Neale Older U.S. veterans with post-traumatic stress disorder (PTSD) appear to have an increased risk of developing dementia, a retrospective study showed. Compared with those without PTSD, predominantly male veterans with the disorder had a 1.77-fold (95% CI…

by Todd Neale

Older U.S. veterans with post-traumatic stress disorder (PTSD) appear to have an increased risk of developing dementia, a retrospective study showed.

Compared with those without PTSD, predominantly male veterans with the disorder had a 1.77-fold (95% CI 1.70 to 1.85) greater risk of developing dementia, according to Kristine Yaffe, MD, of the San Francisco Veterans Affairs Medical Center and the University of California San Francisco, and colleagues.

The results were …

Physician voices

Euthanasia in dogs and the moral lessons for doctors

Edward Pullen, MD

July 2, 2010Jul 2, 201013

We had our dog put down yesterday. Simon joined our family when our son was 10 years old as a two year old that we adopted from the Purdy Prison Pet Parole Program and was with us until he developed…

We had our dog put down yesterday.

Simon joined our family when our son was 10 years old as a two year old that we adopted from the Purdy Prison Pet Parole Program and was with us until he developed status epilepticus forcing our decision to have Simon euthanized.

Simon had been getting old, lame, nearly blind, and uncomfortable most of the time, but we felt he still had some enjoyment in …

Physician voices

Florida EMTs may go bankrupt because of a malpractice lawsuit

WhiteCoat, MD

July 2, 2010Jul 2, 201046

An ambulance service was recently held liable for failing to “do what was necessary” before accepting emergency transport of pregnant patient. A child was born at 25 weeks gestation -- 15 weeks premature -- and was not breathing. Babies born…

An ambulance service was recently held liable for failing to “do what was necessary” before accepting emergency transport of pregnant patient.

A child was born at 25 weeks gestation — 15 weeks premature — and was not breathing. Babies born at this age have a viability of 50-70%. In other words, up to half of children born at this age of gestation die. The family called 911. The paramedics arrived, performed …

Conditions and diseases

Drinking and smoking associated with migraine headaches

MedPage Today

July 2, 2010Jul 2, 20103

by Kristina Fiore Drinking coffee and alcohol, smoking, and lack of physical activity all appear to be associated with migraine and tension-type headaches in teenagers, researchers found. High consumption of cocktails appeared to put students at the greatest risk for…

by Kristina Fiore

Drinking coffee and alcohol, smoking, and lack of physical activity all appear to be associated with migraine and tension-type headaches in teenagers, researchers found.

High consumption of cocktails appeared to put students at the greatest risk for these headaches, increasing the odds almost three-and-a-half-fold, Astrid Milde-Busch, PhD, of Ludwig Maximilians University Munich in Germany, and colleagues reported online in the journal Headache.

“Rather unexpectedly, recommendations to increase fluid intake as …

Physician voices

A medical home does not guarantee increased patient satisfaction

Steve Wilkins, MPH

July 2, 2010Jul 2, 201014

One of the more notable findings from the special report on the TransforMED National Medical Home Demonstration project was that “patient satisfaction doesn’t automatically go up.” Terry McGeeney, CEO of TransforMED, attributed the lack of increased patient satisfaction experienced by…

One of the more notable findings from the special report on the TransforMED National Medical Home Demonstration project was that “patient satisfaction doesn’t automatically go up.”

Terry McGeeney, CEO of TransforMED, attributed the lack of increased patient satisfaction experienced by the 18 participating physician practices to a variety of factors, chief of which “was the turmoil of change experienced by patients as practices implemented after-hours access, quick access to laboratory results …

Health policy

Op-ed: Paying patients to stay healthy widens the wealth gap

Kevin Pho, MD

July 2, 2010Jul 2, 2010

The following op-ed was published on June 15th, 2010 in the New York Times' Room for Debate blog. In an effort to control health spending, companies are spending more money than ever to keep their employees healthy. More than half…

The following op-ed was published on June 15th, 2010 in the New York Times’ Room for Debate blog.

In an effort to control health spending, companies are spending more money than ever to keep their employees healthy. More than half of large businesses, for instance, offer financial incentives to employees who complete smoking cessation or weight management programs.

When you consider that over 40 percent of premature deaths …

Conditions and diseases

Chemicals that cause cancer can’t be accurately studied

Josh Herigon, MPH

July 1, 2010Jul 1, 2010

Nicholas Kristof in the New York Times writes about a new report from the President’s Cancer Panel calling attention to the role common chemicals may play in the development of cancer. The overarching message is that we should be exercising…

Nicholas Kristof in the New York Times writes about a new report from the President’s Cancer Panel calling attention to the role common chemicals may play in the development of cancer.

The overarching message is that we should be exercising much more caution in our trust of chemicals.

I am not familiar with the nuances of regulatory policies for chemicals, but (as Kristof points out) the “existing regulatory presumption [is] that …

Patient voices

Customer service needs to be a priority in health care

John Schumann, MD

July 1, 2010Jul 1, 201073

What do Enterprise Rent-a-Car, KeyBank, and the Cleveland Clinic have in common? They all make customer (patient) satisfaction a top priority. They accomplish this in industry-specific ways, but together their emphasis on service as a passion shares common themes: 1.…

What do Enterprise Rent-a-Car, KeyBank, and the Cleveland Clinic have in common?

They all make customer (patient) satisfaction a top priority.

They accomplish this in industry-specific ways, but together their emphasis on service as a passion shares common themes:

1. Buy-in for a service culture comes straight from the top, and permeates the entire organization.
2. Copious resources are delegated to building a service culture, starting with hiring.
3. Employees are “hired for fit.” If …

Conditions and diseases

Children of lesbian mothers have healthy psychological growth

MedPage Today

July 1, 2010Jul 1, 201012

by Kristina Fiore Children born to lesbian mothers appear to have healthy, if not better, psychological development when compared with average American children, researchers have found. In the first prospective cohort study of its kind, these children were found to…

by Kristina Fiore

Children born to lesbian mothers appear to have healthy, if not better, psychological development when compared with average American children, researchers have found.

In the first prospective cohort study of its kind, these children were found to have better social, academic, and overall competence and significantly fewer social problems than typical American children, according to Nanette Gartrell, MD, of the University of California, San Francisco, and Henry Bos, PhD, …

Real physician voices, twice a week

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