Albert Fuchs, MD

Albert Fuchs is an internal medicine physician who blogs at his self-titled site, Albert Fuchs, MD.

Processed meats and cancer: How much is too much?

Conditions

November 15, 2015

Recently, a group of researchers in the World Health Organization (WHO) released a study that caused a bit of a kerfuffle. The group, the International Agency for Research on Cancer (IARC), published a paper classifying processed meat as a carcinogen. What’s processed meat? According to the authors, it’s “meat that has been transformed through salting, curing, fermentation, smoking, or other processes to enhance flavor or improve preservation.” That includes …

This is the best way to treat chronic insomnia

Albert Fuchs, MD

Conditions

July 9, 2015

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Chronic insomnia affects 5 percent to 15 percent of Americans. It is far from only a nighttime problem. As all of us know from occasional sleepless nights, the following day is unproductive and sometimes dangerous. Sleep deprived people are more prone to accidents, and are more likely to have depression, anxiety, diabetes and high blood pressure.

It is no surprise then that …

Paying people to quit smoking. Does it work?

Albert Fuchs, MD

Conditions

June 17, 2015

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Smoking is a major cause of heart attacks, strokes, emphysema, and lung cancer. Smoking rates have steadily declined in the U.S. in the last 50 years, but about a fifth of U.S. adults still smoke. Helping them quit would make a major contribution to their health.

A study in the New England Journal of Medicine (NEJM) studied the effectiveness of different …

Fixing health care doesn’t necessarily need political reform

Albert Fuchs, MD

Policy

May 18, 2015

It’s very hard to find a product or service that is both lousy and unaffordable. Such expensive duds are usually quickly replaced by cheaper and better competitors. Prior to the Affordable Care Act, health care was becoming more expensive every year while simultaneously becoming less convenient, less personal, and less satisfying. In 2009, I wrote a series of four posts explaining how the health care marketplace reached such …

Delivering bad news shouldn’t be easy

Albert Fuchs, MD

Physician

April 16, 2015

Delivering bad news is part of my job, an important part.

It is fashionable nowadays to speak of the doctor-patient relationship as a partnership. In the sense that both doctor and patient have important roles to play for the patient to get good care, that’s very true. But even in the best of times, it’s a very asymmetric partnership. Even in a run-of-the-mill visit for a sinus infection the patient and …

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Delivering bad news shouldn’t be easy

The power of expensive placebos

Albert Fuchs, MD

Meds

February 19, 2015

The power of placebos has long been known. People who believe that they are taking an effective drug frequently feel better. In fact, prior to the discovery of penicillin, it is likely that the placebo effect accounted for much of the benefit of medical care.

A study published in the journal Neurology makes an interesting connection between the magnitude of the placebo effect and the medication’s perceived price.

The study enrolled 12 …

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The power of expensive placebos

Those who refuse vaccines endanger all of our kids

Albert Fuchs, MD

Conditions

December 16, 2014

Unfortunately, measles is in the news again.

Measles is a very contagious viral illness that causes a high fever, rash, cough, and a runny nose. Complications include pneumonia, brain inflammation and death. Prior to 1963 there were hundreds of thousands of measles cases in the U.S. annually, causing hundreds of deaths. In 1963 the measles vaccine was introduced, leading to an immediate decrease of measles cases in this country.

In 2000 measles was …

Which is the right flu vaccine for you?

Albert Fuchs, MD

Meds

October 23, 2014

The best way to avoid the flu is spending the months from fall until spring in a solitary bunker, communicating with other people only electronically. The second best way is getting the flu vaccine. The Centers for Disease Control and Prevention (CDC) recommends the flu vaccine for everyone over 6 months who doesn’t have a specific contraindication to it.

Because of the increasing number of different flu vaccines that are now …

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Which is the right flu vaccine for you?

Ebola in Texas: Why you shouldn’t freak out

Albert Fuchs, MD

Conditions

October 5, 2014

The first Ebola patient has been diagnosed in the U.S. This news is likely making many of my regular readers wonder, “Should I freak out?” This is a reasonable question, and I will attempt to answer it. But first, let’s go over how this nasty microbe spreads.

Ebola is caused by a virus that is transmitted through contact with the bodily fluids of someone who is sick. It is not airborne; …

Low-fat or low-carb diets: Interpreting results of the new study

Albert Fuchs, MD

Conditions

September 16, 2014

The joys of September! Parents gleefully shove their reluctant children onto school buses, the palm trees in Los Angeles don’t change color, and everyone realizes that they gained 20 pounds during their summer vacation. It’s time to get serious again about losing weight.

But how should you eat to best help you shed the extra pounds? Many people are passionate about their favorite diet, but there is very little data comparing …

The ice bucket challenge: A poor way to allocate your donations

Albert Fuchs, MD

Physician

September 10, 2014

Amyotrophic lateral sclerosis (ALS, sometimes called Lou Gehrig’s disease) is a truly horrible illness. It is a progressive fatal neurodegenerative disorder that leads to worsening muscle weakness.

Weakness in the limbs initially makes handwriting sloppy and makes it hard to button clothes and eventually causes paralysis. Patients also develop weakness in the muscles that control swallowing and speech, eventually requiring them to use feeding tubes and computer text-to-speech software. Eventually the …

The problem with an anti-medication bias

Albert Fuchs, MD

Meds

June 6, 2014

“I don’t like taking medicines.”

All physicians hear some form of this opinion very frequently. Even more frequently, patients don’t state this view outright but rely on it to completely subvert their doctor’s plans.

When I was new to practice such an utterance would shock and confuse me.

“I don’t want to take any medicines,” a patient would declare.

“That’s fine,” I would reassure my interlocutor. “It’s a free country. No one is going …

Curing hepatitis C, but at what cost?

Albert Fuchs, MD

Conditions

May 27, 2014

In the contest to get a creative name, few pathogens have done worse than hepatitis C. In the 1970s there were two known viruses that caused hepatitis: liver inflammation. You might have already guessed that these two viruses were called hepatitis A and hepatitis B. It was known at that time that people sometimes developed hepatitis after blood transfusions and that the majority of those patients tested negative for hepatitis …

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Curing hepatitis C, but at what cost?

Despite positive trends, diabetes care has a long way to go

Albert Fuchs, MD

Conditions

May 6, 2014

The danger of diabetes is not only the immediate risk of very high blood sugar. Diabetes also has many dreaded long-term complications. (In this post I am referring to both type 1 and type 2 diabetes mellitus.) Diabetes greatly increases the risk of stroke, heart attack, and amputation. In the US it is the leading cause of kidney failure and of blindness in adults.

A study performed by researchers at the …

Is what we know about dietary fats wrong?

Albert Fuchs, MD

Conditions

April 3, 2014

Most humans have spent most of human history nearly starving to death. So it’s no surprise that we spend a lot of time thinking about food. And it’s no surprise that food has acquired cultural, social, and religious significance in almost every society. Because food is so important, and because it’s nearly impossible for us not to ascribe powerful effects to anything important to us, every society imbues special health …

Perverse incentives push physicians to order ineffective tests

Albert Fuchs, MD

Physician

March 21, 2014

When I meet a new patient, I’m frequently astounded by the health care he has received. I’ve met patients with absolutely no cardiac symptoms who have been receiving EKGs every six months for years. I’ve had patients brag to me about their annual executive physicals in which myriad tests including treadmill stress tests and chest x-rays were routinely performed. Patients get head-to-toe CT scans under the mistaken hope that they …

The societal problem of opioid addiction

Albert Fuchs, MD

Meds

March 6, 2014

Opioids are a family of pain medications chemically related to opium and heroin. They include morphine, fentanyl, codeine, hydromorphone and others. Opioids have unique properties that make them both indispensable for pain management and extremely dangerous.

Unlike virtually any other family of medications, opioids have no maximum effective dose. If any dose, no matter how high, is ineffective at controlling pain, a higher dose can give more pain relief. Most other …

N. meningitidis: Mother Nature is usually trying to kill us

Albert Fuchs, MD

Conditions

December 12, 2013

Those of us who believe in the unvarying beneficence of Mother Nature have yet to contemplate Neisseria meningitidis. N. meningitidis is a bacterium that can live harmlessly in the throats of healthy people.

But about 500 times a year in the US it causes bacterial meningitis, a life-threatening infection in which the membranes lining the brain and spinal cord become inflamed. Bacterial meningitis is treatable with antibiotics but even with treatment patients sometime suffer …

Lessons from the polio outbreak in Syria

Albert Fuchs, MD

Conditions

November 19, 2013

If you remember the 1950s you probably remember the terror of polio. Polio, short for poliomyelitis, is a disease caused by a virus which can cause severe inflammation of the spinal cord. Though most infected people have no symptoms, a small fraction of patients are left with permanent paralysis and deformities. The disease is sometimes fatal. In the US, the 1952 polio epidemic killed over 3,000 people and left over …

Albert Fuchs, MD

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