Jennifer Gunter, MD

Is Googling patients the same as stalking them?

Physician

May 8, 2014

The New York Times has a recent piece on the practice of doctors Googling their patients. The author, Dr. Warraich, intimates that essentially all doctors have done it at some time. He also writes:

I am tempted to prescribe that physicians should never look online for information about their patients, though I think the practice will become only more common, given doctors’ — and all of our — growing dependence …

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Is Googling patients the same as stalking them?

No, bras do not cause breast cancer

Jennifer Gunter, MD

Conditions

April 29, 2014

The myth that bras cause breast cancer is apparently coming ‘round the barn again. The latest scare-you-out-of-your-brassiere “article” claims there are “five research studies” that show a strong correlation between bra wearing and breast cancer. Well, that certainly sounds all scientific.

Why the bra hullaballoo? A couple of anthropologists wrote a whole book about their incorrect theory back in 1995, Dressed to kill: The link between breast cancer and bras. Every now …

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No, bras do not cause breast cancer

Arizona lawmakers have stepped into the doctor’s office

Jennifer Gunter, MD

Physician

April 18, 2014

Imagine you want health care. You go to your doctor who recommends a medication. Your doctor tells you that the medication used to be prescribed one way 14 years ago, but very rigorous, more recent studies indicate a lower dose is just as effective. And has fewer side effects. And is less expensive.

You are pleased because a) your doctor is up on the latest medical therapies, and b) the least …

Water births should be treated as a medical intervention

Jennifer Gunter, MD

Conditions

April 9, 2014

The joint statement on laboring in water and delivering in water (the latter also known as immersion births) from the American Academy Pediatrics (AAP) and the American Congress of Obstetricians and Gynecologists (ACOG) is making the rounds. I’ve linked to the full statement above, but in essence it says that some women find laboring in water helpful for pain relief (in the first stage of labor it reduces the need for epidurals) …

Statistical significance doesn’t always warrant a miracle headline

Jennifer Gunter, MD

Conditions

March 28, 2014

Interpreting studies is a dicey thing. Often I find what might be statistically significant translated into headlines that might not really get at the nuance of the study or the results.

Take these three for example:

“Pine bark extract improves severe perimenopausal symptoms”
“Two weeks of antibiotic therapy relieves IBS (irritable bowel syndrome)”
“Study: ‘Female viagra flibanserin’ works”

The first line of the last article: “Need a boost to your sex life. The magic could be in …

Does texting ER wait times affect patient care?

Jennifer Gunter, MD

Physician

March 6, 2014

On our recent road trip I was amazed by the number of billboards (from several health care systems and hospitals) advertising texting for emergency room (ER) wait times. My first thought was, “if you can text, how emergent is it?” This was quickly followed by the concern that the option/advertising of texting about wait times might make the ER seem, well, less for acute care and more for convenient care.

Should I be concerned?

There …

Radiologists on the new mammogram study. Who’s right?

Jennifer Gunter, MD

Conditions

February 24, 2014

The BMJ recently published the latest results from the Canadian National Breast Screening Study (CNBSS). A brief summary of the CNBSS: Women were randomly assigned to annual mammography or breast exams and then the outcomes tracked. The results in the BMJ: mammography did not improve survival.

This is a very interesting study and when I first started working on this post I wanted to delve more into the science of …

Deciding what to do with my son’s body

Jennifer Gunter, MD

Physician

January 31, 2014

My eldest son, the first-born of a set of extremely premature triplets, died a few minutes after he was born. Defying the odds I remained pregnant with my other two boys for 24 days.

After holding him for some time in the delivery room, the same room where I myself had delivered hundred of babies and passed them on to families beaming with tears of joy, I was asked about his …

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Deciding what to do with my son’s body

Who is keeping Marlise Munoz on life support against her wishes?

Jennifer Gunter, MD

Physician

January 21, 2014

Brain death is death. This is one of the definitions of death. Even in Texas.

Because brain death is death, a do not resuscitate (DNR) order or invalidating a DNR are both meaningless, because you don’t do procedures on dead bodies. This is why taking someone off a ventilator who is brain dead is not homicide, assisted suicide, or even following a DNR, it is simply the cessation of forcing air into a …

What are politicians doing about the shameful infant mortality rate?

Jennifer Gunter, MD

Physician

January 13, 2014

The infant mortality statistics are out again. This always depresses me because: 1) The rates are atrociously high, and, 2) There is so much legislation passed to restrict abortion in the name of “life,” but politicians and judges seems awfully silent on infant mortality.

In the United States 6.4 infants out of every 1,000 born will not reach their first birthday. This is more than 24,000 infant deaths a year. The United States is also the leader …

Is arthroscopic surgery for a partial meniscal tear unnecessary?

Jennifer Gunter, MD

Conditions

January 2, 2014

Arthroscopic knee surgery is big business in the United States. Arthroscopic partial meniscectomies alone cost $4 billion per year. Yes, billion. But do they work?

I’ve written previously about arthroscopic surgery for a torn meniscus and how it adds nothing above and beyond physical therapy for people with arthritis. We also know that arthroscopic knee surgery for arthritis isn’t effective either. Given the poor performance of these other arthroscopic surgeries, answering the …

Effects of the HPV vaccine last longer than 5 years

Jennifer Gunter, MD

Meds

December 20, 2013

Part of Katie Couric’s controversy on her show about the HPV vaccine was the claim by her expert, Dr. Diane Harper, that the vaccine only lasts for 5 years. I mean, why promote a 5 year vaccine to adolescent girls that will wear off and leave them at risk during their 20s?

The problem with this controversy over the duration of vaccine effectiveness is that it is entirely manufactured.

Dr. …

23andMe is providing data that physicians don’t know how to manage

Jennifer Gunter, MD

Conditions

December 10, 2013

The FDA has ordered 23andMe, a company that does direct to consumer genomic testing, to halt sales. I can’t speak on the accuracy of the results with 23andMe, I think that’s what the FDA is interested in. And this isn’t a post about transparency, because I think everyone should have access to their medical data. This also isn’t a post about genomics being bad. On the contrary, I believe …

I have a shellfish allergy. Can I have contrast?

Jennifer Gunter, MD

Conditions

December 2, 2013

I hear it over and over again.

From a nurse, “She can’t have providine prep, she has a shellfish allergy.”

From the patient, “I can’t have the contrast because I’m allergic to iodine and shellfish.”

The list of allergies placed in the chart by a doctor, “Radiocontrast. Iodine. Shellfish.”

It’s not the fault of the patients who are typically repeating the medical misinformation they have been given. However, the medical professionals who perpetuate the …

Does acupuncture help pregnancy rates in IVF?

Jennifer Gunter, MD

Conditions

November 12, 2013

Acupuncture has become, for many women, an accepted part of their infertility journey. Several studies, including a meta-analysis of 24 studies published in the journal Fertility Sterility in 2012, indicated higher pregnancy rates among women who had undergone acupuncture as part of their treatment protocol compared with women who had no acupuncture or a sham procedure. Any improvement in outcomes is welcome considering the emotional and financial drain of each cycle.

However, there …

Thermography for breast cancer screening: Where is the evidence?

Jennifer Gunter, MD

Conditions

November 1, 2013

Thermography uses heat sensitive infrared cameras to image the body and measure heat emission.

Solid tumors, even when they are tiny, have an increased blood flow and inflammation compared with non-cancerous tissue. Theoretically this could lead to a thermal gradient between a cancer and the surrounding non-cancerous tissues. Some animal studies indicate that thermography might detect heat differences between inflamed and non inflamed tissue and so it was postulated (initially back …

Insurers should stop paying for robotic hysterectomies

Jennifer Gunter, MD

Physician

October 21, 2013

A new study confirms what previous studies tell us. That a robotic hysterectomy is not a safer or a more efficient way to remove a uterus for non-cancerous (benign) surgery than a traditional laparoscopic approach. This study indicates that there is little difference between the two types of surgery with one glaring exception, a robotic hysterectomy was $2,489 more expensive than a laparoscopic hysterectomy.

Several months ago the American Congress of Obstetricians …

Radiation from x-rays and living in Denver: They’re not the same

Jennifer Gunter, MD

Conditions

October 9, 2013

My kids were at the dentist this weekend for their routine cleaning and check ups (yes, Saturday hours!) when the hygienist mentioned x-rays. I smiled and mentioned I’d rather discuss the need with the dentist after his exam. This isn’t a dental x-ray thing, this is what I do for every test that involves ionizing radiation.

My son, Oliver, has had more radiation than most people will have. Ever. In fact, …

What to say to anyone who has a baby in the NICU

Jennifer Gunter, MD

Conditions

September 20, 2013

A friend delivered twins early. One is in the NICU, one died. What can I say or do?

This question was sent to me via Twitter. The person who added my name to the tweet knew that I might have something to offer because 10 years ago I was that friend. I entered the hospital with ruptured membranes at 22 1/2 weeks, pregnant with triplets. My son Aidan died at birth …

Laws based on fetal pain are being dressed with pseudoscience

Jennifer Gunter, MD

Physician

September 6, 2013

10 years ago today my first son was born and 10 years ago today he died.

Born at 22 1/2 weeks he lived for three minutes, at least that’s what was written on the certificate that they gave me at the hospital. It seemed like both hours and seconds.

It was very anticlimactic in a way. I don’t say this to be trite, but it was as if his motor just stopped …