Wednesday, January 31, 2007

The Onion Takes on S.A.D

The Onion

Wah, Wah, I Have Seasonal Affective Disorder




Who doesn't love the Onion? I think it does a lot more for the debate raging around the US Health Care system than C-SPAN does. A whole lot more. What I like best about this piece is how it also subtly attacks our modern perception of mental disease. Does S.A.D warrant the attention and sympathy it gets? Do we take short-term depression too seriously? Why is it that only the Onion prompts me to ask these questions?

The Importance of Knowing what the Doctor is Talking About

The Gadsden Times has a concise, well-written article about the growing danger of medical illiteracy: the inability or unwillingness of patients to understand diagnoses and prescription instructions. As health care becomes more complex and face time with doctors becomes less frequent, patient confusion can lead to even more dangerous health problems. I do believe this is an important medical issue that we need to rectify, but I'm not quite sure if it's entirely new. People have been ignoring doctor's orders ever since there were doctor's orders. This is the type of health article that I find vapid, if harmless. Yes, people very frequently don't ask their doctors the right questions or fully understand the instructions they've been given, and yes, it's a terrible waste of medical resources when that happens, but is it really news-worthy? On the other hand, maybe it's my attitude towards the problem that prevents it from being solved. If medical illiteracy was treated as a modern medical disaster, as opposed to an unfortunate side effect of the entire health care system, we might actually get around to fixing it. Hmm . . .

Tuesday, January 30, 2007

GruntDoc Hosts a Throwdown

Wow, do I love GruntDoc. He posts two excerpts opposing socialized medicine here. Is it just me, or is this issue getting a whole lot more press in the past couple of months? More and more, people are talking about the failings of our health system, and I personally think it's a wonderful thing. Not because I'm some lunatic anarchist (unless you're into that kind of thing, which is totally cool . . . ) but because I relish the opportunity to have a debate about it. Canada, the United Kingdom, swaths of Europe and South America, they all have a socialized medical system and they seem unlikely to give it up anytime soon. They have stopped having the conversation. I can't imagine anything less productive than the premature ending of the debate, particularly a debate raging about such a fundamental social concern as health care. We owe it to ourselves to argue and criticize and nitpick for as long as is prudent, if only so we can be sure that we're not entering into (or backing out of) a social contract without any thought.

D.O., Doctor of Osteopathic Medicine

Newsweek managed to make a huge blunder, one which Gawker has kindly pointed out to us all. It turns out that their Hero M.D. was not an M.D. at all, but instead a D.O., or doctor of osteopathic medicine. Osteopathic medicine "takes a holistic approach to medical care, emphasizing prevention and focusing on the body's musculoskeletal system." Sweet. It's funny, because I also take a holistic approach to medical care. Maybe I should be on next week's cover.

Monday, January 29, 2007

Diet, exercise take off equal pounds?

This is exactly the type of medical reporting that I dislike. This CNN article focuses on a recent study that indicated that dieting and exercise have the same affect on weight loss. A calorie not eaten is the same as a calorie burned off by running. The study also produced data that suggests that gaining muscle mass does not increase metabolic activity and lead to further weight loss, as many Bowflex advertisements would have you believe. Now, I have no problem with relaying the results of this study to the general public, nor do I disagree with any of the findings. I just can't stand the typical end-of-article turnaround that plagues health reporting:

"Ravussin believes exercise is crucial to health, however. 'For overall health, an appropriate program of diet and exercise is still the best,' he said."

Are you kidding me? You just spent an entire article that clearly was meant to shock its readers with the stunning revelation that you can be just as thin by eating lettuce as you can by running 28 hours a day and now you're going to make an obligatory reference to the benefits of a balanced and healthy lifestyle? If an appropriate program is still the best, what exactly makes this news? CNN is praying on a nation obsessed with any new piece of information about dieting and I find it very frustrating.

Reporting Bad Doctors







I'm a Medical Student, Get Me Out of Here, who's graphic I included because I think it's funny, posts about the ethical issues involved in reporting someone who is, in his opinion, a bad doctor. He talks about the damage such an accusation can do not only to the doctor in question, but to the doctor's patients, his hospital, and to the accuser. It's an issue that I'm sure every medical professional has to face at some point in their career, and I imagine that every medical professional has their own rubric for coming to a decision. But I worry that the very nature of health and medicine encourages doctors to not report their peers. Doctors undergo an excruciating training process, they generally work with a team, and that team is often a part of a much larger group such as a hospital or HMO. These and other factors create a strong bond between doctors, a feeling of intense solidarity with others who have undergone similar education and work under similar pressure. This bond might prevent adequate peer evaluation. I can't think of the last time I heard of a doctor taking the stand against another medical professional, whereas I hear stories about medical malpractice suits everyday. Is there a connection between patients suing their doctors and doctors not monitoring their peers? I'm not sure. But I do believe that the people in the best position to determine the ability of someone with special and specific training are the people who also have that training.

Thursday, January 25, 2007

Mobile Phones Make Cancer Grow

It's like a beautiful game of cancer news ping-pong today. The Daily Telegraph reports on a study that found a link between long term cell phone use and a certain type of brain cancer. Individuals who had used cell phones for over ten years were forty percent more likely to develop gliomas, a tumor found in nerve cells in the brain. The most telling detail in the study is that the tumors were more likely to develop on the side where users held their phones. Scary.

Gene Switch Makes Tumors Shrink

BBC News reports on a potential new treatment for cancer here. A gene, deactivated in cancerous cells, causes significant shrinkage (ha) in tumors when it is turned back on. Though it's only been tested in mice so far, the research is very promising. On an only slightly related note, I have a friend named Peter who insists that it's fine that he doesn't exercise and that he drinks seven Diet Cokes every day, because even if he does get cancer, he figures that scientists will have found a cure by then. Feel free to call my friend Peter at 913.530.2280 and tell him he's an idiot.

Wednesday, January 24, 2007

Grand Rounds 3.18

This week's Grand Rounds can be found here. For those of you who don't know, Grand Rounds is a weekly collection/summary of the best medical posts in the blogosphere. One day, my friends, one day I will be up there with the likes of Emergiblog or The Blog that Ate Manhattan. That sounded a lot more "evil scientist" than I intended.

Bush's Health Plan

I'm just going to go ahead and post the "health" section of the State of the Union Address last night.

"A future of hope and opportunity requires that all our citizens have affordable and available health care. When it comes to health care, government has an obligation to care for the elderly, the disabled, and poor children. We will meet those responsibilities. For all other Americans, private health insurance is the best way to meet their needs. But many Americans cannot afford a health insurance policy.

Tonight, I propose two new initiatives to help more Americans afford their own insurance. First, I propose a standard tax deduction for health insurance that will be like the standard tax deduction for dependents. Families with health insurance will pay no income or payroll taxes on $15,000 of their income. Single Americans with health insurance will pay no income or payroll taxes on $7,500 of their income. With this reform, more than 100 million men, women, and children who are now covered by employer-provided insurance will benefit from lower tax bills.

At the same time, this reform will level the playing field for those who do not get health insurance through their job. For Americans who now purchase health insurance on their own, my proposal would mean a substantial tax savings -- $4,500 for a family of four making $60,000 a year. And for the millions of other Americans who have no health insurance at all, this deduction would help put a basic private health insurance plan within their reach. Changing the tax code is a vital and necessary step to making health care affordable for more Americans.

My second proposal is to help the states that are coming up with innovative ways to cover the uninsured. States that make basic private health insurance available to all their citizens should receive federal funds to help them provide this coverage to the poor and the sick. I have asked the secretary of Health and Human Services to work with Congress to take existing federal funds and use them to create "Affordable Choices" grants. These grants would give our nation's governors more money and more flexibility to get private health insurance to those most in need.

There are many other ways that Congress can help. We need to expand Health Savings Accounts, help small businesses through Association Health Plans, reduce costs and medical errors with better information technology, encourage price transparency and protect good doctors from junk lawsuits by passing medical liability reform. And in all we do, we must remember that the best health care decisions are made not by government and insurance companies, but by patients and their doctors."

How about that? Somehow I don't believe that 2007 will be the year that the United States solves its health crisis. But then again, who am I to say?

Tuesday, January 23, 2007

XDR-TB: More Important than Human Rights?

















The BBC posted an article today about the spread of extremely drug-resistant tuberculosis in South Africa, a nation with high rates of HIV infection. Authorities there are recommending detaining patients diagnosed with XDR-TB in an effort to prevent further transmission of the disease, which is doubly dangerous to patients with compromised immune systems. Though I certainly advocate for putting the health of the nation as a whole above the rights of the individual, I wonder if we as a society will recognize when we've gone too far, sacrificed too much freedom. There's no real third party to appeal to when we start trading health for liberty, no one to tell us when to stop.

National Health Insurance













Movin
' Meat has written a lengthy article outlining the costs and benefits of a single-payer health system. In theory, if the national government was responsible for every Americans' medical bills, it could cut costs associated with denying care or processing claims and alleviate the financial pressure health insurance imposes on employers. Would that leave the door open for unscrupulous doctors to over-prescribe care in an effort to scam the government? Maybe, but I'm pretty sure that happens already. Would that add a incredible financial burden onto an already ballooning national debt? Yes, but I would argue that that has less to do with health care and more to do with over-spending on other government programs. Will there ever be National Health Insurance in the United States? Probably not, but then again nobody ever thought that the Dow would break ten thousand or that the Berlin Wall would fall. Read the article and tell me what you think. I haven't quite made up my mind.

Monday, January 22, 2007

Oh My God

There isn't really anything to say.

Freedom to Prescribe











The Concord Monitor published this opinion piece about a New Hampshire law banning the use of physician-specific prescription information for commercial purposes. The article encourages judges and lawmakers to uphold the ban, because selling prescription data makes it easier for pharmaceutical salespeople to pitch expensive or unnecessary drugs to doctors, who in turn pass on those costs to patients and taxpayers. Though I think I agree with the spirit of the law, I am unsure as to whether the piece's logic is sound. I don't see a need for physician-specific prescription information to be sold for commercial purposes, as long as that information is still made available for non-commercial uses. But I'm not sure how providing that prescription data unfairly benefits salespeople. Are doctors such idiots to be duped by their own prescription patterns? Can we pass a law banning other effective sales techniques, like courtesy? I agree with the conclusion but have serious problems with the argument.

God's Diet

This is only vaguely related to medicine and health, but I think it deserves a mention. USA Today compares two articles from two separate newspapers, one describing "God's diet" and the other investigating efforts to "sex up" coffee shops. I can't wait until nutritionists start debating the merits of "the monkey diet" versus "the intelligent design diet" over a grande "nau-ttee" at the local Star-(insert convenient rhyming expletive here). Only in America.

Friday, January 19, 2007

Doctor Anonymous: Uterus transplant

Doctor Anonymous: Uterus transplant.
I think that Doctor Anonymous carefully lays out the arguments against uterus transplants. I'm not sure where I stand on the procedure (are you noticing a pattern?) but I really appreciate that there's a debate about it.

It's Funny Because It's True

I can't tell whether I'm more amused or more worried by this post from The Blog That Ate Manhattan. Do companies have the right to effectively market their products? Of course they do. Should doctors have to change the way they practice medicine because of effective marketing? Of course not.

Vegas Doctor Implanting Stem Cells

Wow. Here we have a Las Vegas physician making unsubstantiated claims about the effectiveness of his illegal stem cell therapies. I can't imagine what it must be like for his patients, hearing about stem cell research in the news and then miraculously discovering a doctor willing to use the technology on them for only six thousand dollars. Are stem cells destined to be modern day snake oil before they're modern day medicine?

Viagra











I'm sorry, but I just find this article hysterical. I mean, is this really news-worthy? I imagine that if you're taking viagra, your decreased sense of smell is probably a blessing in disquise.

Thursday, January 18, 2007

Worth Your Time

I'd like to direct everyone to Kevinmd.com, a truly thought-provoking blog about medicine. His discussion of medical malpractice trials is deft and insightful, and I think the comments make some very strong points. Take a moment to read his stuff. You won't be disappointed.

Cancer Deaths Decline











This CNN article attributes the decline in cancer deaths to earlier cancer detection and improved treatment. I would like to point out that the decline is also due to better informed doctors and patients. Any explanation for a decline in the number of deaths attributed to such a wide spread disease like cancer must take into account effective education programs for the public and for those in the medical profession. We are more aware of cancer than ever before, we are all taking steps to decrease our cancer risk, and a decline in cancer deaths can make the news. Good for us.

Wednesday, January 17, 2007

Military Doctor Gives Afghan Girl Gift of Life














This article, from the Department of Defense News website, makes me really happy. I'm not one to buy into what is clearly government propaganda, but this piece's spin is minimal and message admirable. Doctors throughout the world, be they from Doctors Without Borders or the American military, are doing good where they can with what they can. Quality care is the same in every language: good medicine is a citizen of no country.

Universal Health Insurance

Joe Paduda over at Managed Care Matters posted an article in December about a two-pronged strategy to reform the U.S. health care system. He proposes both universal coverage and community rating as viable remedies to rising health costs. I'm not too sure if I understand exactly what community rating is, or why it is so different from the other means of dividing a population to determine insurance costs. Joe says that with a community rating system "the only means of altering or modifying the premium amount per insured is by geographic area," but doesn't that just mean that geographic areas will become placeholders for things like race and income? How big will the geographic areas be? One could argue that if you give insurers the option of charging people different amounts based on any unit smaller than the state itself, insurers will find a way to make location synonymous with age, sex, and class. Or am I not understanding something?

Tuesday, January 16, 2007

Online Tools for Physicians

Here's an article about Sermo.com, a new online database of sorts for doctors. It lets medical professionals compare information on drugs and drug interactions over the internet. Anything that gets doctors talking to each other is good in my book.

Top Ten Sites for Investigating Doctors

This is a great list of websites to help you check up on your doctor. Sometimes it's hard to get good information on a new physician, particularly if you were referred by your co-worker's cousin's Aunt Rosemary, who may or may not sell her prescription Ambien on Ebay. Because, you know, that's illegal.

Worth Your Time












I'd like everyone to visit emergiblog.com. It's a wonderfully written blog that has a really unique perspective on nursing. It's up for a Medical Blog Award in the Literary Blog category, so you know it's high quality. The stories that Kim tells are half inspiring, half terrifying, half hysterical, and all true. It deserves a moment or two out of your day. I'm also going to steal a picture from the site, because I think it's funny. Oh bedpans, when will you cease to amuse me?

Local Doctor May Lose License For Alleged Sex With Patient

Wow. I guess I don't know what to say about this story. Read it and see for yourselves. The fact that the doctor in question admits to "an encounter" suggests that the woman's accusations are true. I often find myself unneccessarily judging both the accuser and the accused in circumstances such as these. Is that wrong? I mean, on the one hand, clearly something suspect occured between these two people, and at least one of them felt it was cruel enough to warrant criminal action. But, on the other hand, if the doctor is found innocent I doubt the Florida news team will publish a story explaining how he was cleared of all charges. So, much to my own frustration, we are left with half a story. I'll try to follow up on this and see if I can find out the verdict.

A lawyer running an insurance company?

I saw this post on pointoflaw.com about a lawyer in Illinois who is starting a medical malpractice insurance company. I don't know much about medical malpractice law, and I hope to use this blog to educate myself about the topic. It seems that there aren't too many malpractice firms in Illinois right now, and that most insurance firms are in fact run by doctors themselves, instead of by private companies. Can anyone enlighten me as to the nature of the business? Is Illinois particularly litigious, as the post indicates? Gruntdoc.com responds to pointoflaw, and I found a lot of the comments insightful. I'm not quite sure where I stand on medical malpractice suits. I'm inclined to believe that doctors are unduly punished by the lawsuit-happy American public, but I might just be uninformed. Medrants also responds to this development.

Monday, January 15, 2007

Cause of Death: Doc's bad handwriting

I wanted everyone to take a moment to read the Time article here. Despite what you may think, it's actually about a new system for electronically inputting prescriptions. Though I one hundred percent agree with the new technology being tested, I'm not quite sure how I feel about the depiction of doctors in the article. I think the author uses an aggressive and derogatory tag line for an article that isn't really about doctors' handwriting at all. Yes, it is true that doctor error can result in death, but that's been true for centuries. I think I would have liked to learn more about the trend in deaths due to handwriting error over time, maybe a comparison between now and thirty years ago. Has it been increasing, compared to other forms of doctor error? Is the death toll a product of overworked doctors, or of other flaws in the prescription system? I don't really know, and reading the article won't help me find out. I guess this is the type of subtle criticism against the medical profession that I find a little off putting. Tell me what you think in the comments.

Æsculapius, Henry, and Panacea

For my first post, I wanted to outline the purpose of my blog. I've always thought that medicine, while not for me, is a fascinating science, industry, career, and lifestyle. Doctors stand at the intersection of the pharmaceutical industry, the government, patients, lobbyists, hospital adminstrators, etc. I am so impressed by what doctors and other medical professionals can do, yet I often see them maligned, criticized, sued, or otherwise. I wanted to make sure that there was a dissenting voice among the clatter of contrarians, someone who seriously considered the medical issues in our complex world and who didn't condemn the front-line troops because he didn't like the war. You may not agree that doctors deserve our praise, but I hope I can convince you to give them our respect.