Top stories in health and medicine, July 24, 2014From MedPage Today:

  1. Weight Watchers Tops in Efficacy Vs. Cost. Among the most popular diet programs and drugs, Weight Watchers trims the most bulge for the buck, according to a new cost-effectiveness analysis.
  2. Probiotics: Moderate Impact on BP? Probiotics cut blood pressure by roughly 4 mm Hg systolic and 2 mm Hg ...

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As a doctor, I’m trained to do many things: I listen. I ask. I examine, order, and test. And then I assess. I certainly try to treat. All too often, this includes prescribing. What frequently gets obscured in this paradigm is that, on many occasions, the listening part is enough. Take Gene, for instance. He’s a retired biochemist. When I met him for the first time as a patient, I took a ...

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Another year of medical school soon begins.  There's no better way to greet incoming students than this The Book of Mormon parody from the University of Chicago Pritzker School of Medicine (who also brought you their gone-viral rendition of Let It Go).  Good luck, first-year medical students: The book of Netter's will indeed change your life.

We believe in data. We are scientists after all. And yet in this new era of big data is it possible we are measuring the wrong things? Most measures of physician performance are process or intermediate outcome measures aimed at a production line model of care. Was an A1c done, did the physician use a computer to send an order to the laboratory, were antibiotics given within two hours of presentation. Yet ...

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If you (or a loved one) have been admitted to a hospital recently, you were probably surprised by the number of times you were asked the same questions. At first you might assume that the staff are being diligent in double-checking your information, but after the fifth healthcare provider asks you to explain why you’re there, you start to feel as if interacting with “the system” is like talking to ...

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It’s easy to get frustrated in the ER. First, you’re at work. Second, most of your patients don’t want to be there. Third, many (if not most) of your patients don’t need to be there. Finally, by the time you see them, most of your patients are tired of being there. It’s easy to become jaded when you trudge through this never-ending mire of patient after patient, and indeed ER docs ...

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It all comes down to willpower, right?  Strength of purpose.  Muster the resolve to skip dessert, and you have a shot at losing that spare tire hanging off your belly.  Succumb to your temptations, however, and you are simply being weak. But is it just weakness that causes us to overeat? A study in Psychological Science suggests that our inability to resist that mouthwatering looking chocolate cake doesn’t arise simply because our ...

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The Veteran’s Administration is under fire for covering up deaths. Men and women who were eligible for care languished on impossibly long waiting lists and even worse when some died waiting for care their deaths were covered up. This is horrific and everyone wants to know how this tragedy could have happened? Veteran’s hospitals have long waits in my experience because they are underfunded, many (if not all) patients with complex ...

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Top stories in health and medicine, July 23, 2014From MedPage Today:

  1. Salt Consumption Tied to Heart Risk in T2D. Higher salt intake was associated with a greater risk of cardiovascular disease in patients with type 2 diabetes.
  2. Three-Drug Cocktail Has Promise in TB. An experimental, three-drug tuberculosis (TB) treatment regimen demonstrated bactericidal activity in patients with drug-sensitive or multidrug-resistant disease.

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In another entry for the communication category, here’s a little play I wrote: Scene: Pre-op area.  Patient arrives for surgery exactly at the scheduled start time, that is, 90-minutes late. Anesthesiologist (me): Good morning Mrs. Jones.  I’m Dr. so-and-so.  How are you this morning? Patient: Oh, doctor, I have the most terrible headache.  They told me my surgery was at 11 so here I am at 11, and now they tell me I’m late. Me: ...

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Family physician Mike Evans is famous for his terrific whiteboard videos, where he distills complex medical ideas to its most understandable essence.  Here, he tackles low back pain, a condition that most adults will experience sometime during their lives. Watch and learn how more tests for back pain isn't necessarily better.

As many of you picked up from the tone of my last article, I am feeling much, much better. As more time has passed from the disasters of six weeks ago when I lost my relationship and home (making me feel more physically ill than I had felt this entire time), my body has finally had a chance to recover. I also have benefitted from a three-week break ...

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As most everyone knows, medicine is not an exact science. Every patient and every family must be treated individually. We all recognize that many things have the possibility of not going perfectly, especially when an ill child presents to the hospital. I am lucky enough to be a part of many families’ experiences at the hospital that go so well that you want to tell people about them. Goodness knows, there ...

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The other day Atul Gawande tweeted the following:

I am not against checklists. When I was a surgical chairman, I implemented and used one in both the operating room and the ICU. They do not add costs and ...

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I have written many columns urging doctors to be honest with their patients, especially about difficult news.  Too often patients are lead on false hope therapy rides, rather than empowered with honest information so that they can cope with their disease and future. Doctors are not the only ones who can keep a painful secret. I admitted Sarah to the hospital late on Saturday night.  For over two years, she had ...

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The Commonwealth Fund just published its fourth Mirror, Mirror on the Wall study comparing the U.S. health care system with other countries, and as in all previous studies, we ranked as the absolutely worst health care system in the developed world, bar none. Yikes. The Commonwealth Fund studied many health care domains, and we didn’t rank in first place for anything. The best we managed to do is place a lackluster third ...

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Top stories in health and medicine, July 22, 2014From MedPage Today:

  1. Error: You Have No Payments from Pharma. The federal government has a word for physicians who don't have financial relationships with pharmaceutical and medical device manufacturers: "Error."
  2. Do the Eyes Really Have it in Diabetes? Novartis and Google garnered much media attention last week when they announced their partnership ...

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In my past few shifts in the emergency department, I have seen the following patients who were seeking further care after being treated by other providers. One was a child who had been seen twice at an urgent care clinic. He had a fever of 103 degrees and wasn’t eating. The first time he went to the urgent care center, he was diagnosed with an ear infection. He was started on ...

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Adverse events -- when bad things happen to patients because of what we as medical professionals do -- are a leading cause of suffering and death in the U.S. and globally.  Indeed, as I have written before, patient safety is a major issue in American health care, and one that has gotten far too little attention. Tens of thousands of Americans die needlessly because of preventable infections, medication errors, surgical ...

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For scientists and researchers who are developing new treatments for disease, Data is power.  For patients, Data can mean empowerment.  Devices that track health indicators are readily available.  These devices can track heart rate, blood pressure, blood sugar and even respiratory rate and body temperature. In the Wall Street Journal, the medical applications of the Fitbit device are explored.  The Fitbit is a basic pedometer that tracks movement, steps taken, calories consumed ...

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