From the monthly archives:

May 2004

Analyzing the communication between doctor and patient

May 31, 2004

Interesting article from the NY Times investigating communication between physicians and patients. Here are some excerpts:
. . . Two decades ago, in 1984, researchers showed that on average, patients were interrupted 18 seconds into explaining their problems. Fewer than 2 percent got to finish their explanations.
. . . Research shows that only 15 percent [...]

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Why Harvard Medical School is opening a medical campus in the United Arab Emirates

May 31, 2004

Harvard Medical School is planning a medical campus in the United Arab Emirates. Some interesting points:
. . . there are enormous hurdles to fostering US-style health care in a region where medicine is so spotty that the 100 million Persian Gulf residents spend $25 billion a year getting treatment elsewhere, according to Dubai Healthcare City [...]

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Behind the scenes at a Canadian mail-order pharmacy

May 30, 2004

Here is a nice article from the Boston Globe that investigates some of the issues of importing medications from Canada.

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Slow start for medicare cards

May 30, 2004

As a follow-up to what I wrote last week, it seems like the new Medicare cards are slow to take off. And why not? On one hand, you have a dizzying, confusing array of Medicare cards – on the other, you have Canada, which gives you better savings. The choice seems pretty [...]

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Speaking english a disease?

May 29, 2004

Here’s a nice joke from the BMJ:
For those of you who watch what you eat and drink, and worry about heart disease, here is the truth””according to a joke currently doing the rounds. The Japanese eat very little fat, while people in Mexico eat lots. Both groups suffer fewer heart attacks than the British or [...]

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Physicians are punished for missing the rare diagnosis

May 29, 2004

In the article, Why do doctors use treatments that do not work?, several interesting points were made. It is making a case that we need to continually rely on the evidence, and less on empiricism. This is why it is so frustrating when I hear stories where EBM is tossed around like a [...]

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Is Paxil associated with irritable bowel syndrome?

May 28, 2004

IBS is one of the more frustrating diseases to treat. Increased fiber intake, antispasmodic agents, and Zelnorm (for constipation predominant disease) are among the treament choices. However, in many cases, these treatments aren’t enough and many patients unfortunately remain symptommatic. In the GI forum that I moderate, there are many who report [...]

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A slice on rising health costs

May 28, 2004

We all know that one reason for rising health costs is that newer technologies are more expensive. For one small example, consider the evolution from sigmoidoscopies to colonoscopies. The medical director Patient Care writes that sigmoidoscopies have virtually ceased once colonoscopies became a covered benefit under both Medicare and private insurance. Consider [...]

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Inevitable

May 27, 2004

It was only a matter of time that this would happen.
AP:
A businessman has sued the promoters of the Atkins Diet, saying the low-carb, high-fat meal plan clogged his arteries and nearly killed him.

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Scutmonkey comics

May 27, 2004

I got a good laugh from Michelle Au’s scutmonkey comics. Very funny, very true. I particularly like the 12 types of med students.

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More on prostate cancer screening

May 27, 2004

Medpundit and DB has chimed in on the mainstream coverage of the deficiencies of PSA screening for prostate cancer that was discussed here on Tuesday and Wednesday.
Medpundit writes:
Beware of organizations made up of hospitals and urologists who call for lower thresholds for treatment. They have much to gain from the increased number of biopsies such [...]

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Rifaximin for traveller’s diarrhea

May 27, 2004

The FDA approved rifaximin, a non-absorbed antibiotic that remains within the body’s gastrointestinal system, for traveller’s diarrhea. This is in contrast to most other antibiotics which are spread throughout the body. Cipro or Bactrim are medications that are currently used.
A review article has suggested that this therapy may become the treatment of [...]

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Apology after a medical error

May 26, 2004

We’re always told that a sincere apology after a medical error reduces the risk of an impending lawsuit. Here is a story of that theory in practice.

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A normal PSA can miss prostate cancer

May 26, 2004

The mainstream press has caught wind of the NEJM study that was discussed here yesterday. Here are some quotes from the article:
. . . “This study adds to information that perhaps the PSA threshold may be dropped to 2.5 or so,” said Gomella, the Philadelphia urologist. “The number 4 may not be the, quote, [...]

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Cash for prescribing drugs

May 26, 2004

In today’s environment where drug companies are being monitored closely (take TAP’s recent lawsuit in the Boston area for instance) for physician kickbacks for prescribing drugs, comes this story from Italy:
A two-year investigation by the financial brigade found that the Italian subsidiary of Glaxo had mounted an illegal incentives scheme involving 4,713 people, including 4,440 [...]

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Prostate biopsies with a normal PSA

May 25, 2004

In the May 27th issue of the NEJM, a study was released that concluded that biopsy-detected prostate cancer was not rare among men with PSA levels of 4 or less. Prostate cancer was diagnosed in 15 percent of cases in the group with PSAs of less than 4, and of those cases, 15 percent [...]

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