Colon cancer screening rates are still low:
Overall, 58 percent of men and 51 percent of women [aged 50 to 74 years -ed] in the study reported ever having undergone endoscopy, but only 35 percent reported being tested in the five years before 1997. Just 42 percent of men and 31 percent of women reported endoscopy for screening (rather than for disease diagnosis or follow-up).It is recommended by most ...
A nice summary of frequently asked questions to the Vioxx recall from WebMD, including more information on the trial:
What evidence supports the withdrawal?
Merck's decision to withdraw Vioxx from the market is based on new data from a trial called the APPROVe trial. In the APPROVe trial, Vioxx was compared with placebo (sugar pill). The purpose of the trial was to see if the 25 mg dose ...
Pfizer stands by its drug in response to the Vioxx recall, calling Celebrex is an "appropriate treatment alternative," to Vioxx. Too soon to say whether this is a class effect, but certainly Celebrex and Bextra will be closely watched.
James Cramer with a view from TheStreet.com - Merck Will Be Tort Bar's Next Target:
Is Merck going to be a trust for those who took Vioxx? That's what you are betting if you sell this stock down $12. You are betting that the tort bar, which has almost finished destroying tobacco and asbestos, just found its newest target.
Frankly, I think that's a decent bet. I fear ...
Now that Vioxx has been pulled from the market, what to do? My office has certainly been deluged with calls. From what I can gather, the study leading to the recall showed an increased risk of heart attack and other CV complications 18 months after patients took 25mg of Vioxx. Here are some options to ponder if you are on Vioxx:
1) Switch to Celebrex at ...
Following up this previously written piece, today Merck pulls Vioxx from the market. Huge news - and what does the future hold for other COX-2's, like Celebrex and Bextra?
Update:
Here is a link to the study leading to the withdrawal. Some key points:
1) There was an over 3-fold risk of acute MI and sudden cardiac death for those taking over 25mg of Vioxx.
There is an interesting debate going on at Medrants between Dr. Centor and a lawyer. The topic of defensive medicine came up:
Many physicians do order unnecessary tests. This phenomenon occurs most often in emergency rooms, but also occurs in office practice.
When does this occur? I do not have hard data (again db asks for help from the readers), but I believe that I see ...
Medpundit comments on the recent study touting cognitive behavior over medications for insomnia. She writes:
Now, how do I get my patients to believe it? In my experience, people just want "something to help me sleep." I have a hand-out I give patients that describes the steps to improve sleep, which is basically an exercise in retraining bad habits. I go over it with them, but most ...
Pharmacies are thinking about charging for consultations:
Pharmacists like White have long been called on by customers to do more than just fill prescriptions. But drugstores, from giants like Rite Aid to smaller regional chains, are looking to expand their counseling programs and boost revenue - a trend that could be bolstered by the prescription-drug benefit that will become available to Medicare enrollees in 2006.
Think the malpractice crisis isn't affecting the public? Think again:
The IssuesPA/Pew Poll has found that a remarkable 26 percent of Pennsylvanians polled "said rising malpractice insurance costs have forced their family to change doctors in the past year", and that state residents polled also favored a constitutional cap on pain and suffering damages by a margin of 68 percent to 24 percent.
. . . the growing trend of cosmetic neurology. One scenario:
"For instance, if pilots perform better in emergencies when they take donepezil (a drug typically used to treat dementia), should they be expected or required by their employer to take this medication?" Chatterjee said. "We need an explicit notion of what it means to be human and a clear sense of the evolving role of physicians."
Massachusetts has the same number of MRIs as all of Canada, and there are no signs of slowing down:
Not surprising, the number of patients having MRIs is soaring, too; 487,700 scans in 2002, up more than 80 percent in four years, according to the most recent data from IMV Medical Information Division, an Illinois market-research company. Nationally, spending on diagnostic imaging is projected to grow to as much ...
. . . that half of the Viagra pills sold on the internet are fake.
Today marks the debut of Grand Rounds, a weekly summary of the best from the medical blogs. Blogborygmi is hosting this week's edition. Visit and spread the word!
This article suggests that the price-comparison tool on the Medicare web site will have Medicare beneficiaries questioning their doctors about their prescriptions:
The discovery that a competing brand-name drug or generic substitute is significantly less costly will likely convince some beneficiaries to ask their physicians about the appropriateness of a switch, Health and Human Services Secretary Tommy Thompson said at a briefing.
"Nobody compares prices better than ...
Nothing new here, but another article from AMNews comparing the Bush and Kerry health plans.
. . . are drawing closer. Not only in Florida, but also in three other states:
Rivaling Bush vs. Kerry for bitterness, doctors and trial lawyers are squaring off this fall in an unprecedented four-state struggle over limiting malpractice awards. The volatile issue is in voters' hands and each side is desperate to win, spending millions of dollars to make their cases and portray the other side as ...
Studies are continuing to quickly and accurately diagnose chest pain in the ER. I was recently having a discussion where the topic of serum myoglobin came up as a routine part of the cardiac enzyme panel at some institutions.
The hospitals that I work at typically only include the CK, CK-MB and troponin I as markers for cardiac injury - I was less ...
A common scenario that comes up in the GI forum that I moderate is the subject of acalculous biliary pain (ABP - gallbladder pain in the absence of gallstones). The NY Times has an interesting case of this today, where it was diagnosed by repeating the HIDA scan with CCK stimulation. It is a common recommendation that those with a low gallbladder ejection fraction benefit from a ...
More black and white. Tort reform works (from PointofLaw):
The Medical Assurance Co. of Mississippi, which provides medical malpractice insurance to about 60 percent of the doctors in the state, will not raise base premium rates in 2005.
Insurance Commissioner [and Democrat] George Dale said Friday that the decision shows that "those people who said that tort reform would not work and actively fought any civil ...
Ovarian cancer screening clearly touches a nerve. No one doubts that ovarian cancer is a devastating diagnosis, often found when the disease...
According to a recent study from the Archives of Internal Medicine, primary care physicians are referring more patients to specialists than ever...
One of the reasons there is such a movement against vaccines is the democratization of information, perpetuated by search engines like Google....
In a widely circulated CNN article, many radiologists have been found to cheat on their board exams: "Doctors around the country taking an...
I've only had to declare death a couple of times. Once in a three-year-old and once in an adult. In each case...
Billionaire Teddy Forstmann had been diagnosed with a serious form of brain cancer. There’s a tragic twist to the story: according to...
One of the things I love about family medicine is that I get to care for people of all ages. I almost...
I just finished reading George’s recent post on Evelyn Lauder, who recently passed away from ovarian cancer, and am still stirred by...
Here is a toast to the miracle of love. Not to the romantic, chocolate, dance club nightlife type of love. Not warm...
No one wants to die. Even people who want to go to heaven don't want to die to get there. And yet...
One morning this May, I woke up with a stiff neck. I applied hot and cold therapy all day and took an...
Visiting someone who is dying or critically ill is an experience many of us will have in the course of our lives....
A guest column by the American Medical Association, exclusive to KevinMD.com. This week, I’m joining hundreds of physicians and medical students in Washington, DC...
Everyone in the world is talking about “value-driven health care.” Or so it might seem if you pick up a medical journal...
CNN recently posted an article titled "Doctors Going Broke." It described several cases of independent physicians who are near bankruptcy although they once...
One of the things that I like most about my job is engaging with ACP’s physician leadership—the internal medicine doctors who dedicate...
As a follow-up to my post on why patients with implantable defibrillators should have access to their device’s data, I am going...
A recent article in the Wall Street Journal reviewed the emerging role of email in healthcare, arguing that doctors should more aggressively...
Paul Conslato, MD, director of clinical affairs for Lancaster General Medical Group, recently was quoted in the PAMED Better Health Network eZine...
Don’t get me wrong, EMRs (electronic medical records) are inevitable. Over the long-run they are almost certainly good for physicians, patients and...
I have decided to spam for public health. Phone calls, text messaging, and even apps have been shown to help improve health...
Does your medical practice allow anybody to post links and comments on your Facebook page? The short answer is yes. We do....
As a physician, technology cannot replace you, but it can make you more efficient and effective. This was the message from Richard...
Looking ahead to the next several months, I’ve found myself frequently wondering how many physicians will make this their year to take...
