December 2004
All Stories
FDA Approves Pfizer Drug for Diabetes?
Wow - I read the headline and thought, "That's interesting, since I hadn't heard of a new diabetes drug coming." Turns out, the story was for Pfizer's pain medication Lyrica, which is used for diabetic neuropathy, not diabetes.
What a terrible, misleading headline - doesn't anyone edit this stuff?
GruntDoc strikes a nerve
The uninsured was one of the "hot stories of 2004", and its not likely to improve in 2005
Update on the dueling malpractice initiatives in Washington state
Last month, the lawyer-supported initiative was submitted. This week, the physicians submitted their opposing initiative. The battle will be decided in the fall.
Why medical malpractice isn’t a contest between doctors and lawyers
A lawyer weighs in on the malpractice debate
"Medical malpractice is not a contest between doctors and lawyers. It is instead an example of our legal system seeking to render justice through the time-honored tradition of the jury trial, and opposition to this system by insurance companies."
The Washington Post on the malpractice showdown in Maryland
"The medical malpractice special session in Annapolis seemed destined from the outset to end in a veto-override showdown -- and so it has."
Many of the donated organs in China come from executed prisoners
Also of note, the number of executions in China exceeds by at least two fold the total number of executions in the rest of the world combined.
Colonoscopy still the best when compared to virtual colonoscopy
It's not even close - virtual colonoscopy is still not ready for prime time:
When analysed on a per-patient basis, for lesions 10 mm or larger in size (n=63), the sensitivity of ACBE was 48% (95% CI 35-61), CTC 59% (46-71, p=0·1083 for CTC vs ACBE), and colonoscopy 98% (91-100, p<0·0001 for colonoscopy vs CTC). For lesions 6-9 mm in size ...
Are single-dose antibiotics the future standard drug regimen?
Pfizer is getting single-dose Azithromycin ready for battle
They recently submitted a trio of studies to the FDA, aiming for indications in acute bronchitis, sinusitis, and pneumonia. The obvious benefit of increased compliance is cited:
“"Single treatment is a major advance,"” commented Victor L. Yu, M.D., chief of infectious diseases at the Veterans Affairs Medical Center, Pittsburgh. "“In the real world, compliance is an issue.”"
"“Given the efficacy ...
The governor of Maryland is likely to veto a malpractice reform bill
You can't please everyone all of the time - no bill is going to be perfect.
The malpractice insurance industry in Mississippi is being accused of racism
The FDA docs strike back against Dr. Topol
"'Dr. Topol shows a lack of understanding of the FDA's regulatory authority,' FDA doctors Lourdes Villalba and James Witter wrote in their letter."
One of my colleagues is in Thailand, and people are starting to get worried
Here's to a safe return Bill.
New Celebrex prescriptions fall 56 percent, Naproxyn 33 percent
It seems like people are being switched over to Mobic.
Is Children’s Advil responsible for hundreds of thousands of deaths?
Following up yesterday's story on the lawsuit against Children's Advil, the attorney for the plaintiff states:
This is the equivalent of a medical tsunami -- there was no warning put out whatsoever on this apparently benign, over-the-counter medicine.Just a bit over-the-top, don't you think? Clearly a statement from someone who is blinded by the dollar signs of lawsuits.
Medpundit puts him in his place:
I'm not sure ...
In the aftermath of Vioxx, evidence-based medicine is more important than ever
At the end of this article, there is a nice section on Lodine, which was discussed here several times:
In undertaking its drug review, Veterans Affairs also re-examined the value of a lesser-known pain reliever, etodolac, and began using it more. The drug was first sold in 1991 as Lodine by a company that is now ...
Vioxx tops porn as the top spam topic
Merck should be proud.
Kevin Pho, MD
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How I approach ovarian cancer screening with patients
Ovarian cancer screening clearly touches a nerve. No one doubts that ovarian cancer is a devastating diagnosis, often found when the disease...
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Why more primary care doctors are referring patients to specialists
According to a recent study from the Archives of Internal Medicine, primary care physicians are referring more patients to specialists than ever...
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Should Google censor anti-vaccine claims?
One of the reasons there is such a movement against vaccines is the democratization of information, perpetuated by search engines like Google....
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Radiologists who cheat on their board exams: Who’s to blame?
In a widely circulated CNN article, many radiologists have been found to cheat on their board exams: "Doctors around the country taking an...
Physician
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Why an anesthesiologist would be needed for organ donation
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...
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5 ways to avoid a misdiagnosis
Billionaire Teddy Forstmann had been diagnosed with a serious form of brain cancer. There’s a tragic twist to the story: according to...
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Benefits of the Medicare Adult Wellness Visit
One of the things I love about family medicine is that I get to care for people of all ages. I almost...
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Cancer has a way of teaching us poignant life lessons
I just finished reading George’s recent post on Evelyn Lauder, who recently passed away from ovarian cancer, and am still stirred by...
Patient
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In love there is a life giving force
Here is a toast to the miracle of love. Not to the romantic, chocolate, dance club nightlife type of love. Not warm...
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How to get ready for death
No one wants to die. Even people who want to go to heaven don't want to die to get there. And yet...
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The long term cost of a pain in the neck
One morning this May, I woke up with a stiff neck. I applied hot and cold therapy all day and took an...
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Preparing for your visit with someone in hospice care
Visiting someone who is dying or critically ill is an experience many of us will have in the course of our lives....
Policy
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AMA: Advocating for Medicare, military and fiscal responsibility
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...
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A critical look at value driven health care
Everyone in the world is talking about “value-driven health care.” Or so it might seem if you pick up a medical journal...
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Surviving the new landscape of physician reimbursement
CNN recently posted an article titled "Doctors Going Broke." It described several cases of independent physicians who are near bankruptcy although they once...
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Doctors lobby Congress to repeal the SGR
One of the things that I like most about my job is engaging with ACP’s physician leadership—the internal medicine doctors who dedicate...
Tech
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There is a patient attached to that implantable defibrillator
As a follow-up to my post on why patients with implantable defibrillators should have access to their device’s data, I am going...
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The pitfalls of email communication with patients
A recent article in the Wall Street Journal reviewed the emerging role of email in healthcare, arguing that doctors should more aggressively...
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Why adoption of EHRs is a transformational event for physicians
Paul Conslato, MD, director of clinical affairs for Lancaster General Medical Group, recently was quoted in the PAMED Better Health Network eZine...
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Why EMR is a dirty word to many doctors
Don’t get me wrong, EMRs (electronic medical records) are inevitable. Over the long-run they are almost certainly good for physicians, patients and...
Social Media
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Using Twitter to deliver health improvement messages
I have decided to spam for public health. Phone calls, text messaging, and even apps have been shown to help improve health...
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Addressing comments on your medical practice’s Facebook page
Does your medical practice allow anybody to post links and comments on your Facebook page? The short answer is yes. We do....
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The Internet is where patients go for pre-visit consultations
As a physician, technology cannot replace you, but it can make you more efficient and effective. This was the message from Richard...
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5 ways doctors can benefit from professional connections
Looking ahead to the next several months, I’ve found myself frequently wondering how many physicians will make this their year to take...
