September 2009

All Stories

What Mozart can teach us about suberbugs and antibiotic resistance

in Conditions | 2 responses

by Maya SequeiraComposer Wolfgang Amadeus Mozart’s death in 1791 has long been a mystery, but a new study published in the Annals of Internal Medicine suggests that it was, of all things, a common strep infection that killed the maestro at the age of 35.Researchers speculate that Mozart contracted the strep infection—easily treatable today—from a fellow musician who had been hospitalized at a crowded military hospital in Vienna. It’s not ...

The drama of using tPA in stroke within the three-hour window

by | in Conditions | 36 responses

Before telling this story, I’m going to have to lay some background for my non-medical readers.The most obscene word in English, in my opinion, has three letters and is an acronym. It’s tPA (it stands for Tissue Plasminogen Activator).This drug gets a lot of press as a "clotbuster." It has the potential to break down clots and reverse a stroke. That potential, however, has a dark side. By breaking down ...

eRoentgen for the iPhone puts a radiologist by your side

in Conditions | no responses

The following is a sponsored guest post by Constantine Brocoum, a radiologist in Concord, NH. I have personally used eRoentgen, and recommend the product without reservation. by Constantine Brocoum, MDLike most inventions, eRoentgen was developed to respond to a need. As a practicing radiologist, I take frequent calls from primary care providers who need assistance in choosing the smartest way to diagnose their patients’ illnesses. They often need ...

10 things your insured patients need to know about health care reform

in Policy | 10 responses

by Paula Hartman CohenMy husband and I live in Massachusetts, a state that already has health care reform.On April 12, 2006, our state legislature enacted a law requiring all residents to have health insurance.They could buy it themselves, they could buy it from their employer through a group plan or, if their income was below a certain level, they could buy it from the state at a reduced rate. This ...

Why do people cling to false health reform beliefs?

in Social media | 10 responses

Blame motivated reasoning.Newsweek's Sharon Begley writes about the phenomenon, which goes a long way why the myth about "death panels" continues to persist in the health reform conversation. She cites the work of sociologist Steve Hoffman, who explains: "Rather than search rationally for information that either confirms or disconfirms a particular belief, people actually seek out information that confirms what they already believe."And with a growing majority obtaining ...

How can you convince doctors to limit care?

in Policy | 16 responses

In the discussion of cutting health care costs, it's often pointed out that the doctor's pen is the most expensive piece of technology.Hospitalist Bob Wachter talks about the medical profession's zeal to "do everything" as a major driver of health spending. So, how can we stem this tide?Doctors are programmed to advocate passionately for the patient in front of them, with little regard for the macroeconomic impact of ...

H1N1 rap and a swine flu freestyle

in Conditions | one response

Dr. John Clarke is the medical director of the Long Island Railroad and raps some sweet rhymes to H1N1."Hand sanatiza I advise ya get it why, it makes germs die when you rub and let it dry."Genius.width="425" height="344">width="425" height="344">

How hospitalists can provide high quality patient care at the lowest possible cost

by | in Physician | 11 responses

Much has been made of the superior performance – on both cost and quality – of integrated health care organizations like the Mayo and Geisinger Clinics. But since the defining characteristic of these standout systems is at least 50 years of integrated history, few believe that the rest of us – namely the docs and hospitals that provide the bulk of American health care – can quickly achieve such seamless ...

Are generic drugs truly equivalent to brand name medications?

in Meds | 5 responses

In an effort to cut prescription drug costs, there is constant pressure to switch from brand name medications to their generic equivalents.But in this special report from MedPage Today, there may be some variability between generic medications that can lead to clinical symptoms. However, most of the data is anecdotal, and at best, based on retrospective data.For instance, when it comes to anti-seizure medications, some neurologists are cautioning ...

The ultrasound that saved a baby girl’s life

in Patient | 18 responses

by Linda Lee, MDBob Hebert, in his column in The New York Times, recently wrote that, "Life in the United States is mind-bogglingly violent. But we should take particular notice of the staggering amounts of violence brought down on the nation’s women and girls each and every day for no other reason than who they are. They are attacked because they are female."As a family physician I can ...

Can a free market in health care really exist?

in Policy | 35 responses

by James Matthew WeberSome like to talk about a "free market fix" to health care. However, health care and free markets are a contradiction.A free market is an environment where neither the buyer or the seller is compelled to act. There is also an assumption of some level of transparency within the market. In other words, consumers and sellers know what goods and services cost, and can shop around ...

Should patients bear some responsibility when doctors miss a diagnosis?

in Patient | 12 responses

Missing a diagnosis is, obviously, something both doctors and patients continually want to avoid.But when it happens, is it completely the doctor's fault? That's a question Pauline Chen addresses in a recent column. When it pertains to primary care, it all comes down to followup. She cites a recent study looking at breast cancer diagnoses and found that, "roughly a quarter of patients had experienced process ...

What can health reform in the United States learn from Africa?

by | in Policy | 6 responses

As an outside observer of the American health reform debate, I cannot help but notice the disparity of views, the fractured arguments, the protectionism and desperation. My country is in a similar struggle for health care reform, with the main difference being America is a rich nation, and we are poor by comparison. In both debates, however, I have looked for the humanitarian argument, and in many cases found it ...

Is alternative health a form of fundamentalism?

by | in Physician | 17 responses

There once was a time when all food was organic and no pesticides were used. Health problems were treated with folk wisdom and natural remedies. There was no obesity, and people got lots of exercise. And in that time gone by, the average lifespan was ... 35!That’s right. For most of human existence, according to fossil and anthropological data, the average human lifespan was 35 years. As recently as 1900, ...

Is the test that finds the most cancers the best?

in Conditions | 8 responses

When it comes to mammograms, not always.I've written previously that the major problem in cancer screening tests is that they are not specific enough. With both PSA tests looking for prostate cancer and mammograms screening for breast cancer, many lumps or lesions that are slow-growing will be diagnosed, but not necessarily lead to a patient's death.A good piece in the Los Angeles Times outlines the breast cancer screening ...

PSA screening and the overdiagnosis of prostate cancer

in Conditions | 3 responses

by Charles Bankhead, Staff Writer, MedPage TodayOnly one of every 20 prostate cancer diagnoses leads to a benefit that would not have been realized without PSA screening, an analysis of 20-year trends suggests.PSA screening and the overdiagnosis of prostate cancer An estimated 1 million excess diagnoses have accrued since 1986, and the incidence of prostate cancer remains well above levels that existed prior to widespread PSA ...

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