The scientific literature is replete with the failure of vitamins to support diseases.  Yet, the industry is booming and people's cabinets are filled with potentially harmful, poorly studied colorful bottles that make unsubstantiated magical claims. This year, we witnessed Dr. Mehmet Oz, a celebrity doctor who frequently extols weight loss products, supplements and vitamins on his syndicated television show come under fire from regulatory committees for false claims and poor outcomes. The ...

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Top stories in health and medicine, August 6, 2014From MedPage Today:

  1. Advocacy Groups Take Obesity Naysayers to Task. Two obesity advocacy groups took to the pages of the Archives of Internal Medicine this week to castigate a report that questioned the legitimacy of obesity as a disease and cast an unfavorable light on new weight-loss drugs.
  2. Shoulder Pain: PT Works ...

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At the recent gubernatorial candidates forum on mental health, Martha Coakley repeated the oft-heard phrase that depression is like diabetes. Her motivation was good, the idea being to reduce the stigma of mental illness, and to offer "parity" or equal insurance coverage, for mental and physical illness. However, I am concerned that this phrase, and its companion, "ADHD is like diabetes," will, in fact, have the exact opposite effect. A ...

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Anyone from outer space reading the news and watching TV would think that the U.S. has some of the worst health care possible. The negativity appears to be pervasive. Controversy over this, outrage over that. Whether it’s inadequate health outcomes, policy debate, or scandals with patient care, the stories and discussion abound. As someone who grew up and went to medical school overseas and then came to the U.S. for medical residency (along ...

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I knew immediately it was a problem.  It was not just that Faith’s cancer had spread with innumerable masses in her liver, golf ball-like tumors in her lungs, punched out holes in her bones.  It was not that the chemo, third round and toxic, had failed.  Those were awful things.  Rather it was her response as I began to tell her.  As soon as I said, “I looked at the ...

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For a very long time, one of the most valuable business assets in New York City was a yellow cab taxi medallion. With recent value in the $1 million dollar range, ownership of the medallion was a virtual cash annuity, combined with equity growth (in 2004 medallion prices were in the mid $200,000 range and have increased in value 15% year over year in the 9 years since). As one ...

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There are few things more important than our health and our health care. Solving health care for everyone is critical to becoming a healthy, vibrant society. Because our government has controlled our health care for two generations, election realities and political rancor obscures our ability to collectively solve the problem. Allow me to use a fictitious government program, "Foodaid," to defray the noise and illustrate how government-control of our health ...

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Last August I sat surrounded by 163 other ambitious, new medical students on our “introduction to the profession” week. Anxiety was high with undertones of self-doubt mixed with lofty goals. Another distinguished figure had taken the floor to introduce us to the concept of medical professionalism: commitments to patient-centered care, intellectual honesty, social responsibility and advocacy. The long list of medical virtues we were to develop, cherish, and exemplify in ...

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Top stories in health and medicine, August 5, 2014From MedPage Today:

  1. Ebola: Hunt On to Treat, Prevent the 'Merciless' Virus. In the summer and fall of 1976, two outbreaks of a previously unknown hemorrhagic fever took place in Sudan and Zaire. There was -- because of its very novelty -- no specific treatment and no vaccine.
  2. Four Things Mummies Tell ...

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The deadly outbreak of Ebola virus in West Africa is the worst on record, with over 603 deaths reported as of July, 2014 (according to the CDC Ebola outbreak update). The virus is confirmed in Guinea, Liberia and Sierra Leone -- and the crisis appears to be far from over. The geographical complexity of the current crisis highlights one of the most crucial obstacles to successfully ...

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There are few jobs more chaotic than that of physician, at least based on my own experience. Yes there is a schedule of sorts: hospital rounds, procedures, office patients. Unfortunately things rarely go as planned. There is a particularly sick patient on rounds who needs a temporary pacing wire placed. There are more consults than expected. The procedure that was planned to take up to 2 hours takes 4 hours because of ...

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Florida politicians will not change pediatrician resolve to advocate for and protect children. There’s no question that a gag order cannot halt a passionate child advocate. I’d call the recent Florida ruling a dull tool taken to a very sharp crowd. Consider this post an open letter to Florida politicians. I live as far away from Florida as any continental American (you do the math) yet Florida politics affect pediatricians and ...

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Unify the standard to practice primary care An excerpt from The Demise of Medicine. As with the Aesop fable, familiarity breeds contempt. The role and responsibilities of the physician are being slowly eroded by the media, the legal profession, and even other allied health professions. The tools we hone and more importantly the thought processes physicians develop to diagnose and treat are different than the tools nurses or any other ...

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Inevitably, there will come a time in our medical journeys where we will have to have a difficult conversation with a family about the passing of a loved one. Sometimes, it will be an expected event after a patient has dealt with a long illness at an advanced age; other times, it will be an unexpected event in a person who looked healthy a short time before. These events can ...

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Recent research finds that many internists do not feel comfortable or prepared to care for survivors of childhood cancer. Although the rarity of childhood cancer may explain this, the fact remains that as more and more pediatric cancer patients survive into adulthood busy internists often have some survivors in their practices. These patients would have been treated during the last decades of the 20th century or the beginning of ...

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Top stories in health and medicine, August 4, 2014From MedPage Today:

  1. Healthy Behaviors May Help Stressed Cells Stay Young. Major life stressors appear to be associated with significant acceleration of cellular aging over a relatively short period of time, but engaging in healthy behaviors such as eating well, exercising regularly, and getting enough sleep may mitigate that effect.
  2. Obesity in ...

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Medical errors are estimated to be the third leading cause of death in America’s hospitals. Though some of these errors are beyond physician control, many are the direct result of physician action and inaction. I spend a lot of time thinking about how to reduce these errors and I (like many of my peers) lose sleep over the mistakes I witness. When you ask patients what quality is most important in a ...

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To improve patient care, doctors rely on research and published information. According to an American Medical News report, professional journals are still the most popular source of up-to-date medical information among doctors. These medical publications inform physicians on new drugs and treatments, and they contain peer-reviewed studies that both physicians and patients assume are scientifically accurate. But all too often, research findings aren’t as scientific as they should be. And some are flat-out ...

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I am a great supporter of mental health research but worry that it has lost its sense of proportion and is chasing the wrong priorities. The really glamorous stuff consumes almost all of the enormous NIMH budget and now has behind it the huge addition of a $650-million private donation aimed at solving the genetics of mental illness. Neuroscience is an extremely easy sell to Congress and rich philanthropists because it promises ...

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I have never experienced a military boot camp.  I have however completed a rather intense three-year residency in internal medicine followed by another grueling, three-year fellowship in pulmonary and critical care medicine.  I like to think that my experiences were not unlike those of military training. As a matter of fact, being on the medical wards at the county hospital was referred to as being, “in the trenches.”  It was true.  ...

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