Sex or death: The difficult decisions of prostate cancer treatmentAs part of my role as a clinical nurse specialist in a busy prostate clinic, I see men (with their partner) as part of their decision-making process for active treatment for prostate cancer. The purpose of the appointment is for me to explain the results of their prostate biopsy, dispel any misinformation they may have about what those results mean, ...

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Top stories in health and medicine, September 12, 2014From MedPage Today:

  1. Price Tag on Old Insulin Skyrockets. Retired nurse Mary Smith was having trouble controlling her type 2 diabetes on her regular insulin regimen, so her doctor decided to put her on something stronger.
  2. Bedside Ultrasound: Sorting Shadows. In medicine, we frequently propagate half-truths and unsubstantiated certainties. Thus, truth is ...

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7:00 a.m. Lights on.   Coffee, black and a banana. Paperwork.  27 patient visits, 3 emergencies, 35 phone calls.  Lots of computer time. Some laughs and a few tears. Paperwork.  Last family meeting.  Coffee, black.   In between: Thursday. Was not completely successful in explaining to my frantic patient with the multi-page lab printout, how the problem was not that her tests were bad, but that the computer had used the wrong “normal” range ...

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Top stories in health and medicine, September 8, 2014From MedPage Today:

  1. Dialysis Drug OK'd for Marketing. A new phosphate binder has been cleared to treat hyperphosphatemia in chronic kidney disease (CKD) patients on dialysis.
  2. Medicare ACOs See Benefits Despite Issues. Participants in Medicare's accountable care organization (ACO) programs have had their share of frustrations, but their enthusiasm for the ACO ...

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Health screening is part of good preventive care, though over-screening can lead to increased costs, and potential patient harm. Health care professional societies have recently developed excellent public service announcements describing the dangers of over-testing, and new research suggests that though additional medical interventions are associated with increased patient satisfaction, they also lead (ironically) to higher mortality rates. And so, in a system attempting to shift to a “less is more” ...

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

  1. Potent Statin Offers No Help After Cardiac Surgery. The powerful lipid-lowering drug rosuvastatin (Crestor) -- also purported to be an effective anti-inflammatory agent -- was powerless to prevent postoperative cardiac surgery complications such as atrial fibrillation.
  2. Questioning Medicine: The Pain Management Fiasco. I spent my intern year at a ...

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Does owning cancer equipment change treatment patterns? Today’s article follows the money trail to expose a different form of bias: the kind that takes place when doctors own their own diagnostic and therapeutic equipment. For people living with cancer, this kind of bias can have a particularly painful impact. Radiation therapy brings out medical bias In the United States, cancer is the second most common cause of death, killing nearly 600,000 ...

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I have a new favorite doctor show, “The Knick” on Cinemax, airing on Friday nights.   The show stars Clive Owen as the charismatic cocaine-addicted chief of surgery Dr. John Thackery at a fictitious New York City hospital called The Kickerbocker at a time when surgery was one foot out of the barbershop.  The tagline is, as they say, priceless: “Modern medicine had to start somewhere.” On the third episode, last Friday ...

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Top stories in health and medicine, September 2, 2014From MedPage Today:

  1. Reflections on Effect of Stand Up To Cancer. The week before Stand Up To Cancer's (SU2C) fourth-biennial live 1-hour commercial-free prime time roadblock telecast on Sept. 5, Nobel Laureate Phillip A. Sharp, PhD, shared his views about the efficacy of this mass media approach to educating the public about cancer and ...

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The electronic medical record that my office uses features a clinical protocol button that we are encouraged to click during patient visits to remind us about potentially indicated preventive services, such as obesity and tobacco counseling and cancer screenings. I once tried it out while seeing a 90-year-old with four chronic health problems. The computer suggested breast cancer, colorectal cancer, and cervical cancer screenings: three totally inappropriate tests for the ...

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