Imagine you want health care. You go to your doctor who recommends a medication. Your doctor tells you that the medication used to be prescribed one way 14 years ago, but very rigorous, more recent studies indicate a lower dose is just as effective. And has fewer side effects. And is less expensive. You are pleased because a) your doctor is up on the latest medical therapies, and b) the least ...

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Of the 6.7 million pregnancies in the US each year 48% are unplanned. Disturbingly, about half occur in women who were using contraception at the time of conception.  That statistic haunts me. As health care providers we must take that to heart and change the way we think about birth control counseling. Is there more that we can do to help prevent unplanned pregnancy in those who are actively using ...

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The joint statement on laboring in water and delivering in water (the latter also known as immersion births) from the American Academy Pediatrics (AAP) and the American Congress of Obstetricians and Gynecologists (ACOG) is making the rounds. I’ve linked to the full statement above, but in essence it says that some women find laboring in water helpful for pain relief (in the first stage of labor it reduces the need ...

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From MedPage Today:

  1. USPSTF Praised for Preeclampsia Guidance. When it comes to whether or not to treat women at high risk for preeclampsia with low-dose aspirin therapy, the U.S. Preventive Services Task Force (USPSTF) guidelines are spot on.
  2. Early Signs of Stroke Missed in Many Cases. Many strokes may be missed in emergency departments (EDs) in the days before the problems become obvious.

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"I feel bad ..." Amy whispered, then paused. I'm a family medicine resident, and I was doing my gynecology rotation, which involved spending a few days at a Planned Parenthood facility. This was my first day. I'd been assigned a patient to shadow: a young woman named Amy, who was here to have a first-trimester abortion. I'm a fan of Planned Parenthood's work providing high quality, affordable contraceptive and gynecological care. In ...

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On December 31, 2011 right before midnight, I took the test of excitement and new beginnings and found out that I was pregnant. While this news was joyous in nature, it was soon marred by uncertainty and harsh reality. After my test, I followed up with a doctor’s visit a month later, as was expected, and soon learned that the cost for this bundle of joy would be around $12,000 to ...

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Given all the complaining I and my colleagues do about the problems with the EMR, I figured I’d take the opportunity to tell you about something good that came from having my practice online. A patient came to see me last week for a check up and requested a prescription for birth control pills.  She’d used them in the past without problems. I wrote the script and sent her on her ...

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She asked me, “Is it okay to laugh?” My patient Linda, who was only 12 weeks pregnant, had just had a chorionic villus sampling, or CVS. During this procedure, a small piece of placenta (chorionic villi) is removed via a long, thin needle inserted into the woman’s uterus, and then the sample is sent to a laboratory for genetic analysis. My patient fell into the category of advanced maternal age, and ...

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Interpreting studies is a dicey thing. Often I find what might be statistically significant translated into headlines that might not really get at the nuance of the study or the results. Take these three for example:

  1. "Pine bark extract improves severe perimenopausal symptoms"
  2. "Two weeks of antibiotic therapy relieves IBS (irritable bowel syndrome)"
  3. "Study: 'Female viagra flibanserin' works"
The first line of the last article: "Need a boost to your sex life. The magic could be in ...

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Readers have contacted me about a recent study that links acetaminophen use in pregnancy to the later development of ADHD in children. Is Tylenol yet another thing pregnant women need to avoid? The study, titled “Acetaminophen use during pregnancy, behavioral problems, and hyperkinetic disorders” was published this month in JAMA Pediatrics. Dutch researchers looked at about 60,000 children born from 1996-2002. Their parents have been filling out questionnaires and ...

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