Tons of ink have been expended on the health effects, both positive and negative, of alcohol consumption. Beneficial effects on the heart were discussed in the 1990s based on the “French paradox.” A paper published in 1995 noted that there was less ischemic heart disease in France compared to the U.S., despite higher saturated fat intakes and a higher prevalence of smoking.
The relatively lower incidence of ischemic heart disease in …
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In 2020, firearm fatalities displaced motor vehicle accidents as the leading cause of death of U.S. youth (ages 1 to 19). We long ago dramatically reduced infectious deaths (though vaccine hesitancy threatens to upend this victory), and the “big five” have been auto accidents, firearms, cancer, suffocation, and drug overdose – accidental in the youngest and intentional or accidental in teens.
Between 2000 and 2015, firearm deaths remained steady at about …
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In a New York Times article, “The Huge Waste in the U.S. Health System,” it stated that the estimated waste is at least $760 billion per year: “That’s comparable to government spending on Medicare and exceeds national military spending, as well as total primary and secondary education spending.”
Why is waste so prevalent? There are many sources. The biggest one, and the one that should most concern …
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There are many disparities in health care. Black mothers have a much higher rate of maternal death than do white women. All women are less likely to get guideline-advised cardiac care than do men. Among the many such examples, perhaps the hardest disparity to solve is that of the poorer access to health care faced by rural communities. People living in rural counties have higher death rates from cancer and …
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For most of us, going to the doctor is not at the top of our favorite things-to-do list, but it may be one of the most important. Whether the visit is for a scheduled check-up or to deal with a new problem, there are ways you can make the visit less stressful and more useful.
You must remember that things have changed. In the “good old days,” when I started in …
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Doctors and policy wonks hear a lot these days about “low-value care.” What exactly is that, and should you care?
The term refers to tests, medications, and procedures that add little to a patient’s health or well-being but which cost them or the system more money than any benefit warranted. Some of the earliest research that looked at this was done at Dartmouth, where they found enormous variations in the cost …
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For centuries, doctors felt that their notes were their property, and none of the patients’ business. This attitude slowly shifted, and the Health Insurance Portability and Availability Act (HIPAA) of 1996 put into law the fact that patients must be allowed to review and get copies of their medical records. Despite this, access to records has remained a daunting task for many. A study done in 2017 of 83 hospitals, …
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Earlier in June, the U.S. Food and Drug Administration (FDA) won a major legal victory by getting an injunction to prevent Florida-based US Stem Cell Clinic from offering its treatments. The company claimed to create stem cells from patients’ body fat and use these to treat a variety of serious illnesses, including Parkinson’s disease, ALS, and chronic lung disease. This company is just one of many that have sprung up …
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Two recent patient experiences prompted this post. In the Wall Street Journal, Dana Hawkins-Simons described several years of being seen by specialist after specialist for her complaints of tiredness, dizziness, ringing in the ears, palpitations, shortness of breath and “brain fog.” She finally researched her symptoms and demanded that she be checked for vitamin B12 deficiency, which turned out to be the cause of her symptoms.
Recently, the …
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You can save your baby for $2 million. Can you afford to do this? If you cannot, should we all pay?
Spinal muscular atrophy (SMA) is a rare genetic disease affecting the part of the nervous system that controls voluntary muscle movement. All types of SMA result from a single known cause, a deficiency of a protein called SMN, for “survival of motor neuron.” When SMA symptoms are present at birth …
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As my patients aged along with me, I noticed both the expected increased numbers of people with some form of dementia and even more patients who were worried about this topic. Unless you have been away on a ten-year safari, you are very aware that dementia is a growing problem. Some 5.8 million Americans are living with Alzheimer’s disease, and similar numbers occur in most western countries. The incidence goes …
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One of the arguments made against adopting single-payer health care in this country is that it would “lead to rationing.” This assumes that we lucky people in the U.S. have unlimited access to whatever health care we need and are at risk of losing it.
This argument came to mind when I saw a few recent news items. One was that a federal judge, U.S. District Judge Robert Scola, recused himself …
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A wag once said: “There is no such thing as a healthy person, just one who has not had enough tests.”
As we make every minor deviation from the average into a disease, that jest is becoming uncomfortably close to the way our current medical system behaves.
Part of the problem is that many diseases represent an arbitrary cut-off of a number. Thus, hypertension is defined as a blood pressure above a …
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This is the scenario. You (or your mother) were admitted to the hospital with pneumonia. On the third day a cheery continuing care nurse comes in and says, “You don’t have a fever, and the doctors feel you can be discharged to finish your course of antibiotics, but your nurse tells me you are still too weak to go home, so we are going to send you to rehab. Here …
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Kaiser Health News told the story of a 69-year-old woman who went to a new doctor for her annual check-up, assuming it was covered by Medicare and was happy with the visit until she got a $400 bill.
Most Americans believe in “annual check-ups,” at which your doctor reviews your medical history, gives you a thorough physical and orders lab tests. The actual value of such visits has been questioned, but …
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During my time in practice, I had at least eight patients who came to me sure they had systemic lupus erythematosus, also commonly called SLE or lupus. This is an autoimmune disease, characterized by joint pain, that can affect almost any organ, including skin, kidneys, brain, and heart, and can even be fatal. In every case, they had been given this diagnosis because of a blood test called an ANA, …
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To treat any condition, the doctor needs to know what it is. You would not expect to have your sore ankle treated with penicillin or to have an appendectomy recommended for your sore throat. While this may be self-evident, I know of at least one patient who had a normal appendix removed because the surgeon did not notice the few telltale blisters that were warning the careful observer that the …
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