2008 Resolutions for Patients and Doctors

#1 Doctor: Resolve to let patient speak without interruption and describe their symptoms. Patient: Resolve to focus on the problem I am seeing the doctor about and not come with a list of 10 complaints for a 15 minute visit.#2 Doctor: Resolve to keep a pleasant tone of voice when answering night and weekend calls from the answering service or nurses. Patient: Resolve to get

Patients Who Google

I read an article in Time Magazine from a Dr. Haig who couldn't tolerate a patient who "googled" him, her health conditions and treatments. It made me stop and think about patients who "google". They often send me articles they have discovered about their illness or bring information they have downloaded. Many times the information is not exactly evidence based nor well researched. There are

Giving Thanks

The darkness has settled in on this Christmas Day and the dishes are almost done. Wrapping paper is in the recycle can, the dog and cat are sleeping and everything is peaceful. For this and many things, I give thanks:That my family is relatively well and my son's strept throat (or could it be mononucleosis?) has turned the corner.That I am a physician and can actually treat these illnesses on

Happy Holidays: The Rap

Just for fun. Happy Holidays to all.

Track Santa's Progress Across the World

It is almost Christmas Eve and that means Santa will be starting his 'round the world magic ride. How does he do it? We can't always explain the magic of Christmas but with modern technology we can track Santa via Norad space stations. So if you have children or are just a child at heart, don't forget to Track Santa.You can begin on Christmas Eve!

Bad Habits

With the New Year looming, I always start getting more introspective. There is something about starting a new year that makes me think "change" is possible and I can be fresh and new.Marshall Goldsmith has written a book called "What Got You Here Won't Get You There" with some simple tips for successful people. His premise is that simple bad habits keep us all from achieving what we could in

Answer-Quiz #5

The answer is #3 - Ehlers Danlos Syndrome. This rare genetic condition causes hypermobility and extreme extension of joints due to abnormalities in collagen synthesis and connective tissue. Like many medical conditions, it was named after two doctors from Denmark and France who discovered it at the turn of the century. Thanks for playing.

Medical Quiz-How Smart Are You #5

I saw Cirque du Soleil this week. It is a wonderful acrobatic extravaganza and one act had three beautiful girls who did amazing, flexible things with their bodies that looked absolutely unreal.I am sure they had this condition. Can you name it? Click on the image for a closer look.Answer will be posted tomorrow.

Hearing Aids and Insurers

I blogged a few days ago about the fact that hearing aids are not covered by Medicare or by private insurance. Dr. John Ford at California Medicine Man wrote a thoughtful analysis about that question. Check it out!

Grand Rounds This Week

To see the best of this weeks medical blogs go to Shiny, Happy Person and marvel at the haiku theme. EverythingHealth was mentioned too by this clever British Psychiatrist.

Superbugs and Farming

READ MY BLOG- THEN WATCH THE VIDEO IN THAT ORDERA recent issue of JAMA addressed the issue of antibiotic resistance and the effect of farm practices on creating resistant "superbugs". This topic has been reported on for decades but more and more scientific evidence is emerging that cannot be refuted. Now researchers have found, in two distinct studies of humans, that bacteria are developing

Hearing Aids - Surprise! You're on your own.

I learned something yesterday from a patient (and friend) that was a surprise to me! I did not know that hearing aids are generally excluded from insurance coverage and Medicare (insurance for Americans over 65) also does not cover hearing aids. I argued "No, that can't be true" but, sure enough...my young friend who suffered sudden hearing loss was correct. She should know as she had

The Uninsured - Everyones Concern

It's election time (the longest election in history)! Today's post will be a primer in who are the Uninsured in America that we hear so much about.45 Million people under age 65 lacked health insurance. (Over age 65, Medicare kicks in and Medicare is government sponsored. If you are a billionaire, you get Medicare too)Eight out of 10 (8/10) came from working families and 70% worked FULL TIME

Answer to Quiz #4

The answer is #5 - Calcinosis. These lumpy bumps are soft tissue calcium and phosphate deposits due to chronic renal failure. The parathyroid glands help regulate calcium in the body and these bumps resolved after she had her parathyroids removed. (NEJM)

How Smart Are You? Medical Quiz #4

Click on the image for a better look. (this is a wrist) The answer will be posted tomorrow.

Grand Rounds-Check it Out

Grand Rounds this week is at Odysseys of George. It is really great with beautiful diving photos and great links to the medical blogosphere. EverythingHealth is one of the featured links. Check it out.

Kids Fail Physical Fitness Test

The California Department of Education reports that more than two in three California public school students failed to meet State physical fitness standards. They measured over a million fifth, seventh and ninth graders in six areas:Cardiovascular enduranceBody fat percentageAbdominal strength and enduranceTrunk strength and flexibilityUpper body strength and enduranceOverall flexibilityThere is

Physicians Roles at Guantanamo Bay

Hundreds of prisoners at Guantanamo Bay, Cuba have gone on hunger strikes to protest their indefinite detention without legal process and inhumane treatment. When this happens, 6-point restraints have been and are still being used to immobilize prisoners and nasogastric tubes are inserted for force feedings.Force feeding of competent prisoners who have refused food is a violation of the Geneva

It's Flu Season - Why in Winter?

The New York Times ran a great article about a study that answers an age old question. Why does the flu (influenza) season always happen in the winter? We seldom see flu in Summer or even the Fall. In the tropics flu doesn't even exist.There have been hypothesis that it was from overcrowding in schools and homes, or in the winter people are stuck inside and can pass the germs. But people are

Wonder Where the Money Goes in Healthcare?

Here is the answer:Breaking News: UnitedHealth Group’s former chairman and chief executive officer, William McGuire, M.D., will forfeit more than $400 million under agreements reached with the company and the Securities and Exchange Commission over an options backdating scandal, on top of $200 million he has already relinquished.

Answer to Quiz #3

The answer is # 5 Dupuyten's contractureThe flexion contractures of Dupuytren's involves the flexor tendons of the hands and creates a contracture that is not painful. The cause is unknown and treatment is surgical release of the tendons.

Medical Quiz - How Smart Are you #3?

This middle aged man comes to the office wondering what is wrong with his hands. He has no pain. What is the diagnosis? (Click on image for a close up view)Answer will be give tomorrow.

Grand Rounds This Week

For great links to great medical blogs check out this weeks Grand Rounds, hosted by Dr. Geek. Thanks for including EverythingHealth, Dr. Geek. The reading choices are eclectic!

New Changes in Dental Prophylaxis

The American Heart Association has published the new recommendations that will spare thousands of patients from loading up on antibiotics before a trip to the dentist. For decades certain patients have been taking antibiotics for protection before dental procedures but now the rules have changed.Infective endocarditis is a rare but life threatening condition that was thought to be prevented by

RBRVS-For Primary Care No Good Work Goes Unpunished

The results are in - Medical Residents are not choosing to enter the Generalist fields of medicine in the United States. With current trends, less than 10% of those training in Internal Medicine will work as general internists. Compare this with JAMAs report that all European countries have a broad Generalist foundation comprising 70-80% of practicing physicians. The consequences of our

Answer to Medical Quiz

The answer is # 5:Black hairy tongue (lingua villosa nigra) may be associated with the presence of chromogenic organisms (e.g., C. albicans) and the use of certain medications (e.g., doxycycline and bismuth). The pathophysiology is thought to be due to proliferation of the filiform papillae of the tongue, which stain black with porphyrin-producing chromogenic bacteria or yeast.I take exception to

Medical Quiz - How Smart Are you?

Which condition could cause this type of finding in the mouth? (Click on illustration to get a close up view ). Answer will be posted tomorrow.

Grand Rounds

This weeks "Grand Rounds" of medical blogs is being hosted by Prudence, MD. I'm happy to report she found EverythingHealth worth a mention in her review of the weeks best blogs. Check her out for great blogging links

Germs- A Traveler's Companion

I read an article about the top places to find "germs" and travel is a big exposure.I am not afraid of germs because I know they are ubiquitous and there is no way to eradicate bacteria, but having just returned from an overnight in a Hotel...I realize I have been in the midst of a virtual hothouse of germs. Think about these bacteria and virus infested environments:Hotel room remote control:

High Intensity Interval Training

Now that the big feast is over, many people turn to exercise to try and burn off those extra calories. High-Intensity Interval Training (HIT) is one way to rev up your metabolism and get aerobic benefit in short bursts of time.HIT is repeated sessions of relatively brief, intermittent exercise that is done with "all out" effort. A single HIT can last from a few seconds to several minutes,

Dennis Quaid's Twins-Preventable Error

Hollywood and the tabloids were rocked this week with the report of actor Dennis Quaid's two week old twins receiving a lethal dose of Heparin at the prestigious Cedars-Sinai Medical Center in Los Angeles.It shows that VIPS are not immune to preventable hospital errors, no matter how much staff attention, privacy and spa-like treatment they receive from hospitals (and they do!)This case is not

Thanksgiving Day Relaxing Medical Trivia

Here is more EverythingHealth trivia to read, marvel at, and appreciate just how wacky and wonderful our world is:You have 10 quadrillion cells inside your body. The mitochondria in each cell are so tiny that you can pack a billion into a grain of sand.Given an adequate supply of nutrients - a single bacterium could produce 280,000 billion offspring in a day. (Wash your hands please)If you

Grand Rounds is Up

The Medical Blog Carnival, "Grand Rounds" is hosted this week by Mexico Med Student and EverythingHealth was a featured blog. Check it out for good medical links!

China - Recycled Condoms

It's amazing what dangers and weirdness one can find on the world wide web! The latest comes from China Daily and New Express Daily which reports used condoms are being reprocessed into rubber bands and hair ties. They are being sold at local bazaars and even beauty salons.First we have poisoned dog food, followed by "date rape" tainted kids toys and now used condoms? It goes without saying

Christmas - Too Early for Joy

It makes me a little crazy to see Christmas ornaments and music before Thanksgiving. Way before Thanksgiving. I saw some displays before Halloween.I like my holidays to fall sequentially. It makes me feel like there is a natural order to things. Labor day should be hot and school should start AFTER Labor day. Our kids schools start the Wednesday (can you believe they start school on a

Cardiac Rehab - Proven but Underused

Cardiac rehabilitation for patients who have had a heart attack or procedure is proven to reduce new cardiovascular complications just as well as medication. Published guidelines since 1995 have recommended a comprehensive approach to cardiac rehab, including exercise training and lifestyle interventions. Despite this benefit, less than 30% of eligible patients are referred to cardiac rehab

SCHIP - Nasty Politics Affect Our Children

I say "our children" because we should all care about providing health care for the youngest, most helpless members of our society. It's not "them"...it is "us".SCHIP (State Childrens Health Insurance Program) is a Federal and State government program that provides health insurance for families who earn too much for Medicaid but are near the poverty level and cannot begin to afford health

Grand Rounds

A nod and thank you goes out to Dr. Anonymous for featuring EverythingHealth in this weeks Grand Rounds for outstanding health blogging. Check it out for lots of good health links.

Testicular Cancer- Basics to Know

Testicular cancer is rare but curable when diagnosed early so there are a few facts everyone with an adolescent son or relative should know.It is the most common cancer in young adult men between age 15-35. It is very rare in African American men and is more common in men who have an undescended testicle. Testicular cancer is almost always detected by the patient himself. Young men entering

The Purple Pill for Reflux? Choose the Cheapest

Proton Pump inhibitors (PPI) are one of the most widely prescribed medications in the world. Why are there 5 different PPIs on the market to treat acid reflux? Is one better than the other? Is the cheaper generic (Omeprazole) as good as Prevacid? or Protonics? or Aciphex? or Nexium?With the help of The American Family Physician Journal, let me dispel the confusion. First, there are different

Professional Freedom Beckons

I have now received three amazing solicitations from MDVIP. This is the Boca Raton corporation that will set a doctor up to do concierge, retainer medicine. The letters invite me to join a few exceptional physicians who seek "professional freedom, personal freedom and financial freedom". One invite came in a bottle with sand and seashells inside, inviting me and my guest to all expense paid

Costs Rise Faster than Revenue

The Medical Group Management Association (MGMA) does an annual cost survey of medical offices. It won't be a surprise to any practicing physician who runs an office that practice costs increased by 7.4% while revenue rose only 1.8%. Family practice, cardiology and general surgery fared the worst with even lower revenue gains against losses from last year. Pediatrics and orthopedic surgery were

The Doctor Shortage

Merritt and Hawkins is one of the largest healthcare recruiting firm in the U.S. They published the results of a study that showed 48% of the physicians age 50-65 years of age are planning to cut back their office hours or retire within the next 1-3 years. The disturbing fact is that 1/3 of ALL physicians are in this age group.To prepare for the physician shortage, new medical schools have

Worst Health Care Scams

Open any magazine and you will see them. A miracle product that will make you thinner, sexier, healthier, live longer, more virile or more beautiful. Here is my vote for the years Worst Health Scams. They have no scientific merit but are great examples of compelling advertising.1. Hoodia (Hoodia Gordonii) - When they say "As mentioned on Oprah" a red flag should go up. I don't know if this

Medical Quiz

The answer is Cocaine. The hole you are looking at is on the hard palate which is the floor of the nasal passage. Excessive cocaine snorting has created this perforation, which is permanent.

Drug Quiz- How Smart Are You?

This quiz from New England Journal of Medicine will test your knowledge of adverse drug effects. What is your answer? Check in tomorrow for the correct answer.

The End of Polio

A medical student today will go through their entire career without ever seeing a case of polio. The polio virus was feared throughout the early 20th century, leaving millions paralyzed or dead. During Summer and Autumn, polio epidemics spread human to human with this highly contagious disease. In the 1940's and 50's, negative pressure ventilators called the "iron lung" were used to support

It's Post Secret Day

Every Sunday the new Post Secrets are online. They only last a week. Don't miss out at this sad, amusing, wonderful look at mankind.

MRSA- it's tiny microbes

With all of the continued interest in MRSA (methacillin resistant staph aureus), it is a good time to remember just how bacteria work. According to author Bill Bryson..."if you are in good health and averagely diligent about hygiene, you will have a herd of about one trillion bacteria grazing on your fleshy plains-about a hundred thousand of them on every square centimeter of skin. You are for

Rate Your Doctor

I think the internet will have a huge impact on patient satisfaction of how they are treated by doctors. The idea of internet sites that rate doctors and hospitals has been around for about 5 years. In the past the sites have been difficult to view, some cost money and they were not user friendly. But like anything new...it may now have reached a tipping point.I logged onto Ratemd.com and was

Patient Safety- Run the OR Like a Jet Plane

We all know about the poor patient who goes in for a right kidney operation and ends up having the "good" left one removed instead. Or the patient with the allergy who is given the wrong anesthesia and has a reaction. Or the patient who is given the wrong blood type. These things happen despite the fact that doctors and nurses are doing their very best to heal under really tough circumstances.I

Transparent Pricing for Patients

There is a big push toward having patients be smarter consumers of health care as a way to control costs. Employers are pushing for medical savings accounts (where the patient has a pot of money they spend on health care or just save) and more and more insurance products have high deductibles and more cost sharing by the patient. The simple way of explaining it is that if someone else is paying

Surgical Model

In my medical training, oh so many years ago, we learned from cadavers. While this was a good way to learn basic anatomy, the physiology of how the body worked was a slower process. Thanks to Unbounded Medicine for this look at the way students can learn now. This reproduction of a patient was crafted with animal organs that really give the student a much better idea of how the body functions.

MRSA - It's preventable

Everywhere I turned today, I was engaged in discussions about methicillin resistant staph aureus (MRSA) and tonight I read a new article in JAMA that says it is twice as prevalent as we thought.MRSA is a common skin bacteria-Staphylococcus aureus-that has become a "bug on steroids" and is resistant to penicillin, methicillin and other drugs that used to kill it flat. It has developed over time

Healing Environments

While the housing market has bombed, new hospital buildings are the rage in California due to a law that says they need to be seismically (earthquake) safe. As hospitals are planning the hospital of the future, many are using architectural design to reduce stress and promote safety and healing.What type of building promotes safety and healing? We know what doesn't work. I've practiced in

Plastics and Chemicals That Can Harm

The chemical, bisphenol-A (BPA), is used to produce polycarbonate plastic and epoxy resins and is found (get this!) in water bottles, baby bottles, food containers, compact discs and dental sealants. The chemical can leach into foods, be inhaled or enter by other routes and the US Centers for Disease Control and Prevention found this chemical in the urine of 95% of people they sampled. BPA is

Withdrawl of Kid's Cough Medicines

McNeil Pharmaceutical has stepped up to the plate and done the right thing by voluntarily withdrawing a number of cough and cold preparations that may be harmful to kids under the age of 2. Recent findings show these medications can be overused by parents and there are no safe guidelines for tiny tikes and these preparations. McNeil has begun by informing physicians of the following:We have

Thought for the Day

Optimism is an intellectual choice.

Sport Concussions

One of my most "googled" blogs was "A bump on the head". Falls and head injuries are common and an estimated 300,000 sports-related concussions (also known as mild traumatic brain injury) occur annually in the United States. Researchers estimate that 63,000 of those occur in high schoolers playing football.The tough thing about concussions is that there is no marker or test to know if a person

Medicare Drug Plan - Profitable to Insurers

The New York Times has an article that is no surprise to physicians and pharmacists who care for patients. Guess what? The wonderful Medicare Drug Plan for seniors has turned into a cash cow for insurance companies that administer it. Duh! Since when do Insurers ever do anything with the government that doesn't fatten their pockets? Audits, conducted by the Department of Health and Human

Doctors and Email

I tried to phone a patient last night with the results of her bone density test. She wasn't home and the thought of playing phone tag for the next few days was not appealing. I asked her husband for her email address and emailed her the results with my recommendations. Mission accomplished!Everyone emails. My son chats online with all of his friends together every night. You can order shoes

Thunderstorms and iPods

Letters have been circulating in the New England Journal of Medicine about the potential dangers of iPods (and MP3 players) and their ear wires attracting lightning to strike during a thunderstorm. An initial report of a jogger wearing his iPod and being struck by lightning came from Vancouver, BC. The patient did not lose consciousness, but he had amnesia, perforated eardrums and a fractured

Give an Hour - mental health for vets

Just when I feel so discouraged about the direction our country is headed, I get a lift by learning about a new organization that is developing a national network of mental health professionals that will provide free care for returning Iraq and Afghanistan vets and their families."Give an Hour" is a non-profit of volunteer mental health professionals across the United States that will donate an

How to Interpret Medical Studies

We are bombarded with news of medical breakthroughs every day. How can you know what studies are valid and important, and which ones are just fluff? Here are some ways to tell the difference:How many people were in the study? The more the betterWho were the subjects, researchers and sponsors? The funding source of the study is important and might change the motives. Do the researchers have

Milestone for EverythingHealth

We bloggers love visits. I am amazed that Everythinghealth has had over 10,500 visits since I started tracking in about March! Readers come from all over the globe..Dubai, Ireland, Spain, Australia, Brazil, Canada, UK, China, Indonesia, Denmark, Mexico, Germany, France, Egypt, Italy, Thailand, India, Israel, Hungary, Philippines, and across the U.S. (So sorry if I left your country out.) I am

Colorectal Cancer and Coronary Artery Disease

A landmark study was released in Jama last week that showed a strong correlation between colon cancer and blockage in the coronary (heart) arteries. It is becoming known that colon cancer and Coronary Artery Disease (CAD) have the same environmental risk factors. Diabetes, smoking, hyperlipidemia, sedentary lifestyle, high-fat, low fiber diet and hypertension are significant health hazards

Insurance Profit - Yes There is Blame

Health Affairs had an analysis of why hospital bills are so high and said you could "Blame the Paperwork". Anyone in the health industry could have told you that! The amount of waste and expense in getting the bill paid by the insurance company could cover the uninsured in the U.S.The study, funded by PNC Financial Services Group, contends that about one-third of all healthcare

Top 10 Prescribed Drugs

Patients are always complaining that they take so many prescription drugs. Most drugs people take are not treatment but are preventing disease and early death. That's why they are taken chronically. (and are such a financial boon for the pharmaceutical industry). The top 10 drugs prescribed by Internists in 2006 are:1. Lipitor (a statin for high cholesterol..now used for diabetes too)2.

Gloves for Garbage Pickers

The next time you feel like complaining because you have a crummy boss or benefits are being slashed...think about work conditions in Delhi. This eye opening glimpse of the life of "ragpickers" from the New York Times is enough to silence any whiner."More than 95 percent of New Delhi has no formal system of house-to-house garbage collection, so it falls to the city’s ragpickers, one of India’s

Cigarette Additives

It drives me crazy that tobacco farmers are subsidized by our government and that tobacco makers have targeted other countries to pick up the slack of decreased cigarette smoking in the United States.The 2007 farm bill was passed in July and continues the 75 year tradition of tobacco subsidies. As the tobacco farmers line up for government handouts, the Wall Street Journal reports:"Nationwide,

More Maasai Health

Our Maasai visitors have left and we feel an emptiness in our home. They were so loving and warm and touch is a huge part of their culture. We really feel blessed to have experienced these wonderful, musical people from Kenya and we hope to visit them there when we can.The Maasai's are a tribe of 350,000 found in Kenya and Tanzania. They are semi nomadic cattle herders and warriors who now live

Post Secret-again

Its Sunday and for anyone who missed the link to Post Secret website, I wanted to give it again. Each week the secrets change so check back every sunday for the new ones. Some are pretty heartbreaking!

New FDA Approvals/Medical Updates

Readers of Everythinghealth like to be on the cutting edge so here are so here are some new Food and Drug Administration (FDA) approvals.Home-Based Fertility Screening: The first at-home fertility screening test for men and women enables couples to assess fertility earlier. the screening kit includes male (motile sperm) and female (follicle-stimulating hormone) tests proved 95% accurate. It is

Stop the Clash of Civilizations

No explanation needed. The film is the blog!

Maasai Medicine

The next best thing to travel and experiencing something new, is to have travelers come to you. I have been fortunate to be able to host a Maasai Cultural Dance troupe in my home this week as they perform in my town. Their mission is to uplift the villagers in Kenya, Africa by selling their beads and art and earning money that they take back home. That money is used for education and a better

The Hospitalist - What the heck is that?

The average American doesn't know that a revolution has occurred in medicine and there is a new type of doctor called a "Hospitalist". It is the fastest growing branch of medicine and there are 20,000 doctors today that practice only hospital medicine. Most hospitals in America employ Hospitalists and if you are admitted to a hospital, it is likely that he/she will be your main attending

Guest Post-Hangovers 101

Hey, Everythinghealth readers! Check out the blog Med-Friendly. I wrote a guest post on "Hangovers 101" that is there for the reading.

Five Must Do's For a Sick Loved One

When a loved one is sick, we often feel totally helpless and caught up in the medical world. If people only knew how important their role as caregiver really is. Credit goes to Elizabeth Cohen, CNN, for these wonderful tips on how to fight for and protect a sick loved one.Don't be afraid to intervene: If you see something going on that strikes you as wrong, say so. A medication that you've

Primary Care Doomed - what does it take to get paid?

Most primary care doctors are running a small "mom and pop" business and any business will fail if payment is not received. A review of "ageing reports" (accounts receivable) can be eye opening for the doctor. Thirty-60-90 days past due can be a financial disaster. But what about bills that are not paid for over a year? It is not uncommon for active patients who get prompt return phone calls,

Katrina Nursing Home Owners Aquited

Justice was served when the jury acquitted the operators of St. Rita's nursing home in New Orleans, on 35 counts of negligent homicide and 24 counts of cruelty to the infirm today. The Manganos, age 64 and 67 have run that home for 20 years and have been through many hurricanes. Katrina was different. The water surge and levee break caused water to rapidly rise and evacuation of all the bed

ADHD and Food Additives

Parents around the world can now say "See, I told you so!" A study released in Lancet and reported in the New York Times has shown a possible link between attention deficit hyperactivity disorder (ADHD) in children and common food additives.This was a well run study that focused on a number of food colorings and the food preservative "sodium benzoate", that are found in many foods. Children

Why Are Americans So Fat?

In just one year, a new study shows, obesity rates have shot up across the country.Why are Americans so fat? Here are my reasons...feel free to add your own.22% of Americans did not do any physical activity in the past month.Our government subsidizes high fructose corn syrup. It is cheap and in everything!No one cooks anymore. Fast food is fat food.Kids have too many choices. (remember when mom

Plain Soap Kills Germs as Well as Antibacterial Soap

I was surprised at the results from researchers at University of Michigan School of Public Health that found the effectiveness of plain ole' soap is as good as antibacterial products at killing bacteria.Soaps, detergents and other "antibacterial" products that contained triclosan were no better than plain soap for preventing infections. Washing your hands is very important for preventing the

Out of Town

I will be at my sister-in-law's wedding for the Labor Day Weekend, so check out my Favorite Links on the right side of this blog for some great reading and fun. Come back next week for more EverythingHealth.Aren't Abby and Jay cute?

Katrina revisited

This time two years ago I was flying with my medical kit to New Orleans to help during the Katrina Disaster. I cannot get the gulf coast out of my mind and it is a tragedy that continues for millions of people. I offer these photos and I hope we will never forget that we are all in this crazy life, at this point in time.... together.

Need Botox? Come on in.

The New York Times cites a study in Dermatology that shows you can get an appointment quickly if you need Botox, but you will wait for weeks if you want to have a mole checked for cancer.In medicine, we talk a lot about the problem of "access". Well, it looks like access is not a problem for cosmetic procedures. Dr. Kimball, a Harvard dermatology professor summed it up, "This study shows the

Breaking News - more uninsurred

According to the U.S. Census Bureau, the number of Americans without health insurance rose to 47 million in 2006 (up from 44.8 million). This means 15.8% of Americans have no health insurance to cover their medical needs.Ever wonder why hospital costs are so high? Ever wonder why people use the ER for primary care? Ever wonder why we rank so low in the world on health outcomes? Ever wonder why

Are Too Many People Being Diagnosed with Depression?

You can't open a medical journal or medical news without reading another article about how to screen patients for depression and prescribe antidepressants. The British Medical Journal has explored this in a "Head to Head" article where over diagnosis and under diagnosis of depression were debated.On the Yes side is Dr. Gordon Parker who argues that feeling depressed is normal and that 95% of

Premie Baby born in airplane

Here is a heartwarming story for the weekend. A 25 weeks pregnant mom was traveling to Crete with her husband when she went into early labor. Her water broke and somewhere above Düsseldorf, Germany, she delivered a 1 lb. baby with the help of a flight supervisor. This air hostess hero, Carol Miller, took control of the situation and suctioned the little blue baby with a drinking straw.

Doctor Online Ratings

Doctors used to get referrals from word of mouth. The internet has taken that to new highs with online physician rating websites like ratemds.com. Boasting 334,669 ratings and climbing, with 580 new ratings added yesterday, this trend of saying whatever you want anonymously and publicly should bring a chill to every practicing physician. With use of a smiley or frowney face, not to mention

Post Secret-a window into the mind

I found a new website that is a fascinating view into human nature. Post Secret was started by Frank Warren and he invites strangers to send him postcards that tell a secret. He now receives 100-200 cards a day from people who want to express their inner thoughts and secrets. Each week he chooses the 20 best cards to publish on his blog. Also, his is the most visited advertisement free blog on

Medicare won't pay for preventable conditions

Medicare, the largest health insurer in the U.S., has announced that it will not pay for 8 hospital conditions that could be preventable. Starting in October, 2008, if a patient enters a hospital and acquires these conditions, the hospital will not get reimbursed for the costs. The conditions that we doctors call "never-events" because they should never happen, are:Urinary tract infection from

Body Mutilation-Chinese Foot Binding

I love medical history and the idea that what we do today will seem barbaric to cultures in the future. One such ancient practice is Chinese foot binding. This practice, which went on for over 1000 years took foot fetish to a national high. At age 3 a little girls toes were broken and bent underneath the foot and wrapped in tight cloth. The goal was "three inch golden lotus" feet and it was

Medical Procedures-show me the money

Several times a week I get mailers or ads offering courses in medical procedures. This one reads: "Why learn procedures? You are working harder and making less. (They got that one right). Procedures will help you increase revenue and profits without a large investment or extensive training. You do most of the work, others get paid more than you" (Bingo, right again). "Stop turning revenue

Maggot Medicine

Warning, this is really gross but for you brave souls, now you can see first hand how maggots are used to help heal chronic wounds. Don't view if you can't stand the "ick" factor but be aware that most everything in Medicine involves "ick" and we docs find it pretty darn interesting.

Otitis Media- Treat or Watch?

Most parents are heartbroken when they hear their toddler cry with an earache. It is one of the most common reasons for a visit to the pediatrician and most parents expect antibiotic treatment. The American Academy of Pediatricians and the American Academy of Family Practice issued guidelines in 2004 for most cases of acute otitis media (ear infection) and those recommendations call for

"Red Yeast Rice"- FDA warning

The Federal Drug Administration (FDA) has issued a warning to consumers to steer clear of several "cholesterol-lowering" supplements that may contain a drug - Lovastatin.Red Yeast Rice, Red Yeast Policosonal Complex and Cholestrix are over the counter supplements that were found to contain the prescription drug, Lovastatin. The products are manufactured by Nature's Value, Kabco Inc, Sunburst

Caffeine reduces cognitive decline

As I am sipping my morning latte I am thrilled to read the results of a new study just out in Neurology that suggests that caffeine may reduce cognitive decline in women without dementia. Another gulp of coffee and I am that much smarter!French researchers report that women who drank more than 3 cups of coffee per day had less mental decline during 4 years of follow-up, compared with those who

"Minute Clinics" be afraid, be very afraid

We have lots of problems with access to care in the good ole' USA. Forty five million (and growing) have no insurance. Eight in 10 are from working families and 28% of young adults have no insurance. Even with health insurance, we are paying more out of pocket for health care.So with all of these issues, isn't it amazing that the delegates to the American Medical Association have singled out

Tattoos and Work

It's nice when other bloggers visit and mention my writing on their blogs. Compensation Force (an HR site) linked me and so, of course, I checked it out. The HR world is quite a newsy place! I enjoyed reading about "How to respond to a racist joke" (Don't laugh, play dumb with a blank look and say "I don't get it". Make the joke teller feel embarrassed). "Tattoos and work: how body art plays

Racial Diversity and Medicine

If you are Black, Hispanic or Native American, I bet you have noticed something. There are no doctors of your race to treat you. Blacks, Hispanics, and Native Americans make up 26 percent of the U.S. population, but only 6 % of practicing physicians come from these minorities. Underrepresented minorities have worse health status in many dimensions compared with the white population.My work

No Period Birth Control Pill

The FDA has approved Lybrell, the first oral contraceptive pill that allows women to Cease having periods! This "no period" OCP works the same way as the usual pill. It uses the same low dose estrogen/progesterone combination but instead of 21 days on and 7 days off, this pill is taken continuously throughout the month.Menstruation occurs in a normal monthly cycle when estrogen, in

Smoking Cannabis will Make you Crazy

Who would have thought, with all of the problems in the world, that "Reefer Madness" would rear its head and the headlines would be screaming "The Use of Cannabis Causes Psychosis".The Lancet has just published a review of longitudinal studies and found that daily or weekly use of cannabis (marijuana) could increase psychosis by 40%.These findings puzzle me. In the UK and New Zealand, 1 in 5

Why Are Doctor Bills So High?

Who hasn't wondered why doctors need to charge so darn much for an office visit? If you have insurance and bother to look at what the insurance company pays, it is always much lower than the charge. Why does medical care cost so much? Is the doctor gouging? One of the best explanations I have seen is stolen from another blog. I would like to give credit but all I know is the name Dr. Adam.

Doctors and Money

My prior post engendered hundreds of visits and some great comments on Kevinmd blog. Check out these comments about "Do Doctors Make Too Much Money?" I guess money, sex and politics are what really get conversation going!

Do Doctors Make Too Much Money?

An article in the New York Times says the reason health care costs are so high in the United States is because doctors are paid too much. I saw that and my eyes bugged out. I just came home from a meeting with physicians and hospital administrators and the entire meeting was spent discussing the financial challenges physicians face in keeping their doors open to see patients. The goal of this

SICKO -laugh and cry

I saw "Sicko" last night...Michael Moore's latest documentary about the health care industry in the U.S. Let me tell you..he got it right! The movie was chuckle out loud (col) funny and at the same time, left the viewer with a feeling of outrage. For every outrageous insurance denial story, every doctor I know could supply 100 more. See my prior post on one such denial and how it affected a

YouTube Debate-health question

Did you see the Democratic debate? I loved the format and the fact that everyone can participate. The YouTube debate will change politics forever. The questions were finally relevant and reflected what we actually care about. We need to keep the pressure on both the Dems and the Republicans and push for healthcare reform. This is just one of the questions. We want answers!

DASH diet-for hypertension and everyone

A recent study found that a diet proven to reduce blood pressure is hardly used by any patients with hypertension. The eating plan modeled on the Dietary Approaches to Stop Hypertension (DASH) calls for eating foods low in saturated and total fats along with increasing consumption of fruits and vegetables. Despite the repeated recommendations for this diet as the MOST HEALTHY and the MOST

Doping-ruining the sport

It is sad that the prestigious Tour de France continues to be ruined by the cyclists taking performance enhancing drugs known as "doping". From baseball, to field sports and now cycling, the heroes we long to admire are selling out to this bargain with the devil.Michael Rasmussen from Denmark is the lead cyclist wearing the coveted yellow shirt. He is now under suspicion for missing 2 drug tests

Top 25 Medical Advances

USA today is hardly a scientific journal, but it is read by millions of people all over the world. They picked their "Top 25 Medical Advances since 1982" and ranked them. What do you think?1. AIDS2. Smoking Cessation3. Obesity4. Cancer detection5. Antidepressants6. Infant mortality7. Anticholesterol medications (statins)8. Cancer vaccines9. Automated external defibrillators10. Direct to

Your Stools - endless fascination

You may not cop to it, but everyone is fascinated with their bodily waste (aka: bowel movements, stools, number 2, S*#t, dump,crap, elimination).This handy chart can finally answer all of your questions about different types of bowel movement and what is "normal". As you can see, there are many variations with type 1 being consistent with constipation. Type 6 and 7 are diarrhea.What is normal?

The Umbilical Cord-Don't Rush to Cut

If you or someone you know is pregnant, a recent study from JAMA is something you should know about. It has to do with when to cut the umbilical cord. That is probably something you never thought about, right? The placenta and umbilical cord contain up to 60% of the fetal blood red cells and this blood is rich in stem cells. We are just learning how important these precious stem cells are in

Women In Art

Stretching Before Exercise

You would think it would be easy to answer the question "Should athletes stretch before exercise?" A review of the literature is less than precise on this subject but here are some key points:* Stretching performed before exercise can increase flexibility for up to 90 minutes but there is little evidence that such routines improve performance, reduce muscle soreness or prevent injuries.*

U.S. Surgeon General Compromised by Politics

I have tried to be non-political on this blog and focus only on EverythingHealth. But I can't ignore sharing this article from the New York Times that quotes Dr. Richard H.Carmona, the former US. Surgeon General under George Bush (the son). As the "Nations Doctor", he reports that the Bush administration forced him to weaken or suppress important public health reports, including those on tobacco,

Melanoma or a Benign Mole?

The biggest malpractice risk for physicians is "failure to diagnose". If a patient shows up with a skin growth, most physicians will reach for the scalpel and remove it or biopsy it rather than take the risk of missing a cancer. But only 3-10% of suspicious moles are melanomas so that means a lot of unnecessary surgeries and costs are incurred.A pilot study has shown that applying a simple tape

It's not raging rapids - but I'm back

Although this photo doesn't look like raging rapids, it was a beautiful hike near Cataract Canyon, Utah, on the Colorado River. I couldn't risk my camera during the rapid runs so no photos of the dangerous level 5 rapids! You'll just have to believe me.Did you notice that last week was a major heat wave across the entire United States? The map in USA Today showed every state was red or orange..

On Vacation

Dear readers,I will be rafting the rapids on the Colorado River for the next week. Stay healthy, wear lots of sunscreen and visit EverythingHealth again in about a week.TB

Common Drug Interactions

Did you know that a lack of acid in the stomach significantly affects the body's ability to absorb thyroid hormone? That is just one of many facts that patients often don't know. Here are a few others: * Proton Pump Inhibitors (PPI's like Prilosec, Aciphex, Protonics, Nexium) reduce calcium absorption. If you are on these pills,(and millions of people are) you will need extra Calcium. * Warfarin

Chatty Doctors

Wow, I read an article in the New York Times on "Chatty Doctors" and had to gulp and wonder if I have ever done that. It seems researchers videotaped 100 primary care doctor-patient interactions and they found the doctors talked about themselves in 1/3 of the visits. This wouldn't be so bad except they never circled back to the patient's issues and wasted a lot of the precious visit time

Osteoarthritis vs. Osteoporosis

Patients often confuse Osteoarthritis and Osteoporosis. They are two very different conditions. The following is a quick comparison: Osteoarthritis (Degeneration of cartilage at joints)o Painfulo Cause unknown but occurs with aging, prior trauma and geneticso Mainly joints of hands, knees, hips and spineo Worse in obese peopleo Calcium does not helpo Swelling

Medical Tests - think twice

An article in the New York Times struck home with me today. It has to do with excess radiation exposure from CT scans, X-rays and other ionizing radiation from medical tests.Many patients think more is better when it comes to diagnostic testing. They request scans for headaches, backaches, new knee pain and screening total body scans "just to make sure I'm ok". Despite warnings that body scans