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What Are People Really Using NRT (Nicotine Replacement Therapies) For?

Nicotine replacement therapies (NRTs: patch, gum, lozenge, nasal spray and inhaler) are intended to be used to help smokers to quit smoking completely. But an international report was recently published, finding that of the 17% of smokers who had used NRT in the previous year, approximately a third had used it for reasons other than quitting smoking.

The study was based on a survey of 6532 smokers in Australia, Canada, United Kingdom and the United States, and found similar patterns in each country. The patch was by far the most commonly used NRT (70%), followed by the gum. Overall, about 8% of NRT users had used NRT just to reduce their smoking, and around 8% had used it to help them cope in situations where they couldn’t smoke. The report stated that, Read more »

This post, What Are People Really Using NRT (Nicotine Replacement Therapies) For?, was originally published on by Jonathan Foulds, Ph.D..

It’s All the Same: Love The Docs, Hate The System

I’ve spent the last few days with much of our European team, today in Madrid, Spain.

Here are a few quick observations, as the American reform process continues.

1.  Every country’s health care system has developed in the unique circumstances of its history.  That is, the health care system of each country is the result of a collection of changes, fixes, restrictions, reforms, market developments and whatever else has happened over the last several decades.   The result in each country are systems that work better or worse, but which in most all cases are very confusing to the people that work in them or get care from them. Read more »

*This blog post was originally published at See First Blog*

Fake Doctors With Real Drugs: Quackery In Canada

Two weeks ago, Canadian Skeptics United published on their Skeptic North site a piece by an Ontario pharmacist criticizing a proposal by the province to grant limited prescribing rights to naturopaths. The essay, which was reprinted in the National Post on Tuesday, outlines the intellectual and practical conundrum presented by allowing those with education that diverges from science-based practices to prescribe drugs.

The naturopath lobby came out in force and was relatively unopposed in the 54 comments that followed, primarily because the NP closes comments 24 hours after online posting. Therefore, those with a more rational and considered viewpoint based in facts were locked out from commenting. This is quite disappointing to me personally and professionally because of the wildly emotional appeals, strawman arguments, and smears and attacks on the author himself without, of course, addressing his well-founded criticism of the prescribing proposal before the provincial government.

At the Skeptic North post, the piece even drew a naturopath who equated the criticism of his/her field with the Nazis and Mussolini. However, you can’t write critiques of these practices without attracting attacks ad hominem, especially Godwin’s Law, that are the resort of those whose arguments are logically flawed. Read more »

*This blog post was originally published at Science-Based Medicine*

Healthcare Reform Bills Legitimize Quackery

snake-oil-20I’ve been warning folks about this for years – and alas, fake medicine and quackery has finally oiled its way into the healthcare reform bills. We are in the midst of a growing primary care shortage, and on the brink of vastly expanding health insurance coverage without increasing the supply of physicians and nurses. How will our country solve the supply/demand mismatch? Potentially by allowing people without appropriate training in science and medicine to become your “medical home.” That’s right – your next doctor or nurse may be someone with an online degree in snake oil salesmanship.

I know it’s hard to believe… But please read this press release (reproduced below) for more information – and call your Senator to complain. Maybe we’ll be able to get these sections removed before a bill passes? Read more »

How To Avoid Unnecessary Testing: Listen To The Patient

I  remember very clearly as a medical student hearing my attending hammer home the importance of the  history and physical examination.  Everyday I heard the same thing

The history and physical examination is the most important part of patient care

After seven long years of hospitalist medicine, I gotta say my attendings were right.   If you listen to what the patient is telling you, the answer is often staring you in the face. Unfortunately, in this volume driven world of fee for service we live in, time is not on the physician’s side.  Most elderly  patients are incapable of separating important medical information from irrelevant medical  information, which can make history taking a very  painful part of being a doctor.  So they just talk and talk and talk. Read more »

*This blog post was originally published at The Happy Hospitalist Blog*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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