February 25th, 2010 by Harriet Hall, M.D. in Better Health Network, Opinion, Research
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Everybody knows that colonoscopy is the best test to screen for colorectal cancer and that colonoscopies save lives. Everybody may be wrong. Colonoscopy is increasingly viewed as the gold standard for colorectal cancer screening, but its reputation is not based on solid evidence. In reality, it is not yet known for certain whether colonoscopy can help reduce the number of deaths from colorectal cancer. Screening with fecal occult blood testing (FOBT) and flexible sigmoidoscopy are supported by better evidence, but questions remain. It seems our zeal for screening tests has outstripped the evidence.
Statistics show that the life-time risk for an adult American to develop colorectal cancer (CRC) is approximately 6%. Colorectal cancer is the second leading cause of cancer deaths in the United States. In the US there are currently 146,970 new cases and 50,630 deaths each year. Between 1973 and 1995, mortality from CRC declined by 20.5%, and incidence declined by 7.4% in the United States. Read more »
*This blog post was originally published at Science-Based Medicine*
February 24th, 2010 by DaveMunger in Better Health Network, Expert Interviews, True Stories
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“I like your watch,” pharmacist Jin Jun tells me as I’m sitting down to interview him.
I have a plastic runner’s watch, nothing special, but I see Jun is wearing something similar. “Do you run?” I ask him.
Jun is a tall, personable man who runs marathons, it turns out, and he enthusiastically invites me to run in a 5K race this weekend. I’m not sure I’ll be able to make it but I ask him for the details anyway.
Jun is equally passionate about his job, which one day a week involves helping the patients at the Carolinas Medical Center Infectious Disease Clinic with HIV drug adherence. I ask him how he handles cases like LaShana Walker’s, where some days she just doesn’t feel like taking her medications because they make her so nauseous. Read more »
*This blog post was originally published at The Daily Monthly*
February 24th, 2010 by RyanDuBosar in Better Health Network, News
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ACP Internist looks at how states are using grants to fix their primary care shortages.
Michigan launched grants for primary care doctors to repay medical school loans and is looking to tap into federal incentives to fill its needs in rural and urban shortage areas. Alaska also needs primary care doctors, so the state senate is pushing through recruiting incentives of its own. (They should show re-runs of Northern Exposure.) Rural Indiana doesn’t have a quirky ’90s hit television program to its credit, but it has nurse practitioners who are finding their niche on physicians-led teams–relieving the backlog and providing patient education. (Detroit Free Press, KTUU-TV, Journal & Courier) Read more »
*This blog post was originally published at ACP Internist*
February 24th, 2010 by Happy Hospitalist in Better Health Network, Opinion, True Stories
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As a hospitalist I sometimes come across patients who, for what ever reason, refuse to take the medications prescribed by their in-patient doctors. Some patients refuse out of fear. Some doctor told them years ago that taking medication X would make them worse. Some patients refuse out of ignorance of their disease process. Most of the time however, they just don’t understand why the medication is necessary. Some patients just refuse out of stubbornness. And some patients refuse because they have a really good reason.
However, when you’re dealing with critical illness and the only thing that’s going to save your patient’s life is a treatment plan they are refusing, sometimes you have to be in their face with reality. So how do I handle situations with patients who have the capacity to make poor medical decisions but refuse life saving medications? How do I convince my hospitalized patients to take their medications I’ve prescribed? Read more »
*This blog post was originally published at Happy Hospitalist*
February 24th, 2010 by SteveSimmonsMD in Primary Care Wednesdays
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I don’t know if I can do it this time. A month ago, when it appeared that Congress had backed out of passing Health Care Reform legislation, I felt neither happy nor sad. I didn’t know how I felt but this past Monday, after the following triad of events had unfolded, it became clear to me that I feel weary towards the whole healthcare reform process:
- First, several states temporarily halted a rapacious rise in health insurance premiums from companies with quarterly profits last year in the billions of dollars. Seriously, don’t these companies have PR firms?
- Second, the Senate Finance Committee actually issued a drug warning and in this one act illuminated either a glaring problem with Congress or – far more concerning and unfortunately for us, more likely in this instance–some type of bias at the FDA.
- Thirdly, the President called for a televised debate on health care between ‘both sides.’ Then, within days, he posted his own plan on the White House website. It is a ten page summary I found hard to follow that left me with a troubling sense of déjà-vu.
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