October 28th, 2010 by Felasfa Wodajo, M.D. in Better Health Network, Health Tips, News, Opinion, Research
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Bedbugs are back. For many people, this is only slightly curious, since their understanding of bedbugs stops at the second half of the bedtime admonition: “Sleep tight, don’t let the bedbugs bite.” But, for those others who have experienced a home bedbug infestation, it is a modern nightmare.
The tiny critters can hide in any furniture crevice or fabric fold and come out only in the wee hours of the night in search of their favorite food: human blood. Their bites cause intense itching which can last days to weeks and they can remain dormant and hide for months.
The cause of the recent resurgence is unknown. It does not seem to be paying any great regard to socioeconomic status nor to cleanliness. In metropolitan New York, it seems to have caused a minor panic, with families having to temporarily move out of their homes for toxic fumigation and thousands of dollars of clothes and artifacts being disposed of for fear of contamination. For a chilling recounting, check out this article in the UK Guardian: “How bedbugs invaded New York.”
Since so many skin afflictions are related to insect bites, the folks at Logical Images have just released Bedbugs ‘n Things, an iPhone app that describes the most common perpetrators of insect bites, identification by the appearance of the bite marks and recommended treatment. For bedbugs in particular, it goes further and gives a thorough set of guidelines for concerned traveler so they avoid bringing home uninvited travelers inside their luggage or clothes. Read more »
*This blog post was originally published at iMedicalApps*
October 28th, 2010 by Steve Novella, M.D. in Better Health Network, Health Policy, Opinion, Quackery Exposed, Research
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In my group practice, the Yale Medical Group, drug company-sponsored lunches and similar events have been banned. This is part of a trend, at least within academic medicine, to create some distance between physicians and pharmaceutical companies, or at least their marketing divisions. The justifications for this are several, and are all reasonable. One reason is the appearance of being too cozy, which compromises the role of academic physicians as independent experts.
But the primary reason is the belief that “detailing” by pharmaceutical sales representatives has a negative effect on the prescribing habits of physicians. There is reason to believe this may be the case because of cases of bad behavior on the part of pharmaceutical marketing divisions — ghost writing white papers, for example.
The concern, backed by evidence, is that pharmaceutical companies introduce spin and bias into the information they provide to physicians, whether though CME, detailing, literature, or sponsored lectures. Even when the information itself is not massaged, it is cherry picked, so in the end physicians are not getting a thorough and unbiased assessment of the facts. Read more »
*This blog post was originally published at Science-Based Medicine*
October 27th, 2010 by KevinMD in Better Health Network, Health Policy, News, Opinion, Research
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Authors of a recent study from the Archives of Internal Medicine are unlikely to endear themselves to specialists. As reported by Reuters, and provocatively titled, Do specialist doctors make too much money?, the study gives a per-hour breakdown of how much doctors make.
I think this is a good approach, since annual salary figures do not account for the number of hours doctors work — and in the case of primary care doctors, this includes uncompensated time doing paperwork and other bureaucratic chores.
Here’s what they found:
… the lowest wages — amounting to $60.48 an hour — [were] paid to primary care physicians.
In other broad categories of practice, surgeons took home the highest average hourly wage of $92. Internal medicine and pediatric docs earned about $85 an hour, the researchers report in the Archives of Internal Medicine.
Looking at salaries among 41 specific subspecialties, however, they found neurologic surgery and radiation oncology to be the most lucrative at $132 and $126 per hour, respectively. These were followed by medical oncologists and plastic surgeons, both making around $114 per hour; immunologists, orthopedic surgeons and dermatologists also took in more than $100 an hour. At the low end of specialist pay, child psychiatrists and infectious disease specialists made around $67 an hour.
Of course, regular readers of [this] blog know that healthcare reform will do little to decrease the disparity. The pay raises that will be coming to primary care will be far too little to change the perception that, in the United States, specialists are more valued by far. Read more »
*This blog post was originally published at KevinMD.com*
October 27th, 2010 by AnneHansonMD in Better Health Network, Health Policy, News, Opinion, Research
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For new readers, it’s my tradition to put up posts summarizing tidbits I picked up at the annual American Academy of Psychiatry and Law (AAPL) conference. It’s random, it’s not explained in detail, but it’s stuff I thought was interesting.
The conference started out with a keynote speech by AAPL President Stephen Billick. The title of his talk was “Be True To Psychiatry.” His point was that forensic psychiatrists are clinicians first, and that even a forensic evaluation can have therapeutic effects. He cited many examples in his practice in which a criminal or civil evaluation had potential beneficial “side effects” regardless of the forensic opinion. His main point: the forensic psychiatrist’s obligation to be neutral and objective does not preclude kindness. A point well taken, and appreciated.
A session on suicide risk assessment gave a very nice illustration of the basic problem inherent in these assessments: even assuming an “ideal” case situation with a “perfect” psychiatrist, a thorough suicide risk assessment would take four hours. Risk assessment is time consuming and inherently will be incomplete. We make the best decisions we can based on the limited data we have at the time. Read more »
*This blog post was originally published at Shrink Rap*
October 27th, 2010 by Happy Hospitalist in Better Health Network, Health Policy, Health Tips, Opinion
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“Why should I take my blood pressure medication,” you ask? The more I do this thing called hospitalist medicine, the more I appreciate the power of lifestyle choices we all make.
Every opportunity I get I give my patients my smoking lecture and charge their insurance a CPT 99406. Everybody knows that smoking is bad for you and it causes lung cancer. Nobody knows all the other stuff. They’re always shocked.
Maybe it’s time for me to start a blood pressure lecture. I often have patients who say: “Why should I take my blood pressure medication?” They always answer their own question with the same answer: “I was feeling fine. I didn’t see a reason to take my blood pressure medication.”
You see, these are people with insurance. These are people with the Medicare National Bank. These are people who don’t have to lift a finger or a dime to pay any out-of-pocket expenses for their healthcare. And yet, they still lack the motivation to care for themselves, even with incredible resources out there these days to help them — things like great online blood pressure chart sites for home monitoring.
Whatever the reason — whether it’s ignorance, laziness, lack of motivation, lack of remembering, or selfishness — people just don’t take care of themselves. Read more »
*This blog post was originally published at The Happy Hospitalist*
