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Helpful Breast Cancer Q&A

Preya Ananthakrishnan, MD

Attendees of the breast cancer awareness symposium “Bridging the Gap: Promoting Breast Cancer Prevention, Screening and Wellness” were given the chance to submit questions on breast cancer in the minority community. This is the first part of these questions answered by Dr. Preya Ananthakrishnan, Assistant Professor of Clinical Surgery and a host of the event.

Q: I am a 51 year old Black women, whose mother died 13 years ago from breast cancer & her sister was diagnosed last year. I had a mammography 2 weeks ago and got the dreaded come back letter. Should I get genetic counseling?

Dr. Ananthakrishnan: I would suggest that your sister with the breast cancer get tested first, and if her test result is positive then you should get tested. Furthermore, it is likely that even though you got a “call back” letter after your mammogram, it is very possible that you don’t actually have a breast cancer. I would advise you to go in as soon as possible to work up whatever abnormality was seen. If you do in fact have a breast cancer, then you should certainly undergo genetic testing yourself.

Q: What is considered “early detection” of breast cancer?

Dr. Ananthakrishnan: Early detection is finding a breast cancer before symptoms actually occur. This could be by finding it on a mammogram before actually feeling a lump in the breast, or by finding a small lump before it becomes a big lump. Early detection can sometimes allow for less aggressive treatments and improved outcomes.

Q: Is radical mastectomy surgery still performed? I hear little about it now. Read more »

*This blog post was originally published at Columbia University Department of Surgery Blog*

Economic Incentives Motivate: What We Can Learn From The Rand Health Insurance Experiment

The use of economic incentives to motivate behavior is neither a Democratic or Republican idea. It is human nature to be motivated by economic incentives. The concept of individual responsibility is an American idea. It has been tarnished in recent years.

There is no question in my mind that government has the responsibility to be compassionate and help the needy. It is my view that government should help individuals help themselves.

The costs associated with Medicare and traditional healthcare insurance are rising. Every stakeholder points a finger at the other stakeholders as the cause.

President Obama’s Healthcare Reform Act is raising costs higher in anticipation of cuts in the future. He is in the process of forcing individuals to be more dependent on the government rather than promoting individual responsibility.

Obamacare will fail to control costs.

All anyone has to do is look at a Rand Corp. study of 29 years ago to see what works and what doesn’t work. Read more »

*This blog post was originally published at Repairing the Healthcare System*

Can Electronic Health Records Make Disparities Disappear?

According to Kendra Blackmon at and a new study published by the National Institute of Standards and Technology (NIST), the answer is maybe.

Earlier this year, NIST published a report – Human Factors Guidance to Prevent Health care Disparities with the Adoption of EHRs – which declares that “wide adoption and Meaningful Use of EHR systems” by providers and patients could impact health care disparities.

Making this happen, however, will require a different way of thinking about electronic health records (EHRs). While the report notes that EHRs primarily are used by health care workers, patients still interact with these systems both directly – such as through shared use of a display in an exam room – and indirectly. For patients to obtain the intended benefits of this technology, EHR systems should display or deliver information in a way that is suitable for their needs and preferences, the report says. Read more »

*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*

Pediatric Emergency Drug Calculator: Great Idea, Not Ready For Prime Time

Photo Jun 12, 10 15 47 PM Pediatric Emergency Drugs is designed to be a quick med list calculator for pediatric emergencies. For folks who deal with pediatric emergencies have the challenge of not only determining the proper drugs to use, but also to get the dosage right by age.

At the first page you are met with a screen to enter the age of the child and either allow the program to pick the estimated weight or put your own weight in. This is a nice feature as often in pediatric emergencies patients arrive through the door needing immediate care and a weight is unavailable. The estimated weight it appears to pick is the 50% for a boy of the selected age. Allowing you to pick the gender of the child would be helpful in narrowing down the weight a little further since girls of a given age would weigh a little less.  Another option would be to allow the use of Broselow colors. These days the standard for most ERs is the Broselow tape which is a plastic foldable tape that doses based on length.

Once you select your patient you have a section of drugs broken down into: cardiac arrest meds, infusions, and bolus drugs. The cardiac arrest meds are short a few drugs. There are no drugs for treating ventricular fibrillation (amiodarone)  and they do not make mention of the dose of electricity for synchronized cardioversion (only for defibrillation). The infusion list assumes you are mixing all drugs in 50mL bags which is not usually the case. (we usually use 100 or 250mL bags for drips). Also, in America thanks to JCAHO regs medicated infusions need to be have standardized concentrations and not use the “rule of 6” employed by this program. The list of bolus drugs is missing a few key drugs as well such as midazolam and hydrocortisone for sepsis. Read more »

*This blog post was originally published at iMedicalApps*

The Centers For Disease Control And Prevention (CDC) Bloggers Join The Better Health Team!

It is with great pleasure that I welcome our CDC colleagues to the Better Health blog team. Going forward, Better Health will feature content from the CDC blogs on a weekly basis, and our collaborative efforts will be highlighted on the CDC blog pages as appropriate.

Better Health and the CDC share a common mission: to reach as many Americans as possible with scientifically accurate, trustworthy, and helpful medical information. As social media platforms (such as blogs, Twitter, and Facebook) become a gathering place for people seeking health information – it is important for experts to be able to provide content through these channels. The CDC’s relationship with Better Health is an excellent example of a public-private partnership that can magnify reach and relevance.

By becoming a content partner with Better Health, the CDC joins a prestigious international team of physicians, nurses, health experts and patient advocates, including notable organizations such as the American College of Physicians blogs, Harvard Health Publications, Diario Medico, Healthline, the Center For Advancing Health, and the Columbia University Department of Surgery. Read more »

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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