Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

The Right To Mourn

Grief and lossI seem to have had a run on bereavement recently, in that I’ve had several patients who have lost loved ones. Some have wound up in my office for unrelated complaints, only to have the grief spill out. I’ve become aware of the struggles of others via Facebook.

I’ve found this handout (from Family Practice Management several years ago) to be very useful. I keep copies in my office and hand them out when needed, but it occurs to me that having another way to disseminate this helpful information would be a good idea. Read more »

*This blog post was originally published at Musings of a Dinosaur*

A Truly Useful EMR

I love computers. Really, I do. Despite my oft-repeated claims about the shortcomings of electronic medical records in their current form, I do believe that information technology has the potential to be of great help to me and other physicians in providing quality care to Americans.

Stop laughing. I really mean it.

I do not believe, however, that IT best serves the medical needs of our patients when used to create non-interactive silos of information sequestered in the offices and clinics of individual doctors. Even hospitals and large integrated health systems information remains stuck within that system, providing limited utility when patients travel, or even go to a doctor not affiliated with the system.

Although some (especially in government) seem to feel that expanding those kinds of integrated systems is the way to go, the problem is that not all patients want to get their care from Mayo Clinic clones across the country. Still, I have an idea for using currently available technology to vastly improve the way medical care is delivered anywhere in this country. Read more »

*This blog post was originally published at Musings of a Dinosaur*

The Selectiveness Of Science Denialism

Statement #1:

The holocaust never happened. Hitler loved Jews and respected Jewish culture. The photographic evidence of the camps, including the bodies and atrocities, were all fakes designed by the State of Israel to generate international sympathy.

Statement #2:

Traditional Chinese medicine (TCM) is an effective treatment for numerous medical conditions. Acupuncture has been around for centuries and is widely practiced in China and elsewhere. Science has proven its efficacy in controlled experiments.

With any luck, that first statement should generate dozens of hits from watchdog groups berating me for spreading the vile lie of Holocaust denial.

The second statement, or words perilously close to that effect, has appeared in the New England Journal of Medicine, a previously-prestigious medical publication now revealed to be no better than the National Enquirer or any other sleazy tabloid, fit only for lining bird cages and wrapping week-old fish. Thanks to this wonderful article by Harriet Hall, it turns out that the first reference to “needling” in Chinese medical literature is from 90 B.C., although it doesn’t refer to acupuncture. It’s talking about lancing abscesses and bloodletting. The technology required to make sufficiently thin needles didn’t even exist until 400 years ago.The Chinese government tried to ban acupuncture several times around the turn of the twentieth century. The actual term “Traditional Chinese Medicine” was coined by Mao Tse Dung in the 1960s! (Go read Hall’s article linked above. It’s awesome.)

So riddle me this, campers: Why (and how) do science denialists get away with these outrageous lies? Read more »

*This blog post was originally published at Musings of a Dinosaur*

Defining Family Practice

Family DoctorI like Dr. Rob, the one with the “distractible mind.” And although I thoroughly agree with the stance he takes in his recent post against cholesterol screening in kids, I must take issue with his opening statement:

I have a unique vantage point when it comes to the issue universal cholesterol screening in children, when compared to most pediatricians. My unique view stems from the fact that I am also an internist who deals with those children after they grow up on KFC Double Downs.

From Dictionary.com:

“Unique: existing as the only one or as the sole example; single; solitary in type or characteristics.”

Your med-peds training allows you to follow patients from birth to death (but no obstetrics or gynecology). You can care for all organ systems and all stages of disease (but without as much training in psychiatry). Congratulations! You’ve just (re)invented family practice (except for the above shortcomings). Oh, wait — that’s already a recognized specialty with its own residency programs, boards and everything like that, forty years now.

This misuse of the word “unique” is one of my pet peeves. “Unique?” I don’t think that word means what you think it means. After twenty years in practice, I agree that there probably isn’t much difference between what Dr. Rob does and what I do. After twenty years, I’m not even sure how much relevance remains from our “training.” Still, there remains a great deal of confusion about the very real differences between family practice and med-peds residencies. Read more »

*This blog post was originally published at Musings of a Dinosaur*

Latest Interviews

The Surprising Economic Burden Of ADHD (Attention-Deficit Hyperactivity Disorder)

If you can read this you need to download a more recent browser It is estimated that as many as million U.S. adults have ADHD Attention-Deficit Hyperactivity Disorder A recent research study publication-pending suggests that the economic burden of ADHD on America could be as high as billion annually. I…

Read more »

Is The Adderall Shortage A Harbinger Of Future Drug Supply Problems?

If you can read this you need to download a more recent browser Today most- if not all- Doctor’s offices are strained by the shortage of some prescription medication or vaccine. A month ago President Obama signed his executive order directing the FDA to take steps to reduce drug shortages…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: The First Step To Improve Health Care Is A Close Examination Of How It’s Delivered

My friend and former Chair of the CFAH Board of Trustees Doug Kamerow has written a book that I think you will like. Besides being a mensch and witty as heck Doug is a family doctor and a preventive medicine specialist. In his new book Dissecting American Health Care Commentaries…

Read more »

“Your Medical Mind” Explores Factors That Influence A Patient’s Medical Decisions

Recently I had a conversation with Shannon Brownlee the widely respected science journalist and acting director of the Health Policy Program at the New America Foundation about whether men should continue to have access to the PSA test for prostate cancer screening despite the overwhelming evidence that it extends few…

Read more »

Book Review: Food Truths, Food Lies

Food Truths Food Lies written by family physician Eric Marcotte M.D. may be the most refreshingly evidence-based diet book of the decade. You will not find a single mention of super-foods magical berries or supplement must-haves in the entire book. What you will find is the cold hard truth about…

Read more »

See all book reviews »