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Free And Convenient Flu Vaccines Increase Vaccination Rates In Healthcare Workers

Far more health care workers got flu vaccines this year than at the same point last year, according to a survey by the Centers for Disease Control and Prevention, although rates are still far less than ideal.

While flu vaccination rates among health care professionals have risen slowly over the past decade, less than half this group were vaccinated until the 2009-10 season, when an estimated 62% of health care workers received seasonal flu vaccines and an additional 2% of workers got only the H1N1 influenza vaccination, the report said. In the 2010-11 season, 63.5% of health care professionals reported flu vaccination.
The Advisory Committee on Immunization Practices recommends that all health care professionals get the flu vaccine every year, and the national Healthy People 2020 objective for health care professionals influenza vaccination is 90%. Read more »

*This blog post was originally published at ACP Hospitalist*

The Slippery Slope Of Anti-Vaccine Complacency

I got a package in the mail today: My very own (complimentary) copy of Paul Offit’s new book, “Deadly Choices; How the Anti-Vaccine Movement Threatens Us All.” Needless to say, I can’t wait to read it. Not coincidentally, Dr. Offit has been making the rounds of interviews in the wake of the book’s release. Although I haven’t heard any of them directly, I did see a reference to this NPR interview on the FaceBook page of an old friend, who quoted from it thusly:

IRA FLATOW:  You write that some pediatricians will not see kids who are not vaccinated. Is that a good solution to the problem?

DR. PAUL OFFIT: I don’t know what’s a good solution to that problem. And I feel tremendous sympathy for the clinician who’s in private practice. On the one hand, and my wife sort of expressed this, she’s a general practitioner, a pediatrician, you know, she’ll say, you know, parents will come into her office and say I don’t want to get vaccines, including, for example, the Haemophilus influenzae vaccine, which is vaccine that prevents what was, at one point, a very common cause of bacterial meningitis.

And, you know, we’ve had three cases or three deaths, actually, from this particular bacterial form of meningitis in the Philadelphia area just in the last couple years.

And, you know, to her, it’s like, you know, let me love your child. Please don’t put me in a position where I have to practice substandard care, which can result in harm, which can hurt your child. Please don’t ask me to do that.

And I certainly understand the sentiment. On the other hand, if you don’t see that child, you know, where does that child go? Do they go to a chiropractor who doesn’t vaccinate?

I think it’s hard because then you lose any chance to really immunize the child.

My friend then offers his take, that of a pediatrician in private practice. Read more »

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

Influenza: It’s Not “Just The Flu”

One of our readers suggested that I review the book The Great Influenza: The Epic Story of the Deadliest Plague in History, by John M. Barry. It’s not a new book (it was published in 2004) but it is very pertinent to several of the issues that we have been discussing on this blog, especially in regards to the current anti-vaccine movement. It’s well worth reading for its historical insights, for its illumination of the scientific method, and for its accurate reporting of what science has learned about influenza.

In the great flu epidemic of 1918, influenza killed as many people in 24 weeks as AIDS has killed in 24 years. It’s hard to even imagine what that must have been like, but this book helps us imagine it. It tells horror stories: Children found alone and starving beside the corpses of their parents in homes where all the adults had died, decomposing bodies piling up because there was no one left who was healthy enough to bury them.

Sometimes the disease developed with stunning rapidity: During one three-mile streetcar trip, the conductor, three passengers, and the driver died. In another incident, apparently healthy soldiers were being transferred to a new post by train: During the trip, men started coughing, bleeding, and collapsing; and by the time it arrived at its destination, 25 percent of the soldiers were so sick they had to be taken directly from train to hospital. Two-thirds of them were eventually hospitalized in all, and 10 percent of them died. The mind boggles. Read more »

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

Improving Health For Older Adults

New clinical trials and published research are giving us information on how to improve health in elderly patients. Here are some brief points from the Cleveland Journal of Medicine that were surprising to me:

– Each year 30 percent of people age 65 or older fall and sustain serious injuries so preventing falls and fractures is important. Vitamin D prevents both falls and fractures, but mega doses of Vitamin D (50,000 mg) might cause more falls. A better dose is 1,000mg a day in people who consume a low-calcium diet. 

– Exercise boosts the effect of influenza vaccine.

– The benefits of dialysis in older patients is uncertain, as it does not improve  function in people over age 80. We don’t even know if it improves survival. Older patients who receive dialysis for kidney failure had a decline in function (eating, bed mobility, ambulation, toileting, hygiene, and dressing) after starting treatment.

– Colinesterase inhibitors (Aricept, Razadyne and Exelon) are commonly used to treat Alzheimer disease, but they all can have serious side effects. Syncope (fainting), hip fractures, slow heart rate, and the need for permanent pacemaker insertion were more frequent in people taking these drugs. The benefits of these drugs on cognition is modest.

– A new drug called Pradaxa (dabigatran) will likely prove to be safer than Coumadin (warfarin). Over two million adults have atrial fibrillation and the median age is 75. The blood thinner warfarin is critical for prevention of strokes but it caries a high risk of bleeding and drug levels have to be monitored frequently. Dabigatran will probably replace warfarin, but it will probably also be a lot more expensive.

As I often say, medicine and science are constantly changing and evolving. As new evidence comes forth, physicians and patients need to re-evaluate they way we do things.

*This blog post was originally published at EverythingHealth*

Vaccines: Top 10 Reasons To Get Your Shots

Vaccines have saved more lives than any other medical intervention in history. They are incredibly safe and effective and are well-tolerated by most people. In the US, the Centers For Disease Control and Prevention (CDC) carefully reviews all reports of adverse reactions that could be associated with vaccines. Over decades of review, they have found that the rate of potential severe reactions is so low that they cannot even calculate a risk.

There are many vaccines available for babies, children, and adults. Please check these vaccine schedules to make sure that you and your family are fully protected from vaccine-preventable diseases. (Or you can ask your doctor/nurse to review your vaccine needs with you in person.)

Vaccines for ages 0-6 click here.

Vaccines for ages 7-18 click here.

Vaccines for adults click here.

In case you have any doubts about the value of protecting yourself from disease, here are my top 10 reasons to get vaccinated: 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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