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Many Smokers Just Need That Extra Push To Help Them Quit

Researchers found that while the vast majority of smokers want to stop, the vast majority who wanted to got little support from their health care providers. Not that they’d approached their provider, either.

68.8% of current cigarette smokers said they would like to completely stop smoking, and 52.4% had tried to quit smoking in the past year. However, 68.3% of the smokers who tried to quit did so without using evidence-based cessation counseling or medications, and only 48.3% of those who had visited a health-care provider in the past year reported receiving advice to quit smoking.

Little overall change has been observed in these measures in the past decade. However, Read more »

*This blog post was originally published at ACP Internist*

What We Really Need: Teamwork In Medicine

Atul Gawande says that we’re used to doctors working like “cowboys” – rugged individualists who are responsible for making sure your care gets done right.  We don’t need cowboys, he says.  We need “pit crews” – teams of doctors working together toward a common goal, with each playing their own role.

It’s an appealing idea.  Pit crew-like teams work, and work well, in trauma units across the country.

But there’s a problem: if you haven’t just been airlifted to a hospital after a horrible accident, you’re not going to be treated by a pit crew.  You’re going to be on your own, shuffled from one 15-minute specialist visit to the next, likely with no one person in charge of your care.

Dr. Gawande knows this, and he picks a heck of an example of the problem: Read more »

*This blog post was originally published at BestDoctors.com: See First Blog*

When A Cancer Patient Might Be Better Off Choosing Hospice Care

Cancer is a dreadful disease. Just dreadful.  Make no mistake: I have tremendous respect for the awesome doctors who treat patients afflicted with it day after day. Still, paradoxically, I can’t help but notice that some of them have just as hard a time as do other doctors with caring for patients at the end of their lives. I believe a large part of their difficulty stems from the ridiculously dysfunctional either/or approach to palliative care and hospice we’re stuck with in this benighted country.

The problem is that in order to qualify for hospice, patients must not only have a certified life expectancy of less than six months, but they must also not be undergoing any active treatment for their malignancy. When you stop to think about it, though, this is actually quite discriminatory. We don’t require people on hospice with other diagnoses to discontinue their life sustaining medications. Patients with COPD are allowed to continue their bronchodilators; CHF patients don’t have to stop their ACE inhibitors and digoxin. But if a cancer patient wants to qualify for hospice, they have to forgo curative treatments like chemotherapy.

So what if the oncologists call it “palliative” chemo instead? Read more »

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

How Can iPhone’s Siri Aid The Medical Professional?

Next week,  it will be my turn to write our article for the Clinical Psychiatry News website.  Over there, we try to have our writing more specifically aimed at an audience of psychiatrists.  I’m going to be writing an article on Siri and the Psychiatrist….in honor of my new iPhone 4s and the “personal assistant” function named Siri.  Okay, I’m obsessed.  Everyday, I find new things it can help me with.  Today, I asked it, “What’s the meaning of life.”  What, you don’t ask your cell phone the finer existential questions?  Siri answered, “All available evidence suggests chocolate.”  Wow!  How old is Liza Minelli?  65 years, 7 months, 20 days.  Calculate a tip? No problem.  Convert Celius to Fahrenheit?  A cinch.  And she takes dictation.  “Siri, please text Patient A Read more »

*This blog post was originally published at Shrink Rap*

Help! My Diet Is So Gross. Do I Have To Do It This Way? Insights Welcome!

I’m feeling rather nauseated today. This is my fifth day of a high-protein, low-fat, low-carb diet, and I have already developed a deep-seated hatred of egg whites. My regimen includes uncomfortable quantities of grilled chicken breast, fat-free cottage cheese, Greek yogurt, and egg protein, occasionally garnished with a lettuce leaf or perhaps a blueberry. Just yesterday I had to drink a plastic test tube of liquid protein to meet my goals (see offending product image to the left). It looked like a blood-tinged albumin sample, and tasted like orange flavor crystals with a splash of soy sauce.

I know that the scientific literature (if we distill it and perhaps oversimplify it a bit) seems to suggest that there may be a short-term advantage to high-protein diets in terms of weight loss, but that this advantage fades after a year. Yet almost every trainer and athlete I’ve encountered keeps telling me that the only way to get “really lean” is to eat unimaginable amounts of protein, avoid refined carbs, dramatically limit the complex carbs, and dial down the fat intake. Essentially, I must be reduced to swilling test tubes of orange-soy “albumin.”

When I strenuously protested the diet plan presented to me by my trainer, she simply said, “If you care what food tastes like then you’re not serious about losing fat.”

“Well how long do I need to consume 50% of my calories as protein?” I asked meekly, assuming that there would be an end point in sight. 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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