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Latest Posts

Navigating Cancer Post-Treatment: Who Will Help You?

It is completely understandable if you associate the term “cancer survivor” with an image of glamorous, defiant Gloria Gaynor claiming that She. Will. Survive. Or maybe with a courageous Lance Armstrong in his quest to reclaim the Tour de France.  Or perhaps it is linked for you with heroic rhetoric and pink-related racing, walking and shopping.

Phil Roeder from

I never call myself a survivor because when I hear this term, I recall my experience following each of four cancer-related diagnoses. It has not been triumphant. It’s been terrifying and grueling.  It hasn’t taken courage to get through the treatment.  It’s taken doing the best I can. I am not still here because I am defiant.  I am here because I am lucky, because I am cared for by good clinicians who treated my cancers based on the best available evidence, and because on the whole, I participated actively in my care. But mostly I am here because each successive diagnosis was made as a result of being followed closely with regular checks and screenings and because my doctors responded effectively to questionable findings and odd symptoms.

There are 12 million Americans living today who have been treated for cancer. Not only are we at risk for recurrences but, as Dr. Julia Rowland, director of the Office of Cancer Survivorship at the National Cancer Institute, notes, “Research shows that there are no benign therapies.  All treatment is potentially toxic and some therapy may itself be carcinogenic. Today, people are living long enough to manifest the health consequences of efforts to cure or control their cancer.”

Who amongst our clinicians is responsible for helping us watch out for those consequences for the balance of our lives? Read more »

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

CDC Reports Increased Deaths From Prescription Pain Medications: Should We REALLY Blame Doctors For This Trend?

The overdose death rate from prescription opioids, referred to as “narcotics”, has reached “epidemic levels” in the US according to a report just released by the Centers for Disease Control and Prevention (CDC).  The report further states that the intentional misuse and abuse of popular opioids such as OxyContin, Vicodin, methadone and others now cause more deaths than those caused by heroin and cocaine combined.

Dr. Thomas Frieden, CDC Director told reporters that “Narcotics prescribed by physicians kill 40 people a day.” He continued by stating “Prescription painkillers are meant to help people who have severe pain. They are, however, highly addictive.”

The report states that increased prescribing of pain medications by doctors is a significant cause of this growing number of deaths. However, the situation is far more complicated than this report presents. Poor pain management and prescription drug abuse has become Read more »

Energy Star Food Rating System: Another Futile Attempt To Promote Healthy Eating?

The Institute of Medicine has just released it’s recommendation that all foods be rated with an ‘energy star’ system: three stars = good, zero stars = bad:

The Energy Star system is a model because it’s simple and easy to use, and also because it’s gained traction with industry, which now develops products with the rating in mind, committee members said.

Except that this rating system hasn’t gained traction with industry:

But the Grocery Manufacturers Association and Food Marketing Institute announced their own front-of-the-pack system, called Facts Up Front, in January. It gives information on calories, saturated fat, sodium and added sugars but doesn’t rate foods according to those components.

In a statement today, the GMA said it has “concerns about Read more »

*This blog post was originally published at Dr. Wes*

Institute Of Medicine Suggests 8 New Preventive Services To Improve Women’s Health

Eight preventive health services for women should be added to the services that health plans will cover at no cost to patients under the Patient Protection and Affordable Care Act of 2010, according to a report by the Institute of Medicine.

The recommendations encompass diseases and conditions that are more common or more serious in women than in men. They are based on existing guidelines and an assessment of the evidence on the effectiveness of different preventive services. They include:

1) screening for gestational diabetes in pregnant women between 24 and 28 weeks and at the first prenatal visit for women at high risk for diabetes,
2) adding high-risk human papillomavirus DNA testing in addition to conventional cytology testing in women with normal cytology results starting at age 30, and no more frequently than every 3 years,
3) offering annual counseling on sexually transmitted infections for all sexually active women,
4) Read more »

*This blog post was originally published at ACP Internist*

The Right To Bear Salt: Is Sodium Restriction Warranted For The General Population?

Q. What is the difference between a public health expert and Il Duce?
A. Mussolini was not nearly as arrogant as a public health expert.

In prior posts, DrRich related how two major publc health efforts over the past few decades – the effort to put all of us on low-fat diets, and the effort to reduce everyone’s cholesterol levels – have amounted to massive experiments, based upon insufficiently-tested assumptions and surmises and hypotheses which the experts arrogantly (and incorrectly) determined to be fact, and which were conducted upon the entire American population without its knowledge or consent.

These public health experiments cost billions of dollars, needlessly transformed large swatches of American industry, and (at least in the case of low-fat diets) likely produced significant harm to the citizenry. Furthermore, despite such results, these misbegotten public health efforts have inured Americans to the notion that it is right and proper for government experts to determine for each of us what we must and must not eat.

DrRich now feels obligated to call his readers’ attention to yet another experiment which these same public health experts have launched, an experiment under which each of us – once again – is to become an unwitting research subject, an experiment whose results are unpredictable, but which has a realistic chance of producing harm to many of us. DrRich speaks, of course, of the new US dietary guidelines, published earlier this year, regarding sodium. Read more »

*This blog post was originally published at The Covert Rationing Blog*

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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