I read the LA Times article by Shari Roan, Study urges more individual mammogram guidelines, with interest. As Roan notes, guidelines to date have mainly focused on a woman’s age and not her other risks factors.
The American Cancer Society recommends that healthy women undergo screening mammograms every one to two years beginning at age 40 regardless of risk factors. In 2009, the U.S. Preventive Services Task Force recommended a different schedule which urged the inclusion of an individual’s personal risks: screening for women ages 40 to 49 should be based on individual risk factors and women ages 50 to 74 should be screened every two years.
Monday, a paper was published in the Annals of Internal Medicine (full reference below) which argues for a more personalized approach to screening mammograms.
The study by Dr. Steven R. Cummings, senior author and senior researcher at the California Pacific Medical Center Research Institute, and colleagues was based on a computer model comparing the lifetime costs and health benefits for women who got mammograms every year, every two years, every three to four years or never. Read more »
*This blog post was originally published at Suture for a Living*
You are an individual right? To your mom and dad you are/were like no other. Hopefully your family and friends continue to see you as one-of-a-kind. Had you considered your doctor should see you that way too? Not as yet another one with diabetes, or heart disease, or cancer, but as a singular human being with biology that may be different from even the next person through the door with the same diagnosis.
This is the age of “personalized medicine” and it will accelerate in 2011. It is our responsibility as patients to ensure the power of this concept is leveraged for us each time we interact with the healthcare system. This is especially true as we manage a serious chronic condition or a cancer.
Now, in research and in clinical practice there are refined tests to determine what our specific version of a disease is and there are tests to see how a targeted therapy is working in our bodies. In other words, there’s the opportunity to see which therapy might be right for us that might be different than what is right for another person, and then there is the opportunity to monitor the therapy early on to see if it is doing its job. Read more »
*This blog post was originally published at Andrew's Blog*
The past two weeks I’ve been the “dayfloat” resident on the cardiology inpatient service. With the 30-hour-shift work “restrictions” placed on medical residents, there has been a need for new systems of care to ensure the safety of newly admitted patients and cardiology dayfloat is one of them. My job is to round with the post-call team, help them get out of the hospital on time, and then take care of their patients through the end of the work day. It’s a fairly easy rotation, as they go, though because I “float” from one team to another without patients of my own, it’s also not the most satisfying.
Towards the end of my two week rotation, I was paged by a nurse because a patient’s husband wanted an update on his wife’s condition. Glancing at my “signout” — a one-page synopsis of the patient’s presenting illness and hospital course — I learned that Mrs. FN (as I will call her) was admitted to the hospital for heart failure secondary to “medical noncompliance.” It appeared that she had not had any of her medications for well over a week, which likely precipitated the shortness of breath and fluid overload that led to her admission. On top of this, the patient had a number of “dietary indiscretions” including eating Chinese food, which likely only exacerbated her condition. Read more »
*This blog post was originally published at BeyondApples.Org*
Should doctors face consequences if they run late? From The New York Times’ health blog, Well, comes a story where a medical group promises “same-day appointments and longer, more personalized visits that start on time.”
Sounds good, right? But it comes with a caveat, namely, a $199 annual membership fee. A tremendous amount of primary care can be bought with that amount of money, and if patients were willing to pay that, service will most definitely improve. Read more »
*This blog post was originally published at KevinMD.com*
I was invited to speak at the National Library of Medicine’s 2010 Annual Conference. Today I heard fellow speaker Uwe Reinhardt, Ph.D., discuss healthcare economics, and although his presentation was entertaining, as a physician I found it to be rather disturbing.
On the one hand I understand Reinhardt’s desire to engage Americans in a rational conversation about limited healthcare resources. My friend Dr. Rich Fogoros has been calling for this for many years. Yet, I was disappointed by his enthusiastic reductionism — that peoples’ lives should be reduced to a mere societal cost equation. He also said that, “When America grows up, it will look a lot more like Europe,” and cited a conversation with Dr. Phil Gingrey as an example of the congressman’s over-valuing human life. Read more »