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Declining Cancer Screening: Why It’s The Right Decision For Some

One wonders how many men have their blood tested for PSA levels looking for prostate cancer without being asked if that’s what they really wanted.

The Foundation for Informed Medical Decision Making (which supports my web publishing efforts) has now posted on its YouTube page a video clip with a man who has some regrets about his prostate cancer screening and treatment experience. It’s the same man featured in the New York Times Sunday magazine piece, “Can Cancer Ever Be Ignored?

Relevant excerpt from the NYT piece:

“Tim Glynn, a self-described country lawyer from Setauket, N.Y., was 47 in 1997 when he went to his primary-care doctor, troubled by a vague feeling of being down. After his physical exam, Glynn was sent to have his blood drawn. Along with thyroid and cholesterol levels, the doctor ordered a P.S.A. test. Read more »

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

The Importance Of Increasing Our Knowledge Of Placebo Neurophysiology

There has been an ongoing debate about placebos on SBM, both in the articles and in the comments. What does it mean that a treatment has been shown to be “no better than placebo?”  If our goal is for patients to feel better and they feel better with placebos, why not prescribe them? Do placebos actually do anything useful? What can science tell us about why a patient might report diminished pain after taking an inert sugar pill? The subject is complex and prone to misconceptions. A recent podcast interview offers a breakthrough in understanding.

On her Brain Science Podcast Dr. Ginger Campbell interviewed Dr. Fabrizio Benedetti, a physician and clinical neurophysiologist who is one of the world’s leading researchers on the neurobiology of placebos. A transcript of the interview [PDF] is available on her website for those who prefer reading to listening. The information Dr. Benedetti presents and the expanded remarks by Dr. Campbell after the interview go a long way towards explaining the placebo phenomenon and its consequences for clinical medicine. Dr. Campbell also includes a handy list of references. I’ll try to provide a summary of the main points, but I recommend reading or listening to the original.

A common misconception is that Read more »

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

Ten Things You Might Not Know About Afib

September is Atrial Fibrillation Awareness Month. Lots of folks don’t know too much about the condition, which is an irregular heart beat that can lead to serious complications such as dementia, heart failure, stroke or even death. To help spread the word, StopAfib.org presents these 10 afib facts and figures that will probably surprise even

some healthcare professionals:

  1. Afib affects lots of people. Currently up to 5.1 million people are affected by afib. And that’s just in America. By 2050, the number of people in the United States with afib may increase to as much as 15.9 million. About 350,000 hospitalizations a year in the U.S. are attributed to afib. In addition, people over the age of 40 have a one in four chance of developing afib in their lifetime.
  2. Afib is a leading cause of strokes. Nearly 35 percent of all afib patients will have a stroke at some time. In addition to leaving sufferers feeling weak, tired or even incapacitated, afib can allow blood to pool in the atria, creating blood clots, which may move throughout the body, causing a stroke. To make matters worse, Read more »

*This blog post was originally published at Atrial Fibrillation Blog*

Psychiatrist Considers The Difficulties That Would Arise When Treating Children

My hat goes off to kiddy shrinks.  It’s a tough field, full of issues we don’t see in adult psychiatry.

Our comment section often buzzes with talk about the over-diagnosis of bipolar disorder in children and the ethics of giving psychotropic medications to children.  The Shrink Rappers never comment on these things.  Why?  Because we don’t treat children.  I have no idea if the children being treated are mis-diagnosed, over-diagnosed, wrongly-diagnosed, or if the increase in treatment represents a good thing—- perhaps children who would have suffered terribly now are feeling better due to the option of medications.  I’ve certainly had adult patients tell me their children were treated with medications, the children have often eventually stopped the medications and emerged as productive adults.  Would they have outgrown their issues anyway.  Or did the treatment they received switch them from a bad place to a good place and enable them to carry on in a more adaptive way?  Ugh, my crystal ball is on back-order at Amazon!

Why I’m Happy I’m Not A Child Psychiatrist: Read more »

*This blog post was originally published at Shrink Rap*

The Misuse Of A National Television Platform To Promote Health Information

In a highly-promoted appearance, legendary Florida State football coach Bobby Bowden went on ABC’s Good Morning America yesterday to announce that he had kept silent since 2007 about his diagnosis with prostate cancer.

First, let me say that I’ve always liked this guy. Funny. Charming. Coached teams that were fun to watch.

But that doesn’t make you an effective communicator on prostate cancer.

If you listen very carefully to the following clip (it took me 3 times watching the clip before I caught this), you’ll hear interviewer Robin Roberts rapidly mention that Bowden “is being compensated” for his appearance by “On the Line.”

On the Line” is sponsored by several entities including two drug companies that make prostate cancer drugs and by Project Zero – whose executive made news on this blog recently by writing that Dr. Otis Brawley of the American Cancer Society “has killed more men by giving them an excuse to not be tested.”

You could probably find less conflicted sources Read more »

*This blog post was originally published at Gary Schwitzer's HealthNewsReview 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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