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Herbal Remedy May Reduce Urinary Tract Infections?

The number one Google news item today is a report of a mouse study (published in Nature Medicine, but apparently still embargoed to the public as it is not listed on their website) that suggested that an herbal supplement could (in combination with antibiotics) “eradicate” urinary tract infections.

In usual fashion, the buzz preceded the science, and now we have thousands of people on the lookout for forskolin (a root extract of coleus) tablets from the local health food store. Do these have any possible merit?

A recent review of the literature about this herb was conducted by the good docs at Harvard, and turned up “no conclusive evidence for its [forskolin’s] use for any health condition.”

My friend Dr. Charles also read the reports of this “miraculous” new cure – which posits that recurrent urinary tract infections are caused by pockets of bacteria that hide inside bladder walls. Dr. Charles rightly points out that there are many different points of entry for bacteria, and that an herb which (and we don’t know that it even does this) relaxes bladder walls would surely not affect the alternate routes of entry, hence it cannot be curative in all cases.

So my friends, I’m sorry to say that there is little justification for enthusiasm yet. But we will follow the research with interest, in case human subjects do indeed show benefit in the future.

This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Are physician salaries too high?

I am opposed to millionaires, but it would be dangerous to offer me the position.

–Mark Twain

As we consider the wastefulness of the healthcare system, I have heard many people complain that physician salaries are one of the main culprits in escalating costs.

Dr. Reece compares the average income of some of the highest paid physician specialists, with that of hospital executives, medical insurance executives, and fortune 500 CEOs. Check this out:

Highest Paid Physicians

1. Orthopedic, spinal surgery, $554,000
2. Neurosurgery, $476,000
3. Heart surgeons, $470,000
4. Diagnostic radiology, Interventional, $424,000
5. Sports Medicine, surgery, $417,000
6. Orthopedic Surgery, $400,000
7. Radiology, non-interventional, $400,000
8. Cardiology, $363,000
9. Vascular surgery, $354,000
10. Urology, $349,000

Executive Pay for Massachusetts Hospital CEOs

1. James Mongan, MD, Partners Healthcare, $2.1 million
2. Elaine Ullian, Boston Medical Center, $1.4 million
3. John O’Brien, UMass Memorial Medical Center, $1.3 million
4. David Barrett, MD, Lahey Clinic, $1.3 million
5. Mark Tolosky, Baystate Health, $1.2 million
6. James Mandell, MD, Children’s Hospital, Boston, $1.1 million
7. Gary Gottlieb, Brigham and Women’s Hospital, $1 million
8. Peter Slavind, MD, Massachusetts General Hospital, $1 million

2005 Total Annual Compensation for Publicly Traded Managed Care CEOs

1. United Health Care $8.3 million
2. Wellpoint, Inc, $5.2 million
3. CIGNA, $4.7 million
4. Sierra Health, $3.4 million
5. Aetna, Inc, $3.3 million
6. Assurant, Inc, $2.3 million
7. Humana, $1.9 million
8. Health Net, $1.7 million

Top Corporate CEO Compensation

1. Capital One Financial, $249 million
2. Yahoo, $231 million
3. Cedant, $140 million
4. KB Home, $135 million
5. Lehman Brothers Holdings, $123 million
6. Occidental Petroleum,, $81 million
7. Oracle, $75 million
8. Symantec, $72 million
9. Caremark Rx, $70 million
10. Countrywide Financial, $69 million

But the real story here is the salary of our primary care physicians – those unsung heroes of the front lines. KevinMD pointed out a recent news article citing $75,000.00/year as the average salary of the family physician in the state of Connecticut, and that their malpractice insurance consumed $15,000.00 of that. Although this is certainly below the national average for pediatricians (they start at about 110,000 to 120,000), I’ve seen many academic positions in the $90,000 to 100,000 range.

Now I ask you, does it seem fair that the vast majority of physicians (the primary care physicians) are making one tenth of the average hospital executive salary? Should doctors really be in the cross hairs of cost containment?

This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Circumcision reduces HIV transmission in Africa

Recent research suggested that circumcision may reduce the rate of HIV transmission by 50% (foreskin cells are particularly vulnerable to infection with the virus). In response to this news, adult men in Uganda and Kenya have been undergoing the procedure in the hope of reducing their risk of HIV infection.

Some young boys in Kenya were actually expelled from school for not being circumcised. Their parents were asked to bring them back to school once the deed was done.

HIV rates have decreased in Uganda from 15% to 5% after aggressive public health initiatives raised awareness of the importance of safe sexual practices. This is an incredibly positive achievement.

One would hope, however, that circumcision in infancy would become the preferred target age for future procedures.

This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

So you want to be a sperm donor?

In a recent article in the New York Times the process of sperm banking was described in a fairly whimsical way, but the real bizarreness of the business could be found between the lines. Apparently sperm banks compete with one another as they go to all kinds of lengths to tout the quality of their donors:

“It’s kind of an arms race,” explains William Jaeger, director of Fairfax Cryobank, in Fairfax, Va., which, along with California Cryobank, based in Los Angeles, is among the largest sperm banks in the country.

“One year someone adds a personality profile, the next year someone adds something else,” Mr. Jaeger says. “If one of your competitors adds a service, you add a service.”

Certain donor profiles are particularly popular, making it difficult for the supplier to keep up with the demand.

The most-requested donor is of Colombian-Italian and Spanish ancestry, is “very attractive, with hazel eyes and dark hair,” and, Ms. Bader adds, is “pursuing a Ph.D.”

The bank’s files have one man, Donor 1913, who fits that description.

Donor 1913, the staff notes in his file, is “extremely attractive,” adding in a kind of clinical swoon, “He has a strong modelesque jaw line and sparkling hazel eyes. When he smiles, it makes you want to smile as well.”

Donor 1913 is an all-around nice guy, they say. “He has a shy, boyish charm,” the staff reports, “genuine, outgoing and adventurous.”

He also answers questions, including, “What is the funniest thing that ever happened to you?”

Donor 1913 relates an incident that occurred when he asked his girlfriend’s mother to step on his stomach to demonstrate his strong abdominal muscles.

“As she stepped on top of my stomach, I passed gas,” he writes.

Is Don Juan the gas-passer also the most popular donor at Fairfax Cryobank?

The sperm banks say that they only accept 1-3% of donors, but the criteria that I could glean from the article seemed to be:

  1. You’re not overweight
  2. You’re tall (unless you’re a doctor or a lawyer, then you can be as short as 5’7” to 5’8”)
  3. You’ve got a college degree
  4. You have high SAT scores
  5. You are good looking
  6. You have healthy sperm

Apparently, the most requested sperm donor in one of the California banks is a tall man who was in college at the time of his donations, but who later dropped out and took up residence in a mobile home park and made a living walking other people’s dogs.

So, who were the other 97% who didn’t make the cut?

This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

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