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New Pap Smear Guidelines: The Right Care Or Rationed Care?

The American College of Obstetricians and Gynecologists (ACOG) recently reiterated their position that Pap smears should be performed on healthy women starting at age 21. This is different from the past which recommended screening for cervical cancer at either three years after the time a woman became sexually active or age 21, whichever occurred first.

How will the public respond to this change?

Over the past year there have been plenty of announcements from the medical profession regarding to the appropriateness of PSA screening for prostate cancer and the timing of mammogram screening for breast cancer. Understandably, some people may view these changes in recommendations as the rationing of American healthcare. Read more »

*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*

What Doctors And Patients Can Learn From Apple And Steve Jobs

First, I am a big admirer of Apple CEO Steve Jobs for his thoughtful 2005 Stanford commencement speech, his clarity of vision, and his superb skills as a leader. Fortune magazine named him CEO of the decade after turning around the company he founded from near bankruptcy in the late 1990s to becoming the most valued company today. Though I have great respect for him, I haven’t bought an Apple product, ever, until this year.

So I watched with great interest his press conference regarding Antennagate which has consumed technology news with regards to the design of the new iPhone 4 and its new antenna design. Apparently this makes the smartphone vulnerable to dropping phone calls when held a certain way, known as the death grip. If one simply avoided holding the phone that one explicit way, the phone otherwise worked fine. As a result, 22 days after the latest iPhone was available to the public, Jobs and Apple were instead addressing an issue which dwarfed their latest product launch.

Doctors and patients can learn plenty by watching Jobs’ approach to the problem, because the situation he and his team were tackling is similar to what a doctor addresses daily in the office. Read more »

*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*

How Cellphones Kill

San Francisco recently passed a law requiring disclosure to consumers of the amount of radiation emitted by cellphones at the point of sale. Research has been inconclusive on whether there is a link between cellphone usage and cancer. More definitive findings could be years away.

Understandably the law addresses a universal concern that we all have. We are more fearful of threats we can’t see, smell, hear, taste, or touch. Radon, carbon monoxide, and radiation fit these criteria.

Yet, cellphones kill in other ways which are far more immediate, equally as subtle, and just as concerning. This silent epidemic is increasing at an alarming rate. Everyone sees it, but does nothing about it. Read more »

*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*

Preventive Health Tip: Get Vaccinated For Whooping Cough

California recently declared an epidemic of whooping cough (pertussis) which resulted in the death of five infants under the age of 3 months. The pertussis vaccine, which is already given routinely to infants, is first given at 2 months of age, then 4 months and 6 months of age, with an additional booster at 15 to 18 months of age, and then again at 4 to 6 years old.

The vaccines for Bortella pertussis bacteria, which causes whooping cough, does not confer lifelong immunity. In other words, fully-vaccinated children who then become teenagers and then adults lose immunity, can acquire the infection and then spread it. Should babies acquire pertussis, as the public has discovered, it can be deadly. The persistent cough tires the baby, causes difficulty breathing, and can make them turn blue or cyanotic resulting in pneumonia or convulsions. According to CDC, about half of children aged 1 year and younger need to be hospitalized if infected with the illness. Although older children and adults can handle the cough, the infection can cause them to cough for weeks or months. Read more »

*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*

Medical Testing, Doctors, And “X-Ray Vision”

Boston Celtics basketball player Kendrick Perkins injured his knee during the NBA Finals against the Lakers when he landed awkwardly. Unable to weightbear, he left Game 6 not to return for the following pivotal Game 7.

Based on his mechanism of injury and his physical examination, his trainer reported that he tore his medial collateral ligament (MCL) as well as the posterior cruciate ligament (PCL). More amazingly, this was done without the help of a MRI. Since Perkins was unable to play the final game, there was no urgent medical need to expedite the test, as regardless of the result his season was already done.

How do doctors know what’s wrong without X-ray vision or an imaging test? (Note that Perkins did get a X-ray, but X-rays generally don’t show ligament injuries.) Is it guessing? Read more »

*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*

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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