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The Nursing Shortage: A Big Disconnect

With the aging of America, it’s well known that there will be a shortage of registered nurses and nursing assistants to take care of the population. It’s predicted that the shortage of nurses in California will climb to 80,000 by 2015. California has just 653 registered nurses employed per 100,000 people.

One of the problems is a lack of qualified faculty to teach at nursing schools. California was forced to turn away 23,000 qualified applicants from nursing programs during 2008-2009. And this week Humboldt State University announced plans to discontinue the school’s nursing program because of financial concerns and inability to retain nursing faculty. Shortage of nurses and closing nursing programs — now there’s a big disconnect.

*This blog post was originally published at EverythingHealth*

Sex During Pregnancy Is Safe

The Canadian Medical Association Journal (CMAJ) has published a new primer designed to help physicians when they counsel pregnant women. They note that sex during pregnancy is normal and is generally considered safe. The authors point out that there are very few proven contraindications and risks regarding intercourse in normal pregnancy.

Pregnant women and their partners are often afraid to have sex. Men may think they are “invading” the home of the fetus and could actually harm the baby. In fact, the fetus is quite safe, ensconced in the uterus (womb) and the cervix (opening of the uterus) is closed in normal pregnancy. The penis has no contact with the fetus or the uterus during normal intercourse, no matter what the position.

When is intercourse considered risky? Only for women who are at high risk for preterm labor and for those with placenta previa because there is increased risk for hemorrhage. Even women who have had preterm labor may safely have sex unless they have cervical incompetence or a lower genital tract infection.

Women who are under the care of an obstetrician should know if they have any of these risks. The vast majority of women should be reassured that sex during pregnancy is safe for mom and baby.

*This blog post was originally published at EverythingHealth*

“The Hot Spotters”: Is Better Care For The Neediest Patients The Answer To Lower Healthcare Costs?

Author-physician Dr. Atul Gawande has done it again with a well-written article in The New Yorker magazine entitled, “The Hot Spotters.” It deals with the fact that 5 percent of people with chronic illness make up over 50 percent of all healthcare costs.

If we can zero in on providing better preventive care for those people, we can finally get our arms around runaway healthcare costs. How great that you don’t even have to have a New Yorker subscription to read it. Here are a few cliff notes until you get to it:

— In Camden, New Jersey, one percent of patients account for one-third of the city’s medical costs. By just focusing attention on the social and medical outpatient needs of those people, they not only got healthier but costs were cut in half.

— Our current system is unable to reign in costs. We need to completely re-design and fund how we do primary care.

— Charging high co-payments to people with health problems just backfires. They avoid preventive care and end up hospitalized with expensive and life-threatening illnesses that are much worse and more costly. Read more »

*This blog post was originally published at EverythingHealth*

Big Breakfast, Big Calories: Rethink Your Morning “Fuel Up”

Haven’t we all learned that breakfast should be our biggest meal? “Start the day with ‘fuel’ and you can burn it off as the day goes on.” “Eat a big breakfast and you’ll eat fewer calories all day long.”

This advice is probably not true, and in fact a new study published in the January 17th issue Nutrition Journal shows that people ate the same at lunch and dinner regardless of what they had at breakfast. If a person ate 1,000 calories at breakfast (which is easy to do with bacon, eggs, toast, hashbrowns, and juice), he or she had a total increase in calories eaten throughout the day by 1,000 calories.

This doesn’t mean we should be skipping breakfast. The problem may be what we historically think of as an “American” breakfast. It might have worked for the farmer in the past or the laborer hauling lumber, but it’s just too many calories for our current level of activity. Read more »

*This blog post was originally published at EverythingHealth*

Chewable Birth Control

Just in time for the new year, the FDA has approved the first low-dose chewable birth control contraceptive. 

The daily chew will be marketed by Watson Pharmaceuticals, Inc. Fred Wilkinson, executive vice president of Global Brands said: “We believe this product is an important addition to the oral contraceptive category, and that its characteristics will make it a desirable choice for women.”

I have to ask myself: “Why?”

Most birth control failures occur because the woman forgets to take the pill. Will a chewable be more reliant? Is it aimed at gals who just love chewing gum? I don’t get the concept.

Marketing for this breakthrough will begin the in the second quarter of 2011.

*This blog post was originally published at EverythingHealth*

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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