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No Good Answers At Healthcare Town Hall

I am not as well educated in healthcare policy or politics as Dr Wes, Dr Val, KevinMD, Movin’ Meat, or Dr Sid Schwab.  I keep reading and listening, trying to understand and decide where I stand.  I seem to be more of a centrist (I think).

I was not able to attend any of the previous town hall meetings held in Little Rock on healthcare, but was able to attend the one today.  It was sponsored by the Americans for Prosperity.   The headline speaker was John Stossel.  I am happy to note it was a civil discourse though that may be due to most of them leaning the same way.

I didn’t come away any clearer than before.

I do tend to agree with Stossel that “when insurance is paying” (and not the individual) “it changes behavior.”  We aren’t as engaged in the decision making when someone else is paying.  However, it is very difficult to get straight answers or even estimates when it comes to healthcare.  It’s easy to say what an x-ray might cost.  It is difficult to estimate all the drugs, surgeries, care someone might need who has been involved in a major accident.  WSJ Health Blog provides links to sites that can help with cost questions. Read more »

*This blog post was originally published at Suture for a Living*

Medical Treatment Of Ingrown Toenails: 1908 And 2009

Flipping through the 1908 textbook, A Text-Book of Minor Surgery by Edward Milton Foote, MD I found at an antique store last month, I came across the section on ingrown toenails. The causes of ingrown toenails were much the same as one hundred years.

This is a condition in which the edge of the nail, usually of the great toe, by its too close contact with the flesh beneath causes irritation, ulceration, or suppuration. There has been much discussion as to whether the nail or the flesh is the more at fault. This discussion is without profit. It is much better to study the normal conditions, and see what can be done to restore them. Read more »

*This blog post was originally published at Suture for a Living*

Population Control, Contraception, And Climate Change

This year the topic of Blog Action Day is climate change, so I have decided to briefly mention the link between population control/contraception and climate.  This connection is finally getting attention again.  It was discussed when I was in college in the 70’s but became a political hot potato when China limited the number of children their citizens could legally have.

My roommate in college, KB, was an environmental science major.  She and I had many discussions (arguments) over how many children a family should have.  My mother had 8 children.  I also had two half-siblings from my father’s first marriage and 5 step-siblings.  She came from a family of 2 children. Read more »

*This blog post was originally published at Suture for a Living*

Circumcision In 1908: Performed To Reduce Masterbation?

There has been recent debate over whether circumcision should be made mandatory as a way to prevent the spread of HIV, so I thought I would share the section on circumcision from the 1908 textbook, A Text-Book of Minor Surgery by Edward Milton Foote, MD.

Circumcision

This little operation can be performed in a number of ways.  The practice among the Hebrews when circumcision is performed as a religious rite is to draw the foreskin well forward, to cut it off with one stroke of a long knife, to immerse the penis in wine held in the mouth of the rabbi to stop the hemorrhage, and then to wrap it in linen rags.  It is not surprising that dangerous hemorrhage and infection sometimes follow this procedure, and a few lives have been lost in consequence.

Equally reprehensible is the practice among some surgeons of trying to perform this little operation in the shortest possible time.  For this purpose clamps have been devised to hold the foreskin so that both the external and reflected portions can be cut away by a single stroke of the knife.  It is obvious that the amount of skin thus removed cannot be controlled with certainty, and even if the line of incision be a perfectly smooth circular one, a thing which rarely happens, the adjustment in length of the external and internal portions of the prepuce is at best uncertain.  There is no part of the body concerning which most patients are more sensitive, so that the surgeon ought to be willing to give up a few minutes of his time in order to secure a perfect result. Read more »

*This blog post was originally published at Suture for a Living*

Autograph Quilt: Door Prize For Medbloggers At Blog World Expo 2009

As promised last week, here’s the autograph quilt for BWE.  The quilt is going to be used as a door prize.  It has 64 white spaces for attendee’s autograph (name and blog title).  I used batiks in blue, green, and brown shades.  The quilt is machine pieced and quilted.  It is 43 in square.

Here you can see some of the fabrics used. Read more »

*This blog post was originally published at Suture for a Living*

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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