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Inner Ear Infections: Still No Need For Antibiotics

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Kids get inner ear infections and then they get antibiotics, despite a long-standing knowledge that it’s not always best. Any physician knows this, but who hasn’t faced an irate or anxious parent in the exam room insisting on a prescription, whether the evidence warrants it or not?

Reuters reports that the tally for all those antibiotics is $2.8 billion dollars, or $350 per child annually. And there’s only a slight benefit to them.

While hardly comforting to the parents, physicians can add more heft to their argument that antibiotics are only modestly more effective than nothing, and they can avoid the rashes and diarrhea that antibiotics incur. Read more »

*This blog post was originally published at ACP Internist*

How Low Can Oprah Go? Promoting Faith Healing To The Masses

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Several of the bloggers on Science-Based Medicine have been — shall we say? — rather critical of Oprah Winfrey. The reason, of course, is quite obvious. Oprah is so famous that if you mention her first name nearly everyone will know exactly of whom you speak.

For the last quarter century, Oprah’s daytime TV talk show has been a ratings juggernaut, leading to the building of a media behemoth and making her one of the richest and most famous women in the world. Unfortunately, part of Oprah’s equation for success has involved the promotion of quackery and New Age woo, so much so that last year I lamented about the Oprah-fication of medicine, which scored me a writing gig in the Toronto Star.

Whether it be promoting bio-identical hormones, The Secret (complete with a testimonial from someone who used The Secret to persuade herself not to pursue conventional therapy for breast cancer), Suzanne Somers, the highly dubious medicine promoted by Dr. Christiane Northrup, or foisting reiki aficionado Dr. Mehmet Oz or anti-vaccine “mother warrior” Jenny McCarthy onto a breathless public, arguably no one is a more powerful force for the promotion of pseudoscience in America, if not the world.

Truly, the ending of Oprah’s TV show in the spring is a very good thing indeed for science and rationality. Or it would be, were it not for the fact that the reason Oprah is wrapping up her show after a quarter of a century is to start up her own cable channel, so that we can have Oprah-branded and -inspired programming 24/7. The mind boggles.

Still, my dislike for how Oprah promotes New Age mysticism and pseudoscience on a distressingly regular basis aside, I actually did think there were limits to how low she would go. I actually thought there were limits to how egregiously vile a quackery Oprah would endorse. The operative word, of course, is “did,” which now needs to be struck off after last Wednesday, which is when Oprah did an entire show entitled Do You Believe in Miracles? (Guess what answer was implicitly, if not explicitly, endorsed.) Featured prominently in that episode were several segments on the faith healer John of God. Read more »

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

Why The French Don’t Go To The Gym

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gettinbigwithrivaroxaban 300x187 Work out in a Gym? The French say Sacre Bleu!Like their counterparts in other first-world countries, French people know about the health benefits of exercise. And French culture has emphasized, even worshipped, good looks (which these days translates to “fit and trim.”)

So it’s surprising that the French avoid fitness centers as vigorously as factory-produced croissants. But they do.

According to the International Health, Racquet and Sportsclub Association, just 5.4 percent of French people were members of a fitness club in 2008. That’s substantially less than their counterparts in Italy (9.5 percent), the UK (11.9 percent), and Spain (16.6 percent).

“It appears that more people are sitting in cafes smoking cigarettes and drinking coffee than working out … the French don’t see fitness as a lifestyle,” American-born fitness consultant Fred Hoffman told MSNBC. Hoffman has lived in Paris for two decades. Read more »

*This blog post was originally published at Pizaazz*

Making Circumcision A Crime?

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Have you heard? First San Fransisco bans toys in Happy Meals. Now CNN is reporting there’s a  circumcision ban proposed in San Fransisco as well. 

To recap: Anti-circumcision activist Lloyd Schofield has drawn up a proposal outlawing all circumcisions, even for religious reasons (circumcision of boys is traditional in Judaism and Islam.) The punishment would be up to a year in jail or up to a $1,000 fine.

Boy, oh boy. What a hot-bed topic circumcision is. Mandating a ban against all circumcisions is like mandating a requirement that all boys be circumcised. Nobody is right. Everyone is an expert. You’re either for it or against it. But making circumcision a crime? I don’t know. Read more »

*This blog post was originally published at The Happy Hospitalist*

Workers Compensation: A Model For The Future Of American Healthcare?

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There’s a country with an unusual healthcare system. In it, you often spend about as much time with your lawyer as you do your doctor. There are special courts set up to decide what kinds of treatment you are allowed to have. And doctors have to be careful that they don’t say or do the wrong thing, or else they risk being blackballed by insurance companies.

The country:  The United States of America.

You may not realize it, but if you hurt your back at work you end up in a different healthcare system than if you hurt your back at home. Sure, you may end up with similar doctors or hospitals, but your experience of healthcare will be completely different. Here’s why.

If you get hurt at work, you’re covered by the “workers compensation” system. That system has its roots over a century ago, when employers didn’t do much to take care of workers. So the system is based on laws that mandate employers to take care of injured workers, often for the rest of their lives. In exchange for this very comprehensive coverage, employers and their insurers get a great deal of control over what care workers get and where they get it.

Does the workers compensation system represent a model of how a future American healthcare system might work? It might. Read more »

*This blog post was originally published at See First Blog*

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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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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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