April 25th, 2011 by DrWes in Health Policy, Opinion
Tags: bureaucracy, Clinical Guidelines, Complexity, Guidelines, Healthcare Bureaucracy, Rules, US Tax Code
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The above graph from the Cato Institute demonstrates the growing complexity of the U.S. tax code over the years. After doing my taxes recently and trying to track the ins and outs of the law for my wife’s private practice, I can attest to the graph’s accuracy.
But then I was reading an interesting editorial in Circulation: Arrhythmia and Electrophysiology by N.A. Mark Estes III, MD and Jonathan Weinstock, MD that reviewed an article by Roos, et al in the same journal that found only 27 of 698 guideline recommendations from the European Society of Cardiology (median 1.2% per guideline [IQR 0.95% to 3.7%]) were correctly referenced as Class I or III Level of Evidence A recommendations, calling into question the accuracy of guideline recommendations. In their editorial, Estes and Weinstock defended the guideline process but also mentioned the following shocking statistic: Read more »
*This blog post was originally published at Dr. Wes*
April 24th, 2011 by GarySchwitzer in Health Policy, Opinion
Tags: CT Scan, Incidentaloma, Radiation Exposure, Radiology, Screening
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On the US News & World report website, Dr. Kenny Lin writes as a physician and a concerned observer about “Dangers of Incidentaloma: Why To Think Twice Before Getting a CT Scan.”
It’s an important issue. Give it a look.
Lin’s blog, “The Common Sense Family Doctor,” is also worth visiting. Recently he cited one of my alltime favorite essays, “The Last Well Person,” by Dr. Clifton Meador, who wrote in 1994:
“The demands of the public for definitive wellness are colliding with the public’s belief in a diagnostic system that can find only disease. A public in dogged pursuit of the unobtainable, combined with clinicians whose tools are powerful enough to find very small lesions, is a setup for diagnostic excess. And false positives are the arithmetically certain result of applying a disease-defining system to a population that is mostly well. … If the behavior of doctors and the public continues unabated, eventually every well person will be labeled sick. Like the invalids, we will all be assigned to one diagnosis-related group or another. How long will it take to find every single lesion in every person? Who will be the last well person?”
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
April 23rd, 2011 by John Mandrola, M.D. in Opinion
Tags: Cancer, Cycling, Healthy Living, insulin, Nutrition, NYT, Refined Carbohydrates, Sugar, Weight Gain
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After spending an entire vacation reading stories, I would like to start tonight’s post with a tiny dose of fantasy. Can we try using a daydream to learn something about the challenge of making good nutrition choices?
The fantasy goes something like this…
You have just been sentenced to eternal life on a far-away sun-drenched island. This island has mountains, paved roads, wide bike lanes, and mountain bike trails. You get to take two bikes, a couple riding buddies and your family—if they’ll go. You also get to take one Apple product.
Sounds good so far.
The kicker is that you only get four food choices—and liquids count.
You are a cyclist, so after coffee and beer there are only two food choices remaining. Obviously, you will need a protein source. Smart choices here would include nuts, mercury-free fish or organically-fed animals. The protein isn’t the point, let’s keep moving.
Now we are down to the carbohydrate source.
Choose one of the following:
A.) Arugula
B.) Quinoa
C.) Cranberries
D.) Fruit Loops
Herein lies the primary hurdle that smart-nutrition advocates face: unhealthy simple sugars taste really good. Read more »
*This blog post was originally published at Dr John M*
April 23rd, 2011 by KerriSparling in Opinion, True Stories
Tags: Babies, Diabetic Mommy, First Year Of Life, Gastroenterology, Gluten-Free Diet, Pediatrics, Reducing Risk Of Developing Diabetes, Type 1 Diabetes
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(Alternate tittle: “Bring out yer bread!”)
Now that the little bird is the big O-N-E, we have completed one year as parents. And one year doing the gluten-free diet with our baby. This was important to me because I felt strongly about the ties between the early introduction of gluten and type 1 diabetes diagnoses. And after doing some research and discussing this as a family, Chris and I decided to keep our BSparl gluten-free for her first year.
It was pretty easy, to be honest, keeping a little baby off gluten. (Especially since she doesn’t have celiac, so our decision was elective instead of required.) The ease came mostly from the fact that BSparl breastfed for almost six months, and didn’t start on solid foods until just after she turned six months old. All breastmilk and/or formula made for a pretty streamlined food schedule for that first half year. When we introduced solid foods into her diet, we went with organic rice cereal and formula first, then mushed up fruits and assorted other mushed up items (like avocado and shredded chicken breast) mixed with food pouches like these from Ella’s Kitchen. Her diet was pretty mushy for a good long time, since it took about 8 months for her first tooth to bust through. Read more »
*This blog post was originally published at Six Until Me.*
April 22nd, 2011 by John Di Saia, M.D. in Health Tips, Opinion
Tags: Genitalia, Labiaplasty, Minor, Plastic Surgery, Surgical Reduction, Teenager
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Reader Question:
I am 16 in Orange County and want a labia reduction. Can I have it without telling my parents?
For those of you who may not know, labiaplasty (sometimes called labioplasty) is an operation to change the shape of the labiae, a woman’s outer genitals. It can be performed for cosmetic or functional concerns. Some women with large labiae experience pain with tighter garments and in rare circumstances they can get in the way of sexual relations. The operations are different things to different surgeons and have been controversial to say the least.
Quite a bit in the practice of surgery of the privates is a matter of the surgeon’s philosophy. This includes the design and scope of the operation as we’ve mentioned. Traditionally for any surgery on a patient under the age of legal consent, a legal guardian (usually a parent) must consent. Read more »
*This blog post was originally published at Truth in Cosmetic Surgery*
