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911 Disclaimers Are Absurd

April 17th, 2011 by Bryan Vartabedian, M.D. in Humor, Opinion

Tags: 911, Blog Disclaimer, Emergency, Legal Disclaimer

I’m sure you’ve seen them on medical blogs:  Disclaimers that remind readers to call 911 in the event of emergency.

But is someone choking on a hot dog really going to dial up KevinMD or SeattleMamaDoc for help?  Does anyone really believe that 33 charts is the place to deal with your acute airway obstruction when you have a just a couple of minutes to live?

Here’s my theory:  I suspect that the first attorney who came up with the 911 disclaimer did so as some sort of perverse joke.  And rather than seek the input of their own lawyers, all those who followed simply copied the this original language believing it to be judicious and most conservative.  Now it’s the longest running gag in legal history. Read more »

*This blog post was originally published at 33 Charts*

CT Scans For Kids: Is The Radiation Exposure Dangerous?

April 16th, 2011 by Shadowfax in Health Tips, Opinion, Research

Tags: Children, CT Scans, Emergency Medicine, kids, Pediatrics, Radiation, Radiation Exposure, Radiology, Risks

There was an interesting study published this week in the journal Radiology:

Rising Use of CT in Child Visits to the Emergency Department in the United States, 1995–2008 (Abstract)

The results are not surprising to anyone who has been working in medicine in the US over the last fifteen years. Basically, in 1995, a kid visiting the ER had a 1.2% likelihood of getting a CT scan, and by 2008, that number was 5.9%.

I had written about this general phenomon not too long ago, in defense of the general increase of CT utilization in the ER, largely on the basis that CT is a better tool: it provides diagnoses in a rapid and timely manner, and excludes many potential life threats, saving lives and mitigating malpractice risk. That was largely relevant to the adult population, though, and kids are not, as they say, just little adults. The increase in scanning children is more dramatic, especially given the generally lower incidence of disease in kids compared to adults and the chonrically ill. Read more »

*This blog post was originally published at Movin' Meat*

Would You Prefer Longevity Or A Perfect Figure?

April 15th, 2011 by RamonaBatesMD in Opinion, Research

Tags: Body Image, Britain, Cosmetic Surgery, Longevity, Plastic Surgery, Survey, Women

I’ve spent some time thinking about this survey.   I couldn’t find any better information on the survey than the press release from the University of the West of England (UWE).  Perhaps in the future it will be published in a journal for better review.

The  survey was apparently done by the  new eating disorder charity The Succeed Foundation in partnership with the University of the West of England (UWE).  The editor’s notes indicate 320 women (ages 18 – 65 years, average age 24.49)  studying at 20 British universities completed The Succeed Foundation Body Image Survey in March 2011.

Notably, the survey found that 30% of women would trade at least one year of their life to achieve their ideal body weight and shape. Read more »

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

Complementary And Alternative Medicine Can Be A Regressive Force Against True Science

April 14th, 2011 by Steve Novella, M.D. in Opinion, Quackery Exposed

Tags: CAM, Complementary And Alternative Medicine, Homeopathy, Pseudoscience, Regressive Force, Science, Snake Oil, Ullman

Science is a philosophy, a technology, and an institution. It is a human endeavor- our collective attempt to understand the world around us,  not something that exists solely in the abstract. All of these aspects of science have been progressing over the past decades and centuries, as we refine our concepts of what science is and how it works, as we develop better techniques, and organize and police scientific activities more effectively. The practice of science is not relentlessly progressive, however, and there are many regressive forces causing pockets of backsliding, and even aggressive campaigns against scientific progress.

So-called complementary and alternative medicine (CAM) is one such regressive force. It seeks to undermine the concepts, execution, and institutions of medical science in order to promote sectarian practices and ideological beliefs. Examples of this are legion, exposed within the pages of this blog alone. I would like to add another example to the pile – the recent defense of homeopathy by Dana Ullman in the Huffington Post (names which are already infamous among supporters of SBM). Read more »

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

Does Communicating With Patients Take Too Much Time?

April 14th, 2011 by StevenWilkinsMPH in Opinion

Tags: Active Listening, Communicating With Patients, Doctor's Office, Not Enough Time, Patient Communication, Patient Education, Patient-Centered, Short Encounters, Twitter

I recently participated in a Twitter Chat about physician-patient communications. A common refrain from some of the providers in the group was that “there isn’t enough time” during the typical office visit for physicians to worry about communicating effectively. What’s up with that?

The goal of patient-centered communications is to engage the patient in their own health care. While most physicians endorse the concept of patient centered communications, many seem reluctant to employ such techniques in their own practice.  Why?  I suspect that many fear that too much patient involvement will increase the length of the visit.

Take the patient’s opening statement aka “patient agenda” in patient centered lingo.  This is where the doctor asks the patient why they are there.  The resulting patient narrative is an opportunity for the physician to obtain valuable information to help assess the patient.  Patient centered advocates recommend that physicians use open-ended questions like “what brings you in today” to solicit the patient’s concerns and agenda.  Active listening by the physician and paying attention to the patient’s emotional cues are also hallmarks of patient centered communications.

The reality is that regardless of how they are asked, patients are often not able to complete their opening statement.   Read more »

*This blog post was originally published at Mind The Gap*