February 23rd, 2011 by John Mandrola, M.D. in Better Health Network, Opinion
Tags: Andy Kessler, Computer Imaging, Computer-Aided Diagnosis, Doctoring and Technology, Doctors Replaced By Technology, Doctors' Jobs, Dr. John Mandrola, General Medicine, Healthcare Blogs, Healthcare in America, Judging Doctors, Man Vs. Machine, Medical Blogs, Medical Careers, Medical Certification, Medical Licensure, New Doctors, New Medical Technology, Physician Supply and Demand, Service Economy, Service Sector, Technology-Endangered Jobs, The Practice of Medicine, Wall Street Journal
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I am a doctor. Go ahead, call me what you may. Group me into a neatly, prejudged category: “All you doctors.” Just don’t label me a sponge.
That’s right. Recently in the Wall Street Journal, Mr. Andy Kessler, famous author and former hedge fund manager smart enough to turn $100 million into $1 billion, grouped doctors into a sub-category of the service economy which he labeled as “sponges.” We could have done worse: His other categories included “sloppers” (DMV workers), “slimers” (financial planners), and “thieves” (cable companies).
It seems that doctors — along with cosmetologists, lawyers, and real estate brokers — offend him because of the tests and licenses that we deem necessary:
Sponges are those who earned their jobs by passing a test meant to limit supply. According to this newspaper, 23% of U.S. workers now need a state license. The Series 7 exam is required for stock brokers. Cosmetologists, real estate brokers, doctors and lawyers all need government certification. All this does is legally bar others from doing the same job, so existing workers can charge more and sponge off the rest of us.
His essay goes on to argue the tired notion that technology endangers jobs in the service sector — the toll booth operator argument, again. He likes the creators of stuff: Apple and Google. (Duh.) But in my mind, doctoring is about creating something: We create better and longer lives for our patients. Ask the patient cured of cancer how happy they are that some doctor created his or her treatment plan. Read more »
*This blog post was originally published at Dr John M*
February 22nd, 2011 by PJSkerrett in Opinion, Research
Tags: Bad Taste, Chicken Soup for a Cold, Cochrane Collaboration, Common Cold, FDA, Food and Drug Administration, Harvard Health Publications, Harvard Heart Letter, Harvard Medical School, Harvard University, Havard Health Blog, Institute of Medicine, Loss Of Smell, Meenu Singh, Natural Remedies, Nausea, PJ Skerrett, Rashmi Das, Zinc Lozenges, Zinc-Based Cold Remedies, Zinc-Containing Nasal Sprays
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Media channels are a-twitter with the news that zinc can beat the common cold. CBS News, the LA Times, the Huffington Post, and hundreds of others are treating a quiet research report as big news that will have a life-changing effect. After reading the report and doing a little digging into the dark side of zinc, I’m not rushing out to stock up on zinc lozenges or syrup.
The latest hubbub about zinc was sparked by a report from the Cochrane Collaboration. This global network of scientists, patients, and others evaluates the evidence on hundreds of different treatments. In the latest review, on zinc for the common cold, researchers Meenu Singh and Rashmi R. Das pooled the results of 13 studies that tested zinc for treating colds. By their analysis, taking zinc within 24 hours of first noticing the signs of a cold could shorten the cold by one day. They also found that taking zinc made colds a bit less severe.
Sounds good so far. But instead of saying, “Hey, take zinc if you have a cold,” the researchers concluded like this:
“People taking zinc lozenges (not syrup or tablet form) are more likely to experience adverse events, including bad taste and nausea. As there are no studies in participants in whom common cold symptoms might be troublesome (for example, those with underlying chronic illness, immunodeficiency, asthma, etc.), the use of zinc currently cannot be recommended for them. Given the variability in the populations studied (no studies from low- or middle-income countries), dose, formulation and duration of zinc used in the included studies, more research is needed to address these variabilities and determine the optimal duration of treatment as well as the dosage and formulations of zinc that will produce clinical benefits without increasing adverse effects [bold is mine], before making a general recommendation for zinc in treatment of the common cold.”
Not exactly a ringing endorsement. Read more »
*This blog post was originally published at Harvard Health Blog*
February 22nd, 2011 by Elaine Schattner, M.D. in Health Policy, Opinion
Tags: Discrimination and Health, Dr. Elaine Schattner, Employment and Health, Health and the Workplace, Health Discrimination In Hiring, Hospital Employees, Lewis Maltby, Medical Lessons, Negative Impact On Health, New York Times, People Who Smoke, Personal Privacy, Public Health, Smokers, Smoking and Employment, Workrights Institute
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From a [recent] article in the New York Times on hiring discrimination against people who smoke:
“There is nothing unique about smoking,” said Lewis Maltby, president of the Workrights Institute, who has lobbied vigorously against the practice. “The number of things that we all do privately that have negative impact on our health is endless. If it’s not smoking, it’s beer. If it’s not beer, it’s cheeseburgers. And what about your sex life?”
I think he’s right, more or less, in a slippery-slope sort of way, seriously.
*This blog post was originally published at Medical Lessons*
February 21st, 2011 by Glenn Laffel, M.D., Ph.D. in Health Policy, Opinion
Tags: Alcohol Consumption, Alcohol Manufacturing, Alcohol Marketing, Alcoholic Beverages, Beer Institute, Beverage Producers, Booze Bottles, Diageo, Distilled Spirits, Dr. Glenn Laffel, Federal Regulation, Food and Nutrition, MSNBC, Nutrition Labels, Nutritional Analyses, Nutritional Facts, Pizaazz, Public Health, Tax and Trade Bureau, Vineyards, Wine Institute
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Virtually all bottled beverages you can buy have handy-dandy nutrition labels from which you can access information about calories, carbs, and so forth. All beverages except the ones containing alcohol, that is. Why is that?
Maybe it’s because alcoholic beverages contain little to no protein, sodium, cholesterol, Vitamin A, Vitamin C, calcium and iron (remember that alcohol is metabolized as a fat, not a carbohydrate) — so why bother? Then again, alcohol does contain calories — a lot of them. Would people drink less if they knew how many calories they were consuming? Would they drink less if they knew how many “servings” of alcohol were contained in the bottle they just purchased?
Maybe it’s because of the cost of performing nutritional analyses on each vintage of wine, each and every year, would turn profitable vineyards into money losers? Then again, plenty of niche beverage producers who run reasonably narrow margin businesses have never complained about the requirement to provide nutritional information.
The Tax and Trade Bureau is the federal agency that decides what information must appear on the labels of alcoholic beverages. Currently, it does not require manufacturers of wine, beer and the hard stuff to list ingredients. It does require them to list chemicals that folks might have an adverse reaction to things like sulfites, aspartame, and dyes.
The Tax and Trade Bureau also mandates that wines containing 14 percent or more alcohol by volume must state this fact on a label. Wines containing less than 14 percent can either specify the alcohol content or affix the words “light wine” or “table wine” to their labels. In addition, “light” beer bottlers must state calorie and carbohydrate content, and distilled liquor bottlers must specify the alcohol content by volume. Read more »
*This blog post was originally published at Pizaazz*
February 21st, 2011 by Toni Brayer, M.D. in Health Tips, Opinion
Tags: Abnormally High Blood Pressure, Accurate Blood Pressure Readings, Blood Pressure At Home, Blood Pressure Control, Cardiovascular Risk, Dr. Toni Brayer, Elevated Blood Pressure, Everything Health, Family Medicine, General Medicine, Heart Health, High Blood Pressure, Internal Medicine, Nervous About Seeing The Doctor, Office Visit Anxiety, Patients' Anxiety, Primary Care, Stress and Anxiety, Test Anxiety, White-Coat Hypertension
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“But doc, my blood pressure is always normal at home.” I wish I had a dollar for every time I have heard that line and I know it is true. When some patients come to see me, their blood pressure is abnormally high (above 130/90). This is known as “white-coat hypertension.” Although it has been thought to be from anxiety about seeing the doctor, even long-established patients who have no conscious anxiety can exhibit elevated blood pressure in the office.
Because blood pressure naturally fluctuates and the office visit is not a “normal” setting, it is important for patients who have high blood pressure (hypertension) to have their own blood pressure cuff at home. Now that devices are automated and easy to use, everyone with hypertension should be monitoring their blood pressure in the comfort of their own home. I advise multiple readings over a week at different times of day. Get a reading when resting and when rushing around. Take your blood pressure after you exercise and after a meal. It is important to keep a log and write it down. Only then can we see patterns and know if the blood pressure is controlled or not.
Blood pressure readings in the doctors office are not necessarily the most accurate. Patients are often rushed trying to get parked and in on time. Medical assistants can use the wrong size cuff or not position the arm correctly. Listening (auscultation) is not very accurate due to human error. It is the multiple readings over time that give a more accurate picture of blood pressure control.
High blood pressure in the office can be true hypertension or it can be white-coat hypertension that is usually controlled at home. If a patient is on blood pressure medication and has controlled blood pressure at home, I will not add more medication just because they are elevated in the office. If a patient has not been diagnosed with hypertension and his or her blood pressure is elevated in the office, he or she is advised to get their own blood pressure cuff for at home and return with readings for us to review. This way we can minimize unnecessary and expensive medication and make sure we are protecting the patient as well.
*This blog post was originally published at EverythingHealth*
