February 11th, 2011 by DrWes in Better Health Network, Opinion
Tags: Cardiology, Dallas Morning News, Detecting Heart Disease, Dr. Bruce Gordon, Dr. Wes Fisher, Heart Disease, Heart Hospital Baylor Plano, Heart Whisperers, Predicting Heart Attacks, Preventive Health, Preventive Medicine, Primary Care, Silent Killer, Texas
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From the Dallas Morning News, a creative moniker if there ever was one, but it should probably be reserved for primary care specialists instead:
DALLAS — Heart attacks are the No. 1 cause of death and a major cause of disability in America. For nearly half of the casualties, the first symptom is the last. That’s how cardiovascular disease has earned the nickname “silent killer” — you never know when it will strike.
Doctors are trying to change that by treating heart disease as a progressive problem. They are becoming “heart whisperers,” seeking new tests to read the small stresses that can, unchecked, grow into big ones.
“By the time someone rolls in with a heart attack, his family will look at me bewildered, and the patient may say, ‘Doc, what happened?'” says Dr. Bruce Gordon of Heart Hospital Baylor Plano. “But it’s not what happened. It’s what’s been happening. The process has been going on for decades.”
It’s a process that can be accelerated by high cholesterol, high blood pressure, obesity, diabetes, tobacco use and secondhand smoke.
-WesMusings of a cardiologist and cardiac electrophysiologist.
*This blog post was originally published at Dr. Wes*
February 11th, 2011 by Michael Kirsch, M.D. in Health Policy, Opinion
Tags: Dr. Michael Kirsch, MD Whistleblower, Medical Ethics, Organ Transplantation, Selling Human Organs
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I have previously posted on the ethics of paying for organ donation. I find this notion to be ethically troubling, but I believe the issue deserves fair debate. In general, my belief is that a personal anecdote should not drive policy in medical ethics. There are many individual vignettes that are poignant and heartbreaking that tempt us to relax our ethical boundaries.
For example, permitting us to harvest organs from folks who are “not quite dead,” would save lives, but society’s rights outweigh this benefit, in my view. For similar reasons, I resist efforts to relax the definition of death in order to increase the reservoir of available organs. If death is redefined as a result of a search for truth, then the process is ethically permissible. Participants in these discussions would include medical professionals, theologians, ethicists, legal experts and ordinary people.
If a result of this process would be that there would be more organs available for transplantation, then I would be supportive. The distinction is that increasing organ supply would not be the primary objective. In other words, I reject the approach of, “Hey, we need more organs to save lives. Let’s roll back the definition of death to get there.”
Recently, two sisters who were serving life sentences in Mississippi for a crime related to armed robbery were released by Governor Haley Barbour. They were not pardoned, but their sentences were indefinitely suspended. A condition of their release was that one woman must agree to donate a kidney to her sister.
The women have always maintained their innocence, and supporters have argued that the verdict was wrong or disproportionate to the crime. I am not knowledgeable on the facts and offer no view on the whether the verdict and sentence were just. Read more »
*This blog post was originally published at MD Whistleblower*
February 11th, 2011 by EvanFalchukJD in Health Policy, Opinion
Tags: Employee Benefits, Evan Falchuk, First Doctors, Healthcare reform, New U.S. Healthcare System
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Dick Quinn of Quinn’s Commentary has a pithy post about why it’s hard for the government to control healthcare costs. He says:
Nobody complains about the cost of healthcare, rather they complain about their insurance premiums or their payroll deductions for health benefits.
He’s right about what politicians react to. The healthcare reform law is loaded with things that are meant to contain the price of coverage. But I would add two words to his post:
“Nobody who votes complains about the cost of healthcare.”
It’s true: The large employers who pay for much of healthcare in America complain about the cost a lot. But they are doing something about it.
In my work, I have the opportunity to present at events with some of our Fortune 500 clients. (I have one this week with The Home Depot, hosted by the National Business Group on Health. The event information here — you have to be a member of the NBGH to participate). Listening to these customers, you get a good sense of how employers are attacking this problem.
Here are the top three trends I see benefits professionals talking about:
1. Engagement and Prevention
Doing things to help employees be enthusiastic believers in their company is high on the list of many companies’ strategic objectives. Employee benefits are an important part of that.
A senior benefits leader at a Fortune 100 employer I presented with earlier this year said his company surveyed its employees to see what they wanted in their benefits package. Number 1? That the company’s benefits show it really cares about their well-being. Benefits professionals see health benefits as an opportunity to engage employees in their jobs. Read more »
*This blog post was originally published at See First Blog*
February 11th, 2011 by John Di Saia, M.D. in Health Tips, Opinion
Tags: CAL, Cannula, Custom Acoustic Liposuction, Dr. John Di Saia, Experimental Treatment, Fat Removal, Lipoplasty, Medical Gimmicks, NIL, Nutational Infrasonic Liposculpture, PALS, Plastic Surgery, Power-Assisted Liposuction, Surgical Technology, Tickle Liposuction, Truth in Cosmetic Surgery, Ultrasonic Liposuction
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Liposuction (aka “lipo”) is plastic surgery’s “gimmick procedure” having had more angles applied to it than a child’s toy. But there’s money to be made in fat reduction, so the gimmicks will just keep coming.
Enter “tickle” lipo, a new technology superimposed on the liposuction game. In this newer version of the basic liposuction technique, the cannula — the instrument used to remove the fat — vibrates like a whip inside your fatty layers. This supposedly helps remove the fat more evenly and with less pain.
Tickle lipo looks like a hybrid between two other forms of lipo already on the market: Power-assisted liposuction (PALS) in which a motorized cannula breaks up the fat, and ultrasonic liposuction in which sound waves do it. Will tickle lipo be better or worse than its fat-sucking competitors? That will likely depend upon the technology and the skill of those who use it.
However, a funky high-tech instrument won’t make a non-surgeon into a master plastic surgeon, just like a hot race car won’t make you into Jeff Gordon. Check the credentials of anyone who wants to use this tool on you. At this point I would consider tickle lipo an experiment.
– John Di Saia, M.D.
*This blog post was originally published at Truth in Cosmetic Surgery*
February 10th, 2011 by Elaine Schattner, M.D. in Better Health Network, Opinion
Tags: A Fighting Spirit, American Journal of Epidemiology, Columbia University, Dr. Elaine Schattner, Emotional Health, Emotional Strength, Emotional Well-Being, Healing and the Mind, Hope In Healing, Irrational Responses, Magical Thinking, Medical Ethics, Medical Lessons, Mental Health, Mind Cure, Mind-Over-Matter Medicine, Mistaken Beliefs, New Thought, Norman Vincent Peale, Patient Education, Personality Traits, Phineas Quimby, Positive Attitude, Power of Positive Thinking, Pseudoevidence, Pseudoscience, Psychiatry and Psychology, Public Education, Reality-Based Medicine, Richard Sloan PhD, Science and Medicine, Science Based Medicine, William James, Wishful Thinking
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[Recently] I came upon a Jan 24 op-ed, “A Fighting Spirit Won’t Change Your Life” by Richard Sloan, Ph.D., of Columbia University’s psychiatry department. Somehow I’d missed this worthwhile piece on the sometimes-trendy notion of mind-over-matter in healing and medicine.
Sloan opens with aftermath of the Tucson shootings:
…Representative Giffords’s husband describes her as a “fighter,” and no doubt she is one. Whether her recovery has anything to do with a fighting spirit, however, is another matter entirely.
He jumps quickly through a history of the mind cure movement in America: From Phineas Quimby’s concept of illness as a product of mistaken beliefs — to William James and “New Thought” ideas — to Norman Vincent Peale’s 1952 “Power of Positive Thinking” — to more current takes on the matter. These ideas, while popular, are not reality-based.
In his words:
But there’s no evidence to back up the idea that an upbeat attitude can prevent any illness or help someone recover from one more readily. On the contrary, a recently completed study* of nearly 60,000 people in Finland and Sweden who were followed for almost 30 years found no significant association between personality traits and the likelihood of developing or surviving cancer. Cancer doesn’t care if we’re good or bad, virtuous or vicious, compassionate or inconsiderate. Neither does heart disease or AIDS or any other illness or injury.
*Am. J. Epidemiol. (2010) 172 (4): 377–385.
The New York Times printed several letters in response, most of which point to pseudo-evidence on the matter. All the more reason to bolster public education in the U.S. — people won’t be persuaded by charismatic, wishful thinking about healthcare.
It happens I’m a fan of Joan Didion’s. I was so taken by the “Year of Magical Thinking,” in fact, that I read it twice. Irrational responses — and hope — are normal human responses to illness, disappointment, and personal loss. But they’re not science. It’s important to keep it straight.
*This blog post was originally published at Medical Lessons*
