December 3rd, 2010 by StevenWilkinsMPH in Better Health Network, Health Tips, Opinion, Research
Tags: Changing Patient Behavior, Doctor-Patient Communication, Empowering Patients, Family Medicine, General Medicine, Mind The Gap, Patient Empowerment, Patient-Centered Care, Physician Recommendations, Physician-Centric Directives, Preventive Health, Preventive Medicine, Primary Care, Screening Tests, Shared Decision-Making, Steven Wilkins MPH, U.S. Preventive Services Task Force, USPSTF
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“I recommend.” These are two word which, when spoken by a physician to a patient have tremendous power to change behavior. That assumes of course a trusting relationship between patient and physician (but that’s a topic for another day.)
Take the colonoscopy. The U.S. Preventive Services Task Force (USPSTF) recommends that adults aged ≥50 years get a colonoscopy every 10 years. In 2005, 50 percent of adults aged ≥50 years in the U.S. had been screened according to these recommendations. Not surprisingly, the rate of colonoscopy screening is much lower than that of other recommended adult preventive services. I was curious: Why?
Here are two interesting facts:
1. Studies show that patients cite “physician recommendation” as the most important motivator of colorectal screening. In one study, 75 to 90 percent of patients who had not had a colonoscopy, said that their doctor’s recommendation would motivate them to undergo screening.
2. In that same study, in 50 percent of patients where a colonoscopy was appropriate but not done, the reason given was that the physician simply did not “bring up” the subject during the visit. Reasons included lack of time, visit was for acute problem, patient had previously declined or forget. Read more »
*This blog post was originally published at Mind The Gap*
December 2nd, 2010 by AnneHansonMD in Better Health Network, Health Policy, News, Opinion, Research
Tags: American Psychiatric Association, APA, California, Correctional Facilities, Correctional Systems, Dr. Anne Hanson, Mental Deterioration, Mental Health, Mental Health Services, Prison Overcrowding, Prison System, Prisoner Health, Prisoners As Patients, Psychiatry and Psychology, Psychological Problems, Schwarzenegger Vs. Plata
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In California, the U.S. district court has ordered that tens of thousands of prisoners be released to reduce overcrowding. The case, Schwarzenegger v. Plata, was argued this past Tuesday and the transcript is online.
This is relevant to a psychiatry blog because one of the arguments used in support of the releases is the contention that overcrowded facilities reduce access to mental health and medical services and that overcrowding causes mental deterioration and breakdown. The APA filed an amicus brief in the case, but the brief isn’t available online yet. (Keep an eye out for it here.)
The challenge with this case is that there is no (or extremely little) actual research to support the link between overcrowding and psychological problems. Correctional systems have spent a lot of time litigating issues — and experts make a fair amount of money working on these cases — without actual data. Read more »
*This blog post was originally published at Shrink Rap*
December 2nd, 2010 by KevinMD in Better Health Network, News, Opinion
Tags: Balancing Work and Family, Career Cost To Family, Choosing A Medical Profession, Claudia Golden, Doctor's Lifestyle, Doctor's Personal Life, Dr. Kevin Pho, Family Lifestyle, Family Medicine, Female Doctors, General Medicine, KevinMD, Medical Specialty, Medical Students, Medical Training, Physician Burnout, Physician practice, Poorer Care, Primary Care, Professional Demand, Work-Life Balance
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Medical students today consider lifestyle an essential criteria when choosing a specialty. It’s become a cliche that most are looking towards the ROAD (radiology, ophthalmology, anesthesiology and dermatology) to happiness.
There’s been some recent media attention at how women are lured to specialties that offer a greater balance between their family lifestyle and professional demands. Claudia Golden, a Harvard economics professor, recently noted that,
high-paying careers that offer more help in balancing work and family are the ones that end up luring the largest numbers of women. Surprisingly, colon and rectal surgery is one of these, because of rapid growth in routine colonoscopies that can be scheduled in advance, giving doctors control over their time. Goldin says 31% of colon and rectal surgeons under 35 years of age were female in 2007, compared with only 3% of those ages 55 to 64, and 12% of those ages 45 to 54, reflecting the fact that younger women are flocking to the field.
Of course, what’s not said is the grueling training that it takes to become a colorectal surgeon — but the numbers cited above do not lie. The new generation of doctors — both men and women — want greater control of their time. That means more shift-work and a predictable call schedule. Read more »
*This blog post was originally published at KevinMD.com*
December 2nd, 2010 by DrWes in Better Health Network, Health Policy, News, Opinion, Research
Tags: BBC Radio 4's Today, Clinical Testing, Doctors As Paid Consultants, Doctors Speaking Out, Dr. Peter Wimshurst, Dr. Wes Fisher, Freedom Of Speech For Doctors, Libel, Medical Device Companies, Medical Investigators, Medical Lawsuits, Medical Litigation, NMT Medical, Patent Foramen Ovale, PFO, Physician Opinion, Scientists' Rights To Free Academic Debate, Starflex
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Imagine having a medical device that is being tested in multiple centers, but one doctor thinks the device has problems. He says so at a national conference despite glowing reviews by others. Should the company sue the doctor for liable and remove him from their investigative panel?
Today, it seems that might not be such a good idea. This is, in fact, what NMT Medical did regarding comments made by Peter Wilmshurst, M.D. regarding NMT’s patent foramen ovale (PFO) closure device called Starflex:
NMT sued Dr. Wilmshurst for libel after he criticized its research at a US cardiology conference in 2007. The doctor vowed to take the case to trial in order to defend scientists’ rights to free academic debate.
The company threatened Dr. Wilmshurst with libel a second time for subsequent comments he made about the case on BBC Radio 4’s Today programme. Read more »
*This blog post was originally published at Dr. Wes*
December 2nd, 2010 by RamonaBatesMD in Better Health Network, News, Opinion, Research, True Stories
Tags: Double-Hand Transplant, Dr. Ramona Bates, Dr. Richard Edwards, Hand Or Arm Transplantation, Jeff Kepner, Limb Rejection, Limb Transplant, Loss Of Limbs, Louisville, New Limbs, Otto Bock DynamicArm, Patient Satisfaction, Prosthetics, Rejection By The Body, Suture For A Living, Tammy Chinander, The Jewish Hospital Hand Care Center, Transplantation Surgery
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Dr. Richard Edwards, a chiropractor from Oklahoma and the nation’s third double-hand transplant, was recently in the news again. This time it a report that he “may lose the fingertips on his right thumb and pinkie because his body started to reject the new limbs.”
Dr. Edwards’ surgery was live tweeted when it was done in August by Louisville surgeons at The Jewish Hospital Hand Care Center.
Jeff Kepner, the first patient in the United States to receive two hands simultaneously, experienced an episode of rejection which was dealt with successfully.
Rejection is never a good thing in a transplant patient no matter which organ or body part is transplanted. Even though I applaud the advances being made, we must always consider the cost of the proposed treatment and ask: Is there a better option for this individual? Read more »
*This blog post was originally published at Suture for a Living*
