October 26th, 2010 by Bryan Vartabedian, M.D. in Better Health Network, Opinion, True Stories
Tags: 33 Charts, Being A Doctor, Doctor Cries, Doctor's Life, Doctors Are Humans, Doctors' Perspective, Dr. Bryan Vartabedian, Expectations of Medical Students, Feeling Like A Doctor, General Medicine, Humanistic Side of Medicine, Humanizing Medicine, Medicine and Humanism, New Doctors, Next Generation of Physicians, Overwhelmed Doctors, PalMD, Physician Burnout, The White Coat Underground
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PalMD over at The White Coat Underground recently asked: “When did you really feel like a doctor?” Interesting question that I could answer in a number of ways.
While I didn’t know it at the time, I felt like a doctor around 4am during my first night on call. I was an intern on the hematology ward at Texas Children’s Hospital. I was fresh out of medical school, I had chosen a residency known for its mind-boggling volume, and the kids were really sick. I had hit a point where I simply couldn’t keep up with what was in front of me. I stole away into the 6th-floor stairwell in the Children’s Abercrombie building, put my face into my hands, and began to cry.
My first call night was a metaphor for my career. I had no idea at the time that the idea of simply keeping up would be a theme that would follow me through my training and into my day-to-day work.
While I can’t remember the last time I cried at the hospital, I continue to struggle with input. I work to keep up with inbound information and professional social dialog. How I handle information or how I appear to handle it defines me as a physician. Harnessing this attention crash through technology will represent a major defining moment for the next generation of physicians.
*This blog post was originally published at 33 Charts*
October 26th, 2010 by Jennifer Shine Dyer, M.D. in Better Health Network, Health Policy, Health Tips, News, Opinion, Research
Tags: Centers For Medicare And Medicaid Services, CMS, Communication Gap, Consumer Health Information, Doctor Patient Relationship, Doctor-Patient Communication, Dr. Don Berwick, Dr. Jennifer Shine Dyer, General Medicine, Hard-To-Understand Medical Information, Health Insurance, Health Literacy Action Plan, Healthcare reform, Kaiser Permanente, Medical Forms, Patient Education, Patient Handouts, Plain-English Documents, Poor Health Outcomes, Public Health, Reading Medical Materials, Training New Doctors, Type 2 Diabetes, UCSF, Understanding Health Information, University of California-San Francisco
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When it comes to understanding medical information, even the most sophisticated patient may not be “smarter than a fifth grader.”
In one of the largest studies of the links between health literacy and poor health outcomes, involving 14,000 patients with type 2 diabetes, researchers at the University of California San Francisco and Kaiser Permanente found that more than half the patients reported problems learning about their condition and 40 percent needed help reading medical materials. The patients with limited health literacy were 30 to 40 percent more likely to experience hypoglycemia — dangerously low blood sugar that can be caused if medications are not taken as instructed — than those with an adequate understanding of medical information.
Now, federal and state officials are pushing public health professionals, doctors, and insurers to simplify the language they use to communicate with the public in patient handouts, medical forms, and health websites. More than two-thirds of the state Medicaid agencies call for health material to be written at a reading level between the fourth and sixth grades.
A new federal program called the Health Literacy Action Plan is promoting simplified language nationwide. And some health insurers, doctors’ practices, and hospitals have begun using specialized software that scans documents looking for hard-to-understand words and phrases and suggests plain-English replacements. Read more »
October 25th, 2010 by Debra Gordon in Better Health Network, Health Policy, Opinion, Research
Tags: Big Pharma, Copaxone, Cost of Drugs, Cost of Medications, Costs of Disease, Debra Gordon, Drug Companies, ECTRIMS, European Committee for the Treatment of Multiple Sclerosis, FDA, Fingolimod, Food and Drug Administration, Fragmented Healthcare System, General Medicine, Gilenya, Glatiramer Acetate, Health Insurance Coverage, Healthcare Policy, Healthcare reform, Insurance Companies, Interferon beta-1b, Long-Term Healthcare Costs, Long-Term Healthcare Fix, Medications Not Covered By Insurance, Musings on Medicine and Healthcare, Natalizumab, Out-Of-Pocket Costs, Perscription Medications, Quality of Life, Rebif, Sweden, Tysabri, U.S. Healthcare System, Unapproved Prescriptions
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I spent last week in Gothenburg, Sweden covering the European Committee for the Treatment of Multiple Sclerosis (ECTRIMS) meeting. Lots of good science, lots of excitement over the new oral and targeted therapies coming on the market to treat this awful disease. But what I want to write about isn’t the science, but about how it will play out in the brave new world of healthcare in which we all live in today.
For instance, consider the first oral therapy to hit the market: Gilenya (fingolimod), which the FDA approved in September. Last month Novartis announced the price: $48,000 a year.
This is not a rant against the high cost of drugs, however. It is a rant against the inability of our healthcare system to take the long view of the impact of such drugs, a view that is particularly important with a chronic disease like MS that strikes healthy young adults in their early 20s and 30s. Read more »
*This blog post was originally published at A Medical Writer's Musings on Medicine, Health Care, and the Writing Life*
October 25th, 2010 by GarySchwitzer in Better Health Network, Health Policy, News, Opinion, Quackery Exposed, Research
Tags: Australia, Big Pharma Campaigns, Consumer Drug Marketing, Direct-To-Consumer Drug Advertising, Disease Mongering, Drug Hype, Femail Urogenital Problems, Gary Schwitzer, HealthNewsReview.org, Medical Advertising, Medical Marketing Language, Medicalization, Menopause, Multinational Pharmaceutical Companies, Postmenopausal Women, Public Relations, Sexual Dysfunction, Sexual Health, Signs of Aging, Vaginal Atrophy, Women's Health
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Just five days ago we wrote about an American journalist’s observations of medicalization of one problem sometimes observed after menopause: Vaginal atrophy.
Today we see that this disease-mongering trend has popped up in Australia as well. This should be no surprise. Such campaigns are usually led by multinational pharmaceutical companies and their advertising and public relations agencies.
What caught our eye was an article on a women’s health foundation website — a foundation that posts a pretty thin excuse for why it won’t tell you its source of funding. Its article on vaginal atrophy uses classic disease-mongering language:
“Ask a woman over the age of 50 about the ‘signs of ag[e]ing’ and she’ll most likely lament about grey hairs, wrinkles and certain body parts having lost their youthful perkiness. What she probably won’t mention is that is that things are ageing “downstairs” too; up to 40% of postmenopausal women show signs of vaginal atrophy.”
The silent epidemic that no one talks about. The huge prevalence estimate — where does that 40 percent figure come from? Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
October 25th, 2010 by DavedeBronkart in Better Health Network, Health Policy, Health Tips, News, Opinion, Quackery Exposed, Research
Tags: British Medical Journal, Dave deBronkart, Dr. Marcia Angell, e-Patient Dave, e-Patients.net, Empowered Patients, General Medicine, Grant Funding, Inaccurate Studies, JoPM, Journal of Paticipatory Medicine, Lies, Medical Misinformation, Medical Publishing, Medical Research, Medical Science, Medical Studies, Misleading Scientific Conclusions, Peer-Reviewed Journals, Peter Frishauf, Research Grant, Research Studies, Richard Smith, Scientifically Weak, The Atlantic, Understanding Statistics
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There’s an extraordinary new article in The Atlantic entitled “Lies, Damned Lies, and Medical Science.” It echos an excellent article in our Journal of Participatory Medicine (JoPM) a year ago by Richard W. Smith, 25-year editor of the British Medical Journal, entitled “In Search Of an Optimal Peer Review System.”
JoPM, Oct 21, 2009: “….most of what appears in peer-reviewed journals is scientifically weak.”
The Atlantic, Oct. 16, 2010: “Much of what medical researchers conclude in their studies is misleading, exaggerated, or flat-out wrong.”
JoPM 2009: “Yet peer review remains sacred, worshiped by scientists and central to the processes of science — awarding grants, publishing, and dishing out prizes.”
The Atlantic 2010: “So why are doctors — to a striking extent — still drawing upon misinformation in their everyday practice?”
Dr. Marcia Angell said something just as damning in December 2008 in the New York Review of Books: “It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.” (Our post on Angell is here.)
What’s an e-patient to do? How are patients supposed to research if, as all three authorities say, much of what they read is scientifically weak? Read more »
*This blog post was originally published at e-Patients.net*
