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Checkups For You, Checkmarks For Your Doctor

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My car was making a chirping noise when I drove forward and a high-pitched whine when I went in reverse, so I took it into the mechanic and, while he’s under the hood, for some long-deferred routine maintenance (an oil change).

So when the phone rang, I was expecting him to tell me I need new brakes. Nope, it’s the pharmacy, which can’t refill a prescription. I have to see the doctor in person. I’m not sick, but I’d deferred my routine maintenance for too long. In this case, because I’m on a maintenance drug, he needs to check my blood pressure (which by this point was rising). Read more »

*This blog post was originally published at ACP Internist*

Feeding Tubes In The Elderly Demented?

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An article in [last] week’s New York Times entitled Feeding Demented Patients with Dignity suggests that hand feeding dementia patients may be a better option than tube feeding them.

My God, are we really putting feeding tubes in the elderly demented? When did this happen?

During college, I worked as a nurses aide in a nursing home outside Philadelphia. For 20 hours a week (40 hours in the summer) for two years, I cared for patients in all stages of dementia, from the walking confused through to the end stage, stiffened victims confined to wheelchairs or beds. But in all that time, I never, ever saw anyone with a feeding tube. Read more »

*This blog post was originally published at The Blog that Ate Manhattan*

A Story Of Online Care Without OpenNotes

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Next in our series on my experience with OpenNotes, a project sponsored by the Robert Wood Johnson Foundation’s Pioneer Portfolio.

This item has nothing to do with OpenNotes itself –- it’s what I’m seeing now that I’ve started accessing my doctor’s notes. In short, I see the clinical impact of not viewing my record as a shared working document.

Here’s the story. 
______

In OpenNotes, patient participants can see the visit notes their primary physicians entered. Note “primary,” not specialists. I imagine they needed to keep the study design simple.

So here I am in the study, going through life. Five weeks ago I wrote my first realization: After the visit I’d forgotten something, so I logged in. Read more »

*This blog post was originally published at e-Patients.net*

(UPDATE) American Cancer Society: “Only” A Fundraising Ad, Right?

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EDITOR’S NOTE: Following Gary Schwitzer’s HealthNewsReview.org August 11th blog post below entitled “American Cancer Society: ‘Only’ A Fundraising Ad, Right?”, the American Cancer Society pulled its “Screening Is Seeing” ad the next day.

See Schwitzer’s follow-up post “Screening Is Seeing” Ad By American Cancer Society-Cancer Action Network (ACS-CAN) Is Pulled” and a related article by Mary Carmichael of Newsweek: “The American Cancer Society’s Misleading New Ads.

Also see “Common Themes In The Alzheimer’s Test Stories And The Cancer Society Screening Ad” by Schwitzer.

(ORIGINAL POST)

American Cancer Society: “Only” A Fundraising Ad, Right?

A well-intentioned ad campaign run by the American Cancer Society is too vague, and therefore may leave impressions that are imbalanced, incomplete and unsubstantiated — the kind of common tactic seen in many drug company ads. That’s my opinion based on my analysis of the ad and based on my reading of the text.

An American Cancer Society news release states:

The American Cancer Society Cancer Action Network (ACS CAN) is launching a new print and online advertising campaign in congressional districts across the country this week, urging lawmakers to fully fund a lifesaving cancer prevention, early detection and diagnostic program that is celebrating 20 years of screening low income, uninsured, and medically underserved women for breast and cervical cancer. The ads also send the message that when it comes to increasing your odds of surviving cancer, access to evidence-based early detection tools is critical.

The ads reference the Centers for Disease Control and Prevention’s (CDC) National Breast and Cervical Cancer Early Detection Program (NBCCEDP), which has a track record of reducing deaths from breast and cervical cancer. The program has provided more than 9 million screening exams to more than 3 million women and diagnosed more than 40,000 cases of breast cancer and more than 2,000 cases of cervical cancer since it launched in 1990. But with limited funding, the program is able to serve fewer than 1 in 5 eligible women.

The accomplishments of the CDC NBCCEDP are noteworthy. So this blog entry is no knock on that program. It’s a criticism of the ad. Read more »

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

FDA Warning: Industrial Bleach As A Cure For Cancer And HIV?

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On the heels of Scott Gavura’s superb post on dietary supplement regulation in the U.S. and Canada, I bring you one of the most egregious and obscene product cases I have seen in 15 years of teaching on botanical and non-botanical products: Miracle Mineral Solution. Please accept my apologies in advance for not having a scholarly post for you — this is just too unbelievable not to share with science-based medicine readers. Read more »

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

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IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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