May 27th, 2010 by Steve Novella, M.D. in Better Health Network, Health Policy, Health Tips, News, Opinion, Research
Tags: 1990 Farm Bill, Agriculture, Antibiotics, Dietetics, Fads and Fallacies in the Name of Science, Food Fad, Food Safety, Health Benefits, Hormones, Martin Gardner, Nutrition, Nutritional Facts, Nutritional Information, Nutritionists, OFPA, Organic Diet, Organic Farming, Organic Food, Organic Foods Protection Act, Organophosphates, pesticides, USDA
2 Comments »
In 1952 Martin Gardner, who just passed away this week at the age of 95, wrote about organic farming in his book Fads and Fallacies in the Name of Science. He characterized it as a food fad without scientific justification. Now, 58 years later, the science has not changed much at all.
A recent review of the literature of the last 50 years shows that there is no evidence for health benefits from eating an organic diet. The only exception to this was evidence for a lower risk of eczema in children eating organic dairy products. But with so many potential correlations to look for, this can just be noise in the data.
Another important conclusion of this systematic review is the paucity of good research into organic food –- they identified only 12 relevant trials. So while there is a lack of evidence for health benefits from eating an organic diet, we do not have enough high-quality studies to say this question has been definitively answered. It is surprising, given the fact that organic food was controversial in the 1950s, that so little good research has been done over the last half-century. Read more »
*This blog post was originally published at Science-Based Medicine*
May 26th, 2010 by Debra Gordon in Better Health Network, Health Policy, Health Tips, News, Opinion, True Stories
Tags: Check Online, Customer Service In Healthcare, Doctor Running Late, Double-Booked, Family Medicine, General Medicine, Internal Medicine, Internet, Late Doctors, Long Waits for Patients, Lost Appointment, Medical Office Staff, Medical Offices, MedWaitTime, Overbooked, Primary Care, Real Time, Tardy Physicians, Wait For An Appointment, Wait Time, Waiting In Doctor's Office, Waiting Room, Waiting Too Long, Wall Street Journal, Web-Based Service, World Wide Web, WSJ
2 Comments »
I just read a Wall Street Journal article about a new web-based service called MedWaitTime that allows patients to check if their doctor is running late before heading to the office for their appointment — kind of like you can check to see if your flight is late before heading to the airport.
Brilliant.
Nothing peeves me more than sitting in a doctor’s office reading 4-month-old tattered magazines on topics I care nothing about (saltwater fishing, seriously?), and not because the doctor had an emergency (when is the last time a dermatologist had to run out to save someone), but because the office staff routinely double books. I can’t count the number of times I walked out (my limit is 30 minutes unless I’m in agony) after giving the front office a targeted piece of my mind. Read more »
*This blog post was originally published at A Medical Writer's Musings on Medicine, Health Care, and the Writing Life*
May 26th, 2010 by DrRob in Better Health Network, Health Policy, Opinion, True Stories
Tags: Family Medicine, General Medicine, Giving Good Care, Good Medical Practice, Internal Medicine, Philosophy Of Medical Practice, Primary Care, Rules For Good Medicine
No Comments »
The recent discussion of the appropriateness of bringing patients back to the office has really gotten me thinking about my overall philosophy of practice. What are the rules that govern my time in the office with patients? What determines when I see people, what I order, and what I prescribe? What constitutes “good care” in my practice?
So I decided to make some rules that guide what I think a doctor should be doing in the exam room with the patient. They are as much for my patients as they are for me, but I believe that thinking this out will give clarity in the process.
Rule 1: It’s the Patient’s Visit
The visit is for the patient’s health, not the doctor’s income or ego. This means three things:
- All medical decisions should be made for what is in their interest, including: when they should come in, what medications they are given, what tests are ordered, and what consults are made.
- Patients who request things that are harmful to themselves should be denied. People who ask for addictive drugs or unnecessary tests should not get them. Patients who are doing harmful things to themselves should be warned, but only in a way that is helpful, not judgmental.
- All tests done on the patient should be reported to them in a way that they can understand.
Rule 2: Minimize
Many doctors and patients have a “more is better” mentality. This not only costs more money to the system, but it can cause harm to the patient. Read more »
*This blog post was originally published at Musings of a Distractible Mind*
May 26th, 2010 by KevinMD in Better Health Network, Health Policy, Opinion
Tags: Bureaucratic Obstacles, Drug Manufacturing, Family Medicine, Fixing Primary Care, General Medicine, Internal Medicine, Lifestyle, Money Isn't Everything, More Than Money, NEJM, New England Journal of Medicine, New Primary Care Models, New York Times, Paid More, Pauline Chen, Physicians' Salaries, Practice Environment, Primary Care Doctors, Primary Care Innovation, Primary Care Physicians, Primary Care Practitioners, Primary Care Shortage, Reinvent Primary Care, Richard Baron, Way Of Thinking
No Comments »
Much has been recently made about the bureaucratic obstacles that primary care doctors face. With good reason. The impetus was a recent New England Journal of Medicine paper from Richard J. Baron that I mentioned recently.
The New York Times’ Pauline Chen interviewed Dr. Baron, who shared some interesting insights on what needs to be done. He contrasts the inertia in primary care to drug manufacturing.
If you took the resources that went into drug development, for instance, “and put them into a program like this that achieves meaningful levels of behavior change, a lot more patients could be better off.” In other words, research into new primary care models isn’t taking off because the money isn’t there.
But Dr. Baron also notes that money isn’t everything, since “primary care practitioners have been saying that we either already do or would do certain things if you paid us more. It’s true that you can’t do things consistently, reliably and across scales without additional payment. But payment is not enough. People have to change what they are thinking about when they go to work.” Read more »
*This blog post was originally published at KevinMD.com*
May 26th, 2010 by DrWes in Better Health Network, Health Policy, Opinion, Research
Tags: Clinical Research, Clinical Trials, comparative effectiveness research, Cutting-Edge Research, Cutting-Edge Science, Evidence Based Medicine, FDA, Food and Drug Administration, Government Research, Healthcare Lab, Insync, Medical Research, Medical Researchers, Medical Scientists, Medtronic, Peter Orsag, Randomized Trials, Research Centers, Research Studies, Science Based Medicine, Science-Based Evidence
1 Comment »
“…I have always depended on the kindness of strangers.” — Blanche DuBois in Tennessee Williams’ play A Streetcar Named Desire
Years ago when I began my medical training, I recall enrolling patients for clinical research. In cardiology, there were a myriad of questions that needed to be answered, especially in the area of defining which medications were best to limit the damage caused by a heart attack.
Patients routinely participated in large, multi-center prospective randomized trials to answer these questions. It was routine for them not to charged for participating in the trial — the drug(s) and additional testing would be funded by the company whose drug was being studied. Patients enrolled willingly, eager to help advance science and perhaps, in some small way, their fellow man. It never dawned on me in those early days why hospitals and research centers were so eager to promote research. Read more »
*This blog post was originally published at Dr. Wes*
