March 27th, 2010 by Steve Novella, M.D. in Better Health Network, News, Opinion, Quackery Exposed, Research
Tags: Acupuncture, CAM, Complimentary and Alternative Medicine, Placebo Effect, Placebo Medicine, Science-Based Evidence
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In the Wall Street Journal last week was a particularly bad article by Melinda Beck about acupuncture. While there was token skepticism (by Edzard Ernst, of course, who is the media’s go-to expert for CAM), the article credulously reported the marketing hype of acupuncture proponents.
Toward the end of the article Beck admits that “some critics” claim that acupuncture provides nothing more than a placebo effect, but this was followed by the usual canard:
“I don’t see any disconnect between how acupuncture works and how a placebo works,” says radiologist Vitaly Napadow at the Martinos center. “The body knows how to heal itself. That’s what a placebo does, too.”
That is a bold claim, and very common among CAM proponents, especially acupuncturists. As the data increasingly shows that acupuncture (and other implausible treatments) provides no benefit beyond placebo, we hear the special pleading that placebos work also.
But is that true? It turns out there is a literature on the placebo effect itself, and the evidence suggests that placebos generally do not work. Read more »
*This blog post was originally published at Science-Based Medicine*
March 27th, 2010 by KevinMD in Better Health Network, Health Policy, Opinion, Research
Tags: Doctors, End of Shift, General Medicine, Medical Errors, Medical Mistakes, Pager-Free, Patient Hand-Off, Physicians
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When nurses sign out during the end of shift, it’s done so in a quiet setting. Contrast that to medical residents — at least when I was a resident 8 years ago — where pager interruptions during sign out were the norm.
PookieMD compares the situation to the “sterile cockpit” that airline pilots enjoy:
“Pilots have the sterile cockpit–a situation in which, if the plane is below 10,000 feet, only conversation directly relevant to flying is allowed. The rule was developed because take offs and landings are the most likely time a crash will occur, and take offs and landings occur below 10,000 feet. Simple enough, and it saves lives.”
Physicians enjoy no such luxury. Patient discussions with other doctors often take place in distracted settings, under the threat of a pager going off at any time.
Changing this, PookieMD argues, requires a cultural shift. As mentioned earlier, when nurses sign out, it’s sacred time. Doctors need something similar. Studies show that medical errors can arise during the patient hand-off to another physician. Signing out patients in an undisturbed setting may minimize the risk of poor communication, and subsequently, potential mistakes. “Page early and often needs to be replaced with ‘page urgently when appropriate,’” writes PookieMD.
Let’s see if hospital administrators have the courage to make this happen.
*This blog post was originally published at KevinMD.com*
March 27th, 2010 by Paul Auerbach, M.D. in Better Health Network, News, Opinion
Tags: Backcountry Injuries, Emergency Medicine, Epidemiology, General Medicine, WFR, Wilderness First Aid, Wilderness First Responder, Woofer
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In a recent issue of Wilderness and Environmental Medicine (Volume 20, Number 2, 2009), Thomas Welch and colleagues have written an article entitled “Wilderness First Aid: Is There an Industry Standard?” The purpose of their inquiry was to determine if an “industry standard” exists for wilderness first aid training and certification of outdoor adventure and education leaders. To attempt to answer the question, they queried regulatory authorities, national organizations, and school/college groups with regard to their requirements for first aid training of their wilderness trek leaders.
They discovered that 10 or the 22 states with guide licensure programs required any first aid training as a condition of licensure, and none specified a specific course. Of the programs requiring such training, the requirements ranged from a 6-hour standard first aid course to more structured “wilderness first responder” (WFR or “woofer”) certification. Read more »
This post, “Backcountry” Injuries and Wilderness First Aid, was originally published on
Healthine.com by Paul Auerbach, M.D..
March 26th, 2010 by Happy Hospitalist in Better Health Network, Humor, Opinion
Tags: Competent Doctor, General Medicine, Hospital Outcomes, Hospital Quality Imrprovement, Men's Health Magazine, Patient Satisfaction, Sexy Nurse
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From the Tonight Show and the Jay Leno News Service comes this morsel of information about doctors, nurses, patients and hospitals. According to Jay, a Men’s Health poll indicates that 65 percent of men would prefer a sexy nurse over a competent doctor. That’s shocking, but not surprising. I suppose it takes a lot of pressure off the doctors for a perfect hospital outcome. Unless, of course, the nurse happens to be ugly.
I can see it now: In an effort to improve patient satisfaction and reduce malpractice risk, hospitals just need to fire the ugly nurses and keep the hot ones. In fact, as a hospitalist, my malpractice risk depends on it. Forget about all the other quality improvement junk we put ourselves through. I’d put my money on hot nurses any day.
*This blog post was originally published at The Happy Hospitalist*
March 26th, 2010 by Debra Gordon in Better Health Network, Health Policy, Humor, Opinion, Quackery Exposed
Tags: American Medical Writers Association, Health Policy Research, Healthcare Bill, Healthcare reform, Medical Content Sweatshops, Medical Writers, White Paper
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A member of the American Medical Writers Association (AMWA) freelance listserve recently posted this help-wanted ad from Craig’s List:
“We’re looking for an experienced analyst/wordsmith to make sense of the health care bill. We will pay a per-project fee for a qualified writer to put some hard work into summarizing the bill in an 8-10 page white paper. We have a strong preference for individuals with a background in Sociology, Policy Research, Health Care, or statistical analysis. Above all, however, you should have some clippings to point us to so we can evaluate your writing chops. As you can see, this report will include a lot of information, but it’s important that you are succinct and clear in your prose. Think of it as a detailed study done by a respected think tank, but produced for the average consumer.”
The “fee” (and I use the term loosely) for this “detailed study” (?) is $100, which wouldn’t even cover the cost of toner to print out the full bill for reading! (Hence the title of this blog.)
The people behind this posting are not the only ones smoking something, however. Content sweatshop Demand Inc has also been trolling for writers, offering what amounts to a few pennies a word for churning out short articles on topics that a mathematical equation has determined will bring in the most webpage visitors, spiking ad revenue. The sad part is that thousands of my fellow freelancers have taken up the challenge earning, if they’re lucky, about $20 an hour (before taxes and with all expenses out of their own pocket). Most earn far less. Read more »
*This blog post was originally published at A Medical Writer's Musings on Medicine and Health Care*
