March 26th, 2010 by RamonaBatesMD in Better Health Network, Health Tips, Opinion
Tags: Barbie Syndrome, BDD, Body Dysmorphic Disorder, Cosmetic Enhancement, Dr. Glenn Braunstein, Obsession With Appearance, Plastic Surgery
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Interesting article in the Huffington Post last week by Dr. Glenn D. Braunstein: Oh, You Beautiful Doll: Plastic Surgery Risks and Rewards. The article discusses the “Barbie Syndrome” or more accurately “Body Dysmorphic Disorder.” I love this line:
And, finally, try to have realistic expectations — it is unlikely that cosmetic enhancement is going to drastically change your life — after all, you are human, and not a plastic doll.
The article reminded me of my post on Suitability. Not all patients should have surgery. Their reasons for desiring surgery, goals, and expectations should be discussed during the consultation. Risks and benefits must be weighed.
Body Dysmorphic Disorder
- In its simplest definition, it is an obsessive preoccupation with a slight, imperceptible, or actually nonexistent anatomic irregularity to the degree that it interferes with normal adjustment within society.
- This disorder may be present in varying degrees. It is the most common aberrant personality characteristic seen by the plastic surgeon.
- When postoperative dissatisfaction occurs (and in most cases, it will), it almost always is based on what the patient understood rather than what was actually said.
*This blog post was originally published at Suture for a Living*
March 26th, 2010 by GruntDoc in Better Health Network, Health Policy, Opinion
Tags: Emergency Medicine, ER Visits, Healthcare Expenses, Healthcare Policy, Healthcare reform, Primary Care, Unnecessary Care, Urgent Care
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Much of the ongoing healthcare reform debate has focused on unnecessary healthcare expenses—specifically, medical bills that rack up without demonstrably improving people’s health. According to Peter Orszag, the director of the Federal Office of Management and Budget, about $700 billion, or 5 percent of the U.S. gross domestic product, is wasted on unnecessary care, such as extra costs related to medical errors, defensive medicine, and just plain fraud.
At the center of this discussion are “unnecessary” ER visits for minor conditions—colds, headaches, and feverish babies—that could be handled more cheaply in doctors’ offices. If we could only convince patients to take their stubbed toes to urgent care clinics or primary care offices instead of ERs, the thinking goes we could save a load and help fix this whole healthcare fiasco. But there are a few problems with this logic. See:
Are most emergency room visits really unnecessary? – By Zachary F. Meisel and Jesse M. Pines, Slate Magazine
It’s a short, well-written article. It makes some good points and being an EM doctor I happen to agree with most of them, specifically that a lot of money is spent in medicine on procedures of uncertain (at best) benefit. The fix is probably correct, too, though I don’t see Americans jumping on changing their sedentary, easy lifestyles (that includes me.)
*This blog post was originally published at GruntDoc*
March 25th, 2010 by DaveMunger in Better Health Network, Opinion, Research
Tags: Global Recession, Socioeconomics, World Population
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I’ve been searching Twitter for “population” and “economics” this month and came across this article on LifeSiteNews.com. The contention: Low population growth is responsible for the current recession. Here’s a snippet:
“With the decline in births, there are fewer young people that productively enter the working world,” Tedeschi explained. At the same time, he said, “there are many more elderly people that leave the system of production and become a cost for the collective,” increasing social welfare costs that a shrinking proportion of taxable young workers will have to sustain.
There’s actually a smidgen of truth to that. In a nation where the population is growing, the young outnumber the old. Where there are “pay as you go” retirement programs like Social Security in the U.S., this places an increasing burden on the working class to support the elderly.
But to say that the current global recession is due to slow population growth disingenuous. China is still doing quite well, even though its population growth has also slowed. The US continues to have relatively rapid population growth, but it’s in a recession just like places where population is stagnating, like Western Europe and Japan. The places world where population is growing fastest are typically highly impoverished. Read more »
*This blog post was originally published at The Daily Monthly*
March 25th, 2010 by KevinMD in Better Health Network, News, Opinion
Tags: CDC, CT, Defensive Medicine, Diagnostic Radiology, Emergency Medicine, ER Visits, Imaging Tests, Internal Medicine, Medical Imaging, MRI, PET scan, Radiation
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It’s well known that the use of imaging scans, like CTs, MRIs and PET scans, have been growing at an alarming rate. But a recent study provides some stark numbers. According to a recent CDC report, “MRI, CT or PET scans were done or ordered in 14 percent of ER visits in 2007.” That’s four times as often as in 1996. Although a physician called that growth “astounding,” it’s really no surprise.
Emergency departments are becoming more crowded, and with patient satisfaction scores becoming more influential in financial incentives for physicians, sometimes just ordering a test is the path of least resistance. Factor in the spector of defensive medicine which, according to a survey from the Massachusetts Medical Society, accounts for up to 28 percent of tests ordered, it’s a wonder that more scans weren’t ordered.
Imaging scans are a clear cost driver in healthcare, contributing $12 billion to Medicare’s bill. But costs won’t resonate with patients requesting the tests or the doctors ordering them. One encouraging sign is the recent trend of publicizing the harms of scans, like radiation from CTs. I’m finding that patients are becoming increasingly aware of the risk, and making a more informed decision after I explain it to them. It’s a small step forward.
*This blog post was originally published at KevinMD.com*
March 25th, 2010 by Berci in Better Health Network, Opinion, Research
Tags: Clinical Genomics, Gene Therapy, Genetic Research, Genetic Testing, Genetics, Pathway Genomics
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As I’m doing my PhD in clinical genomics, I’m really interested in the connection between the Internet and medicine. I was happy when Pathway Genomics, one of the newest direct-to-consumer genetic companies, offered me a free genetic test.
After an interview I did with them, I sent my saliva sample back and 3-4 weeks later, I received an email that my results were ready. This is my experience and the things I found interesting. As I got a free test from Navigenics a year ago, I plan to compare these services. I was very interested in the service of Pathway Genomics because of what they analyze:
1) Sampling: It was quite an easy process with only a few papers to fill (though it’s always hard to solve FedEX issues from Europe) and clear instructions. A video about a patient showing the whole process in 1-2 minutes, including saliva collection and filling out the paperwork, would be useful.
2) Preparations: I liked that I had to complete a questionnaire focusing on my lifestyle and patient history (Your Environment and Lifestyle, The Shape You’re In, and You and Your Family). As family history is the best genetic test out there, so it’s important to use that data while analyzing genetic results. Though, I couldn’t calculate my BMI (couldn’t use kg and centimeter) and the family history application wasn’t working for me. Read more »
*This blog post was originally published at ScienceRoll*
