February 25th, 2010 by Harriet Hall, M.D. in Better Health Network, Opinion, Research
Tags: Cancer, Colonoscopy, Evidence, Gastroenterology, GI, Guidelines, polyps, screening test, USPSTF
1 Comment »
Everybody knows that colonoscopy is the best test to screen for colorectal cancer and that colonoscopies save lives. Everybody may be wrong. Colonoscopy is increasingly viewed as the gold standard for colorectal cancer screening, but its reputation is not based on solid evidence. In reality, it is not yet known for certain whether colonoscopy can help reduce the number of deaths from colorectal cancer. Screening with fecal occult blood testing (FOBT) and flexible sigmoidoscopy are supported by better evidence, but questions remain. It seems our zeal for screening tests has outstripped the evidence.
Statistics show that the life-time risk for an adult American to develop colorectal cancer (CRC) is approximately 6%. Colorectal cancer is the second leading cause of cancer deaths in the United States. In the US there are currently 146,970 new cases and 50,630 deaths each year. Between 1973 and 1995, mortality from CRC declined by 20.5%, and incidence declined by 7.4% in the United States. Read more »
*This blog post was originally published at Science-Based Medicine*
February 24th, 2010 by Happy Hospitalist in Better Health Network, Opinion, True Stories
Tags: Chronic Disease, Fear Of Death, Internal Medicine, Medications, Motivation, Non-compliance
No Comments »
As a hospitalist I sometimes come across patients who, for what ever reason, refuse to take the medications prescribed by their in-patient doctors. Some patients refuse out of fear. Some doctor told them years ago that taking medication X would make them worse. Some patients refuse out of ignorance of their disease process. Most of the time however, they just don’t understand why the medication is necessary. Some patients just refuse out of stubbornness. And some patients refuse because they have a really good reason.
However, when you’re dealing with critical illness and the only thing that’s going to save your patient’s life is a treatment plan they are refusing, sometimes you have to be in their face with reality. So how do I handle situations with patients who have the capacity to make poor medical decisions but refuse life saving medications? How do I convince my hospitalized patients to take their medications I’ve prescribed? Read more »
*This blog post was originally published at Happy Hospitalist*
February 23rd, 2010 by DrWes in Better Health Network, Opinion
Tags: Hospitals, Law Suit, Legal, Live-Blogging, Live-Tweeting, Social Media, Surgery, Twitter
1 Comment »
Should hospitals send twitter “updates” on patients undergoing complicated catheter ablation procedures using “pre-approved” scripted story lines?
In a far corner of the operating room Thursday, a Web producer and a cardiac expert with St. Vincent’s huddled over a laptop. They chronicled the procedure largely from a script that Oza had signed off on a day earlier.
The procedure uses radio frequencies to scar parts of the heart. The scars block signals sent from a quartet of veins in the left atrium, signals that cause the heart to go haywire. The entire procedure is done using a catheter inserted into a patient’s groin while the patient is anesthetized. Read more »
*This blog post was originally published at Dr. Wes*
February 23rd, 2010 by Shadowfax in Better Health Network, Opinion, True Stories
Tags: Back Pain, Drug Seekers, ED, Emergency Medicine, ER, Migraine, Narcotics, Oxycontin, Pain Management
No Comments »
The first seven patients I saw today were in the ED for:
- Dental Pain (ongoing for three years)
- Back Pain (third visit in one month, 18 in 2006)
- Migraine Headache (six visits in a month, and second ED visit in 18 hours)
- Back Pain (this one was legit)
- Chronic Recurrent Abdominal Pain (ran out of Oxycontin and doctor “out of town”)
- “Cyclic Vomiting Syndrome” (in which only narcotics stop the vomiting)
- Oxycontin withdrawal
Sometimes I wonder why I bother. I occasionally wish my job demanded something more than a valid DEA license, and decision-making skills beyond “yes narcs” and “no narcs.” It just drains the carpe right out of your diem to start the day off in a series of ugly little dogfights over drugs with people whom, to put it charitably, you have concerns about the validity of their reported pain. Read more »
*This blog post was originally published at Movin' Meat*
February 22nd, 2010 by Stanley Feld, M.D. in Better Health Network, Health Policy, Opinion
Tags: Braly, Finance, Health Insurance, Offensive, premiums, Profits, Wellpoint, WSJ
No Comments »
Ann Braly, WellPoint’s CEO, launched a new offensive to protect the vested interests of the healthcare insurance industry now that Obamacare seems to be dead.
The healthcare insurance offensive began with her op-ed article in the Wall Street journal on February 7, 2010. Readers will have a deeper understanding of the offensive if they follow the underlined historical links in this article.
It will destroy President Obama’s credibility, the practice of medicine, patient access to care and increase the number of uninsured. It will bankrupt the country if her offensive is successful.
The healthcare insurance industry is killing the goose that laid its golden egg.
Read more »
*This blog post was originally published at Repairing the Healthcare System*
