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Female Cosmetic Genital Surgery: Should It Be Done?

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I seem to be asked more often these days if I do vulva reduction surgery. I’ve even been asked if I “refresh” vaginas (in which I refer them to their gynecologist.) I’m happy it’s a extremely small part of my practice.

I’m also happy to see that the current issue of Reproductive Health Matters is taking a close look at cosmetic surgery, especially female cosmetic genital surgery. Read more »

*This blog post was originally published at Suture for a Living*

Science And The Pain Scale

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Every day in the emergency department I am confronted by pain. In fact, the treatment of pain is one of the most important skills emergency physicians, indeed all physicians, possess.

For instance, I recently cared for a child with sickle cell disease who was having a pain crisis which involved severe leg pain. His life is one of frequent, intense pain. I gently, and repeatedly, treated his pain with morphine until he had relief. I see hip fractures; all broken bones hurt. I am thrilled to alleviate that discomfort.  Pain is one of the things I can fix, if only temporarily. It makes me happy to see the relaxed face of a man or woman with a kidney stone or migraine, who suddenly smiles and says “thanks!”

But pain is also the source of so much subterfuge. Emergency department are full of individuals who use controlled substances for recreation. I know because they have pain that is entirely unverifiable. They have terrible right flank pain with no gall-bladder, no pancreatitis, no kidney stone (documented by CT), no pneumonia or rash. They have nothing to cause the pain. And yet, dose after dose of narcotic later, snoring in their ER stretcher, they look up at me with hazy eyes and say, thickly, “Cann I gettt somethinn elsss for paaiin…it hurtssss so…bad. zzzz.  Itzzz a tennn.”

So I began to wonder about science and the pain scale. Read more »

*This blog post was originally published at edwinleap.com*

Evidence-Based Social Media In Medicine And Healthcare

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I’ve started  a series on evidence-based social media in which I share peer-reviewed articles that focus on using social media in medicine or healthcare:

The key words used as well as the number and geographic location of searches can provide trend data, as have recently been made available by Google Trends. We report briefly on exploring this resource using Lyme disease as an example because it has well-described seasonal and geographic patterns.

Read more »

*This blog post was originally published at ScienceRoll*

New Movie Promotes “Energy Medicine”

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It’s boring to try to ferret out reliable health information from dry medical journals. It’s easier and more fun to watch a movie. A new movie promises to change the way you think about your health. To bring you breakthroughs that will transform your understanding of how to get well and stay well. To share the discoveries of leading researchers and health practitioners about miracle cures that traditional medicine can’t explain.

If this makes your baloney detector light up, good for you!

The Living Matrix: A Film on the New Science of Healing is an atrociously bad movie that falls squarely in the tradition of What the Bleep Do We Know? In his book Nonsense on Stilts, Massimo Pigliucci characterized the “Bleep” movie as “one of the most spectacular examples of a horribly tangled mess of science and nonsense,” and this new movie is more of the same. Bleep was just silly, but The Living Matrix is potentially dangerous because it might persuade patients to make poor decisions about their medical care. Read more »

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

Physician Burnout: When Being A Doctor Makes You Sick

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Do doctors take care of themselves? Sometimes patients may better follow the advice of physicians who aren’t obese and don’t smoke. That was a question asked in a post last year, entitled “When fat doctors talk to obese patients.”

According to studies, as reported in the Wall Street Journal, it’s a mixed bag:

Physicians as a group are leaner, fitter and live longer than average Americans. Male physicians keep their cholesterol and blood pressure lower. Women doctors are more likely to use hormone-replacement therapy than their patients. Doctors are also less likely to have their own primary care physician—and more apt to abuse prescription drugs.

Clearly there’s room for improvement. Read more »

*This blog post was originally published at KevinMD.com*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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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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