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Minute Clinics Fill A Legitimate Need, But Are They A Good Idea?

All of us have been to fast food establishments. We go there because we are in a hurry and it’s cheap. We love the convenience. We expect that the quality of the cuisine will be several rungs lower than fine dining.

We now have a fast medicine option available to us. Across the country, there are over 1000 ‘minute-clinics’ that are being set up in pharmacies, supermarkets and other retail store chains. These clinics are staffed by nurse practitioners who have prescribing authority, under the loose oversight of a physician who is likely off sight. These nurses will see patients with simple medical issues and will adhere to strict guidelines so they will not treat beyond their medical knowledge. For example, if a man comes in clutching his chest and gasping, the nurse will know not to just give him some Rolaids and wish him well. At least, that’s the plan.

Primary care physicians are concerned over the metastases of ‘minute-clinics’ nationwide. Of course, they argue from a patient safety standpoint, but there are powerful parochial issues worrying physicians. They are losing business. They have a point that Read more »

*This blog post was originally published at MD Whistleblower*

Harvard Revamps MyPlate To Create A Guide To Healthy Eating

Back in June, federal authorities unveiled MyPlate, an icon designed to help Americans follow healthy eating patterns. It’s a nice, colorful image that was a welcome successor to the misguided MyPyramid. But it doesn’t offer much in the way of useful information.

A group of my colleagues at Harvard Health Publications worked with nutrition experts at the Harvard School of Public Health to create a better version. We call it the Healthy Eating Plate. “We gave MyPlate a makeover to provide consumers with an easy to use but specific guide to healthy eating based on the best science available,” says Dr. Anthony Komaroff, a professor of medicine at Harvard Medical School and Editor in Chief of Harvard Health Publications.

The Healthy Eating Plate uses visual elements of MyPlate as a starting point, because the government’s icon is already becoming a recognized teaching tool. But the resemblance ends there: Read more »

*This blog post was originally published at Harvard Health Blog*

Encourage Earlier Mammograms For Women With A Family History Of Breast Cancer

Somewhere along the line I learned to encourage women with a family history of breast cancer to begin getting mammograms at an age 10 years prior to when their mother was diagnosed and to encourage their daughters to begin getting mammograms at an age 10 years prior to when they themselves were ever diagnosed.

I learned this prior to the discovery of BRCA genes.  It was a trend that had been noted among women with strong family histories.  The new study (see full reference below) in the journal Cancer verifies that genetic breast cancers show up earlier in the next generation – on average by 8 years.

The study from MD Anderson looked at 2 generations of families with the BRCA gene to assess the age at diagnosis.  Using the pool of 132 BRCA-positive women with breast cancer who participated in the high-risk protocol at The University of Texas MD Anderson Cancer Center (Gen 2), 106 women could be paired with a family member in the previous generation (Gen 1) who was diagnosed with a BRCA-related cancer (either breast cancer or ovarian cancer).

The median age of cancer diagnosis was Read more »

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

Multaq Simply Does Not Work To Control AF, So Why Is It Still So Over-Hyped?

Did you know September is AFib awareness month?

As a believer in education as the first, and best treatment of AF, I think it’s great to enhance the public knowledge of this highly-misunderstood disease.

By all means…

Tell people about AF’s risks: stroke and heart failure.

Tell them that their fatigue, poor exercise tolerance and breathlessness might not be old age; it might be AF.

Tell them about the importance of early intervention.

Tell them that obesity, inactivity, sleep disturbances, alcohol, and incessantly worrying about everything makes AF more likely to occur, and to stay.

Tell them that Read more »

*This blog post was originally published at Dr John M*

Could Glowing Cats Be The Key To Finding A Cure For HIV?

Photo courtesy of the Mayo Clinic Scientists have added a new species to the menagerie of animals that glow, after introducing jellyfish genes into cats that can now glow green.

Scientists report that they transferred genes from monkeys (and jellyfish) into cats in order to study feline immunodeficiency virus (FIV), the cat equivalent of HIV. In cats and in people, immunodeficiency viruses deplete infection-fighting T-cells. Key proteins called restriction factors that would normally defend against the viruses are ineffective. The research appears in the September issue of Nature Methods.

To research potential treatments, physicians, virologists, veterinarians and gene therapy researchers from the Mayo Clinic and in Japan sought to mimic the way evolution would generate protective protein versions, according to a Mayo Clinic press release. They inserted monkey versions of a gene into the cat genome using gamete-targeted lentiviral transgenesis. This is done by inserting genes into feline eggs before sperm fertilization.

The monkey restriction factor, TRIMCyp, blocks FIV by attacking and disabling the virus as it tries to invade a cell. In the lab, the transgenic cat lymphocytes resisted FIV replication. The scientists said that they can now test the potential of various restriction factors for Read more »

*This blog post was originally published at ACP Internist*

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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