July 8th, 2011 by Bryan Vartabedian, M.D. in Opinion
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It’s the cusp of a new medical year and there’s no shortage of advice on how to succeed as a house officer. The White Coat Underground and Wes Fisher will put you in the right direction. And I love Mary Brandt’s Advice for New Interns.
But just a couple of more points to keep in mind:
Keep your options open. Medicine is changing quickly. You’ll start your career training as a 20th century doctor and retire in a place none of us can imagine. Your ultimate success will be determined by your ability to adapt to a shifting foundation. Keep an open mind.
Quiet your fingers. You are the first generation to have publication tools that make it dangerously easy to breach your patient’s trust. Keep their business off the public forums. Better yet, find a way to apply all this wonderful technology to really move the chains forward. Read more »
*This blog post was originally published at 33 Charts*
July 8th, 2011 by DrWes in Health Policy, Opinion
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It was another headline busting study this week: Pfizer Drug Tied to Heart Risks – a provocative title no doubt fed to the media from the publisher: the Canadian Medical Association Journal. The study was yet another meta-analysis that culled the world’s literature in an attempt to determine if a trend could be found that might implicate Chantix as a causative agent for and increased incidence of heart disease in smokers.
On its surface, the study sounds authoratative, analyzing “14-double-blind randomized controlled trials involving 8216 participants” ranging in duration from “7 to 52 weeks.”
Never mind that 57% (25) of adverse events were weighted from one study and that none of the 14 studies had odds ratios that did not cross the unity line.
Despite this, the lead author concluded:
Despite the limitations of our analysis, our findings have potential regulatory and clinical implications.
Sorry, this is not correct. There are no clinical implications of this trial. Like all metanalyses, meta-anaylses simply cannot determine cause and effect. (Note to main stream media: are you folks listening?!?)
That being said, there’s another concern I have Read more »
*This blog post was originally published at Dr. Wes*
July 8th, 2011 by John Di Saia, M.D. in Research
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The American Society of Aesthetic Plastic Surgery publishes statistics every year indicating which cosmetic operations are on the rise. A journalist at the OC Register asked a group of plastic surgeons why this might be. Being that I am opinionated (why do you think I blog here,) I figured I’d take a shot at some of these:
I. Statistic: TEENS – Nosejobs and Otoplasty (commonly referred to as “ear pinning”) on the rise
Dr D: Part of the development of the teen psyche involves becoming aware of social norms. As they do this, they also become aware of differences and develop standards of beauty. Many of these teen nose jobs are justified as medically-needed, but appearance usually factors in. Otoplasty is a similarly social operation.
II. Statistic: YOUNG ADULTS – Breast implants. Ages 19-34. 166,000 a year. (ASAPS)
Dr D: “Beauty standards” are important motivators here as well. Young adults in the workplace (and social groups) see those around them doing these things and often being complimented. Some of these patients may also be seeking after childbirth “body repair.”
III. Statistic: EARLY MIDDLE AGE – Liposuction. Ages 35-50. 143,000 a year. (ASAPS)
Dr D: A slowing metabolism in this age group combined with more involved work schedules (with increased sedentary time) equals increased trouble “holding back the fat.” Liposuction is easy and can help with that. Add some post-pregnancy issues here as well.
IV. Statistic: YOUNG ADULTS – Botox. Ages 19-34. 371,000 a year. (ASAPS)
Dr D: The fad of Botox use in the really young is an advertising phenomenon as there is no good reason for young people to do this other than to “feel” hip.
My opinions of course. 
*This blog post was originally published at Truth in Cosmetic Surgery*
July 8th, 2011 by Berci in News, Video
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One of the most interesting things I saw at this year’s Doctors 2.0 and You event was Withins’ Blood pressure monitor.
This iPhone-connected blood pressure monitor made its first appearance at CES, but you’ll finally be able to order one of your own today. Compatible with iPhone, iPad, and iPod touch, the $129 accessory costs three to four times as much as off-the-shelf blood pressure monitors, but integrates well if you’re looking to pair it with your Withings scale for a complete vitals management solution.
*This blog post was originally published at ScienceRoll*
July 8th, 2011 by AnneHansonMD in Opinion
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In Dinah’s post “The Chapter I Wish We Had Written” an anonymous commenter wrote about his problems finding an expert witness for his or her employment discrimination case (since I don’t know if Anonymous is male or female I’m going to use a standard male pronoun in this post—apologies if I got this wrong). Anonymous asked his doctor to help with the case, but he refused. He explained to Anonymous that he would be a biased witness and Anonymous also understood that the doctor’s involvement might affect the therapeutic relationship. Anonymous’s doctor gave her a number of referrals to forensic psychiatrists, but since he was not working with an attorney no expert would take the case. Anonymous was understandably frustrated by this situation.
I wanted to write about this because this situation comes up fairly often and I get calls from friends, colleagues and former students asking how to handle it. I’ve already written about what to do when you get served with a subpoena in my post “When Lawyers Call.”
First of all, I think Anonymous’s doctor was particularly astute to recognize the dilemma that arises when trying to help patients in situations like this. Read more »
*This blog post was originally published at Shrink Rap*
