May 16th, 2011 by Mark Crislip, M.D. in Health Tips, Quackery Exposed
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I saw a patient recently for parasites.
I get a sinking feeling when I see that diagnosis on the schedule, as it rarely means a real parasite. The great Pacific NW is mostly parasite free, so either it is a traveler or someone with delusions of parasitism.
The latter comes in two forms: the classic form and Morgellons. Neither are likely to lead to a meaningful patient-doctor interaction, since it usually means conflict between my assessment of the problem and the patients assessment of the problem. There is rarely a middle ground upon which to meet. The most memorable case of delusions of parasitism I have seen was a patient who I saw in clinic who, while we talked, ate a raw garlic clove about every minute.
“Why the garlic?” I asked.
“To keep the parasites at bay,” he told me.
I asked him to describe the parasite. He told me they floated in the air, fell on his skin, and then burrowed in. Then he later plucked them out of his nose.
At this point he took out a large bottle that rattled as he shook it.
“I keep them in here,” he said as he screwed off the lid and dumped about 3 cups with of dried boogers on the exam table.
To my credit I neither screamed nor vomited, although for a year I could not eat garlic. It was during this time I was attacked by a vampire, and joined the ranks of the undead. Read more »
*This blog post was originally published at Science-Based Medicine*
May 16th, 2011 by admin in Health Policy
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In an economic downturn, two classic cost-reducing solutions come to mind in the healthcare services industry: reduce offerings (give fewer services) or control demand (limit access to healthcare or increase copayments). There are many more but these two are the most frequently used. Actually, budget cuts in the Spanish region of Catalonia fit in the first type: they will need fewer resources (both human and material) because their services offered will shrink.
It’s always controversial to cut healthcare services in Spain. Even talking about it leads to accusations of promoting total privatization, attacking the Welfare State and so on. But there is another way to cut services, drugs or technologies. It’s what Dr. Iñaki Gutierrez-Ibarluzea called ‘Evidenced-based disinvestment’ in an op-ed for Spain’s ‘Primary Care Journal’ (‘Revista de Atención Primaria’). It’s easy: just find out which services, technological means or drugs offer little or no benefit for patients’ health. In other words, stop financial support for anything inefficient. Read more »
*This blog post was originally published at Diario Medico*
May 15th, 2011 by GarySchwitzer in News
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A new analysis in the American Journal of Preventive Medicine, “The Public’s Response to the U.S. Preventive Services Task Force’s 2009 Recommendations on Mammography Screening,” included a content analysis of news stories and social media posts around the time of the USPSTF announcement. The authors report:
“Of the 233 newspaper articles, blog posts, and tweets coded, 51.9% were unsupportive, and only 17.6% were supportive. Most newspaper articles and blog posts expressed negative sentiment (55.0% and 66.2%, respectively)….The most common reasons mentioned for being unsupportive of the new recommendations were the belief that delaying screening would lead to later detection of more advanced breast cancer and subsequently more breast cancer-related deaths (22.5%) and the belief that the recommendations reflected government rationing of health care (21.9%).
…
These results are consistent with previous studies that suggest a media bias in favor of mammography screening.”
Also see an accompanying editorial by Task Force members Diana Petitti and Ned Calonge.
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
May 15th, 2011 by Happy Hospitalist in Health Policy
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There is a huge myth being unknowingly perpetrated against the general public when it comes to their rights and responsibilities as a patient. It’s a myth that I can remember hearing as far back as my first few weeks of clinicals during medical school. It was a constant presence during my residency training and even now, as a private practice hospitalist I hear misinformation being handed down day after day, month after month.
This myth is perpetrated by doctors, nurses, and therapists of all kinds. What is this myth? That their health insurance company will not pay for the care provided if they want to leave against the medical advice of their physician.
Will my insurance company pay if I leave against medical advice (AMA)? Yes. They will pay. Medicare and Medicaid pay for services that are medically necessary. For example, if you go to the ER and the doctor recommends a CT scan of your chest and you decline, this does not mean the insurance company will deny payment for your visit to the emergency room. This is what the informed consent process is for. If you have been admitted for a medical condition that requires hospitalization and your care plan meets Medicare medical necessity muster, your care will be paid for whether you leave the hospital when your physician believes it is safe or not. Read more »
*This blog post was originally published at The Happy Hospitalist*
May 15th, 2011 by Berci in Health Tips, News
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Tweet_Fit is an amazing idea that is similar in nature to Kickbee. Here are the details:
Developed by a UK design student, the connected gym accessory attaches to the end of a standard dumbbell and sends updates to your Twitter account when you start and stop your workout. Take it offline and it guides you through the perfect curl. Tweet_Fit’s designer points out that it offers a novel way for trainers to keep track of their clients, and can be used to spur healthy competition between friends.
*This blog post was originally published at ScienceRoll*
