The February issue of Prevention magazine has an article entitled “Surprising Faces of Heart Attack” profiling “three women (who) didn’t think they were at high risk. Their stories are proof that you could be in danger without even knowing it.” No, their stories are not proof of that.
The story is about three women in their 40s. The story varyingly states that the three should have had the following screening tests:
— Advanced cholesterol test, carotid intimal medial thickness test ( CIMT)
— Advanced cholesterol test and stress echocardiography
— Cardiac calcium scoring and CIMT
There’s an accompanying piece: “7 Tests You’re Not Having That Could Save Your Life.”
I asked one of our HealthNewsReview.org medical editors, Harold Demonaco, director of the Innovation Support Center at the Massachusetts General Hospital, to review the two pieces. As his day-job title suggests, he deals with review of the evidence for new and emerging healthcare technologies. He wrote:
The section “7 Tests you are not having that could save your life” states: “If you have not had these cutting edge screenings, put this magazine down and call your doctor. Now.”
Wow. While much of the information is correct, it is the context that is disturbing. Suggesting that these tests are essential in everyone is a bit over the top. Some of the information provided for each test is basically correct. However in some cases the recommendations go well beyond national guidelines.
The major issue here is the tacit assumption that tests are infallible, without any downsides and are always a good thing. That is simply not the case. So who should get these tests? Read more »
A few years ago I started writing a book on what it was like to be a cancer patient and an oncologist. This morning I came upon this section on second opinions:
Is It OK To Get A Second Opinion?
Definitely. And there’s no need to be secretive about it, or to worry about hurting the doctor’s feelings. Second opinions are routine in fields like oncology, and are often covered by insurance. Be up-front: Any decent oncologist can understand a cancer patient’s need to find a doctor who’s right for them, with whom they’re comfortable making important decisions. And in difficult cases, some specialists appreciate the chance to discuss the situation with another expert. So a second opinion can be beneficial to patients and physicians alike.
When things can get out of hand, though, is when patients start “doctor shopping.” For example, I’ve cared for some patients with leukemia who’ve been to see over 10 oncologists. If you’re acutely sick, this sort of approach to illness can be counterproductive — it can delay needed therapy. From the physician’s perspective, it’s alienating: Who wants to invest her time, intellectual effort, and feelings for a patient who’s unlikely to follow up? Besides, oncology is the sort of field where each consulting doctor may have a distinct opinion. (If you see 10 oncologists, you may get 10 opinions.) Beyond a certain point, it may not help to get more input, but instead will cloud the issue. Read more »
*This blog post was originally published at Medical Lessons*
Did you know that one-third of the country’s physicians are over the age of 65? That’s right, there’s a good chance that your doctor is on Medicare. That’s a concern, because physicians aren’t immune to the ails of aging, and are just as prone as patients to succumb to the effects of Parkinson’s or various types of dementias.
Not comforting if you’re about to undergo an operation, for instance. And absolutely frightening when you consider baby boomers and newly-insured patients will flood our health system in the coming years.
An eye-opening piece from the New York Times highlights the trend. It’s up to doctors and medical societies to report doctors who aren’t able to proficiently perform, but few do. According to the data, the rate of disciplinary action for physicians out of school 40 years was 6.6 percent.
Various tactics to ensure competency have been slow to take off. Requiring all doctors to re-certify, for instance, isn’t working, since the vast majority of doctors practicing are “grandfathered” into not being required to take the test. Read more »
*This blog post was originally published at KevinMD.com*
Dr. Shaf Keshavjee, a thoracic surgeon and director of the Toronto Lung Transplant Program, showed the amazing miracle of modern lung transplantation at TEDMED 2010. Here’s his fascinating talk where an actual living, breathing set of porcine lungs were brought on stage for hands-on inspection by the audience:
Here’s a quick interview we were able to get with Dr. Keshavjee just after the talk: Read more »
*This blog post was originally published at Medgadget*
This is a guest post by Dr. Barbara Okun and Dr. Joseph Nowinski.
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End-Of-Life Planning Makes It Easier To Say Goodbye
Saying goodbye as the end of life approaches can be difficult, even for those with a gift for words. In a moving account in a recent issue of The New Yorker, writer Joyce Carol Oates describes the last week of her 49-year marriage, as her husband was dying from complications of pneumonia. Like A Year of Magical Thinking, Joan Didion’s poignant memoir of her husband’s sudden death and its aftermath, Oates’ essay highlights the need for each of us to think about death and dying — and discuss them with loved ones — long before they become a likelihood.
In our work with individuals and families facing death, we have seen too many people miss the opportunity to say goodbye because they avoid what feels like a scary or taboo topic: What do I want to happen when I die? Beginning this discussion early, preferably while you are in good health, can help pave the way for a “good death.” In our new book, Saying Goodbye: How Families Can Find Renewal Through Loss, we offer a guide to help individuals facing a terminal illness and their families navigate the realities of death and dying. Planning ahead is essential. Here are some suggestions for doing that:
Choose your team. Identify support people and specialists (legal, medical, financial, religious) you can count on to advocate for you and help you make decisions. Designate these people to act for you by signing advance medical directives. Read more »
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The February issue of Prevention magazine has an article entitled “Surprising Faces of Heart Attack” profiling “three women (who) didn’t think they were at high risk. Their stories are proof that you could be in danger without even knowing it.” No, their stories are not proof of that.
I asked one of our HealthNewsReview.org medical editors, Harold Demonaco, director of the Innovation Support Center at the Massachusetts General Hospital, to review the two pieces. As his day-job title suggests, he deals with review of the evidence for new and emerging healthcare technologies. He wrote: 
