TALLAHASSEE, Fla. — A state lawmaker has filed a bill that would ban doctors from asking their patients if they have a gun in the home.
Rep. Jason Brodeur, R-Sanford, said he has heard of a number of cases in which doctors asked their patients that question, which he thinks should be off limits.
“What we don’t want to do is have law-abiding firearm owners worried that the information is going to be recorded and then sent to their insurance company,” he said. “If they’re on Medicaid maybe it’s sent to the government. If the overreaching federal government actually takes over health care, they’re worried that Washington, D.C. is going to know whether or not they own a gun and so this is really just a privacy protection.”
Under the legislation, a doctor could face a fine of up to $5 million or be sent to prison for up to five years for asking about guns in the home.
I understand the stated intent as recorded in this news item: Gun ownership is being recorded, lots of things are reported to insurance companies and the government, and this bill is an attempt to keep this information out of those circles, at least as obtained in a doctors’ office where people still believe what they say is between them and their doctor. It should be, but lots of things should be absolute that aren’t. Read more »
*This blog post was originally published at GruntDoc*
That’s the question Dartmouth’s Dr. Gil Welch asks in a column on the CNN website. He reflects on [recent] news about a test in development that might find a single cancer cell among a billion healthy ones — as so many news stories framed it. Welch analyzes:
“But it’s not that simple. The test could just as easily start a cancer epidemic.
…
Most assume there are no downsides to looking for things to be wrong. But the truth is that early diagnosis is a double-edged sword. While it has the potential to help some, it always has a hidden side-effect: overdiagnosis, the detection of abnormalities that are not destined to ever bother people in their lifetime.
Becoming a patient unnecessarily has real human costs. There’s the anxiety of being told you are somehow not healthy. There’s the problem that getting a diagnosis may affect your ability to get health insurance. There are the headaches of renewing prescriptions, scheduling appointments and keeping them. Finally, there are the physical harms of treatments that cannot help (because there is nothing to fix): drug side-effects, surgical complications and even death. Not to mention it can bankrupt you.
Americans don’t need more diagnoses, they need the right diagnoses.
I don’t know whether this test will help some patients. It might, but it will take years to figure that out.Read more »
Federal law generally prohibits physicians from referring their own patients to a diagnostic facility in which they have an ownership issue — a practice called “self-referral” — unless the facility is located in their own practice. This exemption exists to allow patients with access to a laboratory test, X-ray, or other imaging test at the same time and place as when patients are seeing their physician for an office visit. Less inconvenience and speeder diagnosis and treatment — what could be wrong with that?
Much, say the critics, if it leads to overutilization and higher costs and doesn’t really represent a convenience to patients. This is the gist of two studies by staff employed by the American College of Radiology, published in the December issue of Health Affairs.
One study analyzes Medicare claims data and concludes that patients aren’t really getting “one-stop-shopping” convenience when their physician refers them to an imaging facility that qualifies for the “in-office” exemption.
“Specifically, same-day imaging was the exception, other than for the most straightforward types of X-rays. Overall, less than one-fourth of imaging other than these types of X-rays was accompanied by a same-day office visit. The fraction for high-tech imaging was even lower — approximately 15 percent.” Read more »
1. Progress in developing synthetic red blood cells
A University of North Carolina-Chapel Hill research group has created hydrogel particles that mimic the size, shape and flexibility of red blood cells (RBCs). The researchers used PRINT® (Particle Replication in Non-wetting Templates) technology to generate the fake RBCs, which are said to have a relatively long half-life. The findings were reported on-line yesterday in the Proceedings of the National Academy of Sciences (PNAS) (abstract available, subscription required for full text). According to a PR-ish but interesting post on Futurity, a website put forth by a consortium of major research universities, tests of the particles’ ability to perform functions such as transporting oxygen or carrying therapeutic drugs have not yet been conducted.
Developing competent, artificial RBCs is a hematologist’s holy grail of sorts, because with that you might alleviate anemia without the risks of transfusion.
2. Progress in using human stem cells to generate lots of platelets
In an exciting paper published today in Cell Research, investigators stimulated human embryonic stem cells to become platelet-producing cells, called megakaryocytes. According to the article (open-text at Nature PG), the platelets were produced in abundance, appeared typical and clotted appropriately in response to stimuli in vitro. The researchers injected them into mice, used high-speed video microscopy for imaging, and demonstrated that the stem cell-derived human platelets contributed to clot formation in mice, in vivo (i.e., they seem to work). Read more »
*This blog post was originally published at Medical Lessons*
According to a new study in Nature Neuroscience, there are songs that can arouse feelings of euphoria and craving by endogenous dopamine release in the striatum:
If music-induced emotional states can lead to dopamine release, as our findings indicate, it may begin to explain why musical experiences are so valued. These results further speak to why music can be effectively used in rituals, marketing or film to manipulate hedonic states. Our findings provide neurochemical evidence that intense emotional responses to music involve ancient reward circuitry and serve as a starting point for more detailed investigations of the biological substrates that underlie abstract forms of pleasure.
According to study author Robert Zatorre, one of those songs is “Adagio For Strings” by DJ Tiesto:
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