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The Win-Win Referral

One of my patients is an elderly woman who is completely bedbound due to osteoarthritis. Since she’s considered “too old,” she isn’t considered a surgical candidate for a knee replacement. Her son, George, is her caregiver.

George had been referred to our practice through word-of-mouth from a geriatric care consultant. When he called me for an initial visit, his mother had a spot on her left forearm that was growing rapidly. The nodule was red and tender. Both of them wanted a doctor to look at and remove it, and at the house if possible. Read more »

Single-Session Psychotherapy: The Cab Driver Story

Here’s a story that came out of the American Psychological Association (APA) conference:

I was in a cab going to dinner. The cab driver found out I was a psychiatrist so he told me about his life-changing experience with therapy.

At one time he was having an incredible problem with his life. He was using cocaine, couldn’t keep a job, and his relationships were going down the tubes. Therapy helped him quit cocaine and change all that. (Which was good, since he was the driver of my cab. I really wanted him not to be high or in distress.) This kind of turn-around story isn’t unusual for me — parolees will often come back and tell me about things they’ve done in free society that they’re proud of. The unusual part of this story is the fact that he made all of these changes after a single one-hour session. Read more »

*This blog post was originally published at Shrink Rap*

Your Hair May Be Tracing Where You’ve Traveled

Researchers at the University of Utah and IsoForensics, Inc. in Salt Lake City have demonstrated that water can potentially be used as a tracer to determine the travel habits of individuals.

Because of the natural geographic variability in the hydrogen and oxygen isotope content of water, proteins within hair should contain evidence of these ratios and therefore act as signatures as to where someone has traveled. The current study has shown that the geographic source of tap water, bottled water, beer, and soda can be distinguished simply by measuring the isotope ratio of the water within these drinks.

In our opinion if the technology pans out for real-world use, IsoForensics has a bright future with dictatorship governments, security and intelligence services, armed forces, and maybe even some legitimate forensic causes such as war-crime investigations or even anthropology studies.

Abstract in the Journal of Agricultural and Food Chemistry: Links between Purchase Location and Stable Isotope Ratios of Bottled Water, Soda, and Beer in the United States

Image credit: David Hannah

*This blog post was originally published at Medgadget*

Industry-Sponsored Medical Education: Should Big Pharma Buy Doctors Lunch?

Big Pharma Free Lunch WagonAppetite for Instruction: Why Big Pharma should buy your doctor lunch sometimes” is the headline of an article on Slate.com that has upset many readers. I’m not terribly upset about it because it just seems too naive and misinformed to get upset about. The final line of the piece tells you all you need to know about the tone of the column:

“Ousting commercial support is creating a huge chasm in medical education, leaving doctors not only hungry but also starved for knowledge.”

A number of online comments were posted in reaction to the piece. Read more »

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

New Study: Shingles Vaccine Is Safe And Effective

Shingles (herpes zoster) is no fun. It usually begins with a couple of days of pain, then a painful rash breaks out and lasts a couple of weeks. The rash consists of blisters that eventually break open, crust over, and consolidate into an ugly plaque. It is localized to one side of the body and to a stripe of skin corresponding to the dermatomal distribution of a sensory nerve.

Very rarely a shingles infection can lead to pneumonia, hearing problems, blindness, brain inflammation (encephalitis) or death. More commonly, patients develop postherpetic neuralgia (PHN) in the area where the rash was. The overall incidence of PHN is 20%; after the age of 60 this rises to 40%, and after age 70 it rises to 50%. It can be excruciatingly painful, resistant to treatment, and can last for years or even a lifetime. Read more »

*This blog post was originally published at Science-Based Medicine*

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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