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Evidence-Based Medicine: Do Patients Understand It?

Doctors trying to help patients understand a course of treatment must teach them new terms such as “medical evidence,” “quality guidelines” and “quality standards.” Patients might not be willing to accept that language lesson.

A study in Health Affairs concluded that 41 percent of patients didn’t ask questions or tell doctors about problems. The main barriers were that patients didn’t know how to talk to doctors, or their physicians seemed rushed. Only 34 percent of patients recalled physicians discussing medical research in relation to care management.

But, physicians say, that’s only half the problem. Sometimes, patients demand to see specialists when they don’t really need to. Or, they don’t accept it when evidence shows that highly-desired treatments aren’t the best ones for care. One reason may be that one in three patients believe that more expensive treatments work better than less expensive ones, according to the study in Health Affairs. Once the evidence is laid out, it can be a delicate negotiation to get patients to accept that. (American Medical News, Health Affairs, RangelMD, KevinMD)

*This blog post was originally published at ACP Internist*

Healthcare Road Rage

Road and construction projects have stopped all over town, thanks to concerns about future healthcare benefits. From ChicagoBreakingNews.com:

Construction companies and labor unions are divided over healthcare packages. The unions seek a 15 percent annual benefits increase over three years, while contractors have countered with a 1 percent annual increase.

-WesMusings of a cardiologist and cardiac electrophysiologist.

*This blog post was originally published at Dr. Wes*

Avoiding Fireworks-Related Injuries

Time for a reminder about safe fireworks use. This Daily News article by Lauren Johnston — Doctors replace woman’s missing thumb with big toe transplant –- shows and tells you why. An excerpt:

A Long Island woman’s big toe will adapt to function as a thumb after doctors performed a rare transplant operation to replace the vital missing digit.

Shannon Elliott, 25, lost the thumb and two fingers from her left hand in November when a firework exploded in her palm…

Have a safe and happy July 4th — and stay out of the ER. Please follow these fireworks safety tips:

  • Never allow children to play with or ignite fireworks.
  • Read and follow all warnings and instructions.
  • Fireworks should be unpacked from any paper packing out-of-doors and away from any open flames.
  • Be sure other people are out-of-range before lighting fireworks. Small children should be kept a safe distance from the fireworks; older children that use fireworks need to be carefully supervised.
  • Do not smoke when handling any type of “live” firecracker, rocket, or aerial display.
  • Keep all fireworks away from any flammable liquids, dry grassy areas, or open bonfires.
  • Keep a bucket of water or working garden hose nearby in case of a malfunction or fire.
  • Take note of any sudden wind change that could cause sparks or debris to fall on a car, house, or person.
  • Never attempt to pick up and relight a “fizzled” firework device that has failed to light or “go off”
  • Do not use any aluminum or metal soda/beer can or glass bottle to stage or hold fireworks before lighting.
  • Do not use any tightly closed container for these lighted devices to add to the exploding effect or to increase noise.
  • Never attempt to make your own exploding device from raw gunpowder or similar flammable substance. The results are too unpredictable.
  • Never use mail-order fireworks kits. These do-it-yourself kits are simply unsafe.

For more information on injuries that can occur from unsafe use of fireworks, see:

Fireworks-Related Injuries (CDC)

Facts About Fireworks Injuries (Prevent Blindness America)

*This blog post was originally published at Suture for a Living*

6 Tips To A Simpler Lifestyle

I like to pass on good tips, and these ways to simplify your life make a lot of sense. The constant stress we feel because life is so complicated isn’t good for our health. Here are six tips to have a simpler lifestyle:

1. De-Clutter Your Home

Look around. If you have piles of paper, too many “things” and nic-nacs laying around, it’s hard to think clearly and function. An open, clear space allows our minds to feel open and more peaceful. Tackle one room at a time. Be ruthless and donate or toss everything that isn’t useful, beautiful, or has special memories.

2. Limit Family Activities

Try to force family members to choose only those activities that are most important. Many of us are over-scheduled and have no time to “just see where the day will take us.” Thirty years ago no stores were open on Sundays and there wasn’t much to do except go on picnics or just hang out with friends and family. It’s okay to “veg out” and may even be good for your family’s health. Read more »

*This blog post was originally published at EverythingHealth*

The Mystery Of Alcoholics Anonymous

To further emphasize my admiration for superb sci/med/health writing, I wish to add another writer to my growing blog category of “Journalists, Awesome.”

Via my drug abuse research colleague, DrugMonkey, my attention was drawn to a new Wired magazine article by Brendan I. Koerner entitled, Secret of AA: After 75 Years, We Don’t Know How It Works. I strongly recommend this long-form article for anyone in the field of substance abuse and dependence research, psychology and general clinical research, students of excellent science writing, alcoholics and their family members, and anyone who thinks that good science writing no longer exists.

I don’t want to influence your views any further, other than to say that since I poured my first whiskey and water for my grandmother when I was around 7, I’ve had a longstanding interest in why Alcoholics Anonymous helps so many alcohol-dependent folks kick the disease for decades while others trying the approach continue to crash and burn or otherwise abhor its very tenets, especially the “Higher Power” focus. The reader comments there also reflect this bipolar view of the unorganized organization. Read more »

*This blog post was originally published at Terra Sigillata*

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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