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Caught By FDA: Supplement Manufacturers Boost Efficacy By Adding Real Drugs To Mix

Stiff Nights.jpgI should probably create a new blogpost category just for erectile dysfunction dietary supplements adulterated with authentic or synthetic analogs of prescription phosphodiesterase-5 (PDE5) inhibitors (e.g., Viagra, Cialis).

However, FDA has already created a page for this earlier this year after dozens of companies have been identified as putting real drugs into their erectile dysfunction products.

Do the brains behind these companies not realize that FDA is now monitoring every erectile dysfunction supplement for all manner of PDE5 inhibitors?

Apparently not: Read more »

*This blog post was originally published at Terra Sigillata - PostRank (PostRank: All)*

The Importance Of Open-Ended Questions

I can spend 20 minutes interviewing a parent about their child and still not really understand them. During a consult, my interview centers on the objective elements in a child’s history. When evaluating a child for abdominal pain, for example, I have a panel of questions that cover what I need to know to generate a starting hypothesis.

But none of it helps me understand Mom.

Understanding where the parents are at is critical to both understanding a child’s problem as well as pitching a plan of care. Whether it’s revealed to me or not, parents often come to me with an agenda. If my plan doesn’t meet with their view of the situation, it’s going to be much harder for me to help that child get what she needs.

So at the end of my interview (usually when washing my hands) I launch one or all of the following questions:
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*This blog post was originally published at 33 Charts*

When No One Wants To See The Patient: The ER’s On-Call Labyrinth

The call schedule is hidden somewhere inside!

The call schedule is hidden somewhere inside!

Dictation:

‘The patient was seen in the emergency department by Dr. Niemans, who is the acting hospitalist on call for Dr. Whitman’s group, who usually admit for the patient’s actual primary care provider, Emily Knight, PA, who works for  Dr. Robelo, who no longer takes call, but admits his patients to the hospitalist.

Because the patient has COPD and an acute left-lower-lobe pneumonia, pulmonology was consulted.  However, no pulmonologist is available this weekend.  Pulmonary is being covered by Dr. Albertson, pulmonologist in the neighboring city.  I spoke with Dr. Albertson about this and he told me he wasn’t taking call for our patients, and why did people keep bothering him.

The patient’s cardiologist, Dr. Rease, is being covered by Dr. James.  I spoke to Edgar, PA for Dr. James who said that as of 7am, Dr. James was trading call with Dr. Housefield while Dr. James went to his son’s soccer game, but if I had any questions I should call Dr. Housefield’s Nurse Practitioner Michael, who would be rounding for Dr. Housefield, Dr. James and Dr. Josefson, at least until soccer was over or something bad happened. Read more »

*This blog post was originally published at edwinleap.com*

Even Physicians Are Shocked By Healthcare Costs

I took my son to the ER for a broken thumb. It was a minor injury but the thumb is the most important digit on the hand. The ER care was just fine…a quick look, an Xray and a small splint. We didn’t have to wait long and everyone was courteous.

Imagine my surprise to receive the bill from the hospital. Yes, I have insurance. My out of pocket expense was minimal but here is what the insurance company was charged:

  • Hospital Misc.- $56.00 (could this be the splint?)
  • Diagnostic Xray – $342.00
  • Emergency Care- $952.00
  • Surgery – $570.00
  • Total $1920.00

Take a look…surgery? There was so surgery, no procedure. There was no break in the skin. The doctor component of the visit was about 7 minutes (mainly because I knew the doc and we chatted about politics)

This bill is unreal and is comprised of unreal health care costs. Read more »

*This blog post was originally published at EverythingHealth*

The Dirt On Doctors

bathtub I was hesitant to post this photo because it is an image of my girlfriend’s bathtub in New York City. I’m sure she wouldn’t want me to post this, but I figure it’s ok because I didn’t reveal her identity and also, she doesn’t read my blog.

My girlfriend is a physician. She is friendly and smart and well-groomed. Her bathroom, on the other hand, is pretty scary. It’s not unlike other bathrooms I’ve seen in New York – which means this could be partially a cultural phenomenon. She knows it needs cleaning – I guess.

She invited me to stay at her place during a recent visit – instead of a hotel – and I gladly accepted. We planned to have a nice dinner and drinks out on the town. She showed me to my room and casually mentioned that she needed to get some Draino for the bathroom. I wondered what exactly that might mean, and was surprised by her use of understatement in this case. Read more »

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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