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Expert Offers Tips For Preventing Diabetic Neuropathy

[Editor’s note: In recognition of American Diabetes Month, Harvard Health Publications is collaborating with MSN.com on its Stop Diabetes initiative. Today’s post, published on World Diabetes Day, is the first of several focusing on this all-too-common disorder.]

People tend to think of diabetes as a silent, painless condition. Don’t tell that to the millions of folks with diabetes-induced tingling toes or painful feet. This problem, called diabetic neuropathy, can range from merely aggravating to disabling or even life threatening. It’s something I have first-hand (or, more appropriately, first-foot) knowledge about.

High blood sugar, the hallmark of diabetes, injures nerves and blood vessels throughout the body. The first nerves to be affected tend to be the smallest ones furthest from the spinal cord—those that stretch to the toes and feet.

Diabetic neuropathy affects different people in different ways. I feel it as Read more »

*This blog post was originally published at Harvard Health Blog*

Treatments For Kids With Autism And Cerebral Palsy On Insurance Chopping Block

One of the great challenges facing the folks who have been tasked to implement the Big O’s health care law is defining “essential benefits,” the core medical services that insurers must cover.

insurance Are Habilitative Services Part of Essential Care?Despite its voluminous nature, the law is remarkably vague in this regard. It does identify 10 care categories that health plans must provide to consumers who use federally-funded health insurance exchanges to select a plan, but the categories and associated lists aren’t comprehensive or specific (the categories appear at the end of this post).

The Institute of Medicine has been tasked to flesh out the lists of required services. It has begun work amid a frenzy of lobbying by private insurers and consumer groups. Habilitative services are one contentious area, and they illustrate the challenges faced by the IOM. Unlike rehabilitative services which help people recover lost skills, habilitative services help them acquire new ones.

Habilitative services can help autistic children improve language skills, or those with cerebral palsy learn to walk. They can also help a person with schizophrenia improve his social skills. Read more »

*This blog post was originally published at Pizaazz*

ACP Blogger Wins Health Policy Award

Last week, I was honored to learn that the ACP Advocate blog was selected by voters in a national competition as the Best Health Policy/Ethics blog of 2009. Yesterday, ACP issued a news release announcing the award, in which I am quoted as saying that the blog “seeks to inform and entertain readers and to elicit thoughtful commentary from across the political spectrum, not just from ACP members but from others with an interest in health policy.”

Awards and recognition are nice, but what I enjoy most is making readers aware of interesting ideas, studies, and commentary that otherwise might not have come to your attention. Read more »

*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*

How ER Doctors Think: Plastic Surgeons And Wound Closure

In the comments, a question was posed from reader “Seattle Plastic Surgery on Lake Union” (an online handle that is as unwieldy as it is descriptive).  He asks:

I would like to hear your opinion on a topic that is rapidly growing near and dear to my heart…the scenario is thus:

I’m on call, the local plastic surgeon, for the local ER. You are seeing a nice family with a child that has sustained a simple facial laceration. No fractures, no missing tissue, just a simple, linear, forhead laceration.

The Mom asks that a plastic surgeon be called to come in from home and close the wound. You reply that you are able to do the closure, the child is medically stable, and that a you are qualified to close the wound. The family presses you: call the plastic surgeon.

Can you tell me, from an ER doc’s standpoint- what is the most appropriate response from the on call plastic surgeon? Read more »

*This blog post was originally published at Movin' Meat*

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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