What is in a prenatal vitamin? Why do most doctors recommend them? Is there any evidence taking them is worthwhile? I decided recently that I would read through the ingredients of these vitamins, often touted as “essential vitamins and nutrients, crucial for the healthy development of your baby.” Hmmm. Does that mean eating traces of polyvinyl alcohol every day is beneficial?
The fine print ingredients of such brands as “One A Day”, “Centrum Materna”, “Rite Aid” and even the prescription only “Prenate Elite” are a confusing mess of milligrams, international units, RDA’s, and chemicals. As the makers of Centrum explain, “It is very challenging to formulate vitamins and minerals without the use of non-medicinal ingredients which serve to keep the product stable and to prevent the various ingredients from interacting.” They also find fault in the limited number of suppliers of the active ingredients in prenatal vitamins, and therefore claim substances like gelatin are difficult to avoid.
Let’s take a tour of the prenatal vitamin ingredient zoo. Read more »
It’s a scene that plays out thousands of times every day in doctors’ offices across the country — the moment the doctor shifts from addressing the concerns that brought the patient into clinic to when he or she attempts to make sure everything else is going okay.
Often this happens at the end of a sick visit, after working up an upper respiratory infection or back pain. Sometimes it happens after following up a chronic medical problem such as high blood pressure or arthritis, and occasionally it happens under ideal circumstances, during an annual physical or routine wellness visit. It doesn’t necessarily happen at the end of the visit. Often it sneaks it’s way into various points in the encounter — as when the doctor places his or her stethoscope over a patient’s chest while evaluating for knee pain.
What I’m referring to is so indistinct that it doesn’t even have an universal name, but rather goes by many titles — “preventive health,” “preventative health,” “preventive medicine,” “preventive care,” “healthcare maintenance,” “routine healthcare,” “routine checkup,” “annual physical,” and “health and wellness” — to name a few.
But whatever you call it nearly everyone agrees how important it is. The healthcare reform debate was ripe with calls for more “health”-care not just “sick”-care, and one of the most welcome measures in the new healthcare legislation across both sides of the aisle are provisions to support it. Outside of Capitol Hill, from cereal boxes to magazine racks and celebrity doctors, messages about staying healthy are everywhere, as is the general belief that “an ounce of prevention is worth a pound of cure.” Read more »
The first-year medical students I precept were too young to see Tom Cruise’s alter ego Lieutenant Pete “Maverick” Mitchell grace the big screen in the 1986 blockbuster film “Top Gun.” Yet, the story has a relevant analogy to medicine.
According to the film, during the Vietnam war American pilots were relying too much on technology to bring enemy fighters down. They weren’t as skilled in taking out the opposition. They fired their technologically advanced missiles to try and get the job done. They didn’t think. It didn’t work. They forgot the art of dogfighting.
The military discovered that technology alone wasn’t going to get the job done. The best fighter pilots needed the skills, insight, and wisdom on when to use technology and when not to. As a result, the Navy Fighter Weapons School, known simply as Top Gun, was created to retrain the military pilots on this vital lost skill. The goal of the program was specifically to make the best of the best even better.
Like the military, the country is discovering that the healthcare system enabled with dazzling technology isn’t getting the job done either. Read more »
This video was [recently] shown at the 2010 American Academy of Family Physicians annual meeting in Denver. The theme is simple: “We are here. We are listening. We are healing. We are family physicians.”
People ask me all the time “what do you do?” There’s no easy way to explain all the things that I do as a family physician. In addition, each family doc in each community is unique. That’s kind of part of the difficulty of answering the question. But I believe this video does a good job of trying to encapsulate who we are as family physicians:
I’m not a drum banger for the latest “epidemics” to come to media attention, whether it’s H1N1, Vitamin D, or getting your kids CAT-scanned routinely.
But there comes a time in every blogger’s life when he must comment on something that does bubble up into consciousness a tad, shall we say, often.
I’m talking here about an epidemic that we are learning more about each passing day. Something that you or someone you know or sleep with may be diagnosed with, and ultimately treated for (an interesting national problem in its own right): Obstructive sleep apnea (OSA).
What is it, you ask? A new national scourge? Stop the presses! Can I catch it? Read more »
*This blog post was originally published at ACP Hospitalist*
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What is in a prenatal vitamin? Why do most doctors recommend them? Is there any evidence taking them is worthwhile? I decided recently that I would read through the ingredients of these vitamins, often touted as “essential vitamins and nutrients, crucial for the healthy development of your baby.” Hmmm. Does that mean eating traces of polyvinyl alcohol every day is beneficial?
