October 1st, 2010 by Jennifer Shine Dyer, M.D. in Better Health Network, Health Policy, Health Tips, Research, True Stories
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As a medical professional who often treats children with chronic diseases, my patients turn to me not only for treatment advice but often for advice on how to improve their quality of life. I often have difficulty addressing the latter as there is a paucity of research on quality of life outcomes as compared to biomedical outcomes.
However, preliminary data from DR Walker et al. (1) have shown that comprehensive disease management improves quality of life and thereby reduces medical costs for some common chronic illnesses. Recently, a patient shared a story with me that was written by an anonymous author which demonstrates the powerful effect of seemingly small efforts on the quality of life of a disabled child. Read more »
September 29th, 2010 by Lucy Hornstein, M.D. in Better Health Network, Health Policy, Health Tips, News, Opinion, Quackery Exposed, Research
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There’s been a movement afoot for several years now to quantify pain as the so-called “Fifth Vital Sign.” It all started as a well-intentioned effort to raise the level of awareness of inadequate pain control in many patients, but has gotten way out of hand. The problem is that the word “sign” has a specific meaning in medicine that, by definition, cannot be applied to pain.
When you hear us medicos talk about “signs and symptoms” of a disease, it turns out that they are not the same thing. “Symptoms” are things the patient experiences subjectively. “Signs” are things that can be observed objectively by another person.
Headache is a symptom; cough is a sign. Itching is a symptom; scratch marks over a blistery linear rash are a sign. Vertigo, the hallucination of movement, is a symptom; nystagmus, the eye twitching that goes with inner ear abnormalities that can cause vertigo, is a sign. If someone other than the patient can’t see, hear, palpate, percuss, or measure it, it’s a symptom. Anything that can be perceived by someone else is a sign. Read more »
*This blog post was originally published at Musings of a Dinosaur*
September 29th, 2010 by Bryan Vartabedian, M.D. in Better Health Network, Health Policy, Opinion, True Stories
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I had lunch with a group of physicians recently, and along for the ride was a college student thinking of applying to medical school. When talking about the future, I suggested that the work of a physician 30 years from now will be hardly recognizable to today’s physician. Everybody disagreed and the student was confused. There was a lot of denial and myopic rationalization.
But I can’t blame them, really. Most of us see what’s immediately changing in our day-to-day work and the bigger picture gets lost. For most of us, the role of the physician is hard to see for anything other than it always has been. Most live and work as the self-determined independent care coordinator, reactively working to treat disease just as its been done for over a century. But change is happening around us. Read more »
*This blog post was originally published at 33 Charts*
September 28th, 2010 by Davis Liu, M.D. in Better Health Network, Health Policy, Health Tips, News, Opinion
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It’s that time of year again. Children back at school. Football season is underway and baseball playoffs to start soon. The television networks are rolling out their new shows.
And it’s also time to think about getting flu shots. I just got mine today as I have done annually since going to medical school.
Compared to last year, there isn’t as much news about the flu or the flu vaccine. This year the Centers for Disease Control and Prevention (CDC) gives clear guidelines that everyone aged 6 months and older should get the influenza vaccine.
This month the American Academy of Pediatrics recommends that all healthcare providers should be required to get the influenza vaccine.
And one fact that hasn’t gotten much attention is whether the 2009 H1N1 virus is included in the 2010-2011 vaccine: Is it? Yes, it is. This year’s vaccine will be as safe as vaccines in past years as the production process is unchanged. Inclusion of the 2009 H1N1 virus will not be a problem. Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
September 25th, 2010 by JessicaBerthold in Better Health Network, Health Tips, True Stories
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A version of the following post, by Kimberly Manning, FACP, appeared on the blog “Life at Grady.”
“My blood pressure is still borderline? Man!”
“Yeah…and from looking through the chart, it was 150/96 on your admission. It’s pretty much been that since you’ve been here, give or take a few points. That’s a little more than borderline, actually.” I paused for a moment, realizing that I sounded a bit discouraging. “I don’t think this would be hard to get under control at all, sir. I mean…you’re such a motivated patient, you know?”
I studied my patient carefully. He was in his late thirties, although he could totally pass for a twenty-something all day, every day. His skin looked like someone had grabbed him by the tip of his toe and uniformly dipped him in milk chocolate — not a single blemish anywhere.
“I eat right and I exercise…in fact, I’m a health nut! I’m really kind of surprised that my pressure keeps running high.” Read more »
*This blog post was originally published at ACP Hospitalist*
