Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

An Important Tip For Men Who Use Viagra

The medical journal Mayo Clinic Proceedings recently contained some clinical pearls that I wanted to pass on to my men readers who take medication for erectile dysfunction (ED). They reported on a healthy 67-year-old male who took two 25mg doses of Viagra (sildenafil) but still did not get erections. He was frustrated and inquired about other treatments for ED.

The article reported that patients often take Viagra and other phosphodiesterase type 5 inhibitors (Cialis, Levitra) incorrectly. To be effective, Viagra must be taken on an empty stomach at least one hour before intercourse. Research has shown that approximately half of patients who don’t respond to Viagra will have success when they take it properly. The dose can go up to 100mg, but there is no need to increase the medication until the patient learns how to take it.

So there you have it. Take it on an empty stomach at least one hour before sex.

*This blog post was originally published at EverythingHealth*

No Medical School Debt = More Primary Care Doctors?

There’s little question that medical school debt is rising rapidly, affecting the career choice of medical students.

It’s one of the main reasons why the disparity between the number of specialists and primary care doctors is widening. There have been a variety of proposed solutions — most recent of which are medical schools completely subsidizing their tuition. I think that’s a good step forward, but so far has only been limited to a few schools nationwide. Read more »

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

The “Free Stuff” Of Healthcare Reform

It happened. Guilty. I confess. Reading about Dr. Berwick’s recess appointment to lead the Centers for Medicare and Medicaid Services (CMS) induced me to watch a Fox news clip. Gosh, I feel bad about it. It felt good, though.

Patients — that’s you and me — should know that CMS controls doctors, nurses and especially hospital/practice managers. They are ten times more scary than the radar patrol car on the highway.

Dr. Berwick likes the British system of healthcare delivery. In Europe healthcare is free, and everyone likes free stuff. Free stuff happens all the time, doesn’t it?

In Cambridge, Mass — at Harvard — free stuff for all seems a plausible tenet. There must be a lot of coffee shops and free time in Cambridge. In the real world — on Main street, on the farm, in the factory, or really everywhere other than college — people know getting something for nothing is fantasy.

It hasn’t happened yet, so my Dad’s advice about not worrying too much about future events still holds true, but Dr Berwick’s recess appointment to lead the all-controlling CMS has the potential to make caring for patients even more challenging. Yes, more regulations, longer EMR notes with a really careful review of systems, and less pay to doctors will surely improve patient care. Scary indeed. Read more »

*This blog post was originally published at Dr John M*

Online Medical Records: Not All Patients Want All That

Anytime you come across a healthcare article that implies that every patient wants access to this or that — i.e. their medical record, patient-centered care, etc. — you can safely assume that the claim is wrong. Why? Patients are not a monolithic group –- they don’t all share the same motivations, preferences, beliefs or experiences when it comes to their health.

But let’s face. If you are trying to push an agenda, just saying some people want this or that is not the same as implying that everyone wants it.

Take the issue of patient access to physician notes in their medical record. Robert Wood Johnson (RWJ) recently announced their OpenNotes study. The OpenNotes project will evaluate the impact on both patients and physicians of sharing, through online medical record portals, the comments and observations made by physicians after each patient encounter. Okay…so far, so good.

Things begin to fall apart, however, when RWJ cites “a recent study“ in the Journal of General Internal Medicine, as part of the basis for the OpenNotes research. According to RWJ, the study found that “most consumers want full access to their medical records.” Since when did six focus groups (64 people) constitute a representative sample, e.g. most people? Read more »

*This blog post was originally published at Mind The Gap*

The Problem With The Newly-Launched “Healthcare.gov”

If a website touted misleading healthcare information, you’d hope the government would do something about it. But what do you do when the government is the one feeding the public bad information?

Last week the Obama administration launched the new Healthcare.gov. It’s mostly an online insurance shopping website. It’s very much a federal government version of sites like eHealthInsurance.com or Massachsetts’ HealthConnector site, which have been around for years.

So when HHS Secretary Kathleen Sebelius, in announcing the new site, claims it gives consumers “unprecedented transparency” into the healthcare marketplace, you should wonder what she means. But that’s not the big problem with this site. Read more »

*This blog post was originally published at See First Blog*

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…

Read more »

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…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

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…

Read more »

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…

Read more »

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…

Read more »

See all book reviews »

Commented - Most Popular Articles