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Latest Posts

The Simple Truth About Cholesterol

The New York Times recently ran a piece that wondered if doctors were treating patients with cholesterol-lowering medication unnecessarily because a web-based calculator over estimated a person’s risk. The program was proudly sponsored by the pharmaceutical roundtable and was available at the American Heart Association.

The implication was obvious. Simple tool determines an individual’s risk for heart attack or death from heart attack. It over estimates risk. Patients treated unnecessarily. To be also clear, the program did underestimate risk as well.

Unfortunately, the article missed an important point. While the simplified calculator may not be as accurate as the more complex algorithm used by the National Cholesterol Education Program, the truth is doctors are likely to be overtreating patients not because the former program is presented by the pharmaceutical roundtable, but for another reason. Read more »

*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*

My Patient, The “Health Nut”

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*

The Heart Health Risks Of Being A Couch Potato

We’ve all made the excuses: You can’t face the drive to the gym, you’re too tired at night, getting up in the morning is a chore, or it’s too hot or cold outside. So you cozy up on the couch in front of the television. If you’re a couch potato, you’re a gambler — with your life.

Unfortunately you’ll need a big sofa because you’re not the only one whose heart isn’t in physical activity. About 60 percent of adults in the U.S. are not getting the exercise they need, according to a report from the U.S. Surgeon General.

It’s time to get up and face — or better yet, dance to — the music! Here are a few facts that may get you moving for your heart’s sake. Read more »

*This blog post was originally published at Health in 30*

Baby Boomers Are Bypassing Primary Care

Office-based practices are focusing increasingly on patients 45 and older, reports the Centers for Disease Control and Prevention.

In 2008, those 45 and older accounted for 57 percent of all office visits, compared to 49 percent in 1998. Prescriptions, scans and time spent with the doctor also became increasingly concentrated on those middle aged and older, according to data from the CDC’s National Center for Health Statistics.

Also, physician visits increasingly concentrated on medical and surgical specialists and less on care provided by primary care practitioners for those ages 45 and older. Furthermore, for patients ages 65 and older, the percentage of visits to primary care specialists decreased from 62 percent to 45 percent from 1978 to 2008, while the percentage of visits to physicians with a medical or surgical specialty increased from 37 percent to 55 percent. Read more »

*This blog post was originally published at ACP Internist*

Can Sugar Raise Your Blood Pressure?

Most of us know that salt raises blood pressure in many people. When I learned that in medical school almost 40 years ago, I have not touched a salt shaker since. I enjoy having a low normal blood pressure. A new study published in the Journal of the American Society of Nephrology (July 2010) suggests that sugar, especially the fructose that comes from corn syrup, may also raise blood pressure.

A study team from the University of Colorado in Denver looked at sugar intake among thousands of Americans in a major national nutrition survey between 2003 and 2006. Those who consumed more added sugars, such as the fructose in soft drinks, had significantly higher blood pressures than those who did not and ate more natural foods such as fresh fruit. Fructose from corn syrup is a major cause of the obesity epidemic and may also be contributing to high blood presure, the most common chronic disease in adults. Read more »

*This blog post was originally published at eDocAmerica*

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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