May 26th, 2010 by BobDoherty in Better Health Network, Health Policy, Humor, Opinion, Research, Uncategorized
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Here is Edward Bear, coming downstairs now, bump, bump, bump, on the back of his head, behind Christopher Robin. It is, as far as he knows, the only way of coming downstairs, but sometimes he feels that there really is another way, if only he could stop bumping for a moment and think of it.
— From A.A. Milne’s “Winnie the Pooh and the House at Pooh Corner.”
Internists, I expect, will identify with Edward Bear.
Richard Baron’s study in the NEJM on the amount of work he and his colleagues do outside of an office visit — the “bump, bump, bump” of a busy internal medicine (IM) practice — has resonated with many of his colleagues.
Jay Larson, who often posts comments on this blog, did a similar analysis for his general IM practice in Montana, and found that for every one patient seen in the office, tasks are done for 6 other unscheduled patients. Jay writes: “So really there [are] internists [who] are managing about 130 patients per day. Not much consolation when they only get paid for 18 per day.” Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
May 26th, 2010 by SteveSimmonsMD in Primary Care Wednesdays
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Most experienced physicians expect uncertainty in caring for real people with average everyday problems. Yet those inexperienced or uninitiated in medicine tend to see the practice of medicine as exact or even absolute.
I remember waiting in vain as a medical student and resident for my instructors to illuminate a path towards certitude. Instead, I was given something far more real and lasting: An acceptance of the indeterminate mixed with the drive to be compulsive on behalf of my patients.
During my internal medicine internship, I remember a more-senior resident during our daily morning report bemoaning her uncertainty by saying, “But I just don’t know what’s wrong with my patient.” Although she was visibly upset, our program director’s reaction to her comment bordered on amusement, culminating with, for me, an unforgettable response: “Well, you certainly have chosen the wrong profession.”
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May 25th, 2010 by Davis Liu, M.D. in Better Health Network, Health Policy, Health Tips, Opinion, Quackery Exposed, Research
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A patient brought in a flyer for Life Line Screening, where for $129 an individual can have their carotid (neck) and peripheral (leg) arteries screened for blockage, their abdominal aorta screened for aneurysm (swelling), and be tested for osteoporosis. The advertisement claims that “we can help you avoid a stroke,” and their logo notes “Life Line Screening: The Power of Prevention.”
Are these tests worth your money? Short answer: No.
Although the flyer correctly indicates that 80 percent of stokes can be prevented, the National Stroke Assocation does not recommend ultrasound as a screening test. Preventing stroke includes quitting smoking, knowing your blood pressure and cholesterol numbers, drinking alcohol in moderation (if already doing so), exercising regularly, and eating a low-sodium diet. Their is no mention of an ultrasound test. Why? Because there is NO evidence that it helps save lives in individuals who are healthy and have no symptoms (except for the following situations). Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
May 25th, 2010 by Toni Brayer, M.D. in Better Health Network, Health Tips, News, Research
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The European Heart Journal studied 6,000 British civil servants and followed them for 11 years. They found that working an extra 3 to 4 hours a day is associated with increased coronary heart disease.
The researchers controlled and adjusted for lifestyle, cardiac risk factors, and other factors that would skew the results, and still found that people who worked 3 to 4 extra hours a day had a 60 percent increase in risk for heart disease. Read more »
*This blog post was originally published at EverythingHealth*
May 25th, 2010 by Berci in Better Health Network, Health Policy, News, Opinion, Research
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Here are a few papers and publications focusing on how social media can be used in medicine, healthcare and science. These represent the evidence-based approach in social media:
Google docs: a better method than a paper clinical schedule. Kippenbrock T, Holloway E, Moore DD. Comput Inform Nurs. 2010 May-Jun;28(3):138-40.
How to get the most from the medical literature: keeping up to date in nephrology. Cullis J, Webster AC. Nephrology (Carlton). 2010 Apr;15(3):269-76.
Twitter: consider the possibilities for continuing nursing education. Billings DM, Kowalski K, Bristol TJ. J Contin Educ Nurs. 2010 May;41(5):199-200.
Literature search on risk factors for sarcoma: PubMed and Google Scholar may be complementary sources. Mastrangelo G, Fadda E, Rossi CR, Zamprogno E, Buja A, Cegolon L. BMC Res Notes. 2010 May 10;3(1):131.
Effect of visual media use on school performance: a prospective study. Sharif I, Wills TA, Sargent JD. J Adolesc Health. 2010 Jan;46(1):52-61.
Patients’ Evaluations of Health Care Providers in the Era of Social Networking: An Analysis of Physician-Rating Websites. Lagu T, Hannon NS, Rothberg MB, Lindenauer PK. J Gen Intern Med. 2010 May 13.
Tweeting science and ethics: social media as a tool for constructive public engagement. Regenberg AC. Am J Bioeth. 2010 May;10(5):30-1.
*This blog post was originally published at ScienceRoll*
