June 28th, 2007 by Dr. Val Jones in Uncategorized
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I’ve been expressing my concerns over the recent quality control issues in China – first the melamine in pet food, then the contaminated medicines, next the anti-freeze in toothpaste. The New York Times has an interesting piece on the toothpaste scandal. But they miss an interesting issue at play: cost cutting is the underlying cause of all this.
Antifreeze (diethylene glycol) is less expensive and mimicks the flavor of mouthwash. Melamine (the poison recently found in pet food ingredients) is a cheap filler product that increases the apparent protein content of pet food.
So China was putting these cheaper imitation ingredients into their products to improve their bottom line, not because they were particularly interested in causing the death of people and pets.
And before we point a finger at them… let’s think about why the toxic toothpaste got into our hospital and prison systems: because the administrators were trying to buy the cheapest possible products to save on costs. And the least expensive items are often from China. This is a good example of how cost cutting can endanger lives – with both the US and ChinaThis post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
June 27th, 2007 by Dr. Val Jones in News
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Interesting article in the New York Times about doctors talking about themselves too much. Apparently, some doctors spend precious patient interview time talking about unrelated personal information (recent vacation experiences, family members, etc.). In fact, a recent study in the Archives of Internal Medicine suggests that physicians annoy patients with these misguided attempts at building rapport.
We physicians are trained in medical school to be more humanistic and compassionate towards our patients – but we are not given specific direction regarding how to achieve those goals. And let’s face it, we’re kind of geeky in the first place, some of us lack social skills, and we’re under a lot of stress most of the time. The result? Awkward conversations about the most innocuous things we can think of to break the ice – vacations, daily routines, the weather… and perhaps a lot of wasted time.
The research study has its limitations, though. First of all, it only studied physicians in Rochester, New York. Now, my husband is from Rochester – so I dare not say anything unkind… but culturally speaking, the Rochester crew is a little more chatty and casual in their approach to conversations than folks in Manhattan or Boston for example. So there may be a cultural bias at play here in the research.
Second, it’s unclear how much the personal commentary bothers real patients. The conversations were judged by researchers listening to recordings of fake patients who had no previous relationship with the doctor. It’s entirely possible that regular patients might enjoy the personal aspects of the dialogue and actually look forward to hearing how the doctor and his or her family is doing because they have a caring, friendly relationship.
And finally, the study doesn’t address the issue of how to improve the doctor-patient relationship if self-disclosure is so unsuccessful. The poor docs in Rochester are going to be left with a self-conscious uneasiness about idle chatter – and will again not know exactly how to demonstrate humanism as recommended in their medical school training.
But, I must say – that if my doctor spent our entire session talking about herself, I sure would be annoyed, and rightly so. Still, I think I’d like her more if she told me something personal about her own struggles. There’s a balance here – and the complicated interplay of human relationships is hard to measure with standardized patients, audio tapes, and a small geographical location. If your doctor is too chatty, just redirect him/her. You know we do that to YOU all the time. 
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
June 27th, 2007 by Dr. Val Jones in News, Quackery Exposed
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Well, hooray for the FDA. On August 24th a new rule will be phased in, requiring all supplement manufacturers to demonstrate that their products contain the ingredients listed on their labels (nothing more, nothing less). This rule will help to reduce contamination issues (some supplements have been found to contain dangerous levels of lead, bacteria, and other contaminants) and false advertising (some supplements don’t contain as much of an ingredient as the label claims).
This is really good news, and better late than never. Although some manufacturers were already conforming to this rule (kudos to them), this will require compliance for the rest of the companies out there who have been misleading the public about the contents of their supplements.
Some say that this rule doesn’t go far enough to ensure the safety and efficacy of the contents of the supplements, and that these bio-active ingredients should undergo the same degree of testing as pharmaceutical products. Unfortunately, studying all the supplements for efficacy would be an enormous and extremely expensive task that is totally cost-prohibitive. At this point, the best we’ve got is NCCAM, and they are slowly grinding their way through a long list of supplements that are purported to be useful for the treatment of various conditions. They are systematically reviewing them to see if indeed they produce the desired effect, without any undesired effects.
And so at this point, let the buyer beware – supplements may or may not be as helpful as the manufacturer claims, and they may not be as side-effect free as they suggest either. But soon you’ll at least be able to know that they don’t contain toxic chemicals, heavy metals, or dangerous bacteria – and that’s a giant step in the right direction for public safety.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
June 25th, 2007 by Dr. Val Jones in Expert Interviews, News
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This is the weird correlation of the week: women who suffer with symptoms of morning sickness during their pregnancies may be less likely to develop breast cancer later on in life. A group of epidemiologists in Buffalo recently reported this finding at a scientific meeting (Society for Epidemiologic Research). No one is sure what this means, and I dare not speculate… but perhaps there’s some kind of link between a woman’s hormone levels produced during pregnancy, the nausea they cause, and the hormonal milieu that is the background for breast cancer? Or maybe this study has turned up a false association. Only time – and a lot more research – will tell. Of course, if anyone should speculate on this, it’s the breast cancer oncologists like Dr. Gluck. So I dropped him an email to ask him what he thinks.
Dr. Gluck said that first of all, the association between morning sickness and decreased breast cancer risk is relatively weak. So here’s what the numbers mean: For the average 50 year old woman, the standard risk for developing breast cancer is about 2% (one in
50). According to this study, that same woman (if she had severe morning sickness at some point during pregnancy), is about 1.4% (~30%
less).
Dr. Gluck speculates (and this is quite fascinating) that women with morning sickness are subjected to a hormonal milieu that may result in permanent alterations in their breast tissue. The breast tissue (having been exposed to surges of hormones, insulin, and changing blood pressure and blood sugar levels) might be less vulnerable to the genetic mutations that cause cancer.
We’ve known for a long time that women who have children are at lower risk for breast cancer than women who don’t… now it seems that there might be something about women who are really sick when they’re pregnant and decreased risk of breast cancer as well.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
June 20th, 2007 by Dr. Val Jones in Expert Interviews
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There has been a lot of buzz about the new diet pill,
Alli (Orlistat). Gastro Girl and Dr. Val
decided to interview the incoming president of the American College
of Gastroenterology, Dr. Brian Fennerty, about the weight loss drug. He had lots of interesting things to say –
check out these 6 podcast links:
1. Who is a good candidate for Alli?
Answer
2. What should patients know about Alli?
Answer
3. What about oily stool?
Is that a worrisome side effect?
Answer
4. What about people with IBS?
Can they take Alli?
Answer
5. Is there a link between Alli and colon cancer?
Answer
6. What’s the bottom line about Alli?
Answer
Would you like to see more podcasts with experts on this blog? Let me know!
P.S. Want to see what another expert is saying about Alli? Check out James O. Hill, PhD’s blog post.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
