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In The News: Boosting Disease Prevention And Unethical TV Doctors

An article in the New York Times this week looks at a raft of new public health initiatives passed by Congress that are aimed at boosting disease prevention. Examples include requiring restaurants with at least 20 locations to include nutrition information on their menus and mandating employers with at least 50 employees to allow new mothers to express breast milk at work. In addition, Medicaid will now cover smoking cessation counseling for pregnant women and Medicare beneficiaries will be eligible for an annual physical. The initiatives are expected to eventually save money by decreasing the country’s chronic disease burden. (New York Times)

Researchers from Johns Hopkins University recently did a study applying physicians’ ethical codes to the conduct of the fictional doctors on “Grey’s Anatomy” and “House, M.D.” Perhaps to no one’s surprise, TV doctors are behaving very badly. As the abstract of the study states, both shows feature “egregious deviations from the norms of professionalism and contain exemplary depictions of professionalism to a much lesser degree.” (Philadelphia Inquirer, Journal of Medical Ethics)

*This blog post was originally published at ACP Internist*

Birth Control: How Men Think It Works

People, people, people: If you don’t understand how birth control works, you shouldn’t be having sex. What happened to the old days when the boyfriend was expected to sit through the video and conversation about all the types of birth control during the appointment at Planned Parenthood?

A friend sent me a link to the funniest video of men (trying to) explain how birth control works — it’s worth viewing for the laughs. These are all adult men who have some serious misconceptions about how birth control works, but “lady business” as a euphemism for vagina may become part of my vocabulary!

It’s no wonder that the United States has some of the highest rates of teen pregnancy and sexually transmitted infections — our youth are ignorant about how to prevent them. Please talk to your teens about birth control.

Remember that the teens who know the most about sexuality tend to be the ones who don’t have sex. How’s that for motivation to talk to your teens?

Photo credit: nateOne

This post, Birth Control: How Men Think It Works, was originally published on Healthine.com by Nancy Brown, Ph.D..

Vaginal Estrogen – When Less Is More

If there’s one thing I’ve learned over the years when it comes to medications, it’s this – more is not necessarily better. You can have too much of a good thing, and less can sometimes be more.

Certainly that’s been the mantra when it comes to hormone replacement in menopause. Since the WHI findings were released in 2002, we’ve all been going lower and lower with estrogen dosing, and finding that, for many women, it’s more than enough to treat the symptoms.

Now, a new low dose formulation of vaginal estrogen, Vagifem 10 ug, approved in Dec 2009, has hit the market. I have to say that I am thrilled to have this option for my patients.(I know, some of you are in shock that I would actually be talking favorably about a new drug, but hey, when they get it right, they get it right.) Read more »

*This blog post was originally published at The Blog that Ate Manhattan*

Are Claims-Based Alerts A Waste Of Time?

I got a letter from an insurer the other day, warning me that my patient, who had just refilled a prescription for a bisphosphonate I had prescribed almost a year ago for severe osteoporosis (yes, I do still prescribe dugs, despite how I feel about Big Pharma marketing), also had a claims diagnosis in their system for a bleeding peptic ulcer, and was I really sure she should be taking this medication, which could worsen her ulcer?

So do what any conscientious physician would do – I call her. (Of course, no one is ever home when I call these days, so it’s another few days of phone tag before I get her.) No, she has not been diagnosed with anything of the kind. Feels great, in fact. Read more »

*This blog post was originally published at The Blog that Ate Manhattan*

Fighting With Grape Juice In The Wee Hours

BEEEEEEEEEP!

Reaching for the alarm, but it’s not the clock.  Check the cell phone, but it’s not a text message.  Grope for the cat, but she’s not beeping, either.

BEEEEEEEEEP!

Oh yeah, how could I forget?

52 mg/dl.  Not too low, but apparently I’ve over-corrected with those basal changes I made two days ago, and I need to retweak just a little bit.

Wandered out to the kitchen, leaving the BEEEEEEP!ing behind in the bedroom, and also leaving the tube of glucose tabs resting on the bedside table untouched.  Make a beeline for the bottle of grape juice that sat, unopened, in the fridge. Read more »

*This blog post was originally published at Six Until Me.*

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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