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Skin Cancer Where The Sun Don’t Shine

Not all skin cancers are from sun exposure. Viruses such as human papilloma virus (HPV), the virus that causes genital warts, also cause skin cancer. Skin cancer from HPV develops on genital skin in both men and women. It’s rarely talked about, but it’s important and can be deadly.

Did you know that half of all deaths from skin cancer other than melanoma are from genital skin cancer? You probably also didn’t know that women are more likely to die from genital skin cancer as they are from skin cancer that developed from sun exposure (again, excluding melanoma).

We dermatologists are inexhaustible when it comes to warning people about the dangers of sun exposure, but we should also be warning people about the dangers of genital warts. HPV protection, which includes HPV vaccines, is as important as sun protection in preventing death from non-melanoma skin cancer.

Genital warts can lead to deadly skin cancer. If your dermatologist has not checked your genital skin, be sure your primary care physician or gynecologist does. This is especially important, because unlike other sexually-transmitted diseases (STDs) which often have symptoms, HPV or genital warts often don’t. It may be embarrassing, but it could save your life.

*This blog post was originally published at The Dermatology Blog*

Medical Marketing: More Money Wasted

There was a series of ads on the radio awhile back that went something like this:

When Mrs. Willis had a stroke, her husband never slept alone. Her daughter never had to go dress shopping for the prom by herself. And her son didn’t have to sit out the Mother-Son dance at his wedding. Why? Because she came to Hospital A…and she didn’t die!

There’s another ad for one of the big downtown hospital’s cancer center (sorry, “advanced cancer center”):

Every cancer, every stage. Your life depends on it!

Let’s see: No one ever dies at Hospital A. And the big downtown cancer center can cure any cancer. That’s certainly what those ads would have you believe. Even the little local suburban hospitals have taken to advertising: Billboards around the neighborhoods, kiosks at the outlet malls, mainly pushing the lucrative stuff like cardiac care and bariatric surgery.

Every time I see this stuff, I can’t help but wonder how much it all must cost. And how much medical care could have been provided to the uninsured instead of enriching the ad execs and billboard owners who are already rolling in dough. Clearly there is still plenty of money to be made in the hospital business, because these people aren’t stupid. They wouldn’t spend this kind of money on marketing unless there was plenty more to be made from it. I believe it’s a little business concept known as “return on investment.” Read more »

*This blog post was originally published at Musings of a Dinosaur*

Newt Gingrich’s Take On Facebook Saving A Woman’s Life

I’ve seen at least half a dozen links to the op-ed coauthored by Newt Gingrich and neurosurgeon Kamal Thapar about how the doctor used information on Facebook to save a woman’s life. (It was published by AOL News. Really.)

In brief, a woman who had been to see a number of different health care providers without getting a clear diagnosis showed up in an emergency room, went into a coma and nearly died. She was saved by a doctor’s review of the detailed notes she kept about her symptoms, etc., which she posted on Facebook. The story is vague on the details, but apparently her son facilitated getting the doc access to her Facebook page, and the details posted there allowed him to diagnose and treat her condition. She recovered fully.

Newt and Dr. Thapar wax rhapsodic about how Facebook saved a life, and sing the praises of social media’s role in modern medicine. (I’m not sure how this really fits in with Newt’s stance on health reform, within his 12-step program to achieve the total replacement of the Left…but, hey, nobody has the patience these days for so many details anyway.)

Regular readers of HealthBlawg know that I would perhaps be the last to challenge the proposition that social media has a role to play in health care. However, I think Newt got it wrong here. Read more »

*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*

The Virtue Of Unnecessary Care

I case you didn’t hear the news, the American healthcare system is in financial crisis. One of the biggest culprits indicted in this crises is “unnecessary care,” with estimates ranging from $500 to $650 billion (total spending estimate is $2.6 trillion) going toward things labeled “unnecessary.” Personally I think this is an underestimate, as it doesn’t take into account the some big-ticket items:

  • Brand name drugs given when generics would do.
  • Antibiotics given for viral infections (and the additional cost due to reactions and resistance).
  • Unproven costly care considered “standard of care” (PSA testing, robotic surgery, coronary stents).
  • The unnecessarily high price of drugs.

One of the main reasons I am an advocate of EMR is to measure and analyze care, eliminating that which is wasteful, futile, or even harmful. The biggest burden on our system is not the fact that we have a hyper-complex payment system that hides the true cost of care. The biggest burden is the wasteful care that this system agrees to pay for. In fact, I suspect that the main reason our system has become hyper-complex and covert in its spending is to hide this waste from prying eyes.

It sounds easy: Just eliminate costly unnecessary care and save the system. While you are at it, why not bring world peace, eliminate poverty, and make a detergent that cleans, softens, and deodorizes all at once? Read more »

*This blog post was originally published at Musings of a Distractible Mind*

New Food Allergy Guidelines

Walnuts and peanuts by viZZZual.com via FlickrThe National Institute of Allergy and Infectious Diseases (NIAID) issued comprehensive food allergy guidelines to help primary care physicians and subspecialists diagnose and manage patients.

The guidelines were published online at the NIAID food allergy guidelines portal, which also has a frequently asked questions section. The agency will release a patient synopsis early next year.

The guidelines establish consistent terminology and definitions, diagnostic criteria and patient management practices. Additional topics covered by the guidelines include the prevalence of food allergy and management of acute allergic reactions to food, including anaphylaxis. The report also identifies gaps about what is known about food allergy.

NIAID Director Anthony S. Fauci, MACP, said, “Because these guidelines provide standardized, concise recommendations on how to diagnose and manage food allergy and treat acute food allergy reactions across specialties, we expect both clinicians and food allergy patients to greatly benefit from these clear state-of-the-science clinical standards.” Read more »

*This blog post was originally published at ACP Internist*

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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