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The Relationships Between Poverty and Healthcare

Readers interested in the relationships between poverty and healthcare will want to read several new postings on the Web.

One is an article about my Rhoades Lecture at the Wayne County Medical Society in Detroit, “Poverty and Healthcare in America.” It is posted on the World Socialist Web Site.

Second is by James Marks, MD, MPH, Vice President of the Robert Wood Johnson Foundation, entitled “The Poor Feel Poorly.” It is posted on the Huffington Post site.

Third is “Health and Healthcare in America’s Poorest City,” a tragic and dramatic portrayal of America’s failures to its own in Detroit, also on the World Socialist Web Site.

Finally, here is a link to a collection of papers on social inequalities in health by the McArthur Network on SES and Health, published by the New York Academy of Medicine under the title, “Biology of Disadvantage.”

*This blog post was originally published at PHYSICIANS and HEALTH CARE REFORM Commentaries and Controversies*

Topical Medications And Bathing: A Source Of Water Pollution

I have written two posts in the past on proper disposal of unused medications, and I have always been mindful of the medicines as a source of environmental water pollution. This past week the American Chemical Society reminded (head-slapped me) that topical medications are a source of environmental water pollution from their active pharmaceutical ingredients (APIs). Yes, the simple act of bathing washes hormones, antibiotics, and other pharmaceuticals down the drain into the water supply.

Ilene Ruhoy, M.D., Ph.D. and colleague Christian Daughton, Ph.D. looked at potential alternative routes for the entry into the environment by way of bathing, showering, and laundering. These routes may be important for certain APIs found in medications that are applied topically to the skin — creams, lotions, ointments, gels, and skin patches. These APIs include steroids (such as cortisone and testosterone), acne medicine, antimicrobials, narcotics, and other substances. Read more »

*This blog post was originally published at Suture for a Living*

Is Healthcare A Right Or A Privilege?

Is healthcare a right or a privilege? Depending on how you view this determines how you feel about the recent healthcare reform which was signed by President Obama. As a doctor, I firmly believe that having healthcare is a right.

As a nation, we agree that individuals should be accountable for their actions. People often argue that those who are reckless with their bodies by ingesting chemicals via cigarettes or drug use and who subsequently develop cancers shouldn’t be subsidized by others’ insurance premiums as the latter group works hard at staying healthy by exercising, maintaining a healthy weight, and eating generous portions of fruits and vegetables. Some how it isn’t fair. Unfortunately, life and good health aren’t quite that easy or predictable. Read more »

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

“Am I Having A Heart Attack?” A New Self-Test Kit

Home-Heart-Attack-Self-Test-Kit“Am I having a heart attack?” From the files of the strange and unusual comes this self-test kit for myocardial infarction, otherwise known as a heart attack.

For the lay people out there, a heart attack occurs when bloodflow to the heart muscle stops, usually because of a blockage in the arteries around the heart (coronary arteries).  (It’s what happened to Bill Clinton, although his heart muscle didn’t die, as it likely had collateral bloodflow from other arteries.) When bloodflow stops, the heart muscle dies. When the heart muscle cells die, they release compounds into the bloodstream which can then be detected on blood draws.

That is the basis for detecting a heart attack by drawing blood. There are some compounds that are specific to the heart, such as troponins that will only go up when the heart muscle is dying. Other enzymes, such as the CK go up with any muscle damage, including the heart.

That is the basis of this new self-test kit for heart attack testing from China Sky One Medical that tries to answer the “Am I having a heart attack?” question at home. It was approved in China in 2007 and recently received European Union clearance as well. Read more »

*This blog post was originally published at The Happy Hospitalist*

Practice Medicine Or “Advise” For $3,000 A Day?

It’s very generous of Sanolfi-Aventis’s marketing department to make this offer for me to serve as an “advisor” for dronedarone (Multaq), but seriously–I was a bit skeptical that they wanted my “feedback on the reasons for and against utlilization of Multaq® in the appropriate patient as well as to understand communication and educational needs with regard to Multaq® and the atrial fibrillation state in general.”

Where were they when the drug launched? Might it be because this drug hasn’t quite been the blockbuster they’d hoped for?

But, of course, I’d never be swayed to use more of this drug by such important consulting work. No, really.

P.S. Sanolfi-Aventis marketers: Please update your prescriber database with my correct workplace.

Musings of a cardiologist and cardiac electrophysiologist.

*This blog post was originally published at Dr. Wes*

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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