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How A Gynecologist Thinks About Lung Cancer

Out of the Shadows: Women and Lung CancerA new report on lung cancer in women has been published by the Women’s Health Policy and Advocacy Program at Brigham and Women’s Hospital.

Called “Out of the Shadows,” the report seeks to raise awareness about lung cancer, currently the leading cause of cancer death in women, and more importantly, to increase funding for research for its prevention, detection and treatment. (Thanks to Booster Shots, the LA Times‘ fabulous health blog, for highlighting the report.) I encourage you to read the report, which is well written and comprehensive. Read more »

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

10 Things You Didn’t Know About The Healthcare Reform Bill

The healthcare reform bill is 1,017 pages long and contains a lot that will impact Americans. I’m one who believes we had to come into the 21st century and join the rest of the civilized nations in beginning to provide healthcare to all citizens. You be the judge.

Here are 10 things I bet you didn’t know are in the new healthcare reform bill:

  1. Menu labeling. Restaurants with over 20 employees must include calorie counts and other nutrition information on their menus.
  2. SWAG reporting. Doctors must report valuable goodies they receive from health vendors.
  3. Right to pump. New moms must be given space and time to pump breast milk (for employers with over 50 employees).
  4. Research. The bill includes research for postpartum depression.
  5. Tan tax. There’s a 10 percent tax on tanning booths.
  6. Adoption credit. Adoptive parents receive tax credits to encourage adoption.
  7. More research. The bill includes research for Indian health studies.
  8. Safety. The bill includes required background checks for long-term care workers.
  9. Right wing. The bill includes required abstinence education.
  10.  Transparency. Employers must show employer and employee contributions for healthcare on W-2 forms.

Fox News (“fair and balanced”) has said that it’s “what you don’t know that can hurt you.” Fox also said that “42 percent of doctors said they would quit or retire if healthcare reform became law.” It’s time to stop the fear mongering, lies and deception and understand just what this reform will and won’t do for the American public.

*This blog post was originally published at EverythingHealth*

Science-Based Medicine: Why It’s Difficult To Research Surgery

One of the things about science-based medicine that makes it so fascinating is that it encompasses such a wide variety of modalities that it takes a similarly wide variety of science and scientific techniques to investigate various diseases. Some medical disciplines consist of mainly of problems that are relatively straightforward to study. Don’t get me wrong, though. By “straightforward” I don’t mean that they’re easy, simply that the experimental design of a clinical trial to test a treatment is fairly easily encompassed by the paradigm of randomized clinical trials.

Medical oncology is just one example, where new drugs can be tested in randomized, double-blinded trials against or in addition to the standard of care without having to account for many difficulties that arise from difficulties blinding. We’ve discussed such difficulties before, for instance, in the context of constructing adequate placebos for acupuncture trials.

Indeed, this topic is critical to the application of science-based medicine to various “complementary and alternative medicine” modalities, which do not as easily lend themselves to randomized double-blind placebo-controlled trials, although I would hasten to point out that, just because it can be very difficult to do such trials is not an excuse for not doing them. The development of various “sham acupuncture” controls, one of which consisted even of just twirling a toothpick gently poked onto the skin, shows that.

One area of medicine where it is difficult to construct randomized controlled trials is surgery. The reasons are multiple. Read more »

*This blog post was originally published at Science-Based Medicine*

Sir James Black (1924-2010): The Father Of Analytical Pharmacology

Sir James Black - David Levenson Rex Features.jpgHave you ever taken an over-the-counter heartburn relief remedy such as Tagamet, Zantac, or Pepcid? How about the beta-blocker atenolol (Tenormin) or metoprolol (Lopressor) for antihypertensive therapy, or the original less-selective beta-blocker propranolol (Inderal) for migraines, presentation anxiety, or stage fright?

If you answered “yes” to either question, you owe a debt of gratitude to Sir James Black, the Scottish physician who left us earlier this week at age 85. The best obituary I have seen memorializing Sir James comes from the UK Telegraph.

Black was called the father of analytical pharmacology and was said to have relieved more human suffering than thousands of doctors could have done in careers spent at the bedside. Certainly, no man on earth earned more for the international pharmaceutical industry. Read more »

*This blog post was originally published at Terra Sigillata*

CAM vs. Traditional Medicine: Handle With Scientific Care

Here’s some advice I have given teenage boys who are going toe-to-toe with their mothers about a health issue:

Don’t go toe-to-toe with your mother; it’s a no-win situation.  Either you are right, and you are looked at as a “smarty-pants” or you are wrong, and have given her a huge “I told you so.”  If, on the other hand, you keep quiet and listen to what she’s saying, it’s a win-win: either she’s right and you learn something, or she’s wrong, and you have been vindicated.

Fathers often pipe in that this applies to wives as well.  Mom’s don’t seem to disagree (for some mysterious reason).

While this may be sound relational advice, it also needs to be heeded by the medical community in its relationship to “complimentary and alternative medicine” or CAM.  I am not saying we shouldn’t be angry and frustrated with the CAM purveyors who are harming and even killing people (such as the anti-vaccine movement).  I am not saying that we should embrace CAM and put it at anywhere near equal footing with our profession.  What I am saying is that in our enthusiasm to win the argument, we can undermine our own credibility. Read more »

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

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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