July 15th, 2010 by David H. Gorski, M.D., Ph.D. in Better Health Network, Health Policy, News, Opinion, Quackery Exposed, Research, True Stories
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There’s been a bit of buzz in the health blogs over President Obama’s decision last week to use the mechanism of a recess appointment to be the director of the Centers for Medicare and Medicaid Services (CMS).
Recess appointments, for those who may not be aware, allow a President to put a nominee in place when Congress is in recess in order to have him in place without the messy process of having him approved by the Senate. True, the Senate still has to approve a recess appointment by the end of its term, or the seat goes vacant again, but it’s an excellent way to avoid having nasty confirmation fights during election years. Of course, both parties do it, and the reaction of pundits, bloggers, and politicians tend to fall strictly along partisan lines.
If you support the President, then a recess appointment is a way to get around the obstructionism of the other party. If you don’t support the President, it’s a horrific abuse of Presidential power. And so it goes. Either way, I don’t really care much about the politics of how such officials are appointed so much as who is being appointed.
The man who was appointed last week to head CMS is Donald Berwick, M.D., CEO of the Institute for Healthcare Improvement. His being placed in charge of CMS will likely have profound consequences not just for how the recent health care/insurance reform law is implemented, but for how the government applies science-based medicine to the administration of the this massive bill. Read more »
*This blog post was originally published at Science-Based Medicine*
July 8th, 2010 by Mark Crislip, M.D. in Better Health Network, Health Policy, News, Opinion, Quackery Exposed, Research
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Some universities have more cachet than others. On the West Coast it’s Stanford that has the reputation as the best. Then there’s Oxford, Yale, and MIT. I would wager that in most people’s minds the creme de la creme is Harvard, where you find the best of the best. If Harvard is involved, a project gains an extra gobbet of credibility. Brigham and Women’s Hospital also has similar reputation in U.S. as one the hospitals associated with only Harvard and the New England Journal of Medicine (NEJM) — premier university, premier hospital, premier journal.
So if Harvard Medical School and Brigham and Women’s Hospital are offering continuing medical education (CME) for acupuncture, there must be something to it, right? A course called “Structural Acupuncture for Physicians” must have some validity. Read more »
*This blog post was originally published at Science-Based Medicine*
July 8th, 2010 by Steve Novella, M.D. in Better Health Network, Health Policy, News, Opinion, Quackery Exposed, Research
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Mark Hyman, a proponent of so-called “functional medicine” promoting himself over at the Huffington Post (an online news source that essentially allows dubious medical infomercials to pass as news) has posted a particularly egregious article on personalized medicine for dementia.
In the article Hyman distorts the modern practice of medicine, the current state of genetic science, and the very notion of “disease.” It is, as usual, a fine piece of medical propaganda sure to confuse many a reader. Hyman starts with some standard epidemiology of dementia –- it’s a common and growing disorder –- but then descends quickly into distortion and pseudoscience. Read more »
*This blog post was originally published at Science-Based Medicine*
July 1st, 2010 by David H. Gorski, M.D., Ph.D. in Better Health Network, Health Policy, Health Tips, News, Opinion, Quackery Exposed, Research
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On “wholistic” medicine
If there’s one aspect of so-called “alternative medicine” and “complementary and alternative medicine” (CAM) is that its practitioners tout as being a huge advantage over what they often refer to sneeringly as “conventional” or “scientific” medicine is that–or so its practitioners claim–alt-med treats the “whole patient,” that it’s “wholistic” in a way that the evil reductionist “Western” science-based medicine can’t be.
Supposedly, we reductionistic, unimaginative physicians only focus on disease and ignore the “whole patient.” Of course, to me this claim is belied by the hectoring to which my own primary care physician has subjected me about my horrible diet and lack of exercise on pretty much every visit I’ve had with her, but then maybe she’s an anomaly, along with Dr. Lipson on this very blog and pretty much every other primary care doctor I’ve ever dealt with. Anecdotal experience, I know, but since alt-med mavens appear to value anecdotal evidence above pretty much all else I thought it appropriate to mention here. Read more »
*This blog post was originally published at Science-Based Medicine*
June 24th, 2010 by Edwin Leap, M.D. in Better Health Network, Health Policy, Opinion, Research, True Stories
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Every day in the emergency department I am confronted by pain. In fact, the treatment of pain is one of the most important skills emergency physicians, indeed all physicians, possess.
For instance, I recently cared for a child with sickle cell disease who was having a pain crisis which involved severe leg pain. His life is one of frequent, intense pain. I gently, and repeatedly, treated his pain with morphine until he had relief. I see hip fractures; all broken bones hurt. I am thrilled to alleviate that discomfort. Pain is one of the things I can fix, if only temporarily. It makes me happy to see the relaxed face of a man or woman with a kidney stone or migraine, who suddenly smiles and says “thanks!”
But pain is also the source of so much subterfuge. Emergency department are full of individuals who use controlled substances for recreation. I know because they have pain that is entirely unverifiable. They have terrible right flank pain with no gall-bladder, no pancreatitis, no kidney stone (documented by CT), no pneumonia or rash. They have nothing to cause the pain. And yet, dose after dose of narcotic later, snoring in their ER stretcher, they look up at me with hazy eyes and say, thickly, “Cann I gettt somethinn elsss for paaiin…it hurtssss so…bad. zzzz. Itzzz a tennn.”
So I began to wonder about science and the pain scale. Read more »
*This blog post was originally published at edwinleap.com*
