DOCTOR PUNDIT » Holistic Medicine

When Patient Activism Becomes Problematic for Physicians

Michael Douglas, MD, MBA — Mon, 12 Apr 2010 13:31:21 +0000

The battlelines are drawn in the latest medicolegal war which tests how far patient activism can go when the patient asks for, rather demands, a particular treatment regimen unproven in the pantheon of well-studied and documented clinical medicine. The treatment of Lyme disease, an infectious disorder in which the deer tick (found in abundance here in Minnesota) acts as a vector of transmission, is under fire from patient activist groups who say that they aren’t being treated effectively for the disorder’s possible long-term effects, which can be disabling.

Pity the role of infectious disease experts who are often called upon to consult and produce national guidelines based upon sound medical and clinical research. These intrepid physicians now have to navigate and overcome the legislative process which appears to be siding with patients who feel as though they are being maltreated. In Minnesota, the state medical board (which regulates, disciplines, and licenses physicians) has had to initiate a moratorium against actions that may arise out of patient complaints with respect to the treatment of Lyme disease. Elsewhere, activist groups are gaining steam and appear to be influencing its evaluation, classification, and treatment^[1] without the involvement of physician specialists and experts…and with the support of lawmakers. | LINK

which often involves the unproven use of chronic antibiotics, for a year or more..

NEJM Study Highlights Daily Administrative Hassles of Primary Care Physicians A study out this week [PDF] in the NEJM highlights...
Academic Physician Resigns from Board Amid Problematic Ties to Device Company Amid the brouhaha over a congressional probe into over $1...
AMA Cries Foul over Insurers’ Utilization of Quality Parameters to Maximize Efficiency In a reform environment in which appearances are everything, providers...

Monday Newswire: Physicians Humanitarian Group Kidnapped in Somalia & More

Michael Douglas, MD, MBA — Mon, 20 Apr 2009 11:09:31 +0000

Somali gunmen kidnap Doctors Without Borders workers.

Another elder in the region was hopeful the kidnapping could be resolved quickly. “We are hopeful that the gunmen will release the aid workers peacefully, soon after our negotiations come to an end today,” Edin Malag said. Kidnappings of foreign aid workers and journalists by ransom-seeking armed groups are frequent in conflict-wracked Somalia. UN agencies attempting to deliver food aid to the 3.25 million Somalis it estimates need humanitarian support have been repeatedly targeted.

New fund promises low-cost anti-malaria treatment.
What happens when COBRA coverage is terminated without warning?
Times are tough for some (Shriners) hospitals.
Three Vet. Administration hospital patients test positive after exposure to non-sterilized clinic equipment.

Unemployed Workers Feel Extreme Burden of Maintaining Previous Employer Coverage Unemployment carries with it all of the mystery of Pandora’s...
Monday Newswire: MN’s First Influenza-A Case & More NY state recoups over half a billion dollars in amounts...
Monday Newswire: Popular Anti-Seizure Drug Goes Generic & More Popular anticonvulsant (with a multitude of off-label pain uses) gains...

Conflicting “Studies” on the Effects of Caffeine

Michael Douglas, MD, MBA — Fri, 16 Jan 2009 17:36:23 +0000

One of the harmful by-products of an always-on, twenty-four hour Internet world is the sheer preponderance of conflicting information. Behind the need to know about things is the drive to find out exactly what is true and what constitutes sheer fallacy. The implications for the savvy, Web surfing 21st century healthcare consumer increase the burden of assimilating information on both of these levels.

So, with that in mind, consider what researchers are saying about the beneficial effects of caffeine on heading off dementia; as opposed to what other researchers are saying about the harmful effect on mental status in those who imbibe too much of that black nectar we call coffee.

Study: Authors Attempt to Characterize Dementia As a Terminal Illness In the upcoming NEJM, a large prospective study makes the...
Is There a Link Between Coffee Consumption in Women and Possible Lower Stroke Risk? The news out of Javaland continues to extol the benefits...
A Possible Link Between Anti-Oxidant Effects of Caffeine and Reversal of Symptoms of Dementia Should patients with cognitive impairment be given caffeine supplements to...

In Quitting Smoking, a Lesson from the President-Elect

Michael Douglas, MD, MBA — Mon, 29 Dec 2008 11:21:37 +0000

What motivation do, um, motivated smokers have in their arsenal to kick the habit? They need look no further than the efforts of the President (-Elect) of the United States, Barack Obama.

He told Tom Brokaw of NBC several weeks ago, for example, that he “had stopped” but that “there are times where I’ve fallen off the wagon.” He promised to obey the no-smoking rules in the White House, but whether that meant he would be ducking out the back door for a smoke is not known. His transition team declined to answer any questions about his smoking, past or present, or his efforts to quit.Antismoking activists would love to see him use his bully pulpit to inspire others to join him in trying to kick the habit, but he has not yet taken up their cause.

An interesting history of those Commanders-In-Chief who were defined, in part, by the stogies they nursed, in the NYT.

WP: To Reorganize Health Reform Goals, Obama Needs to Learn from His Historic Run for President History often repeats itself, and in the world of President...
President Barack Obama: It’s in the Numbers Are you into numerology? Yep, me neither. But you’ve got...
Time Magazine’s Person of The Year 2008: President-Elect Barack Obama TIME's Obama Cover Says Time: “[I]f he has shown anything...

New Inhalers for Asthma Patients to (Formally) Debut

Michael Douglas, MD, MBA — Sun, 28 Dec 2008 19:22:22 +0000

With the clock ticking ever so quickly toward Jan. 1, asthma sufferers will no doubt try to make a run for the border to get refill scripts on their inhalers. Because, effective that date, metered dosed inhalers must go green:

“It’s possible people may skimp on their medicine because of the cost,” said Dr. Bradley A. Becker, co-director of the Asthma Center for Children at Cardinal Glennon Children’s Medical Center in St. Louis. “Clearly that would not be a good strategy because you might end up in the emergency room.”

Many doctors have been prescribing the new inhalers for several months, helping their patients transition to the devices, which use the more environmentally friendly propellant hydrofluoralkane (HFA) and deliver the quick-relief drug albuterol.

Some physicians and pharmacists, however, say they wouldn’t be surprised to see patients rush to snag up the old inhalers, which utilize harmful chlorofluorocarbon as a propellant. The last day for the old inhalers to be sold is Wednesday.

Seems a little late for environmental concerns, don’t you think?

FDA Scientists Balk at Organizational Undermining at the Hands of DC Politics The Food & Drug Administration is a scientific government organ,...
International-Flavored Medical Reference Makes Online Debut The three-volume Oxford Textbook of Medicine, coming in at a...
FDA Considers Fate of Two Anti-Asthma Drugs Initially, this story wasn’t gaining much traction, but as the...

Survey: More Than a Third of Patients Use Alternative Medicines

Michael Douglas, MD, MBA — Thu, 11 Dec 2008 15:39:29 +0000

As a nation of healthcare consumers, as opposed to “patients”, advocates on both sides of the healthcare delivery equation talk about giving choice to the patient as consumer so that the responsibility of maintaining one’s health is as much the patient’s as it is the provider’s. Given the dire short term outlook of the economy, patients may not even be in that position to make a healthcare choice, as their coverage will more than likely be lost with their jobs. For many, the only “choice” for health maintenance will involve turning to complementary or alternative medications. | LINK

New Inhalers for Asthma Patients to (Formally) Debut With the clock ticking ever so quickly toward Jan. 1,...
House Approves Affordable Healthcare Options for the Unemployed Freshly laid off and unemployed? Have no fear. It will become...
UK Study: Drugs Used in Alzheimer Patients Double Risk of Mortality What should I do as a physician rounding on one...