Category: Diagnostic tests & procedures

Will Your Smartphone Become a Tricorder?

The Star Trek universe is a fairly optimistic vision of the future. It’s what we would like it to be – an adventure fueled by advanced technology. In the world of Star Trek technology makes life better and causes few problems. One of the most iconic examples of Star Trek technology is the medical tricorder. What doctor has not fantasized about walking...

/ May 15, 2013

Too Much Information!

Some people would like to manage their own health care without having to depend on a doctor. They consult Google, diagnose themselves, and treat themselves. The Do-It-Yourself trend in lab tests continues apace. Without a doctor’s order, patients can get legitimate and/or questionable lab tests directly from various companies such as Any Lab Test Now and Doctor’s Data (which has sued Stephen...

/ April 23, 2013

Once more into the screening breach: The New York Times did not kill your patient

One of the more depressing things about getting much more interested in the debate over how we should screen for common cancers, particularly breast and prostate cancer, is my increasing realization of just how little physicians themselves understand about the complexities involved in weighing the value of such tests. It’s become increasingly apparent to me that most physicians believe that early detection...

/ March 25, 2013

Nutrigenomics – Not Ready for Prime Time

Quackery in medicine takes many forms – use of bad science (pseudoscience), fraud, and reliance on mysticism are a few examples. Perhaps the most insidious form of dubious practice, however, is to use genuine and promising medical science to promote treatments that are simply not at the point of clinical application. New treatments, and especially new approaches to treatment, in medicine often...

/ January 2, 2013

A holiday round in the mammography debate

There are times when the best-laid blogging plans of mice and men often go awry, and this isn’t always a bad thing. As the day on which so many Americans indulge in mass consumption of tryptophan-laden meat in order to give thanks approached, I had tentatively planned on doing an update on Stanislaw Burzynski, given that he appears to have slithered away...

/ November 26, 2012

Clinical Practice Guidelines: Cholesterol Tests for Children?

The American Academy of Family Physicians journal American Family Physician (AFP) has a feature called Journal Club that I’ve mentioned before.  Three physicians examine a published article, critique it, discuss whether to believe it or not, and put it into perspective. In the September 15 issue  the journal club analyzed an article that critiqued the process for developing clinical practice guidelines. It discussed...

/ October 9, 2012

Mouse “avatars”: New predictors of response to chemotherapy?

Over the years, I’ve written a lot about “personalized medicine, mainly in the context of how the breakthroughs in genomic medicine and data pouring in from the Cancer Genome Atlas is providing the raw information necessary for developing truly personalized cancer therapy. The problem, of course, is analyzing it and figuring out how to apply it. Another problem, of course, is developing...

/ October 1, 2012

The mammography wars heat up again (2012 edition)

One issue that keeps coming up time and time again for me is the issue of screening for cancer. Because I’m primarily a breast cancer surgeon in my clinical life, that means mammography, although many of the same issues come up time and time again in discussions of using prostate-specific antigen (PSA) screening for prostate cancer. Over time, my position regarding how...

/ August 6, 2012
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Cancer care in the U.S. versus Europe: Is more necessarily better?

The U.S. is widely known to have the highest health care expenditures per capita in the world, and not just by a little, but by a lot. I’m not going to go into the reasons for this so much, other than to point out that how to rein in these costs has long been a flashpoint for debate. Indeed, most of the...

/ April 16, 2012
Simon & Garfunkel - Keep the Customer Satisfied

Keeping the customer satisfied

These days patient satisfaction is becoming more and more important in judging how well hospitals and physicians are doing. Indeed, Medicare reimbursements are linked in part to a patient satisfaction survey administered by the government. The underlying assumption is that patient satisfaction correlates with high quality care, But is that true? I have my doubts. Indeed, there is evidence that, at best,...

/ March 19, 2012