Category: Science and Medicine
The Future of Medicine
Eric Topol, MD, has written a book about the convergence of the digital revolution and medicine. It is full of fascinating information and prognostication, but I wish he had given it a better title. He called it The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care. Medicine will not and cannot be “destroyed.” It will be improved...
Low-Back Pain: Causes, Care, and Consequences
Low-back problems are one of the most common reasons for visits to doctors’ offices and the most common cause of disability among persons under the age of forty five. Most of the time, acute low-back pain is the result of simple strain and is a self-limiting condition that will resolve in four to six weeks, with or without treatment. But since back...
Drinking from the Fire Hose: Odds and Ends on the Gasping Oppression aka influenza
I spend most of my time taking care of hospitalized patients with acute infections and issues of public health are, outside of infection control, not a high priority. Vaccinations in training were always like clean water and fresh food: their benefit was a given and I never needed to consider the benefits and subtleties of vaccination. There is just so much time...
Are Cell Phones a Possible Carcinogen? An Update on the IARC Report
EDITOR’S NOTE: Because I am at the annual meeting of the American Association for Cancer Research in Chicago, between the meetings, working on a policy statement, working on a manuscript, and various other miscellaneous tasks, I alas was unable to produce a post worthy of the quality normally expected by SBM readers. Fortunately, Lorne Trottier, who’s done a great job for us...
Lying for the State
Quacks lie. In some ways, that’s what separates us from them. Real doctors are stuck with the messy truth: with bad news, with uncertain outcomes. It’s this reliance on the truth which gives us much of our credibility. Laws forcing doctors to lie to patients take me back to reading Kundera in the 80s; the hovering fear that everyday actions might bring...
The Species in the Feces: Probiotics and the Microbiome
I do not understand the interest many appear to have in their bowels and the movement there of. But then, I pay little attention to most of my body functions as long they are functioning within reasonable parameters, and as I get older the definition of reasonable is increasingly flexible. The elderly especially seem to obsess about their bowels. My theory is...
How to Choose a Doctor
From an e-mail I received: As a proponent of SBM, and a someone who places a high value on reason, logic and evidence, I would like to find a physician who shares this mindset. He went on to ask how he could go about finding one. Another correspondent was referred to a surgeon by her primary physician, and the surgeon inspired confidence...
Adherence: The difference between what is, and what ought to be
One of the most interesting aspects of working as a community-based pharmacist is the insight you gain into the actual effectiveness of the different health interventions. You can see the most elaborate medication regimens developed, and then see what happens when the “rubber really hits the road”: when patients are expected to manage their own treatment plan. Not only do we get...
The Application of Science
It all seemed so easy In 2010 an article was published in the New England Journal of Medicine, Preventing Surgical-Site Infections in Nasal Carriers of Staphylococcus aureus . Patients were screened for Staphylcoccus aureus ( including MRSA, methicillin resistant Staphylococcus aureus) and those that were positive underwent a 5 day perioperative decontamination procedure with chlorhexidine baths and an antibiotic, mupirocin, in the...
When To See a Doctor
Two weeks ago I wrote about the demise of the traditional annual physical for healthy adults who have no symptoms. The First Step: Identifying a Symptom People who do have symptoms should see a doctor. They should have appropriate evaluations that may or may not include a partial or complete physical exam. One problem is that people may not be able to decide...