The American Medical Student Association: On “integrating” quackery with science-based medicine

There’s a saying in medicine that we frequently hear when a newer, more effective therapy supplants an older therapy or an existing therapy is shown not to be as efficacious as was once thought, and it has to do about how long it takes for the use of that therapy to decline. The saying basically says that the therapy won’t die out...

/ October 22, 2012
Do not use this to try to boost your immune system.

More Boosting the Immune System

Topics, as I noted a fortnight ago in my uniquely misspelled and ungrammatical way, never die.* Or even fade away. There are popular ideas that persist in the world that have little to do with reality. In the reality based world of medicine there are concepts that refuse to die. Atelectasis causing fever or the need to ‘double cover’ Pseudomonas. Neither are...

/ October 19, 2012

Obamacare and CAM III: Great Expectations

In a previous post, we looked at how so-called “complementary and alternative medicine” (or “CAM”) might fit into the definition of “essential health benefits,” which must be covered by insurers pursuant to the Patient Protection and Affordable Care Act (“Obamacare,” or the “ACA”). In another, we contemplated what it might mean for insurers to “discriminate” against CAM providers, which is prohibited by...

/ October 18, 2012

A PANDAS Story

One of the skills I try to teach medical students on their journey to becoming experience clinicians is to consider and address the patient’s “narrative.” Patients have a certain understanding of their illness, its cause, and its role in their life. They make sense of their situation as best as they can, resulting in a story they tell themselves. This is how...

/ October 17, 2012
A_Recruit_Joins_the_British_Army_H17180

Sports Physicals, Sudden Death, and Chiropractors

Sports physicals could prevent cases of sudden cardiac death in children, but could be improved even more. What won't improve things is letting a chiropractor do it.

/ October 16, 2012

Mortality and lack of health insurance

The 2012 election campaign is in full swing, and, for better or worse, health care is one of the major defining issues of the election. How can it not be, given the passage of the Patient Protection and Affordable Care Act (PPACA), also colloquially known as “Obamacare,” was one of the Obama administration’s major accomplishments and arguably the largest remaking of the...

/ October 15, 2012

Chinese Systematic Reviews of Acupuncture

I’ll begin with the possibly shocking admission that I’m a strong supporter of the collection of ideas and techniques known as evidence-based medicine (EBM). I’m even the current President of the Evidence-Based Veterinary Medicine Association (EBVMA). This may seem a bit heretical in this context, since EBM  takes a lot of heat in this blog. But as Dr. Atwood has said, “we...

/ October 12, 2012
Obverse_of_$100_banknote,_Canada_1954_Series,_-Devil's_Head-_printing

Don’t call CAM “cost-effective” unless it’s actually effective

Before deciding CAM is cost-effective, it is important to determine if is just effective. That low bar has not been surmounted.

/ October 11, 2012

More HIV Nonsense in Africa

It is estimated that 5% of people living in Sub-Saharan Africa are infected with HIV – that’s 22.5 million people. Infection rates vary wildly from country to country, with Swaziland having the highest rate at 25.9%. Gambia is below average, at 2% or 18 thousand people, but still has a serious HIV problem, and now finds themselves at the center of the...

/ October 10, 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