As far as my chemo nurse Olga* is concerned, I can do nothing right. She scolded me for sending an e-mail when she thought I should have called, and vice versa. She scolded me for going home before my next appointment was scheduled. She scolded me for asking to speak to her personally instead of whichever nurse was available. She scolded me for calling my oncologist directly. She scolded me for asking whether my clinical information and questions are shared between my oncologist and the staff of the chemo suite. I could go on … “Funny,” I think to myself. “If she had told me the ... Read More
Cutting Medicare Costs for Complex Patients
February 3, 2011 • By • Leave a Comment
For all the political chatter about fraud, waste and abuse, one big reason that Medicare costs so much is that old people get sick. And the relatively small group of patients, those with four or five chronic diseases, is particularly expensive; some researchers estimate these patients account for 75 to 80 percent of Medicare spending. In the current health care system, rife with duplication, fragmentation and off-kilter payment incentives, much of the care for the chronically ill elderly is not particularly coordinated, evidence-based or efficient. In recent years, health care innovators ... Read More
Your Next M.D. Might Be a PDA
January 18, 2011 • By • Leave a Comment
Your doctor has a hunch that your respiratory infection and fever are caused by bacteria (and should be treated with antibiotics), but it might instead be a simple virus, which should be allowed to run its course. Today, lab tests could take several days to complete, but in a couple of years a handheld device called an acoustic wave biosensor might sample a droplet of your saliva to reveal within seconds whether your doctor’s hunch was correct. Just three of these biosensors, developed by the University of New Mexico Health Sciences Center and Sandia National Laboratories, exist at the ... Read More
More Can Also Be Less in Medical Effectiveness
December 10, 2010 • By • Leave a Comment
When the public turns its attention to medical effectiveness research, as Miller-McCune.com did earlier this fall, ("For Dying Cancer Patients, Geography is Destiny") a discussion often follows about how this research might restrict access to new medical innovations. But this focus obscures the vital role that effectiveness research will play in evaluating current medical and surgical care. I am now slogging through chemotherapy for stomach cancer, probably the result of high doses of radiation for Hodgkin lymphoma in the early 1970s, which was the standard treatment until long-term side ... Read More
Uncovering Ancient Brews, and Cures
November 11, 2010 • By • Leave a Comment
When Patrick McGovern dons his Royal Purple latex gloves, the "Doctor Is In." But this doctor isn't working with live bodies; his "patients" are pottery sherds from ancient China, Egypt, Lebanon and even Honduras. Unlike traditional archaeologists who study the sherds themselves for what they can tell us of past civilizations, McGovern, scientific director of the Biomolecular Archaeology Laboratory at the University of Pennsylvania Museum in Philadelphia, is looking for evidence of organic material in these remnants of jars, goblets and bowls. "Most of what we are as humans is organic," ... Read More
Lifesaving Drug Praziquantel Too Expensive for Africa
October 3, 2010 • By • Leave a Comment
Sounding an alarm in a recent commentary in The Lancet, four British and American doctors say that shortages of the drug for schistosomiasis, a parasitic disease as widespread as malaria, have reached the proportions of a humanitarian crisis in Africa. Schistosomiasis has proved difficult to control for centuries; today, it kills about 300,000 people and afflicts more than 200 million yearly with chronic and severe anemia, abdominal pain, diarrhea, infertility and bladder cancer. It stunts children’s growth, affects their memory and IQ, and keeps them out of school. In women, ... Read More
Wind, Brass Instruments Linked to Airway Damage?
October 1, 2010 • By • Leave a Comment
For as supportive as my father was while I was growing up (coaching soccer, chauffeuring me to and from swim practice), he could never quite make it through an orchestral concert — comparing sounds of my elementary school ensemble to those of a dying cat. Indeed, steely resolve helps if your child is learning to play a musical instrument. With luck and enough endurance, years of unending honking might bear fruit as a game-day fight song, a night onstage at Carnegie Hall, or, in my case, the sonorous silence of music journalism. I thought I had heard the end of his disparagement when ... Read More
‘House,’ ‘Grey’s Anatomy’ Violate Codes of Conduct?
June 25, 2010 • By • Leave a Comment
Next time the brilliant Dr. House resuscitates a patient using a pair of tweezers, household twine and the foil from a chewing gum wrapper, you're right to be skeptical. Researchers at the Johns Hopkins Berman Institute of Bioethics analyzed a full season of two hugely popular medical shows — ABC's Grey's Anatomy and Fox's House — and discovered that the dramas were "rife" with incidents that violated professional codes of conduct. Analyzing the second seasons of the shows, researcher Matthew Czarny pinpointed 179 depictions of bioethical dilemmas, ranging from issues surrounding ... Read More
Rx for Humanitarian Relief
April 24, 2010 • By • 1 Comment
Two years ago, in the wake of Hurricane Katrina, Direct Relief International began stockpiling medical supplies annually at hospitals in the cyclone-prone countries of the Caribbean, including Haiti. “We made an educated guess and thought, ‘Let’s boost inventories.’ … It avoids the fog of disasters, which is like the fog of war,” said Thomas Tighe, president and CEO of Direct Relief, a nonprofit group that provides medical assistance in the United States and around the world. (Tighe is also a member of the editorial advisory board of Miller-McCune.) Chaos engulfed Haiti ... Read More
Convincing the Public to Accept New Medical Guidelines
April 20, 2010 • By • 9 Comments
They call it "vitamin I." Among runners of ultra-long-distance races, ibuprofen use is so common that when scientist David Nieman tried to study the drug's use at the Western States Endurance Run in California's Sierra Nevada mountains he could hardly find participants willing to run the grueling 100-mile race without it. Nieman, director of the Human Performance Lab at Appalachian State University, eventually did recruit the subjects he needed for the study, comparing pain and inflammation in runners who took ibuprofen during the race with those who didn't, and the results were ... Read More
