Acupuncture or fake acupuncture?

acupuncture 040608This Respectful Insolence blog post reports on yet another in an increasingly long line of medical studies that demonstrate that acupuncture is nothing more than an elaborate and fancy placebo. In this particular study involving patients in "true" acupuncture and "fake" acupuncture protocols, patients in the sham acupuncture group improved more than patients in the "true" acupuncture group.

My conclusion? On one hand, if you stick pins in people who are complaining about something, then some of them will eventually quit complaining. On the other hand, if you take pins out of some people who were previously complaining, then some of them will also stop complaining.

Thinking about schizophrenia

schizophrenia

Two recent NY Times article regarding the vexing nature of schizophrenia, one sad, one hopeful. Let’s all hope for more of the latter.

An emerging risk of youth sports

ACL%20injury.jpgAs youth sports become increasingly specialized, a family from The Woodlands is the subject of this Gina Kolata/NY Times article on one of the big risks to children of that trend — increased torn anterior cruciate ligaments (“ACL”), the main ligament that stabilizes the knee joint:

The standard and effective treatment for such an injury in adults is surgery. But the operation poses a greater risk for children and adolescents who have not finished growing because it involves drilling into a growth plate, an area of still-developing tissue at the end of the leg bone.
Although there are no complete or official numbers, orthopedists at leading medical centers estimate that several thousand children and young adolescents are getting A.C.L. tears each year, with the number being diagnosed soaring recently. Some centers that used to see only a few such cases a year are now seeing several each week.

A friend of mine and I were discussing last week how unfortunate it is that most children these days depend on their parents to organize athletic activities for them rather than simply playing sports informally with neighborhood friends. Increased specialization is the natural evolution of organized sports, which means more games, more practice and more pressure on growing muscles, joints and bones. Not a particularly healthy risk in my book.

WinkingSkull.com

WinkingSkull.com.jpgCheck out WinkingSkull.com, a worthy counterpart to the Visual Medical Dictionary (noted earlier here) in better understanding anatomy and medical conditions.
Along those lines, did you know that “the bacteria count in the plaque on human teeth approaches the bacteria count in human feces?” (H/T Kevin, MD)
Still biting those fingernails? ;^)

Arnold Kling’s Medicare experience

Arnold%20Kling%20013008.jpgAs I’ve noted many times, EconLog’s Arnold Kling is doing some of the best writing and thinking about health care and health care finance issues in the U.S. right now. In his latest TCS op-ed, Kling describes the care received recently by his elderly father (who sounds as if he should have been a patient of my late father) and observes:

Medicare is wonderful for relieving the elderly from the burden of worrying about health care expenses. By the same token, it is wonderful for relieving doctors of the burden of worrying about the elderly as customers. You get paid for understanding the billing system, not for understanding your patients.

Read the entire op-ed. An update post is here.

The vanishing primary care physicians

primary%20care.jpgThis earlier post on my internist’s decision to adopt a concierge health care model for his practice noted that the economic crisis faced by most primary care physicians was one of the primary reasons for the change in his practice. In this recent post, Kevin Pho passes along the story of yet another internist hanging up the stethoscope as a result of not being able to make ends meet within the frazzled U.S. health care finance system:

“I am an Internist for over 20 years, and I recently closed my primary care practice as I cannot make a living at it. I made $23K in the last 11 months. And, my departure from practice is only the beginning of a tsunami of closures of primary care practices . . .
Primary care is unraveling around us. Indeed, all of the articles about the inordinate strain & crowding of emergency departments across the U.S., overlook the obvious – the impending failure of primary care is going to completely overwhelm emergency rooms. There is no way to prepare for this other than to save primary care.
The whole house of cards has begun to collapse, and all the articles and discussions fail to put it in terms with sufficient emphasis. All of the ‘universal’ systems that actually work are built on very strong and well-funded foundations of primary care. Everything else in health care is built upon that foundation, and that is precisely what is failing across the country. Why are emergency rooms overcrowded? Why are the wait times increasing even for the seriously ill? Because primary care is failing!
Just remember, I told you so.”

And here is another primary care physician’s analysis of why he turned to the concierge model.

The fascinating “Flea”

Lindeman-759645.jpgEric Turkewitz interviews Dr. Robert Lindeman, the Boston-based pediatrician who caused quite a stir last year when the Boston Globe broke the story that he was the anonymous blogger nicknamed “Flea” who was blogging a medical malpractice trial while participating as a defendant. One of Dr. Lindeman’s answers even has a Houston twist:

A hypothetical question: You’ve been called for jury duty and the case involves a question of medical malpractice. What will you tell the attorneys during the jury selection process about your ability to sit impartially?
Answer: “I will tell them that Roger Clemens will admit to using performance-enhancing drugs before I will able to sit impartially on a malpractice jury.”

America’s worst 20 fast food items

carls%20hamburger.jpgMost folks can get by quite well with eating less than 2,000 calories per day. Each of these food items pretty well gets you there.
Caramel Banana Pecan Cream Stacked and Stuffed hotcakes?
By the way, just to show that you can find almost anything on the Web, The Healthy Dining Finder can help you pick healthier choices from standard restaurant menus by eliminating high-calorie add-ons.

No sympathy

question%20mark.jpgThis NY Times article from the other day reports on the increasing numbers of lawyers and doctors who are plagued by self-doubt (who’d have ever thought that?). Mr. Juggles over at Long & Short Capital has no sympathy:

To the lawyers:
In case the Neiman Marcus purchases succeeded in lifting your morale and left you with the impression that what you did counted for something, please let me add some critical information: It doesnít. This is why you are paid, on an hourly-adjusted basis, like a recent (2nd tier) college graduate.
To the doctors:
The fact that I was able to diagnose my own illness after 15 min on WebMD speaks to the value of your knowledge. Perhaps our relationship would be more productive if you would stop making me wait 3 days for an appointment (and 90 minutes once I get to the office) to diagnose a sinus infection that I already know I have. Give me the antibiotics without the self-importance. I will come see you again when I have something you can actually be helpful with. For instance, after I break my arm trying to carry my bonus home, I will come see you and you can set the cast. Until then, please stop whining.