Medicine and Pharmaceuticals

While I rarely admit it, I can be intensely competitive. When I heard about JAMA’s latest article, Comparison of Hospital Mortality and Readmission Rates for Medicare Patients Treated by Male vs. Female Physicians I dropped everything to read that article**. How could this be? I carefully searched the article (checking it twice) for a flaw, in methodology, results or conclusions. Finally I found a flawed assumption the authors made because, well frankly, the Center for Medicare and Medicaid Services (CMS) and the rest of us did too. Here is the problem:

“We assigned each hospitalization [and the consequent outcomes] to a physician …that accounted for the largest amount of Medicare...

Are you shocked by this news?  Me, not so much.  But, hats off to the Harvard research team and their new approach to tackling gender inequality in medicine by getting back to the basics:  Let the evidence speak for itself.  And, it does (to a certain extent).

Since all most people care about is who lives and dies or patient outcomes, why not study if the physician’s gender plays a critical role in the all-important realm of survival?

Ok, so for full disclosure, this article brings me joy.  For so many reasons.  On so many levels.  Mainly, for the chuckle and laughter I already have enjoyed in response to some reactionary, knee-jerk posts on social media and in person that range from dismissing the publication as another feminist attack that would never be granted in the...

Dr. Henry Heimlich, thoracic surgeon and creator of the famed maneuver that saves people from choking to death, died at the age of 96.  

In his own words, he best elucidates the profound nature of this triumph: 

“What makes the Heimlich Maneuver particularly special is this: it is accessible to everyone.  Because of its simplicity—and the fact that it works when performed correctly—just about anyone can save a life.  Each of us can save the life of a stranger, a neighbor, a spouse, or a child.  And it can happen anywhere—in restaurants, homes, ballparks—you name it.  You see, you don’t have to be a doctor to save a life.  You just have to have knowledge and the instinct to respond in a  crisis.”

...

It is a longstanding myth that suicides surge during the holiday season.  According to the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics, the suicide rate reaches its lowest of the year in the month of December.  

The Spring and Fall apparently reflect peak times— a rather consistent finding in recent years.  Regardless of this nuance, suicide is a major public health threat impacting all ages, careers and socioeconomic strata prompting a rippling devastation of families and communities throughout the calendar year.  

Spurred by the Germanwings Flight 4U 925 crash last year, the journal ...

Donald Trump. The Pharmaceutical Industry. If those terms two don't get you into a fight at a cocktail party, nothing will.

But, they need to be discussed, because there could be some big changes coming in both the manner and speed with which new drugs navigate the arduous US Food and Drug Administration pathway from lab bench to pharmacy.

Just one example to provide some context. Media have been making much of the fact that Jim O’Neill, a libertarian with a free-market mindset, has been floated as one possible candidate to head the FDA. Some of his prior statements are troubling but his philosophy could also be helpful, since he is "pro-biotech."

Either way, in talking about one even...

Finally, some worthwhile data.  

In our current culture —especially in the medical sphere, acquiring data for data’s sake has become its own illness whose insidious contagion serves further to fracture and fragment our health care delivery.  

Though I don’t routinely find good news in the topic of death, being the skeptical optimist that I am enables me to see the potential in a new study published in JAMA detailing the mortality rates for major causes of death from 1980-2014.  

Why the cheer?  Because the report is documenting United States county-level trends.  Recognize it is a tempered one, but cheer nonetheless.  Until we start to recognize that policy decisions and implementation...

Babies inside the womb, as they exit and once out into the world —especially if breastfed—are influenced to varying degrees by their mother’s exposures, albeit illicit or prescription drug intake, food ingestion or smoking, to name a few.  

If a pregnant mother is chronically using opioids, for example, then birth with subsequent severing of the umbilical cord enacts an abrupt cessation of the substance to the baby.  The result is a newborn in withdrawal.  This is called neonatal abstinence syndrome (NAS).  It can be mild or happen upon a wide array leading to severe.

A new research letter in JAMA Pediatrics...

There is an ever-growing body of evidence that reinforces the health benefits of animals.  The cardiovascular and mental health ones are known and well-documented.  

A new study published in BMC Psychiatry sought to explore the role pets had in support, self-management and personal networks of those suffering from long-term significant mental illness (e.g. bipolar disorder, schizophrenia).  It concluded “pets should be considered a main rather than a marginal source of support in the management of long-term mental health problems, and this has implications for the planning and delivery of mental health services.”

The qualitative research involved interviews of 54 individuals...

This is clearly the week of me being triggered, given I am no fan of the “trigger warning.” Inside-the-box thinking triggers me. Putting arbitrary limitations on human potential triggers me. Labels that attempt to stifle innovation or possibility trigger me.

Dr. Ben Carson, former Republican presidential candidate and pediatric neurosurgeon, was nominated by President-elect Donald Trump to be Secretary of Housing and Urban Development (HUD).

Immediately, a firestorm of political pushback ensued.

The following is part of Democratic Leader Nancy Pelosi’s statement regarding this decision:

“Dr. Ben Carson is a disconcerting and disturbingly unqualified choice to lead a department as complex and consequential as Housing and Urban Development. There is no...

Welcome to the conclusion of my two part series where I delve further into high altitude illnesses, prevention and management.  

In Part I, At High Altitude with Buzz Aldrin, I addressed the 86 year old American hero-moon-walking icon’s recent medical evacuation from the South Pole, my prior personal experience with him in Vail, Colorado and discussed my own bout with altitude sickness which mainly manifested as an intolerable headache.

As Dr. Aldrin recuperates in New Zealand, he issued this statement about his clinical course after arrival to Antarctica:  “I started to feel a bit short of breath so the staff decided to check my vitals.  After some examination they noticed congestion in my...