A new study just published suggests that the meditative exercise practice of tai chi reduces the pain and chronic fatigue experienced by fibromyalgia patients. The leader of the study Dr. Chenchen Wang comments.
Tai Chi Found To Improve Fibromyalgia Symptoms
August 19th, 2010Patient Matt Freking Becomes Catatonic With Love
August 18th, 2010Patient Matt Freking suffers from narcolepsy with cataplexy and becomes paralyzed whenever he sees or experiences the feelings or sensations of love.Sleep specialist Carol Ash discusses this bizarre condition.
Jan Henderson, PhD – Medical Historian and Blogger (Part 2 of 3)
August 18th, 2010Jan Henderson, PhD, is a Harvard-trained mathematician and Yale-trained medical historian. She shares some of her thinking about healthcare in America in the second part of a three-part interview below.
Which medical journals do you read regularly?
I read the New England Journal of Medicine and the Journal of the American Medical Association.
NEJM has been admirably proactive about conflict of interest. I admire Marcia Angell, who was on the editorial staff for over 20 years. The editorials in NEJM on the health care debate were excellent.
JAMA is a bit more conservative in its commentary, but there are many things I appreciate about it.
They preserve the humanist side of the medical profession with regular features on art, poetry, and essays by doctors. They publish excerpts from JAMA 100 years ago, which is always fascinating.
And they have book reviews. I was disappointed that NEJM decided to discontinue book reviews earlier this year.
I read as much of the Lancet as is available without a subscription, which includes much of the editorial comment. They place a greater emphasis on health in the developing world, undoubtedly a remnant of British Empire days.
There’s a nice review of medical journals called Journal Watch. It’s written by a physician Richard Lehman with an understated British sense of humor.
What is your opinion of Atul Gawande’s public policy positions?
I’m a big fan of Dr. Gawande. The Lancet once said that by advocating safety checklists, he has probably saved more lives than any other physician in history.
The quality of life for patients near death is such an important issue. This is very difficult to discuss in our culture. We don’t want to be reminded of death. So I was pleased to see him open up this topic for discussion.
There was an online comment in response to the article that illustrates its impact. A reader wrote about her father, a smoker who was dying of lung cancer and struggling with a drug treatment that made him very sick.
She sent Gawande’s article to her parents. After reading it, they made plans to discuss treatment and end-of-life issues with their physician. They expressed their gratitude. Gawande’s writing makes a difference.
One of many things I liked about his health care article on McAllen, Texas was the physician’s perspective he provided at the end – something easily overlooked by those not directly involved with patients.
He said there would be dangers in changing health care too rapidly and too drastically. We’re talking about the health and lives of real people here, he said. With a radical change, some people would suffer from the transition.
Personally I’d love to see big changes in health care, but I really appreciated that point of view.
As a keen observer of medical culture, do you have a problem with the ethics of physicians blogging sometimes in great detail about their patients – oftentimes in unflattering ways? Do you feel that patients are being unfairly used?
Of course that’s an unwise and unethical thing to do. But I see a great deal of discussion, in blogs and in medical journals, that tries to educate the medical community about the issues. I hope this is just a period of transition we’re going through.
What are your thoughts on the culture change occurring in medicine regarding the elimination of physicians personally accepting patient care responsibility through the reduction of resident work hours and the forced imposition of duty hour restrictions. How do you feel about medical care rapidly becoming one of a shift-work?
This has been an interesting development in the history of medicine.
In 20th century America, business and industry became bureaucratized and were subjected to outside control. The medical profession held out against this change for a very long time.
It argued that the doctor/patient relationship was special and unique among professions and should be under the control of doctors and patients, not outside bureaucracies.
The medical profession may have also been concerned about loss of prestige and income, but the sanctity of the doctor/patient relationship was central to resisting external control. This more or less committed the practice of medicine to the model of the solo practitioner.
That model didn’t survive 20th century advances in medical knowledge and technology. The lone practitioner was overwhelmed with information.
I was just reading something from a 1910 JAMA on the plight of the physician: “For the overworked physician to steal an hour for the perusal of Carlyle or Coleridge when he ought to be ‘reading up’ an obscure case seems a sort of professional suicide.” And that was only 1910!
As medicine had increasingly more to offer, the demand for medical care increased. Ultimately the solo practitioner model was unable to meet the health care needs of the nation.
Bureaucratized shift-work is not good for doctors and it’s not good for patients. I don’t know what the solution will be.
Primary care doctors are asking to be paid by the hour, not for piece work. That might help. The wealthy can afford concierge doctors. Maybe something will come out of the medical home concept.
If doctors and patients get unhappy enough, perhaps a creative solution will evolve.
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Kentucky Plastic Surgeon Disciplined By Kentucky Board of Medical Licensure
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Was Lou Gehrig Misdiagnosed With Lou Gehrig’s Disease?
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Jan Henderson, PhD – Medical Historian and Blogger (Part 1 of 3)
August 16th, 2010Jan Henderson is a medical historian and the editor of the thoughtful, well-written blog The Health Culture. We recently had a chance to get her thoughts on some of the ongoing developments in medical blogging and the healthcare delivery system.
Where are you from?
I was born outside Boston, but lived in California until college, when I returned east. I lived in Massachusetts, Connecticut, New York, and New Jersey until fifteen years ago, when I returned to northern California.
Where did you go to school and what was your academic major?
I was an undergraduate at Harvard, where I majored in math. I have a PhD from Yale in the history of science and medicine.
What has been your career path from your last educational schooling endeavor and now?
After getting my doctorate, I taught the history of science and medicine at Queens College, CUNY. When budget cuts eliminated the non-tenured faculty positions in my department, I spent a year as a fellow at the Institute for Advanced Study in Princeton.
I was offered a teaching position on the west coast, but wasn’t ready to leave New York.
Since then I’ve alternated between writing about what truly interests me and earning a living. I’ve published two books, spent time at a media industry publication, evaluated mainframe artificial intelligence software, and managed technical documentation and marketing in the personal computer industry.
I left the corporate world in 2000 and spent several years teaching traditional Chinese medicine.
What do you see as the mission of your blog?
I started blogging because I wanted to understand something that changed medicine and ideas about health in the 1970s.
Prior to that time, the policies of the Kennedy and Johnson administrations had assumed the state should be responsible for the health of its citizens.
When political and economic thinking became more conservative in the 1970s and 1980s, governments began to promote the idea that individuals were personally responsible for their health and should practice healthy lifestyles.
A large segment of the population – mainly the educated and economically secure – welcomed these ideas. Feeling personally responsible for one’s health and practicing healthy lifestyles gives one the reassuring illusion of control.
In particular, it’s a good distraction from the things that are beyond individual control, like salmonella in our peanut butter and the superbug MRSA at the gym.
I was caught up in the healthy lifestyles attitude myself. When I look back, I could kick myself for not recognizing what was going on.
Public opinion could have been rallied to support those health issues that need government backing – workplace safety, a healthy environment, an equitable distribution of access to affordable health care.
But politics took a different path and the public went jogging.
I have nothing against healthy behavior and the concept of prevention. What bothers me is misleading the public for political purposes.
Aside from smoking, the evidence for changing behavior is slim – either it doesn’t last (obesity) or, in some cases, it turns out to be wrong (all fats are unhealthy, fruits and vegetables prevent cancer, HRT).
I guess my mission is to be alert and not get fooled again. By writing about what’s currently happening in health and medicine, I’m collecting pieces of a puzzle.
It’s always hard to see the big picture in the moment, but eventually the pieces add up. Also, while history never repeats itself exactly, looking back at the history of medicine provides clues to the present.
Why don’t you accept advertising on your site?
I have nothing against advertising per se. I had Google ads on my blog until May 1, when I changed blogging softwares. For the moment I’m enjoying the uncluttered look.
I find online advertising objectionable when there’s a conflict of interest. I would question the health advice of Dr. Andrew Weil, given the intensity of his sales pitch.
And while WebMD may be a reliable source of information on some health matters, it’s not free to be objective about issues of interest to a prospective cosmetic surgery client.
What medically related blogs do you read?
I’m afraid this is a rather long list. I’m not a specialist when it comes to medicine.
I read KevinMD, of course. Not only does it cover the current issues in medicine and health care, but it gives an inside look at what physicians and other health care professionals are thinking.
During the debate on health care legislation, my favorite sites were Health Beat by Maggie Mahar and GoozNews by Merrill Goozner. Both are experienced journalists and insightful bloggers.
For the pharmaceutical industry, I read Ed Silverman at Pharmalot. He attracts a large number of readers from both inside and outside the industry, and they leave highly educational comments.
For news on health care and pharma, as well as a look at how those inside the industry see things, I read FierceHealthcare and FiercePharma.
For an analysis of health news I read Behind the Headlines from the UK’s National Health Service. They present the science – or lack of it – behind outrageous and distorted headlines. Health news is pretty much the same in the US and the UK, although the slight differences are interesting.
Another UK site I appreciate is Bad Science by the physician Ben Goldacre, author of a book by the same name. The things that make him angry are definitely worth being angry about.
On medical journalism, Gary Schwitzer deserves a medal. His blog is called Health News Review. He also has a website where he systematically analyzes and rates health reporting.
On bioethics, the Hastings Center has a Bioethics Forum, plus there are many other resources on their website.
Dr. Maurice Bernstein runs a Bioethics Discussion Blog. He usually cites an article and then poses a question to his readers. Some of the threads are fascinating, like the one on how readers feel about seeing a male or female physician.
That topic gets so many responses that Bernstein has to close the thread and allow a cooling off period before reopening the discussion. The comments were an eye-opener for me.
On nutrition, food safety, the FDA, and the food industry, I read Marion Nestle. She blogs for the Atlantic and has her own website, Food Politics.
Maryn McKenna wrote an excellent book on community-acquired MRSA, and I rely on her blog Superbug for updates on antibiotic resistance. She’s a medical journalist who understands the technicalities and explains them clearly.
On psychiatry, there’s the Carlat Psychiatry Blog by Dr. Daniel Carlat. I thought his latest book (Unhinged) could have been more objective.
Understandably he defends his profession, whereas I think there’s good evidence anti-depressants have been overprescribed or prescribed for the wrong reasons. But he definitely raises and discusses the issues in psychiatry today.
Thaddeus Pope writes on the ethical and legal issues raised by the ability of modern medicine to keep us alive, both at the end and the beginning of life. His blog is called Medical Futility. He’s a law professor.
I really enjoy a relatively new blog on geriatrics and palliative care called GeriPal. It’s written and frequented by a very nice group of people.
I also read another excellent blog on hospice and palliative medicine that’s been around for years: Pallimed. These are professionals who deal with end-of-life issues every day.
Finally, for fun and inspiration I read Street Anatomy – a daily illustration of the use of anatomy in art, advertising, fashion, commercial products, and street life.
Related Posts
Jan Henderson, PhD – Medical Historian and Blogger (Part 2 of 3)
Jan Henderson, Phd – Medical Historian and Blogger (Part 3 of 3)
Actor Michael Douglas Diagnosed With “Throat Tumor”
August 16th, 2010In a somewhat vaguely worded press release, it was announced today that actor Michael Douglas has been diagnosed with a “throat tumor” of unknown etiology and will undergo eight weeks of chemotherapy and radiation therapy.
Nipple Piercing Greatly Increases Risk of Breast Abscess
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Surgeon Dr. Dan Benishek Wins GOP Primary in Michigan
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Nurse Recruiter Michael Fazio Discusses Current Nursing Shortage
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Boston Med Student and Alleged “Craigslist Killer” Philip Markoff Dead in Apparent Suicide
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