Yet another screening exam found unhelpful
Earlier this month, the American College of Physicians (ACP) published its recommendation in the Annals of Internal Medicine that routine annual pelvic exams are unnecessary for healthy, non-pregnant women with no gynecologic symptoms (bleeding, discharge, pain, etc.).
The ACP looked at evidence on pelvic examinations dating back almost 70 years and concluded:
… no data support the use of routine pelvic examination (excluding cervical cytologic [Pap] examination) for reducing the morbidity [disease] or mortality [death] of any condition. Furthermore, limited evidence suggests that screening pelvic examinations may be associated with pain, discomfort, fear, anxiety,
… Continue reading
The big business of sleep
As someone who has always had trouble sleeping, I find solace in the fact that I am far from alone. The last statistic I saw was that about 60 million Americans complain of some form of sleep trouble. And I suspect that number is under reported.
Sleep experts recommend we get 7-9 hours of sleep every night, and popular media are quick to point out all the ill health effects due to lack of sleep that will kill you.
It’s scary enough to give you nightmares—if you could get to sleep.
Insomnia and fatigue are … Continue reading
Unnecessary care = unnecessary expense
Every day I see a new article about the high costs of health care.
A new study suggests that in a single year, up to 42 percent of Medicare patients got at least one medical procedure they didn’t need — overtreatment that cost as much as $8 billion.
Use of [Mohs] surgery has skyrocketed in the United States — over 400 percent in a little over a decade — to the point that last summer Medicare put it at the top of its … Continue reading
There’s no such thing as a “mild” concussion
Last week I posted about first aid for concussions, which is important because head injuries in kids are a growing concern in the medical and public health communities.
Of particular importance is avoiding the potentially fatal “second impact syndrome”; if a young athlete suffers a “mild” concussion and then sustains another within a few weeks, “diffuse cerebral swelling, brain herniation, and death can occur.” Luckily, it’s rare.
But even minor concussions need to be recognized and treated, and it can be difficult because symptoms are often subtle and most parents … Continue reading
Educating patients and doctors
I’m a big fan of the Choosing Wisely® campaign sponsored by the ABIM Foundation, a non-profit group established by the American Board of Internal Medicine.
Why? Because the campaign’s objective is to reduce the number of unnecessary and potentially harmful (not to mention expensive) medical procedures being done in the US.
Choosing Wisely® aims to promote conversations between physicians and patients by helping patients choose care that is:
- Supported by evidence
- Not duplicative of other tests or procedures already received
- Free from harm
- Truly necessary
In response to this challenge, national organizations representing medical specialists
… Continue reading
Will there soon be a blood test?
My father-in-law recently passed away after suffering with Alzheimer’s for several years. I also have an aunt who is currently living with some form of dementia, probably vascular.
Few diseases strike more fear into those over the age of 50 than Alzheimer’s. Needless to say, both my husband and I worry when we find ourselves saying:
“Oh, what’s the word I want?”
or “Where did I put it?”
or “Why did I come in here?”
So when I read the prevailing health headlines this week about a blood test to predict Alzheimer’s, … Continue reading
The latest report
Most of my nursing career was in breast cancer, so I like to stay current on the most recent research on screening, diagnosis and treatment.
Earlier this week, the British Medical Journal released a pretty stunning report:
In conclusion, our data show that annual mammography does not result in a reduction in breast cancer specific mortality for women aged 40-59.
In normal language that translates to “annual mammograms don’t save lives.”
Aaron Carroll, MD, writes on his blog:
This study is going to make a whole lot of people upset. It’s a large, well designed
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Too many CT scans ordered on children
This morning I read a post by a pediatric intensive care (PICU) doctor who admitted too many CT scans are still being given to children, despite recent evidence that radiation exposure from the scans carries a not insignificant future risk of cancer.
I posted about the results of this study a couple of months ago: Children are more “radiosensitive” than adults; CT scanners can vary dramatically in the amount of radiation exposure; and radiation exposure is cumulative–more CT scans relate to a higher risk.
This doctor focused on the overuse of … Continue reading
As someone who advocates for less medical care, I’m always thrilled to see physicians and others in the health care industry step forward to protest over-testing, over-screening, over-diagnosing, over-treating and over-charging.
Here are some of my favorite health care blog posts and news articles from the last week.
Dr. Lamberts is embracing the newest trend in primary care: the direct-pay model. He does not accept health insurance, but rather charges a modest (age-based) monthly fee per patient. Booting the insurance companies not only lowers his overhead costs considerably, but frees him from so many … Continue reading
CT scans increase a child’s risk of developing cancer
A year ago the British medical journal, The Lancet, published a study looking at the potential cancer risk to children from using CT scans.
CT scans use ionizing radiation, and children are considered more “radiosensitive” than adults.
The Lancet study concluded there was “… a positive association between radiation dose from CT scans and leukaemia” and recommended “…although clinical benefits should outweigh the small absolute risks, radiation doses from CT scans ought to be kept as low as possible and alternative procedures, which do not involve ionising radiation, should be … Continue reading