A study coming out of Harvard this week reveals that ordinary headaches are being overtreated, and it’s costing billions of extra dollars in health care spending.
Each year more than 12 million Americans visit their doctors complaining of headaches, which result in lost productivity and costs of upward of $31 billion annually. A new study by researchers from Beth Israel Deaconess Medical Center (BIDMC) suggests some of that cost could be offset by physicians ordering fewer tests and an increased focus on counseling about lifestyle changes.
The study looked at over 9,000 doctor visits for headaches over a 10-year … Continue reading
The Journal of the American Medical Association (JAMA) published a short article on screening mammograms that included a spiffy infographic on the benefits vs. the harms.
Looking at the graphic I can easily see that if 10,000 50-year-old women are screened, 10 will be “saved”, but 940 will undergo an unnecessary biopsy and 57 will be overdiagnosed. (For copyright reasons I can’t reprint the graphic here, but you can view see it yourself by clicking on the above link.)
The author of the article explains:
Another possible harm of screening is overdiagnosis. This means finding something on a mammogram
… Continue reading
Here’s another great video from Healthcare Triage by Aaron Carroll, MD, on the overuse of antibiotics.
I’ve posted on this topic a few times. Whether it’s physicians prescribing unnecessary antibiotics because they think it’s what the patient wants, or patients demanding antibiotics because it’s what they think they need, too many antibiotics are still being prescribed.
Antibiotic prescriptions are particularly abundant during the cold and flu season, even though the vast majority of colds, coughs and sinus infections are viral and don’t need antibiotics.
Save … Continue reading
I read a disturbing article in MedPage Today—Metformin: A Great Lakes Disaster?
Metformin is one of the most common drugs used to treat Type 2 diabetes. Type 2 diabetes, which is mostly a lifestyle disease (obesity), is epidemic in the United States. Seventy million prescriptions for metformin were dispensed in 2013. That year the cost of treating type 2 diabetes, just for the drugs, was $23 billion.
But the environment is paying, too.
Researchers have found high levels of metformin in Lake Michigan—and this is water after it has been treated in the sewage plants.
More importantly, according
… Continue reading
I’ve posted before about my deep disappointment in Dr. Oz. Once a brilliant heart surgeon, he has, in my humble opinion, thrown his career and integrity away to hustle sketchy weight-loss supplements to an eager and sometimes desperate audience.
Related post: Dr. Oz – Pitchman for profit
And I’ve never been comfortable watching the medical tips proffered by the photogenic docs on The Doctors. I especially distrust the smooth and stylish plastic surgeon’s weight loss and anti-aging advice. He’s mostly drumming up business for his colleagues (I wonder if they pay him?).
So I was pleased to learn … Continue reading
Lack of support for vitamin D
I’ve written several posts on vitamin D. That’s because it’s one of my pet peeves.
Because there was a lot of hype surrounding it several years ago when it became the latest health care fad. Suddenly a low vitamin D level was suspected of contributing to many types of cancer and chronic diseases. Physicians began testing everyone’s vitamin D levels and recommending vitamin D supplements, either over-the-counter or a stronger prescription form.
Further research on vitamin D, however, has not provided evidence that general screening for low vitamin D levels is helpful, … Continue reading
The power of positive thinking
I’ve been meaning for some time to write a post about the placebo effect.
A placebo (from the Latin “I shall please”) is a fake treatment—such as a sugar pill—that is intended to deceive the patient. If that patient improves, or at least thinks so, that is known as the placebo effect.
Before a new drug can be approved by the Food and Drug Administration (FDA), the drug maker must have studies to prove that it is more effective than a placebo. If neither the patients nor the researchers know who is getting the … Continue reading
I was troubled but not surprised to read the other day that the anti-psychotic medication, Abilify, is now so popular that it is the best-selling drug in the US.
Two years ago, Abilify was only the 5th best-selling drug, with its competitor, Seroquel, coming in 6th.
At that time, a psychiatrist warned in the New York Times:
The original target population for these drugs, patients with schizophrenia and bipolar disorder, is actually quite small: The lifetime prevalence of schizophrenia is 1 percent, and that of bipolar disorder is around 1.5 percent. Drug companies have had a
… Continue reading
How many are helped; how many are hurt
My son sent me a great link to an article in Wired magazine about a physician and his colleagues who have started a website called TheNNT.com.
What is the NNT? It stands for “the number needed to treat” and it’s a pretty common measurement talked about in health care. Simply put, it quantifies how many people need to be treated for one person to be helped.
The best therapies have a low NNT:
If your kid is throwing up and you take her to the hospital, she might get a drug
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Or whose best interests are being served?
It’s no secret that our health care system is filled with conflicts of interest.
That’s because, for the most part, the doctors, hospitals and insurance companies that are the framework of the system are for-profit businesses. Like any other for-profit industry, health care sells a product and encourages you (or your insurance company) to buy it.
A friend of mine had a recent experience with for-profit health care that she wanted to share:
In my opinion, anyone who has been told they “must” replace their orthotic inserts every year or every few years … Continue reading