Primary Care

November 26, 2018

With these holiday gifts, health-conscious may need to add dose of skepticism

Holiday gift-giving can be expensive, so the health-conscious may wish to exercise skepticism about some potential purchases with dubious or unexpected consequence.

If you’re considering forking over more than a few dollars, think twice about:

So-called “tall” or “standing” desks. They were supposed to be a response to growing research about workers’ heightened health risks from sitting all day long. But studies show that standing while working with a computer isn’t as beneficial as some advocates may have claimed. That’s because it isn’t exercise or movement — which was supposed to the point of promoting healthier workplace practices, such as getting up from the desk and walking around every few minutes rather than becoming sedentary on the job. Studies, in fact, show that workers who must stand all day suffer health harms, like varicose veins and more. Some employees with posture issues may benefit some from standing and not scrunching themselves up while sitting at a desk. For most of the rest of us, it does matter to get up, exercise, and move. A fancy desk isn’t necessary for that, right?

November 23, 2018

NHL short-changes players and medical science in concussion settlement

by Patrick A. Malone

The National Hockey League, with its new settlement of claims on head injuries, has done the sport and its most important component — players, past, present, and future — no service. Instead, the game’s leaders have shown a disregard for factual medical science, and an excess appreciation for profits over people.

In contrast to the $1-billion concussion accord between the National Football League and its players, the NHL deal is parsimonious, amounting to $19 million or so. It breaks down, in brief, in this way, according to ESPN:

The settlement calls for a payment of at least $22,000 for settling plaintiffs and settling unfiled claims. Besides the cash payout, the NHL’s settlement involves neurological testing and assessment for players paid for by the league, as well as an administrative fund to pay for the costs and up to $75,000 in medical treatment for players who test positive on two or more tests. The settlement also calls for a ‘Common Good Fund’ that would support retired players in need. That would include players who did not participate in the litigation. The NHL also agreed to pay almost $7 million in plaintiff legal fees.

November 19, 2018

Staying healthy, safe and thankful during the holidays

by Patrick A. Malone

As we all race to groaning tables for one of the traditional and happier holidays of the year, here’s hoping the turkeys stay brown, tasty, and on the table. Sadly, food poisoning is a real issue, and not just for worry-warts.

Cooks preparing this major feast may want to keep watch on growing reports from the U.S. Department of Agriculture and the Centers for Disease Control and Prevention about salmonella outbreaks tied to turkey.

As the Washington Post reported:

November 16, 2018

FDA to play yet more catch-up to crack down on e-cigarettes and flavorings

by Patrick A. Malone

Uncle Sam will rip a page from Big Tobacco’s marketing playbook, targeting the taste and buying-ease of nicotine-containing products with tough new restrictions aimed at better protecting kids. Will these latest steps, however, snuff out the increasingly risky youth vaping craze and long problematic menthol cigarettes and cigars? Or are officials too late and being more helpful than not to tobacco interests?

The Washington Post first reported the outlines of plans by the federal Food and Drug Administration to crack on the hot youth trend of using e-cigarettes by barring sales at gas stations and convenience stores like 7-Eleven of certain flavored liquids and devices used in vaping.

But the FDA, in its formal policy announcement, retreated from that tough stance. Instead, the agency says it will require gas stations and convenience stores to require age verification and keep specified products away from the under-aged. It is unclear if this means vendors simply can stash these items under the counters, or if they must be kept in separate adults-only areas.

November 14, 2018

Misdiagnosis: a medical menace to quality and safety of patient care

by Patrick A. Malone

If patients weren’t already unhappy with drive-by medicine, in which clinicians spend on average of 15 minutes with them in an office visit, safety experts warn that too many doctors’ providing of harried care can worsen a medical menace that’s already hard to ignore: misdiagnosis.

Figuring out what ails a patient and taking a correct course of action already is a “complex, collaborative activity that involves clinical reasoning and information gathering,” reports Liz Seegert, a seasoned health journalist and a senior fellow at the Center for Health Policy and Media Engagement at George Washington University.

But, in a briefing posted online for her journalistic colleagues, she goes on to amass some eyebrow-raising information on diagnostic errors, their frequency, harms to patients, and why experts in the field see corrections in this area needed, stat. Among the data points she reports:

November 13, 2018

Harms of medical bunk are real, as $105 million verdict affirms

by Patrick A. Malone

Dr. Otis Brawley, formerly of the American Cancer Society

The rising flood of health care hype, bunk, and conflicts of interst really can harm patients, as has just been emphasized by a $105-million jury verdict, the brave actions of a leading patient advocacy expert, and the commentary of an expert health researcher and New York Times columnist.

In a more perfect world, a patient like Dawn Kali, 45, and a mother of four, wouldn’t give the time of day to the wild claims of Robert Oldham Young. Both live in San Diego, and when she was diagnosed with cancer, she told a court that she found Young persuasive.

November 11, 2018

Voters nationwide sent a powerful health care message. Will partisans heed it?

by Patrick A. Malone

Last week’s election leaves two questions lingering about health care: Will politicians really hear what voters said? And, what help might beleaguered patients now expect from their elected officials?

The Affordable Care Act, the central flash point of almost a decade of bitter political battles, appears stronger and more steadfast with Republicans losing the House, despite their last-minute counter-factual claims to support pillars of Obamacare like protections on pre-existing conditions, minimum- and lifetime-benefits.

Medicaid, a program expanded under the ACA to provide more and more affordable care to the poor and struggling, got a big boost, too, in the midterms. Voters, by the ballot, voted to expand its reach in the “red-red” states of Utah, Nebraska, and Idaho. The new governor in Maine will halt her predecessor’s resistance to the Medicaid expansion, according to her campaign promises. In Wisconsin and Kansas, Democratic gubernatorial candidates who also campaigned for Medicaid expansion, defeated Republicans who had opposed it.

November 9, 2018

Big Pharma shows off its big gall with risky products and dubious practices

by Patrick A. Malone

Big Pharma is a broad commercial sector with many diverse enterprises large and small, but they keep showing they’re united in their giant gall when it comes to their unacceptable products and practices, as timely news reports demonstrate.

Just consider:

As the nation grapples with an overdose epidemic that kills tens of thousands of Americans annually, why would the firm AcelRx race to market — and why would federal regulators approve — a new opioid painkiller? Experts warn the drug is incredibly powerful and so tiny and easy to use that it fast will be much abused and lethal. The new pill, Dsuvia, is just 3 millimeters in diameter — the size of a big grain of sand. Placed under the tongue, it delivers its dose almost as soon as it dissolves. It is said to pack 10 times the potency of an already deadly synthetic painkiller: fentanyl, which is up to 100 times more potent than morphine and many times that of heroin.

November 7, 2018

There they go again: Surgeons ‘innovate,’ but women patients get put at higher risk

by Patrick A. Malone

Women may need to double-up on their consultations with their specialists about treatment for serious gynecological concerns, as new studies have raised troubling questions about a much-touted minimally invasive surgery for early-stage cervical cancer.

These concerns, in a more perfect world, also would prompt greater questioning and oversight by doctors, hospitals, regulators, and lawmakers of surgical “innovations.”

The procedure now in question removes the uterus, part of the vagina, and other surrounding tissues via small incisions and with special laparoscopic instruments, including robots. Surgeons have advocated for this surgery rather than making a large incision in an “open” procedure, arguing the less invasive approach promotes less discomfort and faster healing for patients.

November 6, 2018

Gun violence takes terrible toll on kids too

by Patrick A. Malone

As the nation struggles with grief from the latest mass shooting at a Pittsburgh synagogue, new research shows how grievous the mayhem that guns cause for the young, with weapons injuries over nine years sending 75,000 children and teen-agers to emergency rooms at a cost of almost $3 billion.

The Associated Press reported that researchers at Johns Hopkins found in their published study that:

[M]ore than one-third of the wounded children were hospitalized, and 6 percent died. Injuries declined during most of the 2006-14 study, but there was an upswing in the final year. … 11 of every 100,000 children and teens treated in U.S. emergency rooms have gun-related injuries. That amounts to about 8,300 kids each year. The scope of the problem is broader though; the study doesn’t include kids killed or injured by gunshots who never made it to the hospital, nor does it count costs for gunshot patients after they’re sent home.