Second Opinion

Depression at the End of Life

Is depression a natural and necessary stage we pass through at the end of life or is it a medical condition that needs treatment?

Letting Go at the End of Life

Why is that we have such a tough time letting go when a person has a terminal illness?

Pressures to Breast Feed

Why are American rates of breast feeding so low?

Is denial always harmful?

We all engage in denial to some extent, but can denial cause medical problems?

How Does the Bill Get That Big?

Reading a hospital bill is like trying to understand a foreign language but look carefully because more likely than not there will be errors...

More on Rationing Healthcare

Several letters suggested there were other ways to ration healthcare and many suggested rationing was, well, anti-American.

Rationing Healthcare

Is it possible that in the US we ration healthcare?

End-of-Life Discussions are NOT Just for Cancer Patients

While doctors can do a lot better with regard to talking to people with cancer about end-of-life issues, they are still in the dark ages when it comes to talking to people with other disease who have a poor prognosis...

Why Do New Medicines Work Better Than Older Ones?

There are several explanations for why new medicine appear to work better than older medicines...

Whose Side Is the FDA on?

There are several pain relievers that contain propoxyphene, a substance that is dangerous and ineffective. Why are these still on the market?

Fluorescent Bulbs

While fluorescent bulbs use a fraction of the energy required for traditional light bulbs, they pose a potential danger if broken and an even greater danger if improperly discarded...

AIDS in Rural India, Part III

The impact of village health workers can be enormous but there are still some barriers to what they can accomplish...

AIDS in Rural India, Part II

While AIDS medicines would life-saving, the need in rural India are for far more than just medicines...

AIDS in Rural India

After generations of fighting malaria and dysentery rural India is not trying to contend with AIDS...

Pre-operative Testing: For Whose Benefit?

We all want our surgery to go as smoothly as possible, but at what point is it not in our best interest to have lots of preoperative tests ordered?

Screening for Dementia

  While dementia is a common illness, and one that causes great concern, there are currently no tests to detect the disease early and this may be a good thing...

Humor to educate about drug advertising

Weight Loss and Drugs

No matter how much we wish it were different, there is still no easy  road to weight loss...

Banning Direct-to-Consumer Advertising in Canada

Why is it that Canada prohibits drug companies from advertising products directly to the public?

The Effect of Race on Healthcare

Two men with the same disease. Will their treatment differ?

Traditional Medicine

Patient's Right to Be Informed about Trainees

When we go to a teaching hospital we assume the care may be better. But we often aren't given a choice about who should be involved in caring for us...

Anti-Depressant Medications May Be Less Effective Than We Think

A large, high-quality study suggests that newer antidepressants may be far less effective than we have been told by their manufacturers...

Why Is Some Alternative Medicine Still Alterative?

Despite significant research showing the benefits of some complementary and alternative treatments such as acupuncture, they are still considered outside the mainstream...

Disability Parking

When People Don't Follow the Doctor's Advice

Doctors have a hard time when people don't follow their advice.  But behavior change isn't easy for anyone -- not even doctors.

Substance Abuse and Detection

Despite substance abuse being a major medical and public problem, only twelve out of 125 medical schools surveyed, offer a required course in substance abuse detection and treatment...

Does Everyone Really Need to Lower Their Cholesterol?

Studies suggest we are over-treating people who have high cholesterol but no risk factors for heart disease...

Telephone Medicine

Getting a call from your doctor may not be just another phone call...

The Hidden Curriculum in Medical School

So much of what medical students learn is not from books and lectures but from their watching the behaviors of others. It may be that our actions are teaching the wrong lessons...

Bereavement can Cause Physical Problems

The loss of a loved one can have profound health consequences.

Permission for Clinical Research

Patient permission for publication is essential, but without  publication medical science stands still...

Hospitalists

Buying Influence in Developing Countries

Why are drug companies offering doctors in developing countries free gifts, computers and jewelry? Do those work for you?

Immigrants and Healthcare

Is it true that immigrants come here to use our healthcare system and offer little in return?

Medicinal Hugs

Sometimes an old fashioned hug can be more therapeutic than a pill or procedure...

Admitting Uncertainty

For many years I have been teaching medical students that one of the things we need to change in medicine is for doctors to admit when we don't know something and we need to look it up...

Physicians as Role Models

Does It Matter What the Doctor Wears?

Do doctors need to conform to the traditional appearance of physicians or can they express their personal tastes with nose studs, tattoos and the like?

Caring for Celebrities

Often, in our attempt to provide special care for a VIP in a hospital we end up providing substandard care...

Dying in Prison

What rights do people dying in prison have?

Genetic Testing for Breast Cancer

Why are advertisements marketing B genetic tests for breast cancer to all women?

Screening for Lung Cancer

Why is it if we have a scanner that can detect very small lung cancers it doesn't save lives?

When We Don't Know the Patient's Preference

What happens when a patient needs a treatment and there is no record of their preferences?

Payment for Taking Medicines

Should we pay someone to take their medicines if they're not willing to do so on their own?...

The Consumer Reports of Medications

Why can't we develop a fair, honest and unbiased way to conduct research on the effectiveness and safety of medications?

Confidentiality Even in Death

Even after a person dies their records are confidential...

Unfit to Drive

For people with memory problems driving can be unsafe but what is the doctor's duty to the patient or to society?

Practice Rules Improve Care

Until recently, the decision as to whether or not to order an x-ray was based on the doctor's gut feeling. Now clinical prediction rules exist to help improve these decisions...

Promises Not Kept

It is some times difficult, if not impossible, to keep promises we make...