Wednesday, August 24, 2011

10 New Year’s Resolutions For Doctors And Patients

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#1 Doctor: Resolve to let patients speak without interruption and describe their symptoms.

Patient: Resolve to focus on the problem I am seeing the doctor about and not come with a list of 10 complaints for a 15-minute office visit.

#2 Doctor: Resolve to keep a pleasant tone of voice when answering night and weekend phone calls from the answering service, patients, or nurses.

Patient: Resolve to get my prescriptions filled during office hours, not forget my medications while traveling, and to use night and weekend phone calls for emergencies only.

#3 Doctor: Resolve to exercise a minimum of??four times a week for better health.

Patient: Ditto.

#4 Doctor: Resolve to train my staff and model excellent customer service for patients.

Patient: Resolve to understand that getting an instant referral, prescription, note for jury duty, or letter to my insurance company??from??my doctor is not my God-given right and I will stop??[complaining] if it doesn’t happen the day I request it.

#5 Doctor: Resolve to give at least one compliment a day to my office staff, child, and spouse.

Patient: Ditto.

#6 Doctor: Resolve to apologize when I am late seeing a patient who has been waiting.

Patient: Resolve to understand that when the doctor is late?? another human being needed attention. It might be me in the future who needs extra time.

#7 Doctor: Resolve to do one new thing a month that is novel (??See a??play? Travel? Do a special activity with a child or spouse? Learn a new computer skill? Play music? See a friend?)

Patient: Ditto.

#8 Doctor: Resolve to review all insurance payers and drop contracts that are not paying market rates for my skills and education. I will not go bankrupt.

Patient: Resolve to try and understand the medical economics that require my doctor to drop my insurance. If my doctor isn’t worth paying a little more for the visit, I will find a new doctor.

#9 Doctor: Resolve for each new prescription I write I will explain five things: The name of the medication, the reason for the medication, the side effects, how to take it, and how long to take it.

Patient: Once the doctor has prescribed a medication, I will take it as prescribed or let the doctor know right away if I am stopping it.

#10 Doctor: I will give thanks that I have a wonderful profession where I can help people in a special way.

Patient: I will not underestimate the many years of training and sacrifice my doctors have gone through and I will appreciate that they are trying their hardest to help me stay healthy.


Your Hydration Needs Monitored By An Intelligent Water Bottle


Imagine a water bottle that knows how hard and how far you are running, how much you’re drinking, what’s the outside temperature, and, based on all these variables, the device calculates when you need to have a drink. Cambridge Consultants have developed the i-dration bottle that does just that.

From the press release:

Intelligent sensors in the i-dration bottle can be used to monitor the external temperature, drinking frequency and quantity, and this data is then sent via Bluetooth to its usera??s smartphone. The phonea??s inbuilt accelerometer and gyroscope can measure exercise levels, and by “fusing” the data from a heart rate chest-band and information pre-entered using the smartphone interface (such as height, age and weight), the application can perform an assessment of a usera??s hydration levels. The i-dration bottle then responds accordingly by flashing a blue light if the athlete needs to drink more.

i-dration demonstrates the work that Cambridge Consultants is currently undertaking in bringing mobile applications to life. a??Most people still perceive an a??appa?? to be something that performs a certain task, whether ita??s checking the weather or the latest sports results, in a virtual world. However, we believe that in the next 12 to 18 months we will see a plethora of new dedicated a??hardware apps,a?? such as the i-dration drinks bottle, that will work in tandem with a smartphone to enhance a range of consumer products and services ,a?? said Rachel Harker, Business Development Manager at Cambridge Consultants.

Press release: Real-time hydration advice from new ‘smart’ drinks bottle …


The Key To Killing Common Warts: Patience

Suture for a Living

Ia??m sure I dona??t see as many patients with common skin warts as my family practice or dermatology colleagues, but these patients still make it to my office.?? Sometimes ita??s the primary complaint, sometimes ita??s an afterthought.?? In reviewing the topic, it occurred to me that most patients dona??t need to see any of us for this problem.?? They mostly need to accept the fact that the treatment takes TIME.?? So if you will persist, then you will often be successful without the expense of seeing a doctor.?? (photo credit)

Common warts (Verruca vulgaris) are caused by the human papillomavirus (HPV).?? Warts on the hands or feet do not carry the same clinical consequences of HPV infection in the genital area.?? It is estimated about 10% of children and adolescents have warts at any given time.?? As many as 22% of children will contract warts during childhood.

Common warts can occur anywhere on the body, but 70% occur on the hand.?? Often they will disappear on their own within a year.?? Even with treatment, warts can take up to a year to go away.

Before heading to the doctor, there are treatments you can try at home:?? salicylic acid or duct tape.

When using the 17% salicylic acid gel (one brand name: Compound W), it must be applied every day until the wart is gone.?? Only apply to the wart, not the skin around the wart.?? This treatment is enhanced by covering the wart with an occlusive water-proof band-aid or duct tape after applying the acid.?? It can also be enhanced by gently filing the wart with an emery board daily to remove the dead cells prior to applying the salicylic acid.?? Treatment can take weeks to months.?? Dona??t give up early.

Duct Tape can take weeks or months to be effective.???? Apply the duct tape to the wart and?? keep it in place for six days.?? After removing the tape, soak the wart, and pare it down with a filing (emery) board.?? Repeat the above until the wart disappears.?? Once again, dona??t give up early.

The two?? treatments (salicylic acid and duct tape) can be combined.?? Apply the salicylic acid liquid to the wart before bedtime.?? After letting it air dry for a minute or so,?? then apply the duct tape over the wart, completely covering the area. Remove the duct tape the following morning. Each time you remove the tape, you will be debriding some of the wart tissue. Repeat the application each night, until there is no remaining wart tissue.?? As with using only one treatment, dona??t give up early.

If the above dona??t work or you just dona??t want to take the time, then you may wish to see your physician for removal.?? He can use cryotherapy to destroy the wart.???? This method may involve repeated treatment over several weeks.?? You can do the following to a??get the wart ready for removala?? and make the cryotherapy more effective:

  1. Every night for 2 weeks, clean the wart with soap and water and put 17% salicylic acid gel (one brand name: Compound W) on it.

  2. After putting on the gel, cover the wart with a piece of 40% salicylic acid pad (one brand name: Mediplast). Cut the pad so that it is a little bit bigger than the wart. The pad has a sticky backing that will help it stay on the wart.

  3. Leave the pad on the wart for 24 hours. If the area becomes very sore or red, stop using the gel and pad and call your doctor’s office.

  4. After you take the pad off, clean the area with soap and water, put more gel on the wart and put on another pad. If you are very active during the day and the pad moves off the wart, you can leave the area uncovered during the day and only wear the pad at night.

If none of the above work, then your wart may need to be removed surgically.?? Remember the above all take time, so give them time to work.?? Even if the wart disappears with any of the above treatments, it may recur later.


Treatment of Warts; Medscape Article, May 27, 2005: W. Steven Pray, PhD, DPh; Joshua J. Pray, PharmD

What Can Be Done About a Hand Wart That Keeps Reappearing After Removal?; Medscape Article, May 31, 2007; Richard S. Ferri, PhD, ANP, ACRN, FAAN

Duct tape and moleskin equally effective in treating common warts; Medscape Article 2007; Barclay L.

Duct Tape More Effective than Cryotherapy for Warts; AAFP, Feb 1, 2003; Karl E. Miller, M.D.


Brush Up On Heart Health

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The British Medical Journal reported on a study of??toothbrushing and found that people with poor oral hygiene had an increased risk of cardiovascular disease and heart attack.

We’ve known for the last two decades that inflammation plays an important role in atherosclerosis.??Markers of low-grade inflammation like C-reactive protein are also shown to be higher in heart disease.

The Scottish Health researchers looked at the general population and followed a large subset with questions about their oral health.??They asked about frequency of dentist visits, toothbrushing, and controlled for many co-variables such as general activity, hypertension, smoking, height and weight.??They also collected blood for studies of??C-reactive protein as a marker of inflammation.??They removed from the analysis participants who had no natural teeth (edentulous) and??those with existing cardiovascular disease.

This elaborate and lengthy study showed that toothbrushing is associated with cardiovascular disease, and that subjects who brushed their teeth less than once a day had a 70 percent??increase in heart disease compared with people who brushed twice a day. The inflammation that periodontal disease causes is directly related to increased C-reactive protein and increased heart attacks.

Leave it to the Scotts and the Brits to remind us to brush and floss every day.

REFERENCE: British Medical Journal, 2010; 340: c2451.


New Research On Alzheimer’s Disease

ACP Internist

Data presented at the International Conference on Alzheimer’s Disease in Honolulu this week indicated that exercise and adequate vitamin D levels could help reduce risk for the disorder. Framingham Heart Study researchers found that risk for dementia was halved in “moderate to heavy exercisers” compared with more sedentary people, while researchers on a separate study found that vitamin D deficiency can greatly increase risk for mental impairment.

Another study found that injecting the compound florbetapir into the brain of patients with dementia and then performing a PET scan could help pinpoint the size and location of plaques.

Researchers also reported that tea consumption was linked to a slower rate of cognitive decline in older adults without cognitive impairment, but there was no dose response and more studies will need to be done to determine a definitive link. (CBS News, Wall Street Journal, Medscape)


Driving Safe Cars Can Save Lives

Saving Money and Surviving the <a href='' target='_blank'>Health</a>care Crisis

New England Patriots NFL quarterback Tom Brady was on his way to practice when he crashed into a minivan which allegedly ran a red light.??His Audi S8 car T-boned the other vehicle a few blocks from his home.??A relieved New England Patriots owner Bob Kraft noted after the accident:

“[Tom] arched and prepared himself and we’re just lucky with the glass and angles. We have a lot to be thankful for. It was really a miracle…We’re very, very lucky. Patriot Nation is lucky he had his seatbelt on.”

Was it simply luck or good car design and mechanical engineering???Crumple zones and the passenger cage of a car when built for maximum safety decrease injury.??Yet, unfortunately, there is significant variability among safety in cars.??Brady walked?? away from the accident for a variety of reasons.

As a future hall of fame quarterback, Brady has lightning fast reflexes when analyzing defensive blitzes and options when throwing the football.??Quickly bracing himself for impact may have helped.??Wearing a seatbelt definitely helped. What may have helped the most was the type of car he drove.

Audi cars were recently recognized by the Insurance Institute of Highway Safety as Top Safety Picks with the manufacturer recognized with more models than any other luxury German car brand. Earning a Top Safety Pick requires that the vehicle receive a good rating in each of these categories — high-speed front and side crash tests, a rollover test, and protection against neck injuries after rear impact with evaluations of seat/head restraints.??Perhaps had celebrity Dr. Frank Ryan driven a top safety pick car despite his vehicle’s rollover, he might be alive today.??There is tremendous variability in a vehicle’s ability to protect its occupants which vary among manufacturers as well as models and model year.

Driving a safe vehicle should be as important as exercising regularly, eating healthy, and maintaining a good weight.??Much like quitting smoking or losing weight, the goal is to prevent premature death or disability.??Unintentional injuries are the leading cause of death for those under the age of 34 and the third leading cause of death for people between ages 45 to 54.??Motor vehicle accidents account for the majority of unintentional injuries.??In that moment, all of those healthy habits become meaningless, even for a superstar athlete.??You can do everything right, like Dr. Oz, and discover that you still can have a precancerous colon polyp.

Life happens.??Simply bad luck???Perhaps.??What can you do to mitigate the risk or bad luck further?

Plan for it the best you can.??In this case, having a car brand that is among the safest in the world, helps.??His car saved his life and saved his career.??It protected him from needing an emergency room visit and evaluation.??As a result, Brady simply walked away from the accident.??He made his practice a little while later and finished his drills with teammates.??He displayed no sign of injury or diability.

Was all of that worth the time and effort to find a car that is fun to drive and yet incredibly safe? You bet.??Don’t believe me? Ask his wife, Gisele Bundchen, and his sons Benjamin and John.??I’m sure they are glad to have him home safe and sound, even as he takes his hits on Sunday as the premier quarterback in the NFL.


Nutritional Supplements: Do They Really Help Prevent Disease?

<a href='' target='_blank'>Health</a> in 30

(Guest post submitted by MD Anderson Cancer Center)

Aisles in grocery stores and pharmacies are stacked with vitamins, minerals, herbs or other plants that you take in pill, capsule, tablet or liquid form. And, many of us buy these supplements and take them regularly, hoping to lower our chances of getting cancer and other diseases.

But do supplements really work wonders? Should you take them to help prevent cancer? Our experts say beware.

a??Dona??t be fooled by the label on the bottle,a?? says Sally Scroggs, health education manager at MD Andersona??s Cancer Prevention Center. a??Researchers are still unsure about whether or not supplements actually prevent cancer.a?? Some studies have suggested that supplements may actually increase cancer risk by tilting the balance of nutrients in the body.

Results from the Womena??s Health Study and The Physiciansa?? Health Study II found that vitamins E and C do not prevent cancer. The Selenium and Vitamin E Cancer Prevention Trial showed similar results, suggesting these supplements didna??t help prevent prostate cancer.

a??If you eat lots of vegetables, fruits, whole grains and beans, you should get the nutrients, including fiber, vitamins and minerals, your body needs to lower your chances of getting diseases like cancer,a?? Scroggs says. a??Taking a pill cana??t replace a healthy diet.a??

Not sure which foods get the job done??? See our list of recommended foods packed with cancer-fighting nutrients.

Supplements may benefit some

More research is needed to truly understand the relationship between supplements and cancer risk, according to the American Institute for Cancer Research.

Still, there are some situations when taking a supplement might do your body good. This is especially true for men and women who are not getting enough nutrients because of food allergies, genetics or chronic illnesses.

Here are a few examples of when supplements may be right for you:

  • Women who are pregnant or breastfeeding

  • People at risk for vitamin D deficiency

  • People at risk for osteoporosis

  • People at risk for B-12 deficiency

  • People age 50 or older

  • Vegans who consume no animal foods

Get professional advice

Thinking about taking supplements?

Speak with your doctor or a registered dietitian first. He or she can decide which pills you really need and what dose you should take. Keep in mind that there is no vitamin or supplement thata??s good for everyone.

A registered dietitian also can tell you what to look for on supplement labels. This is important because some supplement labels can be confusing or misleading. Many companies claim their pills can cure cancer when, in fact, they dona??t, according to a recent Congressional study.

a??Remember, supplements are just that a?? supplements,a?? Scroggs says. a??Even if your doctor recommends them, your top priority should be getting the nutrients you need from the food you eat.a??

Do your research and talk to your doctor before you add supplements to your diet

This article originally appeared on MD Anderson Cancer Centera??s Focused on Health e-newsletter. To read the full newsletter, click here. To subscribe to future issues, click here.


American Institute of Cancer Research

Effect of selenium and vitamin E on risk of prostate cancer and other cancers: the Selenium and Vitamin E Cancer Prevention Trial (SELECT). Journal of American Medical Association. 2009 Jan 7; 301(1):39-51.

Herbal Dietary Supplements: Examples of Deceptive or Questionable Marketing Practices and Potentially Dangerous Advice. U.S. Government Accountability Office. 26 May 2010.

Downloaded at, 13 September 2010.

Physiciansa?? Health Study II: Vitamin E, Ascorbic Acid, Beta Carotene, and/or Multivitamins in Preventing Cancer and Cardiovascular Disease in Older Healthy Male Doctors

Vitamin E in the primary prevention of cardiovascular disease and cancer: the Womena??s Health Study. Journal of American Medical Association. 2005 Jul 6, 294 (1): 56-65.


We would love to hear from you.?? Do you take vitamin and supplements??? Do you eat fresh fruits and vegetables??? How do you maintain a healthy diet?

[Image:?? Provided by MD Anderson Cancer Center]