Sunday, December 27, 2015

Aging Parents Continue Caregiving for their Children with Disabilities

I find this topic incredibly important as it becomes more prevalent in our society.  In the past, children with severe disabilities may not have survived longer than their parents.  Today, however, this is more possible with recent developments in medication.  Still, we usually think of children providing for their elderly parents, but what happens when the opposite must occur?  If the parents die, where do the children with disabilities look for further care?  And do many caregivers continue to care for these children even if they are unable to do so?  According to the article, some agencies are now bringing together those who work with the elderly and those who work with the disabled.  I hope these groups will devote funding and caregivers trained to handle these types of situations. 


From:  http://www.jewishjournal.com/opinion/article/aging_parents_of_disabled_adult_children_are_feeling_the_strain

Monday, November 30, 2015

Could Specialists Act As Primary Care Doctors?

 My opinion:  I've frequently thought about this issue myself, but I wasn't sure if this were even possible.  Specialists, like cardiologists and gastroenterologists, went through an internal medicine residency (which is primary care) before they did fellowships in their desired subspecialties.  The article discusses a new program where retired specialists could be re-trained to perform primary care.  I think this is a great idea, especially since many of these doctors could use a refresher on how primary care is practiced today.  I don't know if many retired doctors would be willing to do this, however, but it does appear that they often retire late, or continue to work part-time well into their 70s or later.  Another problem is licensing these physicians, as many of them may not want to take long board exams.  Perhaps boards could become more lenient for primary care physicians, since they do not need as much expertise in specialty disciplines.  This could also encourage more people to pursue primary care in general.  s this idea as realistic as it sounds?  Feel free to comment.
 

From: http://www.wsj.com/articles/second-acts-a-retired-surgeon-takes-on-a-new-medical-mission-1448852623

Saturday, November 7, 2015

Anti-Vaccine Sites Rely on False Information, According to Study

The article remarks that 65.6% of the anti-vaccine websites studied say vaccines are dangerous, 62.2% say that they cause autism and 41.1% say they cause brain damage.  64.7% used scientific evidence and 30% used anecdotes to support the statistics.  Also, some of the websites seemed to promote alternative medicine.  Ultimately, the authors believe that officials should communicate with the anti-vaccine movement differently, possibly by involving health discussions that both sides agree upon, in order to address their concerns. 

In my opinion, while anti-vaccine sites may not use as much evidence based reasoning, I think there might be a point to the anecdotes.  Though they might represent a very small proportion of the population, some people might not react well to vaccines, especially if they have weak immune systems.  I think, if possible, it might be best to check a patient's immune history before prescribing a vaccine.  With children, perhaps it would be better to start with safer, more accepted vaccines first to see if they have any adverse reactions.  I do think, as the article mentioned, that many diseases have been eradicated due to the usage of vaccines.  In 2014, the highest number of measles cases occurred since 2000, and these were mostly in people who did not get vaccinated.  Furthermore, in regards to the authors' conclusions, I'm uncertain that promoting unrelated healthy behaviors will convince the anti-vaccine movement that vaccines are safe.  Rather, the picture should focus mostly on vaccine data that has already been generated.  Is lax regulation of the production of vaccines part of the problem?  And is there some vaccine research that has yet to be done?  Feel free to comment.

From: http://www.medicalnewstoday.com/articles/301904.php

Wednesday, October 28, 2015

Umbilical Cord Blood Can Cure Diseases, But Not Frequently Used

My opinion: I think this is a great, easy way to contribute to healing others' illnesses, but I was not aware that this was possible until reading the article.  Cord blood from the umbilical cord contains stem blood cells that can replace blood cells in leukemia, sickle cell anemia, as well as other diseases.  It is simple to obtain, unlike extracting blood from bone marrow, and they also are less likely to be rejected by the body's immune system.  They can even be put in cryogenic storage indefinitely, which cannot occur with bone marrow.  Currently, only 5-6% of cord blood is saved in the United States.  After birth, the moms probably just want to focus on the health of their child, so I think hospitals might have to ask mothers beforehand if they are ok with donating the cord blood. They also need to be more connected to cord blood banks.  This way, it is possible that blood will be more accessible to those who need it, and blood drives may not be as necessary in the future.  I really believe that this is a fairly simple solution, which is not an easy find in medicine, and that administrative issues need to be overcome to deliver it.  Feel free to comment.

From: http://www.tucsonlocalmedia.com/marana/article_706c566c-7ccf-11e5-93fe-abb879e404a6.html

Tuesday, October 13, 2015

Need a prescription? Pay more in the USA

My opinion:  Though the article is short, its message is strong - people in the USA pay three times that of what the British pay for prescription drugs.  And in many other countries, the price is even less expensive.  The article argues that government control of prescription prices is what helps lower costs.  In the USA, pharmaceutical companies have more power to raise prices, and claim that it is necessary for research purposes.  I'm wondering if this is the same reason college tuition has increased so much in the last couple of decades.  Companies figure that Americans are willing to pay more and hence raise the price of the product.  I've also noticed that a some healthcare, for example, radiology, is being outsourced to other countries.  Is it possible for Americans to buy prescription drugs in other countries and have them shipped for an overall lower price?  I also wonder if less popular drugs, which were not included in the study, also are priced higher in the USA than in other countries.  Have any opinions?  Feel free to comment.

From: http://theadvocate.com/news/13694485-172/us-pays-three-times-more

Sunday, September 27, 2015

How Necessary Is Medical Tourism?

My opinion:  According to the case in the article, many people may seek out medical tourism because physicians in America cannot adequately treat certain patients.  While I have heard of this before, many people travel in order to save money on their medical bills, since care is less expensive in other countries.  Some companies exist just to provide medical tourist services to Americans.  Unfortunately, like in the article, patients may still end up paying hundreds of thousands of dollars.  Now, I wonder how possible it is to outsource healthcare to other countries.  Already, medical images are being sent to radiologists in India.  However, in this case, these physicians must have a license to practice medicine in the U.S., even though they are located in a different country.  I believe that, while many people may try to take advantage of medical tourism, most will not.  This is because they may not have access to air travel, have most of their conditions treated well by American doctors, and that doctors in other countries may not be able to take on foreign patients.  This is especially true in Canada, where doctors have tight schedules, since universal healthcare resulted in high demand for services.  Feel free share your thoughts on this topic.

From: http://www.valleynewslive.com/home/headlines/Medical-Tourism-Hits-Home-329712931.html

Sunday, September 13, 2015

Could Deportation of Illegal Immigrants Cause a Medical Crisis?

My opinion:  I think the sudden deportation of immigrants could cause a lot of unintended problems, and this article has a great perspective on the issue.  Deportation could lead to mental health issues, as it is associated with stress and depression.  But besides that, immigrants might refuse to visit doctors, for fear that they will report them to the government.  Should medical ethics dictate that a patient's immigration status is confidential information?  Usually, from an ethical standpoint, if the information could cause harm to the patient or others, it should be withheld.  Not only could this information result in a lack of access to care, but it could cause a large spread of infectious diseases if a large portion of this group is not treated.  At the same time, many feel that these people should not receive healthcare as they are not legal citizens, and they have not paid taxes to support our healthcare system.  Is there a way to fund these immigrants?  How should these immigrants be sought out if deportation efforts increased?  And lastly, what other problems would arise from mass deportation?  Please feel free to comment.


From: http://www.allgov.com/news/controversies/us-health-crisis-could-result-from-mass-deportation-of-undocumented-citizens-medical-group-warns-150909?news=857378

Sunday, September 6, 2015

Doctors May Overrate Their Foreign Language Skills

I'm sure some people reading this may think that doctors overrate their skills in general.   While possible, I think this also reflects that doctors, when listing their foreign languages, usually don't describe their proficiency in such languages.  Indeed, many doctors who attend medical schools in foreign countries like China list their only language as English!  I think doctors, whether in private practice or in hospitals, should list all of their languages along with their skill level, possibly with a description of their experience in that language.  This will better enable foreign patients to determine if that doctor is adequate for them.  Again, my new website, www.mylanguagedoc.com, allows patients to search for doctors by language.  Doctors may include a description of their practice in which they rate their foreign language skills.  Feel free to comment or ask any questions! 

From: http://www.cfah.org/hbns/2011/doctors-often-overrate-how-well-they-speak-a-second-language

Tuesday, September 1, 2015

Doctors Often Don't Use Translators When Necessary

A very intriguing read indeed.  The article comments that doctors tend to use translators more for discussions that they interpret as important, like explaining a complex medical problem.  However, for more basic talks, like check-ups, translators may not be called in.  Sadly, research has shown that patients who don't speak English well are hospitalized for longer periods of time and are misdiagnosed at higher rates.  Many physicians feel that they don't have the time to use an interpreter, or hospitals don't have enough room in their budget to hire them.  I hope that, with my new website, www.mylanguagedoc.com, some of these issues can be alleviated.  The site aims to connect patients with doctors who speak a common language, which can help in areas that lack translators.  This would also save the doctor time, without having a third party interrupt the appointment.  Doctors can add their contact information to the site if they wish.  Any comments are appreciated.

From: http://www.nytimes.com/2009/04/23/health/23chen.html

Monday, August 31, 2015

Can't Find a Physician Who Speaks Your Language? Translators, Websites Can Help!

The article below reveals the importance of foreign language translation in the medical field.  For patients who don't speak English well, clear communication is necessary to solve complex problems.  Foreign patients are enticed to nod their head after the doctor speaks, indicating that they understand the doctor, when they actually understand very little.  If they cannot repeat what the doctor says with accuracy, then a translation professional is contacted.  I'm proud to announce that I'm trying to alleviate this problem with my new website, www.mylanguagedoc.com.  The website has a directory (the making of which is still in progress) where patients can search for doctors who speak their own language.  Doctors can submit their contact information to the directory if they wish.  While I'm sure translators are very useful, some hospitals may not hire them.  Also, patients may want more direct communication with their physicians, or prefer a doctor who understands their cultural background.  I hope patients and doctors alike will find this directory of good use!  Feel free to leave tips, comments, and spread the word!

From: http://www.bendbulletin.com/business/3459206-151/more-multilingual-workers-are-needed#

Sunday, August 23, 2015

Is Overdiagnosis Harming Patients?

The article below mainly focuses on the detection of miniscule cancers by advanced technology.  Though there's no doubt that this may prevent many deaths, some cancers might not evolve into dangerous ones.  The patient would then need treatment for this cancer, and as many people are well aware, cancer treatments are no fun.  Patients and doctors need to be aware that not all health issues, like some cancers, are particularly problematic.  This would prevent the patient from becoming too anxious when there really is little need to be afraid.  Also, I think overdiagnosis remains an issue when trying to identify a mysterious disease.  Sometimes, I've heard, imagery reveals problems that have nothing to do with the patient's actual disease, therefore misleading doctors from arriving at the correct diagnosis.  In these cases, I think it's important to listen to the patient's symptoms and his or her story about how the illness progressed. This, in combination with certain tests, might better help physicians to pinpoint the exact cause, without having to do every test in the world to figure it out.  Perhaps physicians have discovered how to make diagnoses.  For the future, however, they need to know how to interpret these results, leading to the best treatment options for patients.  Any thoughts?  Feel free to comment.

From: http://health.usnews.com/health-news/patient-advice/articles/2015/08/20/tmi-in-medicine-the-problem-of-overdiagnosis

Monday, August 10, 2015

The Rise of Retail Medical Clinics

My opinion:  I think it's great that clinics are becoming more convenient for patients.  Retail clinics usually appear in busy places, like shopping areas.  The article focuses on CVS adding these clinics to their stores.  These are useful for patients who have urgent issues that are not emergencies, for example, sore throats and cuts.  Now, regular doctors are trying to compete, expanding their hours and creating apps that help patients set appointments.  But retail clinics, according to the article, seem to have mid-level healthcare providers like nurse practitioners instead of doctors.  I think that another kind of retail clinic with physicians would attract a different crowd of people, ones who are more willing to trust doctors rather than nurses or PAs.  But would doctors even want to work in such a setting?  I think that is unlikely, although some primary care doctors might be fine with it.  Ultimately, I can see hospitals and regular outpatient clinics dealing with harder or emergency cases, with more specialists on board, whereas retail clinics will treat less severe issues with mid-level providers.  Could this be the beginning of a separation between primary care and specialties?  And are there any other implications of this?  Feel free to comment. 

From: https://www.bostonglobe.com/business/2015/08/07/walk-clinics-are-forcing-big-medicine-rethink-retail-health-care/DUdP4usrTuVA2AIiJJfUHJ/story.html

Tuesday, July 14, 2015

Will Needles Disappear from Medicine?

My opinion:  The article in the link below discusses many potential advancements that can replace needles.  For example, pills may one day have tiny needles that inject the medication into the intestine so it can reach the bloodstream.  Another involves a pill that will dissolve in the tongue, diffusing through the membrane to the bloodstream.  There may even be microscopic patches full of needles that can be pressed into the skin.  All of these methods are remarkable, but, the article reminds us that only 10% of inventions make it to market.  I can see the needle patches being a reality, but I'm not sure about the edible pill.  What if the needles don't inject in the right place, like in the small intestine?  Also, I'm wondering what the patches will do to the skin over time, as they inject over such a wide area.  Regardless, I'm glad that alternatives are being researched.  Though it may be of minor concern to scientists, I'm sure many patients are tired of sticking themselves with needles.  Any thoughts?  Feel free to comment.

From: http://blogs.discovermagazine.com/crux/2015/07/13/needle-free-medicine/#.VaVeSIXEklI

Wednesday, June 24, 2015

Anesthesiologist Bad-Mouths Patient - Does This Occur Often?

I'm not surprised that there are some doctors who do this.  I've heard other stories where anesthesiologists demean their patients.  In my own personal experience, the operating room personnel sometimes swear at each other or make casual jokes, but these are never directed at the patient.  I just wonder how much of this is unaccounted for, since most patients don't have the opportunity to record their doctors.  Should all operating rooms be monitored after this incident? Does the patient even have the right to secretly record the operation?  Feel free to comment. 

From:  http://www.washingtonpost.com/local/anesthesiologist-trashes-sedated-patient-jury-orders-her-to-pay-500000/2015/06/23/cae05c00-18f3-11e5-ab92-c75ae6ab94b5_story.html

Monday, June 8, 2015

A Personal Analysis of Depression and Suicide in the Elderly

I write this after the recent passing of an elderly family friend due to suicide.  This event has taken quite a toll on us and our community, and I can't help but wonder how it could have been prevented.  Previously, I didn't think that seniors were very likely to commit suicide.  However, the following article insists that their depression is different.  Major life changes occur, for example, the death of a spouse or retirement.  Some believe that loneliness after these experiences may contribute to depression.  Contracting many illnesses could be another factor.  What's most interesting to me, though, is that it is not easily detected.  The article suggests that their symptoms may overlap with those of their other illnesses, ultimately hiding the depression.  In the case I described above, it also appeared that the onset of depression was very quick.  I don't know the answers to a lot of these questions, but like many others, I do not think that we value mental health in this country enough.  Looking back, I wish there was something I could have done, but there's no way I could have known.  Any personal stories or advice?  Feel free to share.


From: http://www.komonews.com/news/consumer/Senior-depression-is-different-and-often-undiagnosed-305790371.html

Friday, May 22, 2015

Will Anesthesiologists be Replaced by Robots, Nurses?

My opinion:  Considering that anesthesiologists are some of the highest paid professionals in medicine, many people believe that they should be replaced by assistants, such as certified registered nurses anesthetists (CRNAs), or even by robots.  The issue is, their replacements may not always provide adequate care, especially with complex surgical procedures.  Many states have already allowed for CRNAs to practice independently of anesthesiologists.  I believe that CRNAs and robots may be used in certain scenarios instead of anesthesiologists.  These doctors may not be eliminated, but will be used to a lesser extent to save money.  Do you think this will occur?  Feel free to comment. 

http://www.wsj.com/articles/SB10001424052702303983904579093252573814132

Wednesday, May 13, 2015

Millions of Births, Deaths Unrecorded

My opinion:  I am not surprised that so many people are not tracked, as poorer countries may not have the resources to keep records.  I agree with the article that the civil registration and vital statistics (CRVS) may make for better records.  When a family member dies, relatives may are asked questions that point to the most likely cause of death.  This is probably the best alternative to physician diagnosis, since many places lack doctors required for an examination.  I do wonder, though, if the family will have any motivation to complete the documents.  Furthermore, what if they are illiterate?  In those cases, someone else would have to do CRVS for them.  Finally, this may not capture the number of children who are stillborn, since it is easy to keep the child's birth a secret from the community.  I believe that a medical worker may have to be responsible for the collection of this data, although he or she does not necessarily have to be a doctor.  Any opinions of your own?  Feel free to comment.

Link:
http://www.medicalnewstoday.com/releases/293782.php