March 7, 2017
The New York Times pointed me to a study in Brain that shows the effectiveness of acupuncture for patients with carpal tunnel syndrome. I see many people getting a different kind of needling – with steroids, but this is intriguing:
Rewiring the primary somatosensory cortex in carpal tunnel syndrome with acupuncture | Brain | Oxford Academic
March 5, 2017
Baseline EKGs are considered poor predictors of heart attacks. This article in The Wall Street Journal says they are not, if coupled with the Seattle criteria.
March 2, 2017
Every year I get at least half a dozen new patients who are “from away”, as we say in Maine. Obviously, I’m “from away” myself. I chose to come here after once driving up from Massachusetts, where I had been an exchange student, and seeing the untouched vastness and the slower pace of life in rural Maine.
Until a few years ago, these new patients were all people who had fallen in love with Maine by vacationing here, or they had come here because of job opportunities.
Lately, I have puzzled over why some of my new patients have chosen to move here; many of them have serious health problems and disabilities, they have never visited Maine before (or seen a Maine winter) and they don’t know a soul here.
A few have hinted about the lower cost of living, and I didn’t really think very hard about that until I saw an article in the Wall Street Journal about a baby boomer in California who moved to an Iowa town of 700 just to be able to survive on the resources she had left to live out her life on.
February 24, 2017
Anorexia Nervosa, a disease I first saw treated with behavioral therapy in medical school on the OB/GYN ward at Uppsala Akademiska Hospital, appears to respond to Deep Brain Stimulation.
February 14, 2017
The American College of Physicians has issued their new guidelines on how to treat low back pain without sciatica. No more “pain is the fifth vital sign”, and no more opioids.
February 13, 2017
Richard Gunderman is a wise and prolific writer, radiologist and professor of many disciplines. He writes eloquently in NEJM Catalyst:
What Is Medicine For?
The core problem, then, isn’t managerial. It isn’t even ethical. It’s ontological, pertaining to the most fundamental question of all: what in medicine is most real?
Recent efforts to convert medicine from a relationship-centered profession to an efficiency-focused production process have shifted the focus of attention……describing…a health care culture seriously out of step with what matters most in patient care. This imbalance inevitably erodes the engagement of health professionals.
October 6, 2016
I have, in my entire life, made up only one joke worthy of standup comedy. It is perhaps similar to Stephen Wright’s “I live on a one-way, dead end street”.
It goes “Is infertility hereditary?”
Of course, there is some serious thought behind it. More serious than I thought, it turns out:
Sons born with fertility treatment ‘inherit problems’
Boys born to fathers who needed help conceiving grow up to have poorer sperm quality than peers conceived without help, a study has found.
April 23, 2016
A Country Doctor Writes is one of the top 100 healthcare blogs on eVisit’s 2016 list. They write:
This blog is a great read from a small-town doctor who’s been practicing on the same families for generations. The posts feature “progress notes,” highlighting interesting and unusual cases, along with touching stories of being the doctor for such a close-knit community.
January 31, 2016
Here’s a headline from this week’s Medical Economics. The article points out that our office notes are scrutinized for lazy documentation cliches that don’t reflect the amount or complexity of work to justify our charges.
What’s that expression about throwing rocks from a glass house?