palmd | August 8, 2009It's true that I don't have a lot of free time on my hands, but last nights UStream event with the crew was lots of fun. Isis and Arikia have been hosting a regular Friday night get-together on UStream, which is a total blast, but last night Isis couldn't tear herself away from her hot, hot science to host. As an experiment, I opened up a UStream channel and we happily chatted far to late into the evening.
And...the format is interesting. I can broadcast live video, and have a parallel text chat. This got me thinking. There are one or two online doctor shows (OK, only one that I know…
palmd | August 7, 2009So, Dear Readers, I've been "dieting", that is, changing my lifestyle now for nearly a week, with some success. Lots of people have their own advice, their own stories, their own beliefs. One fascinating discussion is about whether one must or will necessarily be hungry when eating right. My contention is that most overweight people feel hungry, defined as a desire to eat more, if they have a negative calorie balance.
BUT....
As one super-hot physiologist has pointed out, there are ways to mitigate this.
I say "mitigate" because I really think that there are some people who, if the…
palmd | August 6, 2009A short while ago I wrote about a fear-mongering piece in the Wall Street Journal, written by Betsy McCaughey. It turns out that my imagination was insufficient to comprehend the scope of her audacious mendacity. McCaughey is one of the thugs pushing the lie that the health care reform bill would mandate euthanasia counseling. Her deceitful comments were picked up by Rush Limbaugh and others, and spread across the wackosphere. So what did she say?
The health care reform bill "would make it mandatory -- absolutely require -- that every five years people in Medicare have a required…
palmd | August 6, 2009So yesterday was filled with yummy veggies and fruit, with some proteins and fats thrown in. I made some compromises that were less than healthy (granola bars), but managed to get some great locally-grown melon, salads, and some nice marinated beans, among other things.
This morning I woke up feeling like it was, well, morning, but climbed on the stationary bike for 16 minutes.
Yea!
palmd | August 5, 2009Note: I've been informed by one or two experts whom I trust that my plan sucks. My basic plan is based on a Weight Watchers model, but I take experts with evidence very seriously, so there may be some serious modifications to this post. --PalMD
Obesity is a bad thing. This isn't a moral judgment. If one of your values is long life and good health, then obesity is a bad thing. In general, I think it's a bad idea for me to write about my personal health issues, but I'd like to try an experiment. I suffer from one of the most common and fasting-growing (!) health problems in the U.S.---…
palmd | August 4, 2009Morning report is a daily conference for medical residents. It is done differently at different institutions, but normally a case is presented, often by the post-call team, and discussed by the senior residents and an attending physician. --PalMD
A 35 year old man was brought to the Emergency Department(ED) after being found unconscious on a sidewalk. On initial evaluation by emergency personnel, he was otherwise medically stable, with normal vital signs, a clear airway which he was guarding well, and no obvious evidence of trauma. On arrival at the ED, a CT of the brain and X-rays of the…
palmd | August 2, 2009If you haven't heard by now, the parents who murdered their diabetic daughter are getting a taste of justice. This week Dale Neumann, the father of the diabetic girl whom he and his wife watch die in their home while giving only "prayer", was found guilty of reckless homicide. Death by diabetic ketoacidosis is not pretty. The symptoms start with extreme thirst and frequent urination. Then the person develops headaches, abdominal pain, and vomiting. Eventually, they become confused and lethargic, then lapse into a coma before dying. The discovery of insulin has made this event rare, at…
palmd | July 30, 2009You can count on the Wall Street Journal for pretty good reporting and for extremist right-wing wackaloonery on the OpEd page. Today, they deliver the latter, with bonus fear-mongering at no extra charge.
The piece is entitled, "GovermentCare's Assault on Seniors" and that pretty much sums up the content of the article. Unfortunately (at least, for the moral health of the author), there is little below the headline to justify the inflammatory headline.
Setting aside the oxymoronic tone that simultaneously lauds Medicare and condemns government involvement, the piece is one big mendacious…
palmd | July 30, 2009OK, in parts I and II we talked about health care problems specific to patients and to medical science. Now, on to the providers themselves. Before you start whining about how doctors need to suck it up, remember that you are entrusting your lives to us, and that you should want good people to go into medicine and stay there.
Physician-related problems
Medical education: It is long and very costly. In the U.S., we do not follow a vocational model as many other countries do. Here you must complete a four-year university degree, a four-year medical degree, and a residency program (at…
palmd | July 30, 2009I've been a terrible netizen. I haven't been keeping up with my blog carnivals, especially my favorite, the Skeptics' Circle.
Well, it's up now at Beyond the Short Coat. Go and read!
palmd | July 29, 2009In part I, I presented you wish some admittedly artificial categories of problems in our health care system. First we discussed patient-centered problems. Today, we'll look at problems posed by medical science and practice itself.
Medical science
The science of medicine is not always compatible with the practice of medicine. Medicine is still largely a cottage industry, with hard-working, independent practitioners working in small or medium-sized practices. Aside from licensing statutes, there are no official guidelines that doctors must follow to be officially "certified". Once a…
palmd | July 28, 2009Yes, I know, the two are not mutually exclusive, but I still think it's a good title. The latest bit of evil idiocy? More fanning of fears about health care reform. Don't misunderstand, there's plenty of potential pitfalls to health care reform, but Rush is an idiot. He calls it "Five Freedoms You'll Lose Under Obamacare". Let's see what he's talking about.
I'll let you in on his absurdist intro just for the fun of it:
One of the best points that anybody could make in describing the uniqueness and greatness of this country, do you realize that the history of the world is tyranny? The…
palmd | July 28, 2009I know only one certainty regarding health care reform in the US: I won't be a significant policy maker. And neither, likely, will you. But that doesn't mean we shouldn't educate ourselves, try to understand the problems and potential solutions, because whatever our government implements over the next year, health care reform is going to be a process, rather than a single, achievable endpoint.
I've been consciously avoiding writing this piece, but people keep bugging me. One of the reasons I've avoided it is because I'm not a policy expert, and I don't want to do the extensive research…
palmd | July 27, 2009Smelting: gerund, the act of catching smelt (a small Great Lakes fish) by dipping a bucket in the water during the smelt run season: ex. Smelting is like shooting fish in a barrel.
Sometimes it's too easy. You see, when you criticize someone for being wrong, that's one thing, but when you imply that they are wrong because their entire world-view is incorrect, well, sometimes you get a response.
In a piece last week I was very critical of a new diet and it's creator, and she apparently watches the web, because she came by to comment.
From reading her website and her comment, I get the…
palmd | July 26, 2009Lawmakers and the public in general have no idea how the business and practice of medicine operates. None. When you read statements from many representatives, you see such simplistic, anhistoric thinking that pessimism about health care reform is the only logical response.
Or so it seems from media reports. The New York Times, whose quality seems to be dropping by the femtosecond, reported this week on salaried vs. traditionally paid physicians. This could have been a terrific article, if the reporter knew anything.
Let me catch you up a bit. Doctors are generally paid in one of two ways…
palmd | July 25, 2009Desire is a great friggin' album, and this is one of the better songs, but I never knew about this cover. A shout out to my buddy, whose musical tastes might run in another direction.
palmd | July 23, 2009Alternative medicine practitioners love to coin magic words, but really, how can you blame them? Real medicine has a Clarkeian quality to it*; it's so successful, it seems like magic. But real doctors know that there is nothing magic about it. The "magic" is based on hard work, sound scientific principles, and years of study.
Magic words are great. Terms like mindfulness, functional medicine, or endocrine disruptors take a complicated problem and create a simple but false answer with no real data to back it up. More often than not, the magic word is the invention of a single person who…
palmd | July 22, 2009If you look to your left, you may notice me paddling a black and white cedar-strip and canvas canoe. I am not about to dump into the water---the "lean" is proper solo canoeing posture. A few years decades back, I was the canoeing director at a Canadian summer camp and taught hundreds of kids how to paddle a canoe. Since this is a "science blog", I'll explain this awkward-seeming posture to you.
The proper position for traditional Canandian-style solo paddling is half-way between the bow and the stern, leaning to the side you paddle on, preferably on your knees. The lean itself…
palmd | July 22, 2009Since I abhor the entombment of real news beneath the Michael Jackson story, I didn't think I'd be posting about it, but here I am. You see, Jackson was reportedly under the "care" of a privately hired physician when he died, and was being treated with medications not normally used outside the hospital. I have a problem with this.
According to the Times, authorities are looking for records at the doctor's Houston office. That's not a bad idea.
I'm not a lawyer, and I don't know if: 1) the doctor was licensed to practice in California, or 2) if a doctor from Texas may practice in…