Blogging over at MedPage Today, Shadowfax gives a more detailed look at their indiscretions.

With margins are already well above the national average, the hospital has decided to double down on profits, by limiting hospital beds available to the emergency department, and concentrating on revenue-generating services like oncology and surgical subspecialties.

I’m sure that if they could shut down the emergency department, a drain on most every hospital, they would.

It’s quite eye-opening how blatant they are in limiting care to the community, and now, federal regulations are taking a closer look. Repercussions, aside from the public relations hit they are taking, could be severe, including Medicare pulling its certification from the hospital.

So, in trying to stem the financial bleeding from emergency care, the University of Chicago is providing a template on how not to do it.

kevinmd.com

1. First and foremost, if you are unsure of a symptom, feeling, or situation, get to the doctor immediately. It is far better to be safe than sorry. You do not want to take any chances when it comes to your pregnancy.

2. In false labor, contractions are not usually coming in regular intervals. They also do not increase or grow more and more severe.

3. If you are moving around, and the contractions only seem to get worse, then chances are you are facing the real thing.

4. In false labor pains, the pain is often in the lower belly as opposed to the lower back area. In real labor, the pain can also spread to your legs. Diarrhea is also quite common, or other forms of upset stomach.

5. If the pain comes and goes in response to physical activity or movement, then it is almost always false labor. These actions will normally cause real labor to intensify.

6. If your water breaks, you are in labor or about to be. Do not ever misread this sign. You would be amazed at how many people ignore this as a sign of labor.

7. If your show is pinkish or bloody at all, then real labor is likely. In false labor, it is often brownish in color.

The vast majority of women have at least one false alarm during their pregnancy. Feel free to communicate openly with your doctor about questions that you may have. Every expecting Mother has a unique set of questions, and their own perspective about what is normal or not. The doctor is your resource to go to when you are concerned, and you should always use this resource to the fullest. They are paid well to make you comfortable and the vast majority of doctors love to inform Mothers about health concerns and questions. It actually helps them to do their job easier at delivery to have an informed Mom.

As stated above, the important thing is to listen to your body. The symptoms vary from person to person and no two pregnancies are identical. If you are uncertain, go to the hospital or call your doctor. If you are wrong, doctors and nurses will certainly understand.

romow.com

Psychiatrist Daniel Carlat points to what’s happening at the University of Wisconsin, where company-funded CME lectures conveniently left out side effects of the medications that were mentioned.

For instance, in a Pfizer-sponsored course on smoking cessation, not one of Pfizer-marketed Chantix’s many side effects were mentioned.

CME is a big money industry, and in the cited case, Pfizer contributed some $12.3 million to the University of Wisconsin’s courses.

So, if medical schools were to ban the drug industry from funding their CME, who will pay for them? Cash-strapped medical schools? Likely not.

It’s probably going to fall on individual physicians who, in many states, need CME credits to maintain their licenses. I suspect that CME will become significantly more expensive to attend in the near future.

kevinmd.com

Gary Schwtizer writes about the case of Rep. Debbie Wasserman Schultz (D-Fla.), who is introducing a new bill advocating breast cancer screening to begin earlier than the current suggested age of 40.

Ms. Wasserman Schultz was diagnosed with breast cancer at age 42, and wants “to educate the public, particularly young women and their doctors, about the need for a much earlier approach to breast cancer detection.”

Now, she is to be applauded for being a breast cancer survivor, and no doubt, has gone through a difficult ordeal, including a double mastectomy and removal of her ovaries.

But, as Mr. Schwitzer notes, it is difficult to criticize health advocates like these without sounding heartless. The fact is, there is no definitive data that mammograms improve the mortality rate, and by pushing for breast cancer screening at an earlier age, millions of young women will be exposed to needless breast biopsies and procedures for the false positives that mammograms invariably find.

The concept of false positives simply doesn’t tug on the emotional heartstrings, which is why those who preach evidence-based medicine will have such a hard time convincing the public that less cancer screening is sometimes better medicine.

kevinmd.com

Apparently, one of the biggest mistakes is positioning the head incorrectly, and the problem is traced back to the television drama ER. When surveyed, most young doctors and medical students cited television as the main source of tips on how to intubate correctly, specifically, ER.

But when researchers actually watched the show, “some aspect of the head positioning was wrong in all 22 intubations that could be fully viewed on screen.”

Oops.

So, the moral of the story is don’t believe everything you see on television. I shudder to think how House, M.D. is influencing the current generation of doctors-in-training.

kevinmd.com

1. Understand right away that the only completely effective way to prevent the chances of getting a yeast infection from an infected person is to not have sex with them. This is obvious and the most common sense approach to dealing with a partner who has a yeast infection. Allow them to be treated and healed of the yeast infection before you have sex and you will have no chance of getting the infection.

2. Carefully pay attention to your partner’s physical make up. Knowing your partner well and knowing their vagina well is very important. This can help you to notice redness, swelling, unpleasant odors, and any other irregularities. If you notice anything that seems out of the ordinary, inform your partner and have them get it checked out before having sex. It is always a good idea to be on the safe side where infections are concerned.

3. Many men and women share underwear. Though the odds of getting an infection in this manner are low, the chance exists. If your partner is suffering with a yeast infection, make sure that you are careful to not wear each other’s underwear. This is actually a bad idea to start with from a hygiene point of view, but especially so if one of you have an infection of any kind. Get your own undies!

4. Some people are of the mind that wearing a condom will prevent the spread of a yeast infection. While certainly it is a better option than not wearing anything at all, it is not fool proof by any means. Condoms are only as good as the fit and condition of the condom, and not all of your privates are covered. A transfer of the yeast infection is still possible, but a condom should be the least you would do if you are going to attempt sexual relations anyway.

5. Make sure that you treat the yeast infection immediately and thoroughly. Over the counter anti fungal creams are effective in most cases, but occasionally you may need an oral medication to fight the infection. It is vital that you see your doctor for any infections that you are unable to fix with the anti fungal creams sold over the counter. Make sure you do not ignore and leave yeast infections untreated. That can lead to all sorts of problems, and your sex life will likely be shelved much longer than it would otherwise.

romow.com

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Articles that are provocative, well-written, free of grammatical or spelling errors, and generally follow these guidelines are preferred.

Pieces that have not been published elsewhere are more likely to be accepted, and not all submissions are guaranteed to be published.

A link to the author’s book, blog, or website will be included.

Here are some sample guest pieces that have been published in the past.

If you are interested in submitting a take for consideration, please contact me.

kevinmd.com

Subsequently, the number of drug reps is predicted to fall from about 102,000 at its peak in 2007, to 75,000 by 2012.

There are a variety of reasons for this, including the fact that more doctors simply don’t trust the information that’s presented, to medical schools banning access to the pharmaceutical industry.

A lot of times, it’s simply a matter of time. As doctors are pressured to see more patients, they simply don’t have the minutes available during the day to be detailed.

So, how will the industry evolve? One possibility is increasing online exposure to drug marketing. According to marketing agency Manhattan Research, “about 45,000 doctors meet with detailers using online video, and 300,000 physicians say they are open to doing so.”

It seems that drug detailing may go the way of the printed newspaper, as more physicians are willing to learn about, and listen to, marketing over the internet.

kevinmd.com

The current trend in the marketing of acai pertains to its ability to help shed fat. While this may be true, there are many companies that are offering free trials of supplements containing this wondrous exotic berry. It is important to know that while internet deals on acai may be compelling, that they may also be scams. There are legitimate places in which you can find great deals on acai. The quality of the acai in the supplements is not compromised, and they will ensure that you don’t get scammed.

Health food stores-This is one of the easiest avenues to find the illustrious acai berry. While it is native to Brazil, and cannot be sourced elsewhere, you will not be able to find fresh acai. Health food stores typically offer acai in the form of juice as well as unsweetened pulp. (Pulp being the preferred manner of nutritional consumption)

Vitamin stores-While freeze-dried acai supplements may not be as effective as juice or pulp, it is still a decent source for acai. Acai can be found in many antioxidant supplements as well as by itself.

Grocery stores-Acai can be found fairly easily these days in your local grocery store. Acai can be found in granola bars, various types of organic granolas, teas, yogurts, and even ice cream. While acai juice that you purchase in the grocery store is more than likely not going to be 100% acai, I would suggest you chose one mixed with pomegranate or blueberry.

Online Sources – Acai can be found online from reputable sources, but you must be careful that you are getting the real deal. Research your online stores carefully, and make sure you understand exactly what you are purchasing before forking over your hard earned money.

Acai is as powerful as its marketing. There is no evidence to suggest that acai alone can help you shed unwanted fat. Acai should be utilized as a supplement and not a miracle cure for weight loss. Acai should be thought of more as an antioxidant and fiber source than as a diet miracle cure. I am not trying to steer you away from using acai as I do believe it to be a beneficial supplement.

romow.com

The American Psychiatric Association is taking that recommendation to heart, announcing that it will end industry-sponsored seminars at its annual meeting.

Good for them.

But, I’d be interested to see how many of these professional organizations can survive the funding cut. For instance, the APA stands to lose $1.5 million from the lost revenue previously reaped from drug companies sponsorships.

Large, national organizations can probably withstand the financial losses. However, I wonder if the smaller ones, especially in this economy, can make that same ethical stand.

kevinmd.com