AU Blogspot

                 Thanks to Gianni for permission to use this Photo.

Daniel Carlat, of the Carlat Report, has an article in the New York Times Magazine.  It’s six pages long, and decidedly anti-Pharma.  But Daniel Carlat isn’t from New York– so why would he have an article published there?

You say: well, where he’s from has nothing to do with it, the New York Times is publishing it because of what he says.

Exactly.

His article, well written and persuasive, stands as is, undisputed because there is no forum in which to dispute it.  I guess it would be nice if the Times would allow me to write an op-ed– you know, in op to the ed– but I guess this blog will have to do.

Carlat is wrong, very wrong, not because he is factually incorrect about his target, but because his target is a straw man.  The problem isn’t Pharma.  It’s doctors.

The article, called Dr. Drug Rep, chronicles his introduction into the world of lecturing for drug companies– a company hires you to give a talk about a topic or drug to a bunch of doctors– and the effects of the lecturing on doctors and himself, and then his pulling out.  For context, Carlat is a fairly famous psychiatrist blogger who is both a sort of watchdog of Pharma, as well as a source of information about psychiatric drugs. 

The general message is that Pharma softly manipulates doctors to act as proxy drug reps, which in turn lends credibility/celebrity endorsement to the Pharma message, and thus influences other doctors to prescribe the medicine.  Ok, I hear you.  I have no beef with Carlat, his point is not unique.

But break it down:

So we don’t want doctors lecturing about the drugs.  Okay.  Well, who do we want?  More reps?  Here’s where it all falls apart, and I defy anyone to contradict me: doctors aren’t studying these drugs on their own. (more…)

Thanks to Espelina for permission to use this Photo.

Today I went to the gym and tried something new on the treadmill. I did run, but I did something what is referred to as interval training. Interval training is basically doing intervals of a certain workout, in my case, running in bursts of high and low intensity. By running interval training style you’re burning fat efficiently while improving your cardiovascular capabilities.

Here is the exact workout I did today: (more…)

                 Thanks to Natalie for permission to use this Photo.

We Americans are proud of our work ethic. We work longer hours, and more productively, than any other nation. Our industriousness has long been cited as a source of strength of our economy—but it just might be a source of some of our health care woes as well. 

According to a just-released study from Wake Forest University, professional flexibility is an important contributor to better health. Employees at all levels who have, or feel they have, more job flexibility (e.g. the ability to work from home, choose their hours, etc.) engage in healthier behavior than those that don’t. The study found that employees with flexible schedules exercised more, attended more employer-sponsored health classes, were more likely to describe themselves as living a healthy lifestyle, and reported getting more sleep. When the researchers checked in a year later, they found that as job flexibility improved, so did healthy habits: more flexibility meant more sleep, more health classes, and a healthier lifestyle.

This study deserves attention. Changing behavior is the single most powerful way to prevent health problems. As experts from the Robert Wood Johnson Foundation noted in a Health Affairs article earlier this year, “behavioral issues represent the greatest single domain of influence on the health of the U.S. population,” with 40 percent of early deaths in the U.S. due to behavioral patterns. Anything that promotes health behavior needs to be seriously considered as a strategy for making America healthier—and by extension, health care costs lower. 

Obviously, somehow ensuring that everyone in America had more flexible hours wouldn’t cut early deaths by 40 percent. And there’s no guarantee that more flexible hours will translate into better sleep, more exercise, or more education on a national scale. Any movement for universal job flexibility would have to be coupled with a concerted effort to translate free time into healthy time. (more…)

 
                Thanks to Timo for permission to use this Photo.

Two years ago I guest-blogged at the Freakonomics blog about diet and acne. I wrote that the claim of dermatologists that there is no link between diet and acne was absurd, not only because I had seen for myself such a link but also because it was an impossibly broad generalization.

In an article in the Boston Globe, Cynthia Graber, a science journalist, describes quite a bit of evidence that yes, diet affects acne. The research on which the no-link claim was based tested only two foods (chocolate and sugar)! From which committees of dermatologists generalized to all foods.

SO WHY HAVE DOCTORS been taught for so long that there’s no link? The anti-diet hypothesis . . . arose solely from two studies from the late 1960s and early 1970s. . . . One compares real chocolate bars with fake ones and was conducted at the University of Pennsylvania School of Medicine with funding from the Chocolate Manufacturers Association. . . . The other study examines sugar in the diet of a small group. (more…)

It is holiday time, and everyone is getting ready to cook up a feast. This includes everyone’s favorite dishes, from stuffing to pumpkin pie. Friends and families are gathering together and sharing in the love that speaks so loudly this time of year. There are many things rushing through our minds during this time of year, but one of the things that most people forget to consider is food safety. This is actually a very important issue, when you consider how much cooking is going on, and you want to make sure that you take care in the preparation of your food in order to ensure that no one gets sick.

Special thanks to eyeliam for permission to use this photo.

While the United States’ food supply is one of the safest in the entire world, there are still some 76 million people each year that get sick from food borne illnesses. Food safety can be especially challenging during the holidays, as not only is it already cold and flu season and so many people are already sick to begin with, but also because the menu includes many more dishes than normal.

It is important to know that there are certain people who are going to be especially vulnerable to food borne illnesses, and this includes children, pregnant and nursing women, and the elderly. There are many tips that you can use to help keep your menu as delicious as possible while also making sure it is safe for your guests to eat. The following are ten of the most important suggestions to implement here: (more…)

             Thanks to sidewalkstory for permission to use this Photo.

Should people be worried about the security of their health information?  In the past, I used to believe that perhaps the issues of security and privacy (an issue that is related to but NOT identical to security) were overblown.  I would go so far as to suggest that those with vested interests used these two issues to maintain control and prevent sharing of information (that was the cynic in me).  Around the same time, I also held a similar idea that patients didn’t really concern themselves with privacy so much.  Most patients assume that health providers share information as needed and that explicit consent to share information between providers was the strangest (if not the dumbest) thing.  I also believed that health care organizations seemed relatively secure, based on the measures they take which include triple identity verification and limiting remote access.

Today, I’m not so sure if I feel as confident about the security of my health information.  Recently, a family member of mine was almost a victim of fraud (a stranger tried to withdraw a few thousand dollars from a personal account).  This incident is my personal connection with the issue of security.

I’m not trying to sound like I’m paranoid or some cynic about ehealth and maintaining electronic records of our information.  I actually believe that we need to make more of our health information available in electronic format.  But, we need to be more vigilant about securing our health information. (more…)

                Thanks to Tricia for permission to use this Photo.

In medicine, it’s often hard to tell what your peers and co-workers think about you, personally and professionally. We all work hard to keep an above-board polite but distant interaction, and that’s to everyones’ benefit; nobody wants the kind of interpersonal strife a less-than-friendly environment could bring.

In the last two weeks I’ve made another doctor’s day, and a nurse made mine.

I’m slowly getting to the age where I need an internist, and I asked one of our ‘old-school’ docs if he would mind opening his full and closed practice for me. He smiled as he said ‘absolutely’, and smiled the rest of the day in the ED, and not because I’m such a peach of a person. I recognized the feeling, summarized as ‘people who work with me think enough of me to seek me out when they need help’.  It’s terrifically flattering, really. (more…)

                  Thanks to Huain for permission to use this Photo.

My girl Fergie Ferg is not only a talented entertainer, she’s fit! She’s one of my inspirations in wanting to get in shape and live healthy. (I named my site after a line in one of her songs!) There are always pictures of her working out, and I always wondered what she ate on a daily basis to keep her figure lean and fit.

According to Life&Style magazine and also reported on FitSugar, here is an example of what she eats throughout the day by her nutritionist, Carrie Wiatt.

Seriously, I was so happy when I saw FitSugar’s post, I had to let my readers know about it, so read on to get the scoop of Fergie’s diet!

BREAKFAST: Six-egg-white veggie omelet, seasoned with salsa or hot sauce. Or an on to go breakfast: two slices of 100-percent whole-grain toast with 2 tablespoons of low-fat peanut butter. That actually sounds pretty good, I never thought of having salsa with my eggs.  And I love peanut butter with whole grain toast already, so I guess I’m doing something right!

MID-A.M. BITE: Top 4 ounces of low-fat or no-fat plain organic yogurt with 2 tablespoons of low-sugar granola (such as Bear Naked). “It’s low in sugar and has protein,” says Wiatt, who suggests pairing it with a bowl of fiber-filled berries. (Cottage cheese makes a great yogurt alternative.)  Sounds good too, definitely need to try the Bear Naked granola. (more…)