November 29th, 2011 by Michael Kirsch, M.D. in News, Opinion
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It’s Saturday morning, and I’m in an undisclosed location drinking a fabulous cup of coffee while turning the pages of The New York Times, knowing that ink and newsprint will be vanishing too soon. Yes, I do have an iPad now, but I haven’t figured out how to blog on it. Any suggestions?
Buried in the first section of the paper is an article on stool, which in my view as a gastro specialist, should have merited front page placement. Yes, we all know the adage, ‘one’s man’s trash is another man’s treasure’, but stool – as in excrement – should be prized by everyone. Perhaps, as a gastroenterologist, I have a jaundiced view on this issue, which explains my dyspeptic reaction.
All Whistleblower posts have an accompanying image, and I wonder what visual would be appropriate here. I opted against my first choice, and choose instead a photo of our beloved Labrador Retriever, Shoshie, of blessed memory.
The Times reported a new program to Read more »
*This blog post was originally published at MD Whistleblower*
September 23rd, 2011 by M. Brian Fennerty, M.D. in Research
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The right side of the colon seems to be the Achilles heel of colonoscopy because polyps there tend to be flat and harder to find, and we confer the least protection from later colon cancer in that zone.
A recent article summary in Journal Watch Gastroenterology concludes that when we see a right-sided colon polyp, we may have missed another, so we should go back and look again.
This provocative recommendation represents a major change in the way we normally perform colonoscopy. But the issue is, and always has been, how to identify and remove all polyps from the colon.
So the questions I have Read more »
*This blog post was originally published at Gut Check on Gastroenterology*
August 19th, 2011 by Davis Liu, M.D. in News, Opinion
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Newsweek has a very provocative and yet incredibly too simplistic piece for the public and patients on its cover story – One Word Can Save Your Life: No! – New research shows how some common tests and procedures aren’t just expensive, but can do more harm than good.
The piece is actually well written and highlights facts that have been apparent for some time. More intervention and treatment isn’t necessarily better. Having a cardiac catheterization or open heart surgery for patients with stable heart disease and mild chest pain isn’t better than diet, exercise, and the prescription medication treatment. PSA, the blood test previously suggested by many professional organizations, isn’t helpful to screen for prostate cancer, even though the value of the test was questioned years ago. Antibiotics for sinus infection? Usually not helpful.
Certainly doctors do bear part of the blame. If patients are Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
August 3rd, 2011 by Michael Kirsch, M.D. in Opinion, Research
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Most of us born several decades ago, recall the futuristic book Fantastic Voyage by Isaac Asimov, where a miniaturized crew traveled through a human body to cure a scientist who has a blot clot lodged in his brain. Ironically, miniaturized medical care is now upon us while books are at risk of becoming obsolete.
I hope that gastroenterologists won’t become obsolete, at least until my last kid graduates from college.
I perform an amazing diagnostic procedure called wireless capsule endoscopy (WCE), when patients swallow a camera. Once swallowed, this miniaturized camera takes its own fantastic voyage through the alimentary canal. The test is used primarily to identify sources of internal bleeding within the 20 feet of small intestine, which are beyond the reach of gastroenterologists’ conventional scopes. I have performed over 200 of these examinations, and I am still awestruck when I watch a ‘movie’ of someone’s guts. While most examinations do not reveal significant findings, I have seen dramatic lesions that were bleeding before my eyes. WCE can crack a cold medical case wide open.
Here’s a typical view of the small bowel as seen by the cruising camera: Read more »
*This blog post was originally published at MD Whistleblower*
June 13th, 2011 by Davis Liu, M.D. in True Stories
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Dr. Mehmet Oz recently had a piece in Time titled “What I Learned from My Cancer Scare” in which he became the the more humbled Mr. Mehmet Oz. As noted previously here, Dr. Oz last summer had a colonoscopy at age 50 and much to everyone’s surprise had a precancerous colon polyp. He was advised to follow-up again for a repeat test in 3 months.
As the Time magazine piece noted, he didn’t return for 9 months despite repeated reminders from his doctor.
From this experience, he essentially stumbled upon what has been challenging American medicine and primary care. How do we enable patients to do the right thing and get the screening tests done and treatments necessary to avoid premature death and maintain a high quality of life? As a highly trained professional, Dr. Oz knows the risks and benefits of not doing a preventive screening test. As a doctor, he knows all of the secret protocols and codespeak we use when calling patients or asking them to see us in the office for important matters. As a doctor, he also understood the importance of a repeat colonoscopy to ensure no more colon growths.
Yet he didn’t return for 9 months. Why? Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
It’s Saturday morning, and I’m in an undisclosed location drinking a fabulous cup of coffee while turning the pages of The New York Times, knowing that ink and newsprint will be vanishing too soon. Yes, I do have an iPad now, but I haven’t figured out how to blog on it. Any suggestions?
