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Latest Posts

Why Are Antibiotics Prescribed So Casually And So Frequently?

A good friend of mine and Whistleblower reader contracted the sniffles and received a prescription for antibiotics at a local urgent care center. Nothing newsworthy here. So far this quotidian event sounds like a ‘dog bites man’ story. Had antibiotics been denied, this would have been ‘man bites dog’, as this denial would be a radical departure of standard medical practice, particularly in the urgent care universe.

No doubt, my friend was not assigned the dismissive diagnosis of ‘the sniffles’, but was likely given a more ominous diagnosis of ‘acute upper respiratory infection’, a term that sounds so serious that he might have feared that a 911 call had already been made.

Why are antibiotics prescribed so casually and so frequently? Read more »

*This blog post was originally published at MD Whistleblower*

Video Outlines Testing For Reflux Or Abnormal Esophageal Muscle Activity

Our office has created a new video describing what a patient goes through when they undergo esophageal manometry as well as 24 hour multi-channel pH and impedance testing.

This test is often ordered when a patient is suspected to be suffering from reflux, whether acid or non-acid, or is possibly suffering from abnormal muscle activity of the esophagus.

Symptoms that a patient may experience that may lead to such testing include: Read more »

*This blog post was originally published at Fauquier ENT Blog*

Why Do Physicians Conduct Complete Physical Exams When You Have A Localized Complaint?

One June 20, 2011, NPR aired a great story about how a person may not “see” a person getting beat up on the side of a jogging path when they are focused on a task (pursuing another jogger)… even if they pass RIGHT BY THE FIGHT!!!

In fact, only a third of the subjects reported seeing this mock fight when the experiment was conducted at night. Even more surprisingly, broad daylight didn’t improve the statistics (only 40% noticed the fight).

Though the situation and circumstances do not exactly correspond, there is a lesson to be learned here that applies to a medical visit.

As an ENT, I often see patients for a very specific complaint…

“My right ear hurts.”
“I have a bad cough.”

No matter what the complaint, unless it is for a specific task (there is earwax… can you remove it), I most always still do a complete ear, nose, and throat exam no matter the complaint.

Why??? Read more »

*This blog post was originally published at Fauquier ENT Blog*

Vitamin D For COPD: Why That Won’t Be Enough

I am frequently extolling the health benefits of Vitamin D because almost weekly there is a new study that correlates high vitamin D levels with reducing some disease.  The latest is from the American Journal of Respiratory and Critical Care Medicine and research shows that high doses of vitamin D supplementation improved respiratory muscle strength in patients with Chronic Obstructive Pulmonary Disease (COPD).  The patients that did not receive supplemental vitamin D had blood levels of 22.8 compared to 53.8 in the supplemented group.  The patients who were supplemented had improved respiratory function, strength and less shortness of breath.  It certainly didn’t cure or reverse COPD but the improvement was an encouraging trend in this terrible chronic disease.

In reading about this it got me thinking about COPD and the fact that it is one of the most common reasons for hospitalization and disability in the United States. It is a progressive disease that affects the alveoli (small air sacs that exchange oxygen) and small bronchioles of the lungs.  These airways and air sacs lose their elastic quality and become thick and inflamed.  Mucus forms and patients become progressively short of breath and eventually need supplemental oxygen just to breathe.  COPD is the fourth leading cause of death in the United States.

Did you know that most COPD is caused by Read more »

*This blog post was originally published at EverythingHealth*

Can You Diagnose A Cough By Its Sound?

DiscoveryNews is reporting on a Bedford, Massachusetts company developing software that can detect the difference between a typical cough and one caused by a cold, flu, COPD, or a number of other respiratory diseases. STAR Analytical Services is working with a database of pre-recorded coughs to determine signatures that point to underlying conditions.

The final 100 to 150 milliseconds of the cough contains the distinctive sounds that could help doctors and nurses remotely diagnose a cough as the common cold or more serious pneumonia.

Even with a limited amount of data, scientists can distinguish between a healthy, voluntary cough and the involuntary cough of a sick person. Healthy people have slightly louder coughs, about 2 percent louder than a sick person. Read more »

*This blog post was originally published at Medgadget*

Latest Interviews

The Surprising Economic Burden Of ADHD (Attention-Deficit Hyperactivity Disorder)

If you can read this you need to download a more recent browser It is estimated that as many as million U.S. adults have ADHD Attention-Deficit Hyperactivity Disorder A recent research study publication-pending suggests that the economic burden of ADHD on America could be as high as billion annually. I…

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Is The Adderall Shortage A Harbinger Of Future Drug Supply Problems?

If you can read this you need to download a more recent browser Today most- if not all- Doctor’s offices are strained by the shortage of some prescription medication or vaccine. A month ago President Obama signed his executive order directing the FDA to take steps to reduce drug shortages…

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Latest Book Reviews

Book Review: The First Step To Improve Health Care Is A Close Examination Of How It’s Delivered

My friend and former Chair of the CFAH Board of Trustees Doug Kamerow has written a book that I think you will like. Besides being a mensch and witty as heck Doug is a family doctor and a preventive medicine specialist. In his new book Dissecting American Health Care Commentaries…

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“Your Medical Mind” Explores Factors That Influence A Patient’s Medical Decisions

Recently I had a conversation with Shannon Brownlee the widely respected science journalist and acting director of the Health Policy Program at the New America Foundation about whether men should continue to have access to the PSA test for prostate cancer screening despite the overwhelming evidence that it extends few…

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Book Review: Food Truths, Food Lies

Food Truths Food Lies written by family physician Eric Marcotte M.D. may be the most refreshingly evidence-based diet book of the decade. You will not find a single mention of super-foods magical berries or supplement must-haves in the entire book. What you will find is the cold hard truth about…

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