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Why Are Painkillers Dangerous For Pregnant Women?

A nurse recently asked a very important question that bears repeating: What effect does long-term use of pain pills have on pregnant women? She was concerned because of the increase in number of pregnant women who are taking pain pills on a long term basis based on previous surgeries, accidents or a history of chronic pain.

The most common “pain pills” prescribed are opiates which effectively eliminate or reduce pain but have a great tendency to be abused. Opioids are natural and synthetic type drugs that have the characteristics of morphine. It can only be obtained with a prescription and unfortunately physicians contribute to the problem of dependency and abuse through their lack of scrutiny regarding patient requests. My present home state of Florida has the unsavory distinction of being known as the country’s largest pill mill and it was reported that 80 percent of opiates were not dispensed by pharmacists but by physicians who dispense them from their offices. Consequently, the Florida legislators now prohibit physicians from dispensing opiates in their offices with rare exceptions.

Why are opiates or pain killers dangerous for pregnant women? Read more »

*This blog post was originally published at Dr. Linda Burke-Galloway*

How To Ensure Productive Interactions Between Clinicians And Patients

I sat in a dingy pharmacy near the Seattle airport over the holidays, waiting for an emergency prescription.  For over two hours I watched a slow-moving line of people sign a book, pay and receive their prescription(s). The cashier told each customer picking up more than one prescription or a child’s prescription to wait on the side.  In minutes, the harried white-haired pharmacist came over to ask the person if they were familiar with these medications, described how to take them, identified the side effects to look out for and demonstrated the size of a teaspoon for pediatric medications.  Then he asked the person to repeat back – often in broken, heavily accented English – what he or she had heard and patiently went over the parts they didn’t understand.

I was impressed. This is what every pharmacy should be like – except, of course, for the dinginess, the creeping line and the fact that it was so crowded I could overhear these conversations.  Maybe if we got federal legislation enacted requiring pharmacists to offer counseling with each prescription filled, this kind of attention would be the norm, adherence to medication regimens would improve and drug-related injuries would be reduced.

Wait a minute.  Someone already had that good idea.  It was Read more »

*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*

Can Novel Approaches Fill Primary Care Needs?

New primary care arrangements show how primary care is evolving — or splitting apart, depending upon one’s perspective.

Retainer fees let one practice handle more patients by phone or email. But, points out Richard Baron, FACP, affluent communities can take advantage of such arrangements, and not every community is. And Sam Fink, FACP, of southern California says tele-visits are no substitute for hands-on care. In another model, nurse-led facilities service the poor in north Philadelphia, and more states are expanding the power of the pen to cover shortages. 

Another trend is the shared medical appointment. Led by physicians and conducted by “behaviorists,” the sessions cover a half-dozen or more patients at a time for both primary and specialty care.

Even pharmacists are getting in on primary care. Blue Shield of California is trying a pilot project of pharmacists, believing they have the clinical and patient communication skills to be as effective as doctors, but for less cost. But primary care doctors aren’t completely ceding their profession. There are also pilot projects in California to train more doctors and steer them into communities facing a shortage of primary care services. (USA Today, Fox News, ACP Internist, New York Times, Whittier Daily News)

*This blog post was originally published at ACP Internist*

Fake Doctors With Real Drugs: Quackery In Canada

Two weeks ago, Canadian Skeptics United published on their Skeptic North site a piece by an Ontario pharmacist criticizing a proposal by the province to grant limited prescribing rights to naturopaths. The essay, which was reprinted in the National Post on Tuesday, outlines the intellectual and practical conundrum presented by allowing those with education that diverges from science-based practices to prescribe drugs.

The naturopath lobby came out in force and was relatively unopposed in the 54 comments that followed, primarily because the NP closes comments 24 hours after online posting. Therefore, those with a more rational and considered viewpoint based in facts were locked out from commenting. This is quite disappointing to me personally and professionally because of the wildly emotional appeals, strawman arguments, and smears and attacks on the author himself without, of course, addressing his well-founded criticism of the prescribing proposal before the provincial government.

At the Skeptic North post, the piece even drew a naturopath who equated the criticism of his/her field with the Nazis and Mussolini. However, you can’t write critiques of these practices without attracting attacks ad hominem, especially Godwin’s Law, that are the resort of those whose arguments are logically flawed. Read more »

*This blog post was originally published at Science-Based Medicine*

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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