Entries in Doctors (40)


Doctors Would Advise Themselves Differently than Their Patients, Study Says

Thomas Northcut/Digital Vision(DURHAM, N.C.) -- Primary care physicians often would choose a different option for their own care than what they would recommend to patients, a new study reports.

For the study, published in Monday's issue of the Archives of Internal Medicine, researchers told 242 doctors that either they or a patient could choose one of two surgeries after receiving a colon cancer diagnosis.  Although both procedures had an 80-percent cure rate, one carried a higher death rate with fewer side effects.  The other option with a lower death rate would leave patients potentially needing a colostomy or having chronic diarrhea or other side effects.

They found that 37.8 percent of doctors chose higher mortality with fewer side effects, compared to only 24.5 percent who thought patients would opt for the same option.

"It's a pretty clear message: There's a discrepancy between what doctors recommend to their patients and to themselves," said Dr. Timothy Quill, who authored an accompanying article in the journal.

Quill added that decisions ought to be guided by patient values, not doctors. 

The study's lead author, Dr. Peter A. Ubel agreed that doctors and patients should have in-depth discussions about what matters to the patient.

"Doctors and patients both need to just be aware that advice giving is not as neurtal as they think," Ubell said.  "This is not just about experts handing down expertise.  It fundamentally changes the way people weigh risks and benefits."

Copyright 2011 ABC News Radio


Bipartisan Senate Bill Calls for Medicare Database

Tom Williams / Getty Images(WASHINGTON) -- Senators Charles Grassley (R-Iowa) and Ron Wyden (D-Ore.) have introduced a bill that would disclose to the public the amount of money physicians receive from Medicare for treating patients.

The Medicare Data Access for Transparency and Accountability Act would override a 1979 court injunction keeping government from revealing those numbers.

Grassley and Wyden said they hope the bill will lead to more oversight of Medicare spending which could help the media and public spot Medicare fraud and waste.

“Hiding information on how taxpayer dollars are being spent is not something we do in this country. Moreover, if taxpayer dollars are being spent responsibly there is no reason to hide,” Wyden said in a statement released this week.

Copyright 2011 ABC News Radio


Doctors' Conflicting Interests Can Cost Money and Lives and Hinder Medical Discoveries

Comstock/Thinkstock By Stefan P. Kruszewski, M.D.

(NEW YORK) -- In recent months, the print media have once again outed another group of physicians who benefit from undisclosed financial renumeration from pharmaceutical companies, accompanied by serious conflicts of interest. One headline from The New York Times News Service read "California Docs Paid to Promote Drugs," while other news outlets carried similar stories.

The fact that doctors take money from pharmaceutical companies happens to be old news. But this time around, the docs in question come from Stanford University. Previous news stories reported that doctors receiving pharmaceutical funding hailed from Harvard, the University of Miami, the Medical College of Georgia and the University of Cincinnati College of Medicine.

More than a few of these doctors are psychiatrists who have received tax-supported, public National Institutes of Health and National Institute of Mental Health funding for clinical research, have participated in U.S. Food and Drug Administation advisory panels or have appeared on, or on behalf of, various not-for-profit psychiatric advocacy boards -- some of which are heavily supported by the manufacturers of psychiatric medications.

For example, authors of a psychiatric study might recommend a specific antidepressant therapy but fail to reveal that they are being paid by multiple antidepressant manufacturers to speak, advocate and do research for the companies that sell the drugs. Academic journals, heavily supported by advertising money, are biased and complicit in the conflict of interest fiasco.

Drug promotion and clinical decision-making that are brokered on the backs of dollar bills have a greater chance of causing serious adverse outcomes, including illnesses and death. If a physician embellishes the effectiveness of a drug or minimizes its risk, that directly hurts patients.

Physicians who are heavily supported by pharmaceutical companies and medical device makers are not forming independent, unbiased decisions. Instead, their brains have been lined with gifts, perks and money, which influences their rose-colored opinions.

Conflicted clinical research -- often done especially by and for a particular psychiatric pharmaceutical manufacturer -- whose design and analysis are biased and whose summary and conclusions are misleadingly positive, fracture the backbone of scientific research.

The legacy of fraudulent research lingers for years before it is recognized and repudiated. That effort impedes real progress, wastes time, money and human resources that could be focused on finding real cures to help all of us. And that's not good for anybody.

Copyright 2011 ABC News Radio


Doctors Fail to Monitor Potential Opioid Abuse Appropriately

Brand X Pictures/Thinkstock(NEW YORK) -- Statistics show the abuse of prescription painkillers has been on the rise for nearly two decades, but a new study found that primary care physicians may not be diligently monitoring patients who are taking opioid painkillers such as OxyContin, even those who are at risk for becoming dependent on them. Experts say dependence on opioids accounts for much of the rampant prescription drug abuse.

"We studied a cohort of more than 1,600 primary care patients prescribed long-term opioids and looked at how frequently they received three strategies for reducing the risk of misuse," said lead researcher Dr. Joanna Starrels, assistant professor of medicine at the Albert Einstein College of Medicine and Montefiore Medical Center in the Bronx, N.Y. The three risk-reduction strategies are urine tests, face-to-face office visits at least every six months and within a month of changing an opioid prescription, and limiting the number of early refills.

Data showed that only eight percent of the patients in the study had any urine drug testing, less than half had regular office visits and nearly 25 percent received multiple early refills.

"This suggests that primary care physicians are not using these risk reduction strategies very frequently," said Starrels.

Whitney O'Neill knows just how powerful prescription pain medication can be, and also how easy it could be for doctors to miss the signs of addiction.

For almost eight years, she was physically dependent on them. She started taking the drugs when she was around 12, after a fall caused her to suffer from crushing migraines. She was 17 when she said the drugs became a problem.

"After years of repeated use, I developed a dependency on them," said O'Neill, now 31. "I started to get sick if I didn't take them."

While she doesn't blame her doctor for feeding her habit with a constant supply of painkillers, she doesn't think her doctor realized she had a problem. And at that time, she couldn't admit she was an addict.

"I think it was a missed opportunity to have recognized I had addictive disease," said O'Neill, who is now outreach coordinator for Faces and Voices of Recovery, an advocacy group.

Addiction specialists say a lot of burden falls on primary care physicians, usually on the front lines of pain management. Some believe primary care physicians just don't know enough about addiction, while others say factors beyond their control are contributing to the increased use of opioids.

"Most primary care physicians are not trained in addictions," said Dr. Stephen Ross, clinical director of the NYU Langone Center of Excellence on Addiction. "It's not that physicians are not well-meaning, it's just a lack of education and not knowing how to treat addictions."

"It's not a lack of awareness or caring, but they don't have the tools to help manage the risk," said Starrels. "They may not know what risk the factors are or how to monitor their patients for evidence of misuse."

As for the finding that many doctors provide more early refills to patients at higher risk for misuse, even those who have a drug use disorder, Starrels stressed it's important to figure out why. She says it may be because patients are abusing the medications or because doctors are cautious and prescribing a lower dose than patients need for pain.

"This finding is very concerning, and we need to understand the reasons." 

Copyright 2011 ABC News Radio


Clinical Trial Participation Dampened by Motives, Fears

Thomas Northcut/Thinkstock(DURHAM, N.C.) -- Across cancers and a range of other life-threatening diseases, researchers struggle to recruit enough patients for trials to generate meaningful results.

Clinical trials are a crucial step in the search for disease treatments, tests and causes.  But fears, misconceptions and a lack of awareness -- among patients and doctors -- are major barriers that researchers across all fields are working hard to overcome.

"In just about every major disease, less than 10 percent of patients are enrolling in trials," said Dr. Richard Bedlack, director of Duke University's Amyotrophic Lateral Sclerosis Clinic in Durham, North Carolina.

Bedlack said only five percent of people with ALS (or Lou Gehrig's disease) -- a fatal neurological disease with no cure and only one treatment that extends the average three-to-five-year survival only slightly -- enroll in clinical trials.

Bedlack has been studying what motivates people to participate in trials and what dissuades them from signing up. Patients worry that participating in trials will spur out-of-pocket expenses, impose heavy time burdens, and possibly expose them to dangerous or unethical procedures, according to a survey he presented in December at the 21st annual International Symposium on ALS-Motor Neuron Disease in Orlando.

Websites touting bogus treatments and trials abroad also hinder research efforts in the United States.

Lack of awareness and worries about time burdens and paperwork dissuade doctors from recommending trials, too, Bedlack said.  Many doctors go with the standard treatments, and don't even mention trials unless asked.

Copyright 2011 ABC News Radio


Doctors Remove Part of Cheerleader's Brain to Stop Seizures

Photo Courtesy - ABC News(DENVER) -- It was a stunt that Whitney Henry would never forget. During the summer before her junior year of high school, Henry and her cheerleading teammates were practicing a routine that involved tossing one girl, the flyer, into the air. The stunt quickly went awry when the flyer strayed in mid-flight, slamming her head into Henry's face, knocking out Henry's two front teeth.

While the dental debacle was damaging to her smile, Henry would only learn later how much of an impact this accident would have on her life, and that it would eventually lead surgeons to remove a chunk of her brain.

Henry suffered her first episode six months after the accident. She recalled that she could not speak for about two minutes and experienced intense déjà vu.

"I didn't know if I was just different or if I was having a seizure or what," said the now 20-year-old Henry.

It turned out that it was a seizure and after the first episode, the seizures became more intense and frequent. She experienced 30 to 50 per day. And as a junior in high school, Henry would often have seizures while in school.

The frustrations continued when Henry sought medical help for her mysterious condition. She went through six neurologists and 13 anticonvulsant medications without any improvement.

"It was maddening," said Henry. "I had no quality of life at all."

Between debilitating seizures, and the memory loss and paranoia that came along with the regular episodes, Henry's grades plummeted her junior year.

But after one and a half years of attacks, Dr. Michael Handler, a pediatric neurosurgeon at Children's Hospital in Denver, Colo., finally pinpointed the cheerleading accident as the cause of her condition and suggested surgery to treat it.

"This is not a step we take lightly," Handler told ABC News affiliate, ABC7 in Denver. "It's a step that's hard for some doctors to accept and some patients to accept."

The accident caused a traumatic brain injury that instead of a concussion, caused a contusion -- a big bruise on the brain -- that caused permanent damage. According to the Epilepsy Foundation, epilepsy and seizures affect almost 3 million Americans, and about 300,000 of those affected have difficulty controlling seizures despite medical management.

"Medications are the first line of treatment," said Dr. Brian Greenwald, medical director of Brain Injury Rehabilitation at Mount Sinai Hospital in New York City. "With one or two medications, most people [about 80 percent] can get control of their seizures."

"This injury occurs when [the temporal lobe] slides up against the bony projections that form the base of the skull cavity," said Dr. Gregory O'Shanick, medical director emeritus of the Brain Injury Association of America. "This follows either a direct blow to the head or an acceleration-deceleration of the head that then causes the brain to shift in the skull."

After surgery became an option on the table for Henry's condition, she did not hesitate for even a moment. "My reaction was, 'Can we do it tomorrow?'" said Henry. "I was relieved and anxious to get through surgery and have a new life."

Doctors conducted four week-long studies on Henry before she went into surgery, where doctors removed a golf ball size portion of Henry's temporal lobe.

Dr. Atif Haque, a neurosurgeon at the Fort Worth Brain and Spine Institute, said that most people get brain surgery because of the interference that strokes have on their lives.

Henry has now been seizure free for two years and four months. She is a senior at University of Northern Colorado, and plans on getting her master's degree and Ph.D. in psychology.

"I guess that part of my brain was holding me back," said Henry. "I'm excited to have a fresh start." 

Copyright 2011 ABC News Radio


Doctors Should Be Careful About What They Tweet

Photo Courtesy - Nicholas Kamm/AFP/Getty Images(WASHINGTON) -- Like everyone else these days, doctors are fans of social networking sites and the vast majority use them responsibly.

Still, a new study from George Washington School of Medicine and Health Science says a small number of physicians cross an ethical line that potentially endangers patients or puts their careers in jeopardy.

Checking out Twitter during May of 2010, Dr. Katherine Chretien and her staff examined more than 5,000 tweets from 260 licensed doctors with at least 500 followers.  In all, the researchers found that three percent of tweets were labeled “unprofessional,” which means they involved breaches of patient privacy along with profanity, sexually-explicit remarks and discriminatory statements.

If that wasn’t bad enough, another one percent of doctor tweets featured claims about a product they were selling on their individual websites that couldn’t be readily substantiated, as well as heavy promotion of other specific health products.  A few of these statements were considered potentially harmful because they contradicted acceptable medical knowledge.

Chretien concluded, “This research helped us to identify how physicians are using social media and has helped us gauge whether or not there is need for greater accountability for physicians who use social media.”

Copyright 2011 ABC News Radio


Survey: Use of Temporary Doctors Increasing

Photo Courtesy - Getty Images(IRVING, Texas) -- As a shortage of doctors ensues in the U.S., more and more hospitals and medical groups are resorting to hiring temporary physicians to fill in the gaps, according to a new survey released Wednesday.

The survey, conducted by the temporary physician staffing firm Staff Care, polled various facilities and found that 85 percent of them had used the part-time doctors sometime in the past 12 months.  This new average is an increase from the previous year, when the average was 72 percent.

Of those surveyed, 63 percent noted that the top reason for using temporary physicians was to have someone fill in until the facility could find a permanent doctor.

"There are simply too few physicians to fill all the available vacancies today," said Tim Boes, president of Staff Care.  "Temporary doctors are providing critical, interim patient care services for many healthcare facilities until they can find the full-time physicians they need."

The survey also found that psychiatrists and other behavioral health specialists were the most demanded temporary doctors.

Copyright 2011 ABC News Radio


Study: Length of Doctors' Sleeves Doesn't Impact Bacteria

Photo Courtesy - Getty Images(DENVER, Colo.) -- Based on the assumption that long-sleeves lead to lots of bacterial contamination among physicians, governmental agencies in the United Kingdom and Scotland have recently instituted guidelines banning physicians' white coats and the wearing of long-sleeves garments to decrease the transmission of bacteria within the hospitals.

But a new study suggests that the length of sleeves may not really matter after all.

Researchers at the University of Colorado tested uniforms of 100 physicians who were randomly assigned to wear either short-sleeved or long-sleeved uniforms at the start of their day.  By testing for the presence of bacteria on the physicians’ wrists, cuffs and pockets, the study found there was no difference in bacterial contamination between the long-sleeved white coats and short-sleeved uniforms.

The author of the study, which was published in the Journal of Hospital Medicine, concluded the data “do not support discarding white coats for uniforms that are changed on a daily basis, or for requiring health care workers to avoid long-sleeved garments”.

Copyright 2011 ABC News Radio


New Survey Shows Americans Still Trust Their Doctors

Photo Courtesy - Getty Images

(PRINCETON, N.J.) -- Despite the volubility of medical advice -- both online and around the world -- Americans still seem to trust their doctors and rarely seek a second opinion after their first diagnosis. The latest results from Gallup's annual Health and Healthcare Survey show that 70 percent of Americans trust their doctor's word and see no need to seek additional information or other opinions.

This information contradicts what Gallup describes as doctors' complaints about their patients not trusting their opinions and spending hours surfing online medical sites. The poll shows that the eldery are especially sure of their doctor's diagnoses and medical advice. It also reveals that patients with college or graduate degrees do not necessarily doubt their doctors more than anyone else.

Copyright 2010 ABC News Radio

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