Take a Big Breath

I beg your indulgence this week as I ignore medical news and offer some personal reflections. Unless you’ve been avoiding all news sources for the last few weeks, you know that a lot of people all over the world are scared.  Today’s headlines scream about the worst week ever on Wall Street, with trillions of dollars of assets evaporating.  No one is sure when the housing and credit markets will stop falling.  No one is sure whether the actions of the U.S. and other governments to keep credit fl...
More

Better to Give than to Receive

For the last couple of years I’ve made a commitment to donate blood every month or two at Cedars-Sinai.  Though I must admit the first few times I was scared by the whole experience, I almost look forward to it now.  The nurses treat the regulars like old friends, and the donors are treated to a mandatory break from their busy lives.  Since we can’t be productive, we listen to music, or watch TV, or pick a movie from their eclectic selection.  (Oddly enough, I’ve found that gory horror movies ar...
More

Healthcare Reform

The New England Journal of Medicine and the Massachusetts Medical Society released a video this week of a panel discussion on U.S. health policy.  I thought it was a fascinating and intelligent discussion by representatives of all the stakeholders in the debate.  The discussion covers many topics critical to American healthcare, including the dwindling numbers of primary care physicians, adoption of electronic medical records, providing care to the tens of millions of uninsured, and the...
More

You Can Probably Stop Taking Antibiotics before Seeing Your Dentist

Many patients have been told to take antibiotics before dental procedures.  This recommendation was made to prevent an infection of the lining or valves of the heart called infective endocarditis (IE).  Patients who had leaky heart valves or other heart conditions that were thought to increase the risk of IE were told to take antibiotics before seeing the dentist. Last week the American Heart Association p...
More

The Pedometer Project: Steps that Make a Difference

With the end of 2006 a few days away many of us turn our thoughts to the New Year and seize the opportunity to rededicate ourselves to healthier habits. I personally know all too well how easy it is to stop exercising and how hard it is to start again. I also know how insidious inactivity can be. In the last month alone, I've had to tell three of my patients that they were in the earliest stages of developing diabetes. For them, the need to exercise and to pay compulsive attention to their diet ...
More

Reclaiming the Q Word

A generation ago, in the bad old days, physicians were thought of as unquestioned experts who dispensed orders rather than advice, and expected dutiful compliance from their patients.  Fortunately those days are long gone, and today the patient and the physician see each other as partners in the patient's healthcare, with the patient able to question and even challenge the doctor's recommendations.  This keeps doctors smart and honest and keeps patients ultimately in control of their health.  Bu...
More

Preventive Care Recommendations at Your Fingertips

Preventive medicine is a rapidly growing field.  Testing that detects diseases in early stages, treatments that prevent diseases before they occur, and behaviors that make diseases less likely all hold the promise to keep us healthy and let us live longer.  Unfortunately the field is also increasingly marred by tests and services that are recommended to patients without any scientific evidence that they work, or worse, despite much evidence that they are useless. That's why I've long been a dis...
More

A Habit of Giving

Most of us think of ourselves as people who go out of our way to do the right thing, especially if it helps those less fortunate than ourselves.  We donate to charities; we volunteer our time; we tell our friends about worthy causes.  Nevertheless I was surprised to find that I had forgotten about a much-needed gift that most of us can give:  blood.  A few weeks ago I was embarrassed to find out it had been six months since my last bloo...
More