As summer approaches, researchers at Auburn University have performed a study demonstrating the dangers of that ubiquitous summer accessory, the flip-flop.  They recruited volunteers and recorded their gait in both sneakers and flip-flops.  In flip-flops the subjects took shorter steps and didn't raise their toes as far as they did in sneakers. This makes sense, if you think about it.  When we we...

I've written before on the increasing danger of bacteria that are resistant to multiple antibiotics.  This resistance is a side effect of the use, and frequent misuse, of the many antibiotics physicians have at our disposal.  I've also written about the pressure that physicians sometimes face from patients to prescribe unnecessary antibiotics. Last week Slate published an article by Dr. Zachary M...

"But he can't be a man 'cause he doesn't smoke The same cigarettes as me." -- Rolling Stones, (I Can't Get No) Satisfaction

An article in this week's New England Journal of Medicine illuminates the social dynamics of smoking and quitting, and generated a lot of attention in the media.  The study followed twelve thousand people, many of whom were initially smo...

Osteoporosis, which means very low bone density, is a major risk factor for fractures.  Fractures can be catastrophic for older people, and effective medicines exist to treat osteoporosis and prevent fractures, so detecting osteoporosis before a fracture happens is very important in older patients.  Since osteoporosis is very common in postmenopausal women, screening them for osteoporosis is a wel...

Doctors are trained to try to figure out what's wrong and fix it.  We're trained to make a plan and execute it, to do something.  But that impulse to order the next test, prescribe the next therapy or do the next procedure can harm our patients if it's done without consideration of the patient's goals.  That's particularly true with older frail patients whose quality of life is de...

I almost never write about children's health.  I'm not a pediatrician, and most of what I know about kids' health I learned as a dad, not in training.  This topic, however, is important enough to concern all of us. Measles is a very contagious viral illness that causes high fever, a rash, cough and a runny nose.  Complications can include pneumonia, brain inflammation and death.  In 1958 there we...

Automatic external defibrillators (AEDs) are machines that are designed to be used by non-medical personnel in the event of a witnessed sudden collapse.  The AED is connected to the chest of the patient and automatically detects the patient's heart rhythm.  If the AED detects a rhythm that requires an electric shock, the AED delivers the shock and monitors the rhythm until paramedics arrive.  The ...

Patients paying doctors directly for their care is best for patients, best for doctors, and best for the country.  Most of my patients know that this simple idea has been my obsession for the last few years.  Initially, I thought this idea was just a good way to reorganize my practice.  But now, with Medicare within a decade of insolvency, with decreasing numbers of medical students choosing prima...

New Feature Ask the Doctor

I've read a lot in the news in the last two weeks scary stuff about Singulair.  Should I stop taking it? -- Jeff K.

About two weeks ago the FDA released a communication that it was investigating the incidence of suicidal thinking and mood changes in patients taking Singulair, a medication used t...