U.S. Surgeon General Richard Carmona released today a major review of the scientific evidence on secondhand smoke: The Health Consequences of Involuntary Exposure to Tobacco Smoke. This subject was last reviewed by the Surgeon General's office twenty years ago, under Dr. C. Everett Koop. The comprehensiv...

About a month ago I attended the annual conference of the Society for Innovative Medical Practice Design (SIMPD), a national organization of physicians like me who have decided to stop working for insurance companies, and start working for our patients. The conference was very inspirational. We heard distinguished speakers including Tommy Thompson, former Secretary of the Department of Health and ...

This issue of Annals of Internal Medicine has the most relevant medical study I've read in a long time. We've all been in the scary situation of driving late at night while sleepy and struggling to stay awake. This study asked the important question: Does drinking coffee or taking a nap improve driving lat...

Gastroesophageal reflux disease (GERD), in which acid from the stomach rises into the esophagus causing heartburn, is a very common and uncomfortable problem. A connection between GERD and increased weight has long been suspected. This recent study in The New England Journal of Medicine makes a fascina...

A new study from the National Institutes of Health (NIH) and Centers for Disease Control highlights how common type II diabetes is among American adults. The study is summarized in this NIH news release. 6.5% of American adults have diabetes. Even more alarming is that a third of them don't know they have it. Type II di...

A sad fact of our current healthcare marketplace is that a large number of Americans can't afford medical care other than in the emergency room. It's impossible to have a private practice without considering those for whom even the basics of primary care are an unaffordable luxury. Since I went into private practice six years ago, I made a commitment to volunteer caring for indigent patients. One...

I've introduced you to the Medical Letter in a previous post. It's a great source of unbiased reviews of the medical literature. In their most recent issue, the Medical Letter reviewed the available evidence about acupuncture. Si...

Obesity is a serious problem in America and in my practice. Obesity predisposes to type II diabetes, high blood pressure, and high cholesterol. It also increases stress on joints and worsens arthritis. Nevertheless, losing weight for most patients is very difficult. Dietary modification and exercise have been the most proven weight loss techniques, but many patients can not adhere to a strict exer...

Last month's New England Journal of Medicine has a great lesson about how we should think about risk factors. It's been long known that homocysteine is a risk factor for heart disease. That means that, when looking at large numbers of people, those with high levels of homocysteine have more heart attacks on average than those with low levels. Too frequently, we confuse a risk factor with...

The National Center for Health Statistics released the statistics on the number of deaths in 2004. The results document the biggest drop in the American death rate in almost 70 years. The findings are summarized in this AP article.

The center said drops in the death rates for heart disease, can...