Tag Archives: medicine

Why do doctors call it “practice variation” instead of poor care?

Posted on by Carolyn Thomas
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Did you know that your medical treatment may depend on where you live?  It even has a name: doctors call it “practice variation”. A new U.S. study suggests, for example, that a person living in St. Cloud, Minnesota is twice as likely to undergo invasive back surgery as a patient with a virtually identical diagnosis living in Rochester.  There are a number of reasons for this strange disparity, but one might be that Rochester is the home of the non-profit Mayo Clinic, where surgeons are paid a salary. No matter how many surgeries they do, they earn the same paycheque.  But other physicians elsewhere who are paid per surgery may be inclined to do more surgeries.

Such “practice variation” is not just seen at Mayo. Medicare patients in Fort Myers, Florida, are more than twice as likely to receive hip replacement surgeries compared to their counterparts across the Everglades in Miami, according to Dartmouth Health Atlas researchers in April 2010.    Continue reading →

How to turn a condition into a disease by “selling sickness”

Posted on by Carolyn Thomas
10

“Selling sickness” means that the line between healthy and sick becomes blurred – and demand for medical treatment increases. If you’re a drug company, it’s a swell way to get consumers to demand treatment that may or may not even be necessary. So says a Dutch study that investigated industry-funded information campaigns around common conditions like restless legs syndrome, overactive bladder and heartburn.

These “ask your doctor” campaigns focused on symptom advertising or disease mongering.

Dutch law, as in Canada (but not, significantly, in only two countries: the U.S. and New Zealand) prohibits “Direct To Consumer” public advertising of prescription drugs. You might well wonder why these two countries are the only ones on earth who still permit this marketing practice. Continue reading →

Why there’s no such thing as “clinically proven”

Posted on by Carolyn Thomas
10

I really like reading the common sense essays of Pennsylvania physician Dr. Lucy Hornstein. She’s also the author of the book, Declarations of a Dinosaur: 10 Laws I’ve Learned as a Family Doctor.  I like her writing mostly because I agree with almost everything she says. She’s brilliant, really. Last month, Dr. Lucy took aim at one of my own pet peeves: advertising for questionable health products that claim the benefits of such products are “clinically proven”.

For example, she picked on a radio ad for a colon cleanse product that helps remove the ‘five to ten pounds of waste some experts believe are spackled along the inside of the large intestine’:

“But ‘some experts‘ also believe the moon landing was a hoax, the Holocaust never happened, and homeopathy is effective medicine. Somehow this colon cleansing stuff helps you preferentially lose belly fat. Not really sure what belly fat has to do with five to ten pounds of stuff spackled inside your intestine. But they’re not selling logic. Call right now for your free sample. Or not.  Continue reading →

What we can learn about medicine from watching Grey’s Anatomy

Posted on by Carolyn Thomas
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When the popular TV hospital drama Grey’s Anatomy featured a story line about a patient diagnosed with a rare genetic condition called von Hippel-Lindau disease (VHL), Joyce Graff paid close attention. The Executive Director of the VHL Family Alliance watched as the surgeon onscreen discovers a large cyst on the patient’s pancreas, described as being “in danger of rupturing”. Joyce described the scene:

“The TV surgeon removes a significant portion of the pancreas. But pancreatic cysts in VHL are almost never dangerous, and are not sufficient to warrant operating on the pancreas, which is the last organ you want to touch. Dr. Steven Libutti, one of the world’s experts in VHL in the pancreas, says he has NEVER seen a VHL associated pancreatic cyst in danger of rupturing, and described this scene as pure fiction.”

The potential inaccuracy of medical information presented on widely-watched hospital dramas (about 20 million viewers watch Grey’s Anatomy every week, for example) is a concern to Joyce – and should be to all of us.  But how much educational impact does a weekly visit to the fictional hospitals of Grey’s Anatomy or House or E.R. actually have on the average viewer?  And couldn’t we take advantage of our favourite TV docs to help raise awareness of serious real-life health issues? Continue reading →