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Showing posts from February, 2015

Measles Vaccine - A Right to Refuse Treatment

It’s been amusing to watch Rand Paul, a doctor, trying to ‘clarify’ comments he made suggesting that vaccines for kids should be a matter of parental choice.  Conversely, Rick Perry some years ago had to walk back his aggressive pro-vaccine stance, when he championed mandating HPV vaccines for young girls.  This political clumsiness is not restricted to the GOP.  In 2008, both Barack Obama and Hillary Clinton argued that 'more research was needed on vaccines' potential side effects'. Presidential candidates, it seems, have not all been vaccinated against Panderitis.   Of course, I recognize an informed individual’s right to refuse treatment.  An adult with appendicitis has a right to refuse appendectomy, against the advice of the surgeon.  "You mean I didn't have to get sick?" Does a parent have a right to deny the measles vaccine for their kids?  I don’t think so.  Here’s why. Medical evidence provides overwhelming support for the vaccine’s

Is Your Doctor 'Aware'?

Every doctor understands what the phrase, doctor aware’, means.  This is the phrase that hospital nurses record in their nurses notes when they have notified the doctor, usually by phone, on a patient’s issue.   Once the ‘doctor is aware’, the nurse is in the clear and has transferred responsibility for the issue to the physician. Here are some samples of doctor awareness. Phone Call Notification                                           Nursing Record Doctor, Mrs. Leadbelly just vomited.                        Doctor aware! Doctor, Mr. Wobbly is dizzy.                                         Doctor aware! Doctor, the ultrasound showed a gallstone.          Doctor aware! Doctor, Mrs. Hothead has a fever.                              Doctor aware! Physicians often roll our eyes over these conversations.  Some of these notifications are communicated in the middle of the night about patients we do not know.   Although we can’t usually address the abnormal finding dire

FDA and Herbal Medicine - Caveat Emptor!

Many of my patients are taking herbal supplements, or so they think.  This herbal and health supplements industry likely is envied by traditional pharmaceutical companies.  The latter has to spend zillions of dollars proving safety and efficacy to the Food and Drug Administration (FDA).  Many of these drugs are cast aside during the approval process or afterwards when serious side effects become known or a new medicine is proved safer and superior.  While it’s not quite a crapshoot, there is a strong element of chance at play here. Roll the Dice with the FDA? Herbs and the supplements that are saturating our airwaves escape FDA scrutiny.  They will only draw governmental fire if they are deemed to be dangerous.  They are required to use certain language in their promotional materials that differs from traditional FDA approved prescription medicines.  Take a look at this example: Fosamax:  The FDA has approved this for the treatment and prevention of osteoporosis Glucosam

Medicine is an Art and Science

Medicine is an art, not a science.  We’ve all heard that maxim before, but what does it actually mean for living, breathing patients? Physicians rely upon knowledge and experience when we advise patients.   We try to stay current on relevant medical studies to guide us, knowing that the latest medical ‘breakthrough’ may be debunked in a few years.  Seasoned physicians resist the temptation to abruptly change their medical advice based on a single study, even if published in a prestigious journal. Knowledge and experience are important, but judgment trumps them both, in my view.   The best clinicians are those who consistently exercise excellent medical judgment. A knowledgeable physician may be able to recite a dozen explanations for your high calcium level. An experienced doctor can expertly perform a colonoscopy having mastered the technique. A physician with a high level of medical judgment knows that surgery is wrong for a particular patient, even though medical t