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312 posts categorized "Medicine "

August 27, 2009

Alties vs. healthcare reform

Dr. Amy Tuteur, the Skeptical OB, notices that multi-millionaire crackpot Andrew Weil is making the case against healthcare reform at the Huffington Post. (Update: In a follow-up post, Dr. Amy takes a closer look at Dr. Weil's natural products empire.)

Why? Because he thinks the reforms are inexplicably focused on saving money while curing diseases with medicines. Weil thinks we should scrap that model and focus on making people "healthy," i.e., plying them with his industry's products.

Dr. Weil is so warm and cuddly and charmingly befuddled that it's easy to forget his an advocate for an industry that's every bit as mercenary as Big Pharma. All these special interest groups are vying for government giveaways under the guise of reform, and Big Placebo is no exception.

August 21, 2009

Jon Stewart vs. Betsy "Death Panels" Betsy McCaughey

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August 17, 2009

Tom Daschle is working for the insurance industry, again

Ever wonder why single payer is never, ever on the table? Maybe because so many ostensibly liberal health policy leaders are as beholden to the insurance industry as their conservative counterparts.

For example, Business Week reports that former Democratic senator Tom Daschle is once again working closely with UnitedHealth, the nation's largest health insurance company.

Sommer has retained such influential outsiders as Tom Daschle, the former Democratic Senate Leader who now works for the large law and lobbying firm Alston & Bird. Daschle, a liberal from South Dakota, dropped out of the running to be Obama's Secretary of Health & Human Services after disclosures that he failed to pay taxes on perks given to him by a private client. He advised UnitedHealth in 2007 and 2008 and resumed that role this year. Daschle personally advocates a government-run competitor to private insurers. But he sells his expertise to UnitedHealth, which opposes any such public insurance plan. Among the services Daschle offers are tips on the personalities and policy proclivities of members of Congress he has known for decades.

Conceding that he doesn't always agree with his client, Daschle says: "They just want a description of the lay of the land, an assessment of circumstances as they appear to be as health reform unfolds." He says he leaves direct contacts with members of Congress to others at his firm. [BW]

Even reform standard-bearer Howard Dean joined the lobby firm of McKenna, Long & Aldridge in March as a strategic adviser and policy consultant. McKenna lobbies on behalf of several health care, life science, and insurance companies. When Dean joined the firm, it was announced that he would be advising the firm's lobbyists on healthcare issues.

The White House shouldn't allow Daschle and Dean to continue such apparent conflicts of interest. I'm guessing that their job descriptions have been carefully vetted to avoid violating any ethics guidelines, but let's get real here. Lobbyists are paying top dollar for inside information from current movers and shakers in healthcare policy. That stinks.

Even if everything is on the up-and-up, these arrangements make me question Daschle and Dean's leadership. Can't they wait just a few more months to cash in their public sector credentials?

Sometimes the oligarchy in the United States seems every bit as intractable as the power structure in Honduras.

August 12, 2009

Standup comic Dara O'Briain on homeopathy

Brilliant stand up routine Dara O’Briain mocking pseudoscience, New Age thinking, and sloppy "balance" in science journalism:

August 11, 2009

Could dieting spike a drug test?

Extreme dieting might cause false positive drug tests, the New Scientist speculates.

Here's the theory: THC, the primary psychoactive component in marijuana, is fat soluble and traces of the drug accumulate in adipose tissue. So, maybe burning a large amount of body fat in a short time releases enough of those stored chemicals to deliver a positive drug test in someone who hasn't used the drug lately. There are anecdotal reports of rapid weight loss causing people to fail drug tests long after they stop smoking marijuana.

The New Scientist's conjecture was prompted by a new rodent study reportedly accepted by the British Journal of Pharmacology. Researchers found that a 24-hour fast doubled THC metabolite levels in rats compared to animals that were allowed to eat normally after the same dose.

Even if the study results prove robust, there are a lot of unconnected dots separating starved rats and dieters undergoing drug tests. Still, the fact that rapid fat breakdown seems to increase THC metabolites lends credence anecdotes about false positives linked rapid weight loss. Clearly, more research is needed.

I wish I could say these findings would strike a blow against the urinalysis-industrial complex, if they were ultimately confirmed in humans--but compulsory drug testing is about social control, not scientific precision. The drug testers are probably already scheming to impose mandatory fasting protocols to reach even further back into subjects' chemical history.

On the other hand, this line of research might help victims of false positives dispute the results in court. One study cited by Consumer Reports found that forty-one percent of Americans were dieting. 

July 23, 2009

God is my OB-GYN: Unassisted childbirth for Christ

Kathryn Joyce reports on one sad result of the ultra-pro-natalist Christian Quiverfull movement's love affair with unassisted childbirth: Carri Chmielewski, a mother of eight, has died ended up in intensive care from complications following an unassisted birth that also killed her baby.

The Quiverfulls are Protestants who refuse birth control because they think women should bear as many children as God sends them. They reject birth control because they object on principle to women making choices about their fertility.

As Kathryn explains in her excellent book, Quiverfull, the movement prizes large families as proof of wifely submission.

Resigning yourself to 12 or 13 children sounds pretty submissive, but every flock has its overachievers. Some Quiverfulls demonstrate that extra measure of self-abnegation by accepting as many life-threatening complications as God thinks they should have.

For these folks, trusting a healthcare provider shows a lack of resignation. They see it as a slap in the face to God.

I'm not making this up.  Joyce quotes from Carri's own blog: “God never meant for man (Pregnant Women) to surrender himself (herself) to the total control of man (dr./technology, etc.) God considers that idolatry. We are to surrender ourselves to GOD.”

Continue reading "God is my OB-GYN: Unassisted childbirth for Christ" »

July 22, 2009

That's Surgeon General, not Surgeon Spokesmodel

Koop reagan picture Did anyone ever suggest that C. Everett Koop was too portly to be Surgeon General?

Obama's nominee for Surgeon General, Dr. Regina Benjamin, is a distinguished physician and a noted humanitarian. But she's not skinny. Random people on the internet who have never met her guess that she's a size 18. 

It's hard to imagine a more qualified Surgeon General. She has been honored with a MacArthur "Genius" grant, a Nelson Mandela Award, a Kellogg Fellowship and a Rockefeller Next Generation Leader Award. She's an expert on hot topics like rural health and telemedicine.

Benjamin was the first black woman and the first person under 40 to lead the American Medical Association. She earned an MBA on the side. She treated destitute evacuees after Hurricane Katrina and founded her own rural health clinic that serves as a model for similar facilities nationwide. She did missionary work in Honduras. She's active in the United Way, the Girl Guides the Mobile Chamber of Commerce, and other community groups. She's served select committees and blue ribbon commissions too numerous to name. In her spare time, she enjoys adventure tourism.

Healthy is as healthy does. Dr. Benjamin obviously has a lot of energy. If she's unhealthy, I want to know her secret.

Regina BenjaminBut sanctimonious twerps in the news say it would "send the wrong message" to have a Surgeon General who looks like Benjamin (read: female, black, and curvy). That's really all they're going on. Benjamin's critics have no idea whether she's healthy or what her lifestyle is like.

At first these attacks were confined to fringe outlets like Fox News, but now ostensibly serious publications are concern trolling Dr. Benjamin's BMI. The Washington Post's health blog is actually running a poll asking whether Benjamin's physique should disqualify her outright. The question mirrors the media criticism. Benjamin's fiercest detractors aren't just saying that her weight is one demerit to set against her otherwise impressive resume. They're suggesting that it should bar her from the job.

Regina Benjamin is an incredibly accomplished woman who is being slandered as fat and lazy(?!) because she doesn't fit some bigot's stereotype of what good health looks like.

Benjamin isn't the only female Obama nominee to have her fitness for office questioned because of her weight. When Sonia Sotomayor was nominated to the Supreme Court, people said she was too fat to serve. Did we hear that about Antonin Scalia?

If Benjamin's critics cared about "sending the right message" they wouldn't degrade her. In a society where eating disorders are rampant, these meanspirited attacks send the message that no matter how much they achieve, their worth is still contigent on looking a certain way.

July 15, 2009

Man: Labor pain good for women

Midwifery professor Denis Walsh argues that labor pain is good for women:

In an article for Evidence Based Midwifery, published by the Royal College of Midwives, Dr Walsh said the NHS was too quick to give in to requests for pain-killing injections.

He said: ‘A large number of women want to avoid pain, but more should be prepared to withstand it. Pain in labour is a purposeful, useful thing which has a number of benefits, such as preparing a mother for the responsibility of nurturing a newborn baby.’ [...]

He said labour pain was a timeless component of motherhood, but warned: ‘There has been a loss of rites-of-passage meaning to childbirth, so pain and stress are viewed negatively.’ [Daily Mail--where else?)]

The guilt trip is part of Prof. Walsh's larger crusade against epidural anesthesia for laboring women in the National Health Service.

It's one thing to argue that the risks of a particular pain-relief strategy outweigh the benefits, or to point out that some technique is often used on people who don't need it. Those are empirical questions.

It's another thing entirely to assert that women ought to endure pain for their own good. That's a dubious value judgement based on an unsupported claim about the benefits of pain.

Does Walsh have studies supporting a link between labor pain and maternal responsibility? Or is that just his pet theory that he feels entitled to dispense as if it were a medical fact? If pain builds character, does he advocate torturing new dads to harden them up?

Even if it's true that labor pain confers some marginal psychological benefit, a responsible clinician would lay out the potential costs and benefits and let the patient decide. Of course, the principle applies for pain relief options. Every option from drug-free birth to general anesthesia has its own costs and benefits. It's pretty rare that any one strategy is medically necessary, so the decision should be left to the woman.

Dr. Amy Tuteur, The Skeptical OB, has a great post about the sexist roots of the anti-anesthesia evangelism. She argues that Walsh is carrying on a long and ignoble tradition of romanticizing labor pain and dismissing women's suffering.

June 18, 2009

Adult baby food and the science of overeating

Katharine Mieszkowski has a fascinating interview with Dr. David Kessler, the former head of the FDA and now the author of a The End of Overeating. His book reviews the science of appetite and self-control and describes how food scientists exploit the flaws in our natural appetite control systems to create foods hyperpalatable foods that people can't stop eating:

KM: What makes a food hyper-palatable? Even if you like apples, you're probably likely to eat one and not gorge yourself on four more. Where if you like nachos, you might eat way more than you had intended to when you started. What is the difference between these foods?

DK: It starts with how many chews there are in a bite. If you take a stimulus and you get a sensory hit and it disappears, what do you do immediately next?

KM: You take another bite.

DK: Yes. We're eating, in essence, adult baby food. Twenty years ago the average chews per bite was about 20, now it's two or three. The food goes down in a whoosh and it's very stimulating. It's layered and loaded with fat, sugar and salt. It's as if you have a roller coaster going on in your mouth. You get stimulated, it disappears instantly and you reach for more.

We're often told that the secret to healthy eating is to listen to our bodies. Kessler argues that a lot of junkfood is engineered to make sure those messages aren't sent even when we've eaten plenty.

Tobacco companies have been accused of spiking nicotine levels in an attempt to make their product more addictive. These allegations sparked massive public outrage. Even people who think it's okay to sell of potentially addictive products to adults may bristle at the thought of a company deliberately engineering a product to make it even more addictive. I don't know if the nicotine-spiking allegations were ever proven, it's not in Big Tobacco's interest to give more buzz for fewer cigarettes. But the very idea certainly touched a nerve.

Will the public have the same reaction to junkfood manufacturers when they learn that scientists have studied the instincts that tell us we're full and schemed to defeat them?

June 03, 2009

Too many martyrs

Josh at Thoughts from Kansas draws some important parallels between two American assassinations--civil rights activist Medgar Evars in 1963 and physician George Tiller last Sunday:

Medgar Evers was a civil rights activist in Mississippi. Growing up black in a state where dark skin was a crime, he had the courage to stand up for his rights and the rights of his friends and family. He organized boycotts, sued for admission to a segregated law school, and became field secretary for the NAACP.

His house was attacked with Molotov cocktails, but he didn't back down. In Phil Ochs' immortal phrasing, "They tried to burn his home and they beat him to the ground/ But deep inside they both knew what it took to bring him down." And on June 12, 1963, returning home from a meeting with NAACP lawyers, Evers was shot in the back. Ochs concluded that "The country gained a killer and the country lost a man," [...]

Amanda Marcotte debunks the self-serving myth that run-of-the-mill anti-choice agitators can wash their hands of Dr. Tiller's assasination. Not everyone who objects to abortions is part of the movement, but the movement as it manifests itself on the streets and outside the clinics in this country is ugly and violent.

Its main tactics are harrassment and intimidation from confronting patients on the street to picketing clinic staffers at home. As Amanda details in her post, Operation Rescue of Wichita is directly linked to Tiller's alleged shooter, Scott Roemer.

If you think flirting with violence is just for fringe anti-choicers, remember how then-vice presidential candidate and current 2012 GOP presidential hopeful Sarah Palin tied herself in knots on national TV to avoid classifying clinic bombers domestic terrorists.