Archive for November, 2009

The American Dental Association has launched a program with Temple University to train new dental team members as part of a pilot program that works in communities where residents “…have limited access to dental care.”

Temple University will recruit and train Community Dental Health Coordinators from urban locations in Philadelphia over the next two years.

To learn more, click here.

Physician Elizabeth Vliet, MD speaks out about rationing for women:

I am shocked and appalled at the cataclysmic shift in the guidelines to later age and less frequent mammograms. This is diametrically opposite from the American Cancer Society guidelines, and from what most oncologists and practicing physicians think is needed. I think these new guidelines are detrimental to our goals of getting early detection and prompt treatment for women with breast cancer.

Even more ominous, the recommendation to start mammograms at age 50 instead of age 40 comes at a time when physicians are seeing younger women developing breast cancer. It makes no sense to me as a women’s health physician to suddenly decide to wait until an older age to screen for breast cancer when we know that survival is improved the earlier the diagnosis is made and treatment is begun.

It makes no sense, that is, unless you realize that this change is primarily designed to cut costs, not improve women’s health. I think this is just the start of government-mandated guideline-based rationing of healthcare. As has been the case my whole career, I see that women are the first group to suffer when cost cutting takes precedent over sound medical care.

This is exactly what has been going on with the government-controlled health service in Britain! Due to cost cutting, British women can only get NHS coverage for mammograms every three years from age 50 to 70. What’s been the impact on survival rates? British women have about 20% lower survival rates with breast cancer than do American women.

Cutting back mammograms to every two years beginning at age 50 and ending at age 74 is a change made by a government sponsored panel, much like the ones being set up to decide your care under the Senate and House healthcare “reform” bills now being discussed.

Who were not involved in making these new recommendations? The very physicians you are most likely to see if you feel a lump: cancer specialists, radiologists, and primary care physicians-who are your first ally in getting prompt diagnosis.

The change in guidelines came from the distant and impersonal “review of data” from published studies. This is very different from physicians seeing patients and dealing one on one, face-to-face with the emotional trauma that comes from a cancer diagnosis. As a women’s health physician, I want the best and most timely diagnostic tools available to help my patients determine what’s wrong. I am profoundly concerned that government “experts,” far removed from the daily care of patients, are sitting “on high” to proclaim that women don’t need to start mammograms at age 40.

Even more disturbing: I think some of the reasons these experts have given are paternalistic and demeaning to women. Example: It causes “anxiety” to have a false positive mammogram. So? Women are strong. Women can handle “anxiety.” What is worse? Brief anxiety to find out a lump is not malignant (false positive)? To have the greater trauma and anxiety from waiting until age 50 to have your first mammogram, only to find you have a walnut-sized cancer that has spread to your lymph nodes?

For my patients, I am continuing to prescribe annual mammograms beginning at age 40. I believe this is sound medical practice. I believe this is in each woman’s best interest. And I am not going to stop ordering mammograms just because a woman reaches age 74. Older women are just as worthy of early diagnosis and prompt treatment as are younger women. If you are the woman who is missed because the “guideline” did not fit, it’s your life at stake.

As of January 1st, 2010, the AANA Journal will be available to the public, online and free of charge, soon after the publication of their print edition.

For more information, click here.

The ASA and eleven specialty societies have come together to work to maintain coverage for facet joint injection procedures.  For more information, click here.

November is National Healthy Skin Month. Every year, the American Academy of Dermatology asks dermatologists to share tips and information.

One informative article covers the myths about Vitamin D and sun exposure. Apparently, the risk of exposing your skin to deadly ultraviolet rays outweights the benefits of soaking in Vitamin D through sun exposure. There are plenty of vitamin supplements on the market now that make Vitamin D easily accessible without the risk of skin cancer.

To read more, click here.

A recent study shows that primary care visits have become longer than they were ten years ago, and the improvement in care for the time spent shows “only modest improvements.”

To read more on the study, click here.

The topic of the National Pain Summit in Houston, Texas was the need to provide better pain care for patients across all medical fields.

“The Pain Summit confirmed that the felt need for better pain care in America reaches across all medical fields. Every day, tens of millions of U.S. citizens are suffering from immobilizing pain that affects their jobs, their families, and their spirit; frankly, our doctors are often not trained well enough and our health care system is not organized appropriately to be able to help these patients. We can offer better care. We have the clinical science to start the process. But, funding is needed to educate patients and the public, to streamline medical systems, and to improve and standardize the education of medical students, the training of residents in all specialties, and the training of pain medicine specialists,” AAPM President Rollin M. Gallagher, MD, MPH, explained.

To read more, click here.

A new study suggests that oral health providers can play a roll in the overall health and well-being of their patients. The study is published in the November issue of the Journal of the American Dental Association. Two hundred patients in at private dental practices in Sweden were tested using a computerized system designed by the European Society of Cardiology called “HeartScore.” Dentists could then measure patients’ risk for a fatal heart attack or stroke within a ten year period. They referred patients to seek medical advice when their scores were ten percent or higher.

To read more about the study, click here.

When placed with ultrasound, interscalene catheters proved to be more effective than when placed with neurostimulation. To learn more about ultrasound guidance versus neurostimulation, click here.

A discovery made by Dr. Robert S. Bray Jr., a neurological spine surgeon, CEO and founder of D.I.S.C. Sports and Spine Center will potentially bring relief to thousands of sufferers of chronic thoracic pain and progressive myelopothy.  A multi-level arteriovenous malformation in the thoracic space has previously not been documented in medical literature. 

To learn more about AVM, click here.