May 15, 2012

This article was first published in 2011. It is just as true today as it was then. Some things seem to never change.

My family, my friends and my patients think being selfish is bad! I bet you do, too. I used to think so, as well. Twenty seven years in practice has taught that being selfish is good. Actually, selfishness is essential to an individual’s health.

Today, I saw a selfless young woman who was ill. She had an assortment of complaints. She had not felt well in months. If she was the CEO of a Fortune 500 company, she would have been diagnosed with executive burn out and given two months at Canyon Ranch, an executive retreat. Unfortunately, she is the CEO of a typical American family. She is married, has five children, a dog and works full time. She has living parents who are aging and require help. She is a hard worker, dedicated to caring for her ...

May 14, 2012

James C. Salwitz, MD asks an interesting question in his article which was recently published on KevinMD. “Are smokers to blame for the damage they do to their bodies?” is well worth reading!

Whose fault is it?  Those who read this column know that I tend to agree with Janeben’s comment posted in response to Dr. Salwitz’s laying blame on the pusher and not the user. Accepting fault for one’s own mistakes appears to be downright un-American.

However, I agree with Dr. Salwitz that the pushers in society should be held responsible for the damage they do in providing the cigarettes to the smoking addict!  While I take particular offense at healthcare providers (pharmacies) that sell cigarettes and prescribe and sell medications, I think the larger responsibility should be borne by our government.

May 13, 2012

Doc – “Good morning, Mrs. Smith, how can I help you today?”

Mrs. Smith – “I want to lose 20 pounds. My daughter is getting married in 4 months and I want to look good.  I was hoping you would prescribe some Phentermine (a diet pill). My neighbor’s doc gave her Phentermine and she did great!”

Unfortunately, the above interaction is a common occurrence. My patients want to lose weight for a host of reasons. Many have lost and gained hundreds of pounds over their adult lifetimes. Many have been on fad diets, used pills, seen hypnotists, and nutritionists. They have vilified carbohydrates, banning them from the dinner table. On other occasions, they have vilified fats or proteins. They have juiced, taken nutrients in pill form, powder form, and used other unnatural forms of nourishment all for the sake of weight loss.

May 12, 2012

Over the last few weeks, I have scanned the medical literature for new material for this column. I have looked for new research regarding common diseases, new drug approvals, new diagnostic tools, and helpful preventative tips.

Unfortunately, there is nothing new to report. It’s as if I have been journeying through a veritable desert. What’s really scary is that new medical breakthroughs seem to be drying up. I haven’t had a new antibiotic in years; no new treatments for diabetes, hypertension, dyslipidemias, or arthritis, either.

I have been in practice for over 30 years. I have been spoiled for over 30 years. I have grown accustomed to learning about and utilizing “breakthrough, cutting edge” technology and treatment protocols. I’m starting to believe those days are over.

From where I sit, it looks like Dr. Rich is ...

May 11, 2012

Often, the most difficult part of my job is deciding whether my patient has a viral or a bacterial infection. The second most difficult job is explaining to a patient who has a viral infection why an antibiotic will not work. Patients suffering from respiratory tract infections (URI) want me to cure them. They want antibiotics, the supposed cure-all!  In my early years in practice, it was impossible to differentiate between a virus and bacteria. Antibiotics were considered relatively harmless and everyone who suffered from a URI received one. Since my patients got well (because of or despite taking an antibiotic), they grew to believe that, without an antibiotic, they would not get well. Over the last decade, antibiotic resistant bacterial infections have dramatically increased due to the overuse of antibiotics. In the decades to come, appropriate use of antibiotics will be imperative.

In the real estate business, it’s “location, location, location”. I often hear, “Doc, I’ve got a sinus infection and need an antibiotic.”  “Doc, I’m coughing up green sputum and ...

May 10, 2012

Today was a great day. I cared for 15 caring individuals. Yes, caring is a two way street. Despite ailing from a host of illnesses, today’s patients were, for the most part, happy and caring. Each patient seemed genuinely interested in how I was doing. Many complimented me on how much weight I had lost. My patients who were suffering from viral illnesses even thanked me for not prescribing antibiotics.

Yes, today was a great day. Not all days are as good. Jordan Grumet, M.D. wasn’t as lucky. “Being A Physician Is Like Trying To Parent Two Thousand Teenagers,” published on KevinMD today, tells a different story. Despite spending 15 minutes teaching his patient why an antibiotic is contraindicated in viral illnesses, his patient walked out angry.

The family of a 100 year old comatose patient on tube feedings ...

May 9, 2012

This year, in accordance with the Illinois Department of Health rules, “students entering the sixth and ninth grades will be required to provide documentation of receipt of at least one dose of Tdap for the 2012-2013 year.”

“Tdap is a vaccine licensed and recommended to protect pre-teens, adolescents, and adults against tetanus, diptheria, andpertussis (whooping cough). Tdap is licensed for routine use on or after the 10^th birthday.”

Most of my patients are too young to remember the effects of full blown whooping cough, diptheria, and tetanus. As a matter of fact, I’m too young to have seen tetanus. In the 30 years I have been in practice, I have treated diptheria and whooping cough and can truthfully say I never want to see another case.

Vaccines work!  Despite all of the fears parents have over the ...

May 8, 2012

Are you competitive?  Do you hate to lose?  What if you could enter a competition in which you were guaranteed to win?  One of my patients has found the perfect competition. Mr. X is competing with himself, and, as long as he keeps it up, he is guaranteed to win!

Actually, Mr. X is winning while he is losing. Confused?  You shouldn’t be!  By competing with himself he is losing weight while gaining strength, endurance, and health!  Mr. X is using his MotoActv device to monitor his daily activity. By striving to be more active on a daily basis, Mr. X is running a race in which he is his own opponent.

Mr. X loves technology. Mr. X’s Droid is capable of tracking his eating habits. By tracking his daily ingestion, Mr. X can define what his dietary intake really is and then refine his diet, chicken ...

May 7, 2012

Ever stop to think about the ethics of selling illness in a place of health? Think about it. You go into either of the large national pharmacies with a bad cough/bronchitis. You walk to the back of the store to see the nurse practitioner who prescribes the medication on her company’s formulary list (the one her bosses want her to prescribe/? most profitable?). Next you go to the pharmacist to fill your prescription.

On the way out of the store, standing like a gauntlet, is the cigarette counter where you buy your smokes. Yes, you smoke; and, because you smoke, you have chronic bronchitis. Now think about the ethics of the same establishment selling the disease they treat!  It’s the American way, “One Stop” shopping at its best.

Everyone knows that our healthcare system is a disaster. We complain about the cost of healthcare, the availability healthcare, the doctors, the insurers and just about everything else. I think it’s time we complain about healthcare providers that sell illness.

These peddlers ...

May 6, 2012

I confess.  I wear pink shirts. My daughter doesn’t think men should wear pink.  Apparently, wearing pink is unmanly and is stigmatized.

According to Wikipedia, stigma is defined as:

1. A badge of shame, a physical mark of infamy or disgrace
2. Social stigma, a severe social disapproval of personal characteristics or beliefs that are against cultural norms

But I don’t think there is anything wrong with wearing pink clothes. As a matter of fact, I think it takes a true man to stand up to social norms and hazard the criticism of others.

Dealing with a clothing stigma is one thing. Dealing with a stigma associated with disease is quite something else. Unfortunately, depression and anxiety are two illnesses that still carry significant stigmas. Depressed patients often avoid coming to the doc’s office or discussing their problems with ...