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Annual physical exam impractical


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#21 stocks

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Posted 07 November 2012 - 07:43 AM

Doctor Panels Recommend Fewer Tests for Patients

In a move likely to alter treatment standards in hospitals and doctors’ offices nationwide, a group of nine medical specialty boards plans to recommend on Wednesday that doctors perform 45 common tests and procedures less often, and to urge patients to question these services if they are offered.


The recommendations represent an unusually frank acknowledgment by physicians that many profitable tests and procedures are performed unnecessarily and may harm patients. By some estimates, unnecessary treatment constitutes one-third of medical spending in the United States.

“Overuse is one of the most serious crises in American medicine,” said Dr. Lawrence Smith, physician-in-chief at North Shore-LIJ Health System and dean of the Hofstra North Shore-LIJ School of Medicine, who was not involved in the initiative.


What is the "regression fallacy"

The regression fallacy ascribes cause where none exists. The flaw is failing to account for natural fluctuations.

Things like golf scores, the earth's temperature, and chronic back pain fluctuate naturally and usually regress towards the mean. The logical flaw is to make predictions that expect exceptional results to continue as if they were average.

Example:

When his pain got worse, he went to a doctor, after which the pain subsided a little. Therefore, he benefited from the doctor's treatment.

The pain subsiding a little after it has gotten worse is more easily explained by regression towards the mean. Assuming the pain relief was caused by the doctor is fallacious.


http://en.wikipedia....ression_fallacy

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#22 stocks

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Posted 02 March 2013 - 04:23 PM

The characteristics of health systems are complexity, uncertainty, opacity, poor measurement, variability in decision making, asymmetry of information, conflict of interest, and corruption.

Only 11% of 3000 health interventions have good evidence to support them, said Domenighetti. A third of the activity in the US health system produces no benefit, said a recent study in the New England Journal of Medicine. Half of all angioplasties are unnecessary. Some €153m a day is lost through corruption in health systems in the European Union.

Four fifths of new drugs are copies of old drugs. Screening is creating diseases like ductal carcinoma in situ. Most doctors (80-90%) have taken “bribes” from pharmaceutical companies, although many may not see their free pens and lunches and subsidised travel as bribes (but if they are not bribes what are they?).

Between 15% and 40% of articles in medical journals are ghostwritten. Half of clinical trials are not published, and there is systematic bias towards positive results, hence suggesting that treatments, usually drugs, are more effective and safer than they actually are.

Yet against this backcloth more than four fifths of people in most countries think medicine is an “exact or almost exact science



http://blogs.bmj.com...-slow-medicine/

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#23 Rogerdodger

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Posted 02 March 2013 - 07:45 PM

I was checking out some of my ancestors and they lived into their 90's back in the early 1800's and had kids in the double digits. I wonder what kind of annual physical exams they had. ;)

#24 stocks

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Posted 05 August 2013 - 11:13 AM

How to Stay Well Despite the Health-care System

Answer true or false to these ten statements:

(1) Cardiovascular surgery clearly and unequivocally benefits the patient.
(2) Even though obesity (which is unhealthy) is on the rise in America, American life expectancy is increasing.
(3) There are very reliable methods for screening that spares us the risk of dying from colorectal cancer before our time.
(4) Mammography is of much value to the women screened.
(5) Prostate gland screening for males doesn't work.
(6) It is abnormal to live two years without a backache.
(7) One of the potentially dangerous acts physicians perform is to take a "history" from a patient.
(8) Bone thinning is an insidious illness.
(9) Psychological and social stress is not all bad.
(10) There is compelling evidence that acupuncture, physical therapy, massage, therapeutic touch, and distant healing work for physical complaints.

If you answered true to any one of statements (1,3,4,8,10) or false to any one of statements (2,5,6,7,9), then you may benefit from this enlightening book authored by medical professor Dr. Nortin Hadler.


Link

Back Pain Remains Overtreated

Well-established guidelines for the treatment of back pain require very conservative management — in most cases, no more than aspirin or acetaminophen (Tylenol) and physical therapy. Advanced imaging procedures, narcotics and referrals to other physicians are recommended only for the most refractory cases or those with serious other symptoms.

But a study published in JAMA Internal Medicine suggests that doctors are not following the guidelines.


http://well.blogs.ny...eated/?src=recg

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#25 stocks

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Posted 17 October 2013 - 01:10 PM

Dr John Sarno - Most Back Pain Is Psycho-Somatic

According to John E. Sarno, M.D., TMS is the major cause of pain in the back, neck, shoulders, buttocks, and limbs--and it is caused not by structural abnormalities but by the mind's effort to repress emotions. He's not saying that your pain is all in your head; rather, he's saying that the battle going on in your mind results in a real physical disorder that may affect muscles, nerves, tendons, or ligaments. An injury may have triggered the disorder, but is not the cause of the amount or intensity of the resulting pain.


http://www.amazon.co...ords=john sarno


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#26 Rogerdodger

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Posted 17 October 2013 - 06:43 PM

My wife recently had a check-up and she said that the doctor said everything LOOKED PERFECT! I asked: "What on earth was he looking at?" Then I had to go to the doctor. :lol:

#27 stocks

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Posted 27 December 2013 - 08:45 AM

You may not be better off after knee surgery

Patients who underwent simulated knee surgery fared just as well as those who got the real deal, according to a new study that's raising eyebrows about the most common orthopedic procedure performed in the United States.

The findings, published Thursday in the New England Journal of Medicine, add to a string of papers suggesting that arthroscopic partial meniscectomy fails to help many patients. The operation typically is performed to relieve knee pain, whether from wear or from an injury.

As many as 700,000 arthroscopic partial meniscectomies are performed in the United States every year, at a direct cost of $4 billion, according to the study authors.

"It's pretty obvious to anyone who really has an interest in this that what we've called a meniscal tear isn't really a tear," says Dr. Teppo Jarvinen, who led the research team. "It has nothing to do with the tears we talk about in a 20-year-old athlete who twists or sprains their knee."


Finnish study reaffirms the sense that surgery is not likely to help these patients whose pain is due to arthritis.

A worn meniscus can be a simple result of aging, but it's more common in people whose knees take a lot of pounding, including long-distance runners and people whose jobs have them standing for long periods on a hard floor. Obesity is an additional risk factor.




http://www.cnn.com/2....html?hpt=hp_t2

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#28 stocks

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Posted 21 April 2014 - 05:14 AM

You're on the clock: Doctors rush patients out the door

Studies have found doctors often fall short in the listening department. It turns out they have a bad habit of interrupting.

A 1999 study of 29 family physician practices found that doctors let patients speak for only 23 seconds before redirecting them; only one in four patients got to finish their statement.

A University of South Carolina study in 2001 found primary care patients were interrupted after 12 seconds, if not by the health care provider then by a beeper or a knock on the door.

Yet making the patient feel they have been heard may be one of the most important elements of doctoring, Lickerman said.


http://www.usatoday....h-care/7822161/

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#29 stocks

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Posted 07 April 2015 - 07:54 PM

Nortin Hadler says he would sue any doctor who tried to test his cholesterol. Likewise, his bone density, prostate levels, colon cells, etc. The Harvard-trained doc, now in his sixties and a rheumatologist and professor of medicine and microbiology/immunology at the University of North Carolina at Chapel Hill, says you, too, should avoid these routine tests, as well as most angioplasties, bypass surgeries and routine mammograms. That's because -- contrary to what the medical establishment tells you -- the tests and procedures don't extend most lives, he says; they just convince healthy people they're sick

The Patient Paradox: A world where patients have been turned into customers, and clinics and waiting rooms are jammed with healthy people

A world where pharmaceutical companies gloss over research they don’t like and charities often use dubious science and dodgy PR to ’raise awareness’ of their disease, leaving a legacy of misinformation in their wake.

Explaining the truth behind the screening statistics and investigating the evidence behind the hype, Margaret McCartney, an award-winning writer and doctor, argues that this patient paradox – too much testing of well people and not enough care for the sick – worsens health inequalities and drains professionalism, harming both those who need treatment and those who don’t.

Screening can do more harm than good – but how many people know that when they sign up for breast screening or a cholesterol check? The Patient Paradox argues that screening tests – both in the NHS and private sector – are overhyped and oversold.
This book calls for patients, doctors and policy makers to look at the damage being caused as doctors have become deprofessionalised and patients have been turned into customers.


http://evenstarsexpl...health/#respond


"I would argue that we should move forward with the elimination of the annual physical," says Dr. Ateev Mehrotra, a primary care physician and professor of health policy at Harvard Medical School.

Patients should really only go to the doctor if something is wrong, Mehrotra says, or if it's time to have an important preventive test like a colonoscopy. He realizes popular opinion is against this view.


There's the risk that a doctor will run a test and find a problem that's not actually there. It's called a false positive, and it can lead to a cascade of follow-up tests that can be expensive and could cause real harm. Dr. Michael Rothberg is another primary care physician and a health researcher at the Cleveland Clinic. He tries to avoid giving physicals.

"I generally don't like to frighten people, and I don't like to give them diseases they don't have," Rothberg says. "I mostly tell my family, if you're feeling well, stay away from doctors. If you get near them, they'll start to look for things and order tests because that's what doctors do."


http://www.npr.org/b...ontent=20150406

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#30 MaryAM

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Posted 09 April 2015 - 02:35 PM

I had a ggg+ gramdmother Elizabeth Cox Hutchins - born in 1713 in Virginia and died in 1816 (103 years old) in North Carolina. I'll bet she never even had a blood test, a mamogram or a colonoscopy but she did have 11 children. Her great grandfather, William Cox, came into Jamestown in 1610 on the Godspeed. I think its in the genes.