Common Sense Family Doctor is a regular feature on our website. Today’s topic involves the Agency for Healthcare Research and Quality (AHRQ).
In the ‘Fake News’ era, AHRQ is one of the good guys. The nerd’s nerds. AHRQ is the ultimate eat-your-spinach news that’s good for you, even if you don’t want to hear it or believe it. Not every medical recommendation proves to be fully correct, and we learn from practice. But it is the fact-free ideas that are zealously embraced and defended despite evidence.
Science is much more painstaking.
(One example: the argument that “vaccinations cause autism.” No, it turns out they don’t. That research was never duplicated, and the ‘science’ that initially suggested it was pure cheating by an unethical researcher. Those claims have been thoroughly debunked — partly through the independent efforts of the AHRQ.)
The AHRQ uses transparent science to scrutinize health claims without regard for the prestige or commercial influence of the source. AHRQ must remain independent of political or commercial bias to insure our health care spending actually improves the public’s health.
Read the Common Sense Family Doctor here: Once again, the Agency for Healthcare Research and Quality stands in the line of fire, published March 6, 2018
Common Sense Family Doctor is a regular feature on our website. Today’s topic asks, should a mobile app be your next prescription?
“If you nibble it, scribble it.”
At Mainstreet Clinic, I have encouraged many of you to try Lose It!, a free app that makes calorie counting easier (thank you, Gale!). What’s good about this tool is — if you stick to the format — it mirrors your actual eating behaviors.
I often hear frustrated people say, “I don’t eat anything and I can’t lose a pound!” But a nutritionist said recently on a public radio conversation, “If you nibble it, scribble it.”
Lose It! helps you scribble and keep track of, specifically, every snack and every meal. Lose It! tracks the calories burned via dozens of different exercise options — thereby encouraging you to exercise. The feedback puts you in control. Weight loss inevitably follows.
Read the Common Sense Family Doctor here: Should a mobile app be your next prescription? published January 29, 2018
This essay from the Common Sense Family Doctor makes the case that artificial intelligence will not and cannot replace doctors. In fact, the explosion of information, and the data-crunching capacity of computers, makes the human element more vital and useful than ever. Decision making in health care draws upon medical facts, yes; but at least as much on costs, personal preferences and values.
Read Blog: Artificial Intelligence Will Not Make Family Physicians Obsolete
“As more information becomes readily available, doctors, nurses, pharmacists, and allied health professionals will become more important as the interpreters of that information in accordance with the specific clinical and social history, values, and preferences of the patient and her or his family.” — Look It Up!: What Patients, Doctors, Nurses, and Pharmacists Need to Know about the Internet and Primary Health Care Kindle Edition
House Calls Can Save Money and Increase the Quality of Care
As Dr. Jauhar so clearly shows in this New York Times article (and I wholeheartedly agree), revival of the house call would bring enormous benefits to the health care system, and improve care for those who need this service.
One clear benefit is preventing readmission to the hospital, an increasingly common problem that costs Medicare more than $17 billion a year. On a person-to-person level, doctors seeing patients where they live brings so many vital features to life, and can improve the quality of care significantly.
McKinney Texas initiated a house call program involving local firemen/paramedics working with a team of doctors that has proven to reduce 911 calls, ER visits and hospital admissions up to 65 percent. House call-based programs improve health care communication, timeliness and quality of care, as well as save money – an excellent example of the public’s money saved through improved access and care vs. money saved by taking away coverage from vulnerable populations, as some politicians have recommended.
Mainstreet Clinic provides house calls to those people and families for whom in-office visits are difficult, impractical, or disruptive to the patient. The price is $150/month and includes regular visits (every 8 weeks at a minimum) as well as anytime the situation dictates, for example, upon return home after a hospitalization.
Call the clinic for more details: 580-248-9966.
Common Sense Family Doctor is a regular feature on our website. Today’s topic involves the opioid epidemic.
Some of you will remember the death of OU football standout Austin Box in 2011. His drug overdose was one of more than 50,000 deaths a year in an opioid epidemic that is now near the peak of the AIDS epidemic. Common Sense Family Doctor discusses aspects of this great challenge, and the role of primary care in meeting it.
Read the Common Sense Family Doctor here: Primary care confronts the opioid epidemic, published April 7, 2017
Some orthopedic procedures should be avoided, or at least questioned
Common Sense Family Doctor is a regular feature on our website. Today’s topic involves orthopedic procedures.
This essay from the Common Sense Family Doctor relates some interesting information that might provoke questions and even anger. But things we routinely did in the past (radiation for big tonsils, freezing duodenal ulcers, routine gallbladder removal for all gallstones) have fallen into disfavor based on better science.
This essay should at least call into question some procedures being recommended routinely.
Read the Common Sense Family Doctor here: Patients: steer clear of these six orthopedic procedures, published March 1, 2017
Common Sense Family Doctor is a regular feature on our website. Today’s topic involves sleep apnea screening.
Read the Common Sense Family Doctor Here
Screening means testing people with no symptoms. Since it is difficult to make a person without symptoms feel better, the reason to screen is to find people who are “sick” (even though they show no symptoms) and for whom treatment may prevent serious or fatal things from happening.
Taking blood pressure is a good example of a simple screening test in a person having no symptoms, and we do it all the time because finding and treating high blood pressure is known to reduce the incidence of stroke and heart attack.
MainStreet Clinic treats a number of people whose fatigue, profound sleepiness, headaches, etc. are better because of treating their sleep apnea. But for people without symptoms, screening for sleep apnea would be beneficial only if it prevented bad things from happening in the future.
Advocates of sleep apnea screening point to the belief that untreated moderate to severe sleep apnea leads to cardiovascular events — strokes and heart attacks. But the latest and strongest clinical evidence refutes this. Today’s Common Sense Family Doctor explains why sleep apnea screening for people with no symptoms is not recommended in our MainStreet Clinic practice, and indeed in any evidence-based practice.
We believe in doing for our members what is of demonstrated value, based on you and the best information available.
Here’s a timely essay on health screening data. The Common Sense Family Doctor says, “Causing needless worry about cancer or another absent health condition can seem trivial compared to the prospect of saving a life.” But there are many harms associated with many types of screening, and the data on lives saved is actually quite surprising.
Read more about the psychological harms of screening