For once, we can start with the selfish position. When you are the patient, the healthcare issues should be all about you. As the patient, you are entitled to be the centre of attention. Except, of course, you should never allow this to go to your head. Physicians are entitled to a measure of respect. They do, after all, have the expertise to help you recover. So let’s go on with the idea that all treatment should be a partnership between you and the physician. They have the skills and there’s no need for you to continue suffering needlessly. Read the rest of this entry »

Nothing should ever stand still. This is particularly true of medical science. The day we declare we have a perfect understanding of how the human body works is the day we begin the research on how to cure more diseases and, perhaps, think about modifying the body to make it stronger. In other words, we should never assume we have won any health battle. We are just resting before the next bacterium or virus emerges as threat. So, as one of the first articles posted to this site, it’s useful to look back at the year and record the research highlights. What have we learned and how will this affect the current range of treatments? Read the rest of this entry »

Although it does not often make headline news, there’s been a slow but steady increase in the number of overdoses and deaths due to the abuse of the narcotic painkillers. Unfortunately, many of the prescription drugs give a high similar to the more direct derivatives from the poppy. Read the rest of this entry »

There’s nothing more terrible than receiving news of lung cancer. In most cases, this is the equivalent of a death sentence and the only questions are how to manage the pain as death approaches and what quality of life can be preserved. All too often, the pain becomes unmanageable and there’s death without dignity. However, as pain management clinics establish new approaches to palliative care, we are beginning to see real progress in preserving quality of life. Just to clarify the aim of palliative care, it’s intended to reduce the worst of the symptoms. This is essential when you know you can’t actually stop or even delay the progress of the disease itself. In every sense, this is a team effort involving doctors, nurses, psychologists, counselors, therapists and, where the patient is religious, representatives of the relevant faiths. All these trained professional focus not just on the patient, but also on the families and, where appropriate, the friends. The intention is to produce an emotionally secure environment in which the patients can live out their final period of life. A new study at the Massachusetts General Hospital studied the outcomes of patients over a three year period. Read the rest of this entry »

Human biology is reasonably consistent between the sexes and races, although you get differences in reaction depending both on age and on what the medication is designed to achieve. So, for example, an aging liver processes drugs out of the bloodstream more slowly than in a younger body. So dosages have to be adjusted to ensure you do not produce an overdose of the drug in the bloodstream of an older patient. Similarly, drugs designed to change the level of hormones in the body either will have no effect on the “wrong” sex or produce rather unfortunate effects unless, of course, a sex change is being planned. That said, something like a painkiller is equally effective in all cases. The way the neurotransmitters send messages from one part of the brain to another is identical. So, if one group receives different treatment, the explanation cannot lie in the nature of the drug or what it is designed to do. There must be different explanations. Read the rest of this entry »

The latest report from the Census Bureau has produced some worrying figures. It seems almost 17% of us are living below the federal poverty line. You have to go back to 1993 to find a higher percentage of Americans living in poverty. To add to the interest, the Super Committee in Washington has just begun its discussions on what to do about the federal deficit. Its choices are between increasing revenue to maintain more of our services or simply cutting spending. Given the terrible state of our economy, it’s hard to see what the federal government can do to help the poor. In this, there’s a secondary consequence looming into view. Read the rest of this entry »

For many people, it’s easy to forget pain is not just a medical problem in the sense you see a doctor. Dental problems can cause severe pain and the management of that pain is a matter for the dentist. This does not mean the two professions are independent. There’s no reason why one cannot learn from the other. Pain is pain no matter what the cause. Read the rest of this entry »

Unlike Hollywood and the science fiction writers who invented telepathy years ago, real humans can’t tell what each other are thinking or feeling. So, at one end of the scale, this limits the experience of sex to whatever is going on in our own heads. At the other end of the scale, doctors have no way of knowing exactly how much pain is being experienced by their patients. All they can do is ask. Read the rest of this entry »

People who report long-term pain are often either treated with skepticism, or simply prescribed painkillers and told to go away. There’s abuse on both sides of the fence. As a nation, we take more painkillers than any other country. This produces several million people who are dependent on the drugs. In a way, this is an inevitable outcome of the current situation in the medical profession. So many doctors are now tied into networks, each with their own performance targets. They are not allocated enough time to hold a meaningful conversation with their patients. Their real function is to refer for more tests or write prescriptions. Either way, this produces a billable outcome and earns their profit. So, early on, doctors are wrong to be skeptical of their patients. But after the patients have become dependent, skepticism isn’t relevant. The only thing that brings peace to both sides is another prescription. Read the rest of this entry »

For some time, there’s been concern that the average US doctor is failing his or her patients. This is due to a number of problems, but the most important is that almost every doctor is trapped in a for-profit system. This puts pressure on the individual to meet performance targets regardless of the actual quality of care delivered. In many cases, this means creating billable work to do on each patient while actually spending as little time with each patient as possible. So if the patient complains of pain, the shortest time is spent in writing out and handing over a prescription for a painkiller. If the complaints continue, the prescription is changed to a higher dose and then a stronger drug. As a country, we take more painkillers per head of population than any other country in the world and we have one of the highest rates of dependence.
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