Placebo Journal - Medical Humor With A Purpose

Placebo Gazette #160
(Keeping Our Finger On The Prostate Of Medicine)

7/14/10

Just Doesn't Get It

Backwards: Teens and Sleep

Face Transplants

Gullible Me

Placebo Journal Update

Morons on the March

A Penny For Your Life?

PTSD and the Military

1. Just Doesn't Get it

In a recent article of the Journal of the American Board of Family Medicine, Dr. Perry Pugno (director of the AAFP's Division of Medical Education) recommends that the residency length for family medicine should expand to four years. Brilliant. In the Placebo Journal Blog, Dr. Douglas Farrago recommends that the best way to finally kill the profession of family medicine would be to expand the residency to four years.

Dude, only 2% of medical students are choosing primary care as it is. Do you not get it?

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2. Backwards:Teens and Sleep

A new study, which the media is loving, in the July issue of Archives of Pediatrics & Adolescent Medicine, shows that allowing teenagers to start school just a half later has many benefits. If you read the WSJ piece you will see the kids have better moods, less daytime sleepiness and blah, blah, blah. Is this what science has come to? Yeah, we all know kids should sleep longer and get 8, 9, or 10 hours a night. The problem is that parents don't make them get to sleep at reasonable hour. What this study and its author suggests is that maybe we should cater to teens even more and let school start later. Heck, why stop at a half hour? Let's start school at 11:30 AM. Not only is this generation of kids noted for helicopter parents but now we have helicopter researchers who just want to coddle them some more. When they get older I hope that their jobs will understand that these new adults need to start later.

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3. Face Transplants

It is absolutely incredible how good we are getting at doing transplants. In France, a 35-year-old man with a genetic disorder has an entirely new face including tear ducts that cry and a chin that sprouts stubble. This latest surgery was the first involving so many different facial features even replacing eyelids and tiny tear ducts. Wow, times have changed. I remember when I was a resident that they were trying to do eyelid transplants using the excess and discarded foreskins from circumcisions. These were for kids who were born without eyelids. It didn't work, however, as all the kids grew up to be cockeyed.

Ok, that was joke in bad taste.

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4. Gullible Me

What, most doctors aren't that gullible? Maybe they can think for themselves? A new study in the June issue of the Archives of Surgery found that 72% of 590 surveyed doctors and medical students said industry sponsored lunches were appropriate, 60% said samples improve care for their patients, and 71% said pharmaceutical and device company money is useful for funding residency programs. This study did not follow doctors and see if their prescription habits are swayed by these things. That is the real issue but I think physicians are smart enough and mature enough to make some decisions on their own. A lunch here or there, a pen now and then or a stuffed animal is not going to make me prescribe certain drugs. Besides, it gives Big Pharma's marketing people a chance to make fools out of themselves which in turn gives us more material for the Stupid Pharmaceutical Tricks section in the Placebo Journal.

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5. Placebo Journal Update

You only have two weeks to subscribe if you want to get the August Issue. I have to say that this one is really coming together. It includes such favorites as:

Avandiatar - for those that prefer movies over exercise
Sickly Bandz - bracelets for medical disease
DeFraud University - get your bogus degree here
Tons of new and cool x-rays
Much, much more!

If you are ready to start subscribing to the only medical journal that will make you laugh then click below:

REMEMBER ONLY TWO WEEKS LEFT TO GET IN ON THIS ISSUE!

6. Morons on the March

Web sites and media in general are always looking to dispense advice. It makes for great viewing and is very popular. My issue with it is when the advice is wrong. I want to nominate Melanie Haiken at Caring.com for July's Morons on the March Award (a new fake award I just came up with) who was able to get her list of "15 Medical Tests Every Man Should Have" published on MSN's website. See if you can pick up some tests she recommends that ARE NOT recommended by the best medical organizations out there (hint: PSA, bladder cancer screening, etc.)? Who is Melanie Haiken? I am sure she is a good person with a good heart but her medical background is a master's degree in Journalism and a B.A. in English. Perpetuating lists like this just confuses patients and needs to be left to the professional organizations who offer recommendations based on evidence.

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7. A Penny For Your Life?

Here's a story that will truly warm your heart. La Rosa Carrington has leukemia and needs chemo five days a month. After losing her job, she kept her insurance through the COBRA plan but had to pay a larger percentage of the cost. Before getting the bill showing what her payment would actually be she figured it out on her own that she owed $165.15 a month and began sending in checks. Unfortunately the insurance company calculated the bill to be $165.16 a month and subsequently canceled her policy. Carrington fought back but the customer service team stuck to their guns until they redid the calculation and lo and behold, the patient was right. Finally, chalk one up for the patients! Heads need to roll on this one.

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8. PTSD and the Military

I am not a veteran and I have never worked for the VA. I say this upfront to admit my limited knowledge of working with military personnel. That being said, I truly believe that recent news from the Department of Veteran Affairs is going to open Pandora's box. A new ruling will make it easier for lot more people to get diagnosed with, and get disability benefits for, the diagnosis of post-traumatic stress disorder (PTSD). If soldiers can simply show that they served in a war zone and in a job consistent with the events that they say caused their conditions then that would be good enough. Here is what a NY Times article says:

They would not have to prove, for instance, that they came under fire, served in a front-line unit or saw a friend killed. The new rule would also allow compensation for service members who had good reason to fear traumatic events, known as stressors, even if they did not actually experience them.

At the risk of sounding cold-hearted, this is a crock of sh#t. Psychiatric disease is hard enough to diagnose. I have seen so much abuse of "disability" in the civilian world that it is scary. You may say that ex-soldiers are different but I am not so sure. War is hell and I am sure EVERY soldier in or near combat zones would "fear traumatic events". Read the rest of the NY Times piece and you will see that I am not the only one questioning this decision. This is going to cost the country billions for a long time. Let me end by giving you another quote from the paper:

Supporters of the rule say the veterans department will still review all claims and thus be able to weed out the baseless ones.

Yeah, right.

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Doug Farrago MD

King of Medicine

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