CDC press release worth reading: CDC melanoma information.
For more information (be patient, the connection is slow), click here.
For more information (be patient, the connection is slow), click here.
Showing posts with label Skin Cancer. Show all posts
Showing posts with label Skin Cancer. Show all posts
Wednesday, October 19, 2011
Monday, June 6, 2011
Do You Get What You Pay For?
When I first practiced medicine, a visit with my internal medicine partners, was scheduled to last 20 minutes. During that $9 visit, our standard of care called for taking the patient's history, performing a significant physical examination - including looking at the skin, checking for enlarged lymph nodes, examining the heart, lungs, abdomen and breasts, performing a brief neurologic examination, and preparing a chart note which listed significant items and findings. Because there was continuity of care, with patients not changing insurers and doctors every year, we knew our patients well and recognized important changes in their histories or physical examinations. We noticed unusual moles and lumps and masses and though we did not have electronic records, computers, or the extraordinary array of lab tests now available, we had the standards, skill, time and interest to establish early life-saving diagnoses leading to curative treatment for many.
When patients visit their "primary care providers" now, there is neither time nor interest nor a standard of care supporting the performance of anything other than a "focused" examination. The patient is asked what the major reason for the visit is, and anything else is likely to receive not even cursory attention. Ask yourself - when did your doctor (or non-physician health care provider) last ask you whether you had noted any changes in a mole and actually had you remove sufficient clothing so that a skin examination could be done?
The June 6, 2011 New York Times front page features an article titled "Two New Drugs Show Promise In Slowing Advanced Melanoma" which describes two new drugs [also reported in the June 2, 2011 New England Journal of Medicine (Funded by the National Cancer Institute and others; ClinicalTrials.gov number, NCT00019682)) which offer a short window of response to advanced melanoma skin cancer. The article is well written. But my readers, need to understand that if the melanoma had been found at an early stage in a routine office visit by a health care provider with sufficient professional standards, skill, time and interest to actually look at the patient sitting there on the examining table, that melanoma might have been diagnosed at an early curable stage when it would never require drastic new treatments with significant side effects which offer only short-term respite at enormous patient and societal cost.
So the next time you go to your doctor for a "focused" visit, ask that the doctor (or other provider) to spend enough time to actually look at your skin. Maybe this simple request will save your life.
The adherence to professional standards, professional skill, interest and willingness of my doctor during a recent visit, to look for, find and recommend treatment for my melanoma - hopefully - will save mine.
When patients visit their "primary care providers" now, there is neither time nor interest nor a standard of care supporting the performance of anything other than a "focused" examination. The patient is asked what the major reason for the visit is, and anything else is likely to receive not even cursory attention. Ask yourself - when did your doctor (or non-physician health care provider) last ask you whether you had noted any changes in a mole and actually had you remove sufficient clothing so that a skin examination could be done?
The June 6, 2011 New York Times front page features an article titled "Two New Drugs Show Promise In Slowing Advanced Melanoma" which describes two new drugs [also reported in the June 2, 2011 New England Journal of Medicine (Funded by the National Cancer Institute and others; ClinicalTrials.gov number, NCT00019682)) which offer a short window of response to advanced melanoma skin cancer. The article is well written. But my readers, need to understand that if the melanoma had been found at an early stage in a routine office visit by a health care provider with sufficient professional standards, skill, time and interest to actually look at the patient sitting there on the examining table, that melanoma might have been diagnosed at an early curable stage when it would never require drastic new treatments with significant side effects which offer only short-term respite at enormous patient and societal cost.
So the next time you go to your doctor for a "focused" visit, ask that the doctor (or other provider) to spend enough time to actually look at your skin. Maybe this simple request will save your life.
The adherence to professional standards, professional skill, interest and willingness of my doctor during a recent visit, to look for, find and recommend treatment for my melanoma - hopefully - will save mine.
Thursday, November 20, 2008
Was There A Free Lunch?
Early Monday morning, I had an office visit with a physician who had a "No Free Lunch" sign prominently posted next to the sliding glass reception window. The notice said that the doctor would not accept free lunch, samples, sales/educational information or other materials from pharmaceutical companies.
Two days later I attended a no-charge all-day continuing medical education program for approximately a thousand physicians, nurses and related professionals, conducted by a national medical education company which has been funded by pharmaceutical companies, an insurer and a local medical society. Subjects included incretin hormones for management of type 2 diabetes, osteoporosis prevention, reducing cardiovascular risk by focusing on HDL, the beneficial blood component, asthma, new Beta blockers for hypertension treatment, fibromyalgia and actinic keratoses/squamous skin cancer. These are all relevant medical subjects and just happen to be conditions for which medications may be prescribed.
While several pharmaceutical companies had tables with representatives, the number was smaller than in previous years. Other than a speaker who (to me suspiciously) grandly extolled the virtues of sitagliptin, the obvious and indirect commercial message was subdued compared to past years. The speakers were professional, competent qualified and (except as described above) appropriately restrained.
And my lunch - half of a plain turkey sandwich, diet coke and an apple. Healthy, but not necessarily "free."
Two days later I attended a no-charge all-day continuing medical education program for approximately a thousand physicians, nurses and related professionals, conducted by a national medical education company which has been funded by pharmaceutical companies, an insurer and a local medical society. Subjects included incretin hormones for management of type 2 diabetes, osteoporosis prevention, reducing cardiovascular risk by focusing on HDL, the beneficial blood component, asthma, new Beta blockers for hypertension treatment, fibromyalgia and actinic keratoses/squamous skin cancer. These are all relevant medical subjects and just happen to be conditions for which medications may be prescribed.
While several pharmaceutical companies had tables with representatives, the number was smaller than in previous years. Other than a speaker who (to me suspiciously) grandly extolled the virtues of sitagliptin, the obvious and indirect commercial message was subdued compared to past years. The speakers were professional, competent qualified and (except as described above) appropriately restrained.
And my lunch - half of a plain turkey sandwich, diet coke and an apple. Healthy, but not necessarily "free."
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