Winter of 2016
PMH STORY
The PMH Story section has been a place where we have written about how our model of medical care benefits subscribers. We certainly try to look at things from the patient’s, not the doctor’s, point of view, although the two are closely aligned. We would like to invite any subscriber to submit a brief description of what PMH means to them. What does PMH do for you that is meaningful and desirable and is not generally available in a non-PMH practice?
You may submit these anonymously. Understand that if we do have a chance to publish this, we will change names and dates (and sometimes even gender) to make sure that the patient cannot be identified as a unique individual in our practice though the story will be true and unique.
DEHYDRATION AND HYPERTENSION MEDICATIONS
Every summer we see patients who have fallen or fainted due to dehydration. Here’s a heads up to stay healthier during hot weather. A recent correlation has been made between summertime and increased risk for dehydration and fainting-syncope. Fainting spells accounted for 700,000 emergency admissions last year in the USA. Problems with dehydration accounted for at least one-quarter of these. In Arizona, it is called “summer syncope syndrome.” Key features include low blood pressure and blood pressure that falls when standing up. The most common symptom is light headedness.
BACON GETS NO RESPECT BY Robert H. Kelly, MD FACP
The World Health Organization recently called red meat a probable carcinogen and processed meat as a known carcinogen. Other known carcinogens include asbestos and tobacco. If a drug was a known carcinogen, the FDA would likely not approve it for sale. And yet, of course, many of us enjoy red meat and processed meat. One wonders if there is a certain degree of anxiety at the World Health Organization.
TRANSPLANTATION: BLOOD, PLASMA, STOOL By Allan R. Kelly, MD FACP
The development of transfusion and transplantation is one of the great triumphs of modern medicine. All the way from plasma for hemophiliacs, to skin for burn victims, or a whole heart, the ability to donate a healthy organ to another in need is a good thing. Doctors are now studying stool (also called fecal) transplants.
HERNIA REPAIR…WITH MOSQUITO NET By Allan R. Kelly, MD FACP
Why is American medical care more expensive than in other countries?The January 14, 2016 New England Journal of Medicine may shed some light. Lofgren and others performed a “randomized trial of low cost mesh in groin hernia repair.” The authors compared two types of mesh for hernia repair. One type of mesh was produced by a prominent medical products company, Covidien. The second mesh used in this randomized and controlled experiment was a simple mosquito net produced by a plastics company in India. The Covidien mesh was polypropylene. The Indian mesh was polyethylene. The Covidien mesh cost $125.00 when purchased in Uganda. The Indian mesh was less than $1.00 for an entire mosquito net. The mosquito net was cut up into smaller pieces which were washed and sterilized.
OUT-OF-HOSPITAL OR IN-HOSPITAL BIRTHS By Allan R. Kelly, MD FACP
In our modern world there is a paradoxical interest in out-of-hospital births for pregnant women. Pregnancy and delivery are not common issues at PMH, but I thought our readers would be interested because,for some patients, out-of-hospital birth is considered highly desirable.
PMH QUOTATIONS Winter 2016
“The death of common sense is neither pretty nor fast…we are distracted by the need to fill out irrelevant information and are subsequently left with less time to get through the important parts of our visit.”
N. Skolnik, M.D. and C. Notte, M.D., 2015
“As with most guidelines, these [COPD exacerbation preventing guidelines] can be a bit monotonous and hard to read if your goal is to stay awake.”
Douglas Paauw, M.D., 2015
“I have witnessed the peace, the comfort, the joy, and the sense of completion when a person chooses to live unencumbered by the demands of modern medical therapy.”
Larry D. Cripe, M.D., (2016/01) JAMA, 315 (3), 266.