Winter 2020
PMH STORY
The member had become ill, and the family was worried. An area of infection was suspected in the ear, not a simple ear infection. She had been to an emergency clinic and drops were started, but the area of inflammation seemed to be increasing. There was confusion and she came to the hospital.
Dr. Kelly saw her in the emergency room. There appeared to be an area of infection. Antibiotics were started and an infectious disease consultant suspected that infection was present and continued antibiotics. However, the appearance of the inflammation was atypical. It was the weekend but Dr. Kelly texted an ear, nose, and throat specialist. This specialist texted back saying that he would be by the next morning.
Dr. Kelly was seeing the member on rounds when the specialist arrived. Doctors do not see each other as much as they used to. So, it was good to see the ENT doctor appear and say good morning. Dr. Kelly and the specialist then went to the patient’s room, a quick examination led to a decision to proceed with biopsy to confirm the diagnosis. The biopsy showed cancer. .
This is a PMH story about the importance of our medical community and colleagues. Collegiality is the spirit of cooperation, a synthesis of hard work that benefits a patient. Their value to a patient is great but it comes and goes rather quickly. Professionalism, continuity of care, collaboration has a different value when it extends over years and decades of life and of needing medical care. And that value is great. That is part of what PMH provides.
Robert H. Kelly, MD, PLLC
HEARING AIDS AND PERSONAL SOUND AMPLIFICATION PRODUCTS
All of us will lose hearing acuity as we get older. It is common to ask if a hearing aid can help. Hearing aids have been available only from otologists and physicians, and these hearing aids are expensive. There is a newer product called a personal sound amplification product. (PSAP) You can search this on the web and find devices that are inexpensive. We have no intention of replacing the judgment and guidance of our otology colleagues and hearing aid centers, but we thought you would be interested in a controlled study from Korea comparing hearing aids (expensive) and PSAPs (cheap).
Allan R. Kelly, MD, FACP
SOFT DRINKS MAY BE DANGEROUS
Researchers in Europe published a large, retrospective study regarding the association between soft drink consumption and increased risk of death. The study included more than 450,000 patients over 10 Western European countries. The participants reported their frequency of soft drink consumption and other lifestyle habits (degree of physical activity, smoking status, etc.). The researchers then followed the medical records of these patients for almost two decades, taking note of the cause of death. The results of the study found that people who drink at least two soft drinks daily were more likely to die younger than those who do not consume soft drinks. Consumption of artificial sweeteners was even worse. While many people believe that “diet” or low-calorie sodas are healthier, artificially-sweetened soft drinks were associated with an increased risk of death from cardiovascular diseases, such as heart attacks and strokes, than occurred in people drinking sugar-sweetened beverages.
Kaitlin Phillips, MS IV
WHAT MEDICAL NEWS INTERESTS PEOPLE?
The Journal of the American Medical Association keeps track of how many people come to their website and what articles they read. As of December 2019, the most popular article reviewed on-line in the JAMA network was on firefighters, pushups, and the development of cardiovascular disease. More than 500,000 Americans reviewed this study.
Allan R. Kelly, MD, FACP
TESTOSTERONE AND MALE AGING
At the University of Pennsylvania, 170 men were studied to see the effects of testosterone replacement on coronary artery calcification or plaque. Testosterone treatment was compared to a placebo and the volume of cholesterol plaque potentially blocking the coronary arteries was measured. The average age was 70.
Robert H. Kelly, MD FACP
SMOKING CESSATION
Tobacco use contributes to premature disability, illness and death, especially COPD and atherosclerosis. Its use reduces healthy survival as much as 20 years from expected. Tobacco use is also much more common in those with mental illness — in my opinion, it causes mental illness. Stopping smoking will return a person to normal risk of cardiovascular disease within five years, and a normal risk of lung cancer in 15 years. Psychological health also improves. Getting off a toxic smoke improves vigor.
Robert H. Kelly, MD FACP
PMH QUOTATIONS
“Ask any physician of 20-year standing how he has become proficient in his art, and he will reply, by constant contact with disease: He will add that medicine he learned in the schools was totally different from the medicine he learned at the bedside… Having earned doctor of medicine, you have only reached a point from which you can begin a lifelong process of education.”
William Osler, M.D., 1903
“Amid the complexities and changes in healthcare today, Medicines’ most fundamental element remains the relationship between patient and physician. Practicing physicians despair that the focus on cost has reduced them to cogs in the healthcare business machine, with daily reminders of ever-growing productivity expectations on top of questioning regulatory and clerical demands.”
John Noseworthy, MD, 2019, President, Mayo Clinic
“[The Mayo Clinic] was built on two durable and influential principles. The best interest of the patient is the only interest to be considered, and, in order that the sick may have the benefit of advancing knowledge, union of forces is necessary.”
William J. Mayo, 1910