Medicine
lborkowski | October 8, 2012With the help of a University of Missouri School of Journalism fellowship and Investigative Reporters and Editors, The Oregonian's Anthony Schick spent the summer investigating child labor in Oregon, where agriculture plays a major role in the economy. After visiting fields and interviewing farmworkers, he reports that child labor is "far more widespread than statistics show." He describes Diana and Elvin Mendoza Sanchez, ages 12 and 9, whose typical summer days involve picking fruit from 6 or 7am until 5pm, and submitting their buckets under their father's name. Schick writes:
Nearly…
oracknows | October 7, 2012On Friday, I wrote about the sort of case that outrages me every bit as much as cases of cancer quackery that lead to the death of patients. I'm referring to the case of Amanda Sadowsky, a four month old infant who died after suffering traumatic brain injuries that appeared consistent with shaken baby syndrome (SBS). As I've pointed out before, what I've found to be one of the most disturbing antivaccine claims of all is the assertion that SBS is a "misdiagnosis for vaccine injury." As you might recall, SBS is the name originally given to a triad of findings consisting of subdural hemorrhage…
lborkowski | October 5, 2012by Kim Krisberg
In the west Texas city of San Angelo, Planned Parenthood has been serving local women since 1938. It was one of the very first places in Texas to have a family planning clinic.
"We have grandmas bringing their granddaughters in," Carla Holeva, interim CEO of Planned Parenthood of West Texas, told me. "We're very much part of the community."
Today, the San Angelo clinic is preparing for some big, and unfortunate, changes. Last year, Texas lawmakers voted to exclude Planned Parenthood and other organizations affiliated with abortion providers from the state's Women's Health…
lborkowski | October 4, 2012Monday was the start date for an Affordable Care Act provision aimed at reducing high rates of hospital readmission among Medicare patients. This year, hospitals determined to have excess readmissions for patients with acute myocardial infarctions, heart failure, and pneumonia can lose up to one percent of their Medicare reimbursements for the year -- and in future years, the list of applicable conditions will get longer and the percentage of payments at risk will rise to three percent. But to what extent are readmissions under hospitals' control?
First, a bit of background: Readmissions are…
oracknows | October 4, 2012I've frequently discussed the difference between what has come to be known as "evidence-based medicine" (EBM) and "science-based medicine" (SBM). Basically, SBM is EBM in which prior probability and plausibility of proposed medical and surgical therapies are considered along with clinical trial evidence. I don't plan on getting into that specific issue in detail right here. Rather, I bring it up because the best medicine is based on science and evidence. However, I've also pointed out that medicine, while it should be science-based, is not and can never be, strictly speaking, a science. (Look…
cmonforton | October 2, 2012The Pump Handle is launching a new "Public Health Classics" series exploring some of the classic studies and reports that have shaped the field of public health. If you have a favorite Public Health Classic to recommend, let us know in the comments. And if you're interested in contributing a post to the series, email us at thepumphandle@gmail.com (send us a link to the report or study along with a sentence or two about what you find most interesting or important about it). As we add more posts to the series, they'll all be available in the "Public Health Classics" category.
A headline from…
denialism | October 1, 2012Slate has an interesting article about Romney campaign mailings that appear to contain buzzwords for chronic Lyme disease advocates in Virginia. Romney's plan for Lyme disease includes these two points:
IMPROVE SYNERGY
Ensure that government agencies have an open line of communication and work with patients, researchers, doctors, and businesses in an objective, comprehensive manner.
SUPPORT TREATMENT
Encourage increased options for the treatment of Lyme Disease and provide local physicians with protection from lawsuits to ensure they can treat the disease with the aggressive antibiotics…
oracknows | September 28, 2012From time to time, I tussle with various animal rights activists online. Over the summer, unfortunately the radical animal rights types, those who think that, at the very least, vandalism is perfectly acceptable in the name of their cause, some of whom think that action up to and including murder of scientists could potentially be morally justified, came to my campus. They also threatened and harassed an excellent scientist whom I know personally and with whom I've served on a committee. That's a bit too close.
Then there are animal rights apologists whom, although they make a point of…
oracknows | September 26, 2012There's an oft-quoted saying that's become a bit of a cliché among skeptics that goes something like this: There are two kinds of medicine: medicine that's been proven scientifically to work, and medicine that hasn't. This is then often followed up with a rhetorical question and its answer: What do call "alternative medicine" that's been proven to work? Medicine. Of course, being the kind of guy that I am, I have to make it a bit more complicated than that while driving home in essence the same message. In my hands, the way this argument goes is that the whole concept of "alternative"…
oracknows | September 17, 2012Homeopathy is what I like to call The One Quackery To Rule Them All. Depending upon my mood, I'll use more or less of J.R.R. Tolkien's famous poem about the One Ring from The Lord of the Rings, but the point is usually made. Homeopathy is major quackery.
And it is, too. On the off chance that there's a newbie reading this who hasn't been a regular reader of this blog or other skeptical blogs and doesn't know what homeopathy is. (Regulars can skip this paragraph if they wish, but I wouldn't. It's entertaining.) Basically, homeopathy is a system of magical medicine thought up over 200 years ago…
oracknows | September 11, 2012I sense a disturbance in the skeptical blogosphere. It is something that I half-expected, but, even so, it nonetheless somewhat surprised me when it arrived in the form of comments on my blog and e-mails from readers, fellow supporters of science-based medicine, and others asking me what I thought. In a way, it makes me glad that I didn't blog about this back on Monday, when the study that is the focus of this disturbance was published. Had I written about it then, all I would have had as fodder was the study itself. However, waiting a couple of days has allowed me to see the reaction of the…
oracknows | September 2, 2012For my international readers, it's a holiday here in the U.S. That means I plan on taking it easy, which means I've decided on doing, in essence, a "rerun." I chose this particular rerun based on my post from last Thursday. I thought that rerunning this particular post is a good reminder of what the cost of eschewing science-based therapy for breast cancer can be, and that price is horrible. This particular post dates back to 2006; so, if you haven't been reading the awesomeness that is my blog that long, it's new to you. I'll be back with new Insolence tomorrow.
I've written before about how…
oracknows | August 31, 2012Here we go again.
Every so often, criticism of the antivaccine movement builds to the point where it extends beyond the blogosphere to enter the national zeitgeist in a way in which people other than blogging geeks like myself start to take notice. It happened a few years ago, when washed up actress Jenny McCarthy teamed up with the antivaccine propaganda group Generation Rescue to sell her story of how she believes that vaccines caused her son Evan's autism and managed to score an appearance on The Oprah Winfrey Show. It happened again three years ago, as preparations for the H1N1 pandemic…
oracknows | August 29, 2012As a cancer surgeon specializing in breast cancer, I have a particular contempt for cancer quacks. In particular, that contempt smolders and occasionally bursts in to flames right here on this very blog and, to a lesser degree, elsewhere, when I see instances of such quackery applied to women with breast cancer. They are, after all, the type of patients I spend all my clinical time taking care of and to whose disease my research has been directed for the last 13 years or so. That's why I keep revisiting the topic time and time again. Unfortunately, over the years, when it comes to this topic…
oracknows | August 28, 2012If there's one thing that practitioners of pseudoscientific medicine crave more than anything else, it's respectability. Believing that science-based medicine is corrupt and that their woo is as good or better, they delude themselves into thinking that they can function as well or better than primary care doctors practice and therefore should be given the same privileges that physicians are granted. To them, it makes sense. On any objective basis, however, it does not. The reason is simple. The two most common "disciplines" that seek the same scope of practice as primary care doctors are…
oracknows | August 27, 2012I might as well lay it on the line right at the beginning. It's not as though it will surprise my regular readers given what I've been writing here, most recently about when Rob Schneider played the Nazi card to express his opposition to California Bill AB2109. It's a bill that does something very simple and very necessary; basically it requires that parents seeking a nonmedical exemption from school vaccine mandates actually visit a health care professional to provide informed consent before an exemption is granted. Yet, even suggesting that maybe—just maybe—nonmedical exemptions are too…
oracknows | August 26, 2012If there's one thing I've been railing about for the last few years, it's how scientific and medical studies are reported in the lay press. It seems that hardly a week passes without my having to apply a little Insolence, be it Respectful or not-so-Respectful, to some story or another, usually as a result of the story having caught my interest, leading me to look up the actual study in the peer-reviewed literature. This is something I've learned the hard way that I have to do, having been burned a couple of times in my early blogging career. Sometimes, even now, I forget. For example,…
oracknows | August 22, 2012Since I seem to be on a roll the last few days discussing cancer quackery, I thought I'd just go with it at least one more day. Frequently, when I get on these rolls laying down the Insolence, both Respectful and not-so-Respectful, over antivaccine quackery I start whining about how I need to change topics, but not this time around, not this topic. It takes a lot more than what I've posted lately to make me feel as though I need a change of pace. Besides, for whatever reason, the blog fodder is flying at me fast and furious, whether it be the dubious testimonial I discussed yesterday, yet…
oracknows | August 20, 2012[NOTE: Please be sure to read the addendum!]
I hate cancer quackery.
I know, I know, regular readers probably figured that out by now, and even new readers rarely take more than a couple of weeks to figure it out. That's because cancer quackery is a frequent topic on this blog. One of the most powerful tools of persuasion that cancer quacks employ in promoting their quackery is something I call the cancer cure testimonial. Basically, a cancer cure testimonial is a story of a patient using alternative medicine and "curing" himself of cancer. Such testimonials come from both practitioners and…
lborkowski | August 20, 2012Recent investigative reports in the New York Times and Washington Post delve into some of the profit-maximizing practices among healthcare providers that are can put patients' lives at risk. Polls have found that people have high levels of trust in their doctors, but these pieces show how financial pressures and incentives can lead to decisions that aren't in patients' best interests.
Last week, Julie Creswell and Reed Abelson reported in the New York Times on hospital giant HCA, which was bought by private equity firms (including Bain Capital) in 2006 and has since generated impressive…