Dr. A Show 26: Wrap-up

Thanks so much to Dr. Doug Farrago from Placebo Journal for being on the show. We talked about what it's like being a Family Medicine physician in Maine. Talked a little bit about his boxing career and a little bit about his practice. Of course, we talked about his book, his magazine, his blog, and his youtube channel. It's great seeing a doc utilizing all kinds of new media. I'm hoping other docs do the same in the near future.

Next week, I'll be taking the show over to Talkshoe which is another internet radio site. Our guest will be Bertalan Mesko from Science Roll. Very impressive blog if you have never checked it out before. He also hosted Grand Rounds this week. The link to The Doctor Anonymous Talkshoe Show is right here.

I'll talk more about it soon. But, it's similar to BlogTalkRadio in that to fully participate in the show, you'll need to officially register on their site for an id. What's interesting about it is that you do not have to use a phone to call in they have something called The ShoePhone - which is software you download. And, if you have a microphone or headset for your computer, you can use that to participate in the show. So, that's what is going on for Show #27. In the mean time, enjoy Show #26!

Doug Farrago, MD on The Dr. A Show

Thursday, February 28th, 2008 at 9pm Eastern Time

Join us on Thursday night for Dr. Doug Farrago who is the the self-proclaimed "King of Medicine" and is creator of the empire we know as The Placebo Journal. This is probably one of the only people in the medical blogosphere who is more connected than me.

Not only is he an author of a book and a blog, he also has a magazine and even has his own channel on You Tube called "Placebo Television." In the above video post, he talks about Dr. Robert Jarvik who was back in the news this week. He ends each video with this signoff, "Thank you for tuning into Placebo Television, where we always keep our finger on the prostate of medicine." Can't wait to ask him about that.

Take part in the chat room, which is the "show within the show." A great opportunity to interact with medbloggers you've only read about. You can even call into the show to talk and/or ask a question. See you for the show!

For first time Blog Talk Radio listeners:
*Although it is not required to listen to the show, I encourage you to register on the BlogTalkRadio site prior to the show. I think it will make the process easier.

*To get to my show site, click here. As show time gets closer, keep hitting "refresh" on your browser until you see the "Click to Listen" button. Then, of course, press the "Click to Listen" button.

*You can also participate in the live chat room before, during, and after the show. Look for the "Chat Available" button in the upper right hand corner of the page. If you are registered with the BTR site, your registered name and picture will appear in the chat room.

*You can also call into the show. The number is on my show site. I'll be taking calls beginning at around the bottom of the hour. Hope these tips are helpful!

I'm A Blogaholic: Gone

The I'm A Blogaholic blog was started almost a year ago during the whole Flea episode - and when Fat Doctor took down her blog (she did eventually come back). At the time, the blog was a great way for people to just talk about what was happening at the time.

But, as typically happens, people move forward and move on. And, that has showed in the past few months. The number of posts and the number of visitors have decreased. So, I've decided that The I'm A Blogaholic Blog has run it's course and will be taken down in the next few weeks. So, thanks for the memories!

Google YOUR private health information?

What if I told you that companies like Google and Microsoft will soon have the opportunity to handle your private medical information? Maybe this is information that you do not want anyone else to know - other than - say your doctor? Earlier this week the state of Tennessee announced a partnership with AT&T for the first statewide network to share health information.

An article in today's Washington Post states that the Cleveland Clinic, in association with Google, will be starting a pilot project that is aimed at putting personal electronic health records in the hands of consumers. (I've talked about personal health records on this blog in the past)

What Cleveland Clinic wants to do is have the ability to merge outside electronic medical records with their own system. For example, if I refer a patient up there, currently, the only thing I can do is send paper records and even x-rays up to Cleveland Clinic with the patient. How much more convenient would it be for me and the patient to have a way to send electronic records and have the opportunity to feed it into their system. That would save time and paper.

What Google wants to do is be the reservoir of all this information - and in some way, make this information available to the health consumer - meaning the patient - meaning you. That's a good idea, right? Here's the problem: What about all the privacy issues? How comfortable are you that companies like Google and Microsoft would have your private medical information?

Medical files in the care of health-care providers like doctors, pharmacies and hospitals enjoy legal protections specified by the Health Insurance Portability and Accountability Act (HIPAA). Covered files are strictly controlled, can't easily be subpoenaed, can't be exploited for profit and have to be stored securely. But Microsoft and Google aren't health-care providers.

"When you move records from a doctor to a personal health record, your protection evaporates," said Robert Gellman, author of a World Privacy Forum study on the subject released last week. He concluded that such systems "can have significant negative consequences for the privacy of consumers."

People joke about "googling" someone - like friends - or even enemies - just to see what comes up. I know my patients "google" my real name to try to learn more about me. What if MY personal medical information was in the hands of Google? What if YOUR personal medical information was in the hands of Google or Microsoft?

In this country, our privacy is pretty much gone anyway. I mean if you're out in public and do something stupid, someone with a camera cell phone records it and is on you tube within the hour. Or Flickr? Or someone blogs about it? And we've all heard of employers who have obtained this information and people are fired. But, this is invasion of privacy on an entirely new level.

Now, people from a potential boss to a private investigator would possibly have the ability to look up your most private medical and health information? This is just wrong and it's dangerous. The article says that an act of Congress is needed to require non-medical providers like Google to follow the same privacy laws that I follow and that hospitals follow. Do you think this will happen? What do you think about these tech companies holding your personal medical information?

Update: This post is less than 2 hours old, and I already have someone fired up! Check out Cathy's take on this (she's been a patient at The Cleveland Clinic).

Antibiotics overused in Alzheimer patients

Should people with Alzheimer's disease/dementia be treated with antibiotics? According to a new study, they say that antibiotics are being overused in patients with dementia and antibiotic use should be considered more carefully especially in this time of antibiotic resistant superbugs. (AP)

The study raises ethical questions about when it's acceptable to withhold perhaps futile treatment and let people die, and whether public health issues should ever be considered.

"Advanced dementia is a terminal illness," said study co-author Dr. Susan Mitchell, a senior scientist with the Harvard-affiliated Hebrew Senior Life Institute for Aging Research in Boston. "If we substituted 'end-stage cancer' for 'advanced dementia,' I don't think people would have any problem understanding this."

People wouldn't have a problem understanding this? Of course, when you paint a picture like that. Here's the question, though- What is advanced dementia? There really is no consensus definition. Of course, really end stage cases even medical students can diagnose. But, the problem is that there is a spectrum of diagnosis. Where do you draw the line between moderate dementia and advanced dementia? There is no agreement with this.

I can see both sides of the end of life debate getting ready to do battle again. Remember Terri Schiavo? Remember Baby Emilio? Remember the use of chip implants in Alzheimer patients? The use of antibiotics in dementia/alzheimer patients is just another chapter in this debate.

One side is saying that the progression of antibiotic resistant organisms can be stopped by appropriately prescribing antibiotics - meaning not those patients with advanced Alzheimer's disease. The other side is saying once you limit antibiotic treatment for people with Alzheimer's, the danger is there to start using the same argument to stop treatment of other medical conditions (like high blood pressure). What's your take on this debate? I'm curious....

The Shamrock Shake

I have been a blogging slacker for the past few days. I do have a lame excuse, though. I was on call last weekend, and I have to tell you, there are a lot of ill people out there and the hospital has been hopping for the past few weeks.

Anyway, as I was making "rounds" at McDonalds yesterday, the friendly drive-thru chap asked, "Would you like to try a Shamrock Shake?" Wow! It's only February, and our local McD's has already gotten out the shamrock shake. This is great stuff! If you haven't had this before, you have to try it.

I do admit that I like the taste of mint. So, the shamrock shake is definitely delish to me. And, as Dr. Rob has stated recently that obsessing about anything is bad. I kind of get addicted to the shamrock shake - especially when they say "for a limited time only." Anyone with me on this? What do you think?