Vegas Nite One

Wish you were here! What's the caption? Gimme your best shot...

Viva Las Vegas

As I mentioned previously on The Doctor Anonymous Show, there will be no show for May 8, 2008 since I will be out of town. Where am I going? Well, I will be in Vegas Baby! (see video post above) In case anyone is interested, here is the current forecast for Vegas (They say it's a dry heat, right?)

I'm going out there with people from the hospital for a conference. I haven't even looked at the schedule yet, but I hope that it's not an all day thing. What's the time difference out there, anyway? I guess I'll find out. With me being on call last weekend, I'm still catching up on things and haven't been able to think ahead that much.

Our flight leaves this afternoon and we'll be arriving there in the early evening tonight. I hope to be shooting some video out there and posting it here. Wouldn't that be nice? It's been a few years since I've been out there. As with my previous trip this year, make sure to keep track of My Twitter Feed to see what I'm doing. I may even check out this Brightkite account that I just got. Anyway, any suggestions on what I should do when I'm out there in Vegas?

Grand Rounds

Grand Rounds 4.33 is now up and running over at Suture For A Living. (apologies for the late posting of this today). There is no theme this week. But in addition to the great posts, there are some great pics! Thanks to Dr. Ramona for including my post this week:

Dr Anonymous asks a simple, yet, controversial question: If someone has used marijuana - even if used for medical reasons - should this prohibit him or her from being considered to be on a transplant list? Hospitals throughout this great nation struggle with this question every day.

If you don't know what Grand Rounds is, it is a weekly compilation of the best posts from the medical blogosphere that moves to different sites each week. And, who doesn't like reading about medicine and science? Next week, Grand Rounds moves to the site called Health Business Blog.

Doctors Overmedicating Kids

You've probably seen this your morning news stories, but doctors are being blamed (imagine that) for overmedicating kids (again). In fact, according to a study reported by the Associated Press, American children are taking what are called "anti-psychotic" drugs at a rate six times higher than children in the UK.

Does it mean U.S. kids are being over-treated? Or that U.K. children are being under-treated? Experts say that's almost beside the point, because use is rising on both sides of the Atlantic. And with scant long-term safety data, it's likely the drugs are being over-prescribed for both U.S. and U.K. children, research suggests.

What are "anti-psychotic" drugs? Well, according to the article, the most commonly prescribed drugs in the UK in this study have the names of risperdal and thioridazine. Now, I have to tell you that these are medications that I hardly use in adults. And, I have never used these drugs in children.

The new U.K. study, involving 1992-2005 health records of more than 16,000 children, is the first large examination of these drugs in U.K. children. It found the increase was mostly in medicines that haven't been officially approved for kids. They were most commonly prescribed for behavior and conduct disorders, which include attention deficit disorder.

Ah, HA! Here we go. The issue of attention deficit disorder is so divisive among the parents, teachers, and docs that I talk to - that this article will continue to fuel the fire. There are some who debate whether this diagnosis even exists. There are others who believe that docs do not medicate these kids enough. So, why do US docs medicate kids more?

A recent report in The Lancet suggested that the U.K.'s universal health care system limits prescribing practices there. The report also said direct-to-consumer ads are more common in the United States. These ads raise consumer awareness and demand for medication.

While drug company ties with doctors are common in both the U.S. and U.K., Vanderbilt University researcher Wayne Ray said U.K. physicians generally are more conservative about prescribing psychiatric drugs. Ray co-authored the U.S. study, published in 2004.

So, again, it's the doctors fault that American kids are overmedicated for attention deficit disorder. What is new about that? It'll be interesting to see how the parents, teachers, and medical blogs will react to this report today. We'll see.

Finally, if you haven't seen this already, the American Heart Association made a statement last month that kids who will be receiving attention deficit disorder drugs - these kids should receive a heart test (ECG/EKG) before start of these medicines. The American Academy of Pediatrics has not taken a position on this recommendation as of yet. But, this recommendation could have a huge impact. Here is what's on the AAP website:

The American Heart Association is now recommending children with attention deficit hyperactivity disorder (ADHD) should have heart tests - including an electrocardiogram (ECG) - before starting treatment with stimulant drugs. The AAP is evaluating the science behind these recommendations and will offer its guidance in the near future. Meanwhile, parents with questions or concerns about the AHA statement should consult their child's pediatrician.

By the way, just to clarify, family docs also take care of kids. Why couldn't they say "consult their child's physician." Sheesh.

Show 33 Wrap-up

Thanks so much to my guest Dr. John Halamka for being on The Doctor Anonymous Show. Very knowledgeable guy. So much so that I have to admit that I was a little intimidated after doing research for this interview. But, to my pleasant surprise, not only is he a knowledgeable guy, a very nice guy - and funny.

We talked about his early love for medicine and technology. He is the first physician in his family and talked about how he built his first computer. Then, the talked about how he used this passion for technology in medical school and in residency. Following his emergency medicine residency, the pursued a fellowship in Health Informatics and then eventually ended up in his position right now which is Chief Information Officer at Boston's Beth Israel Deaconess Medical Center.

How do you incorporate technology in a health setting? We talked about when he started in Boston and when Paul Levy became CEO of the hospital there. Since it's my show, I talked about my situation being a physician leader at my hospital and how sometimes physicians can be resistant to change - particularly technology change.

Close to the end of the show, we talked about the partnership between Google Health and Cleveland Clinic in the area of health information. He informed me that his hospital has also partnered with Google for a similar program. Sarebear called into the show and discussed topic as well.

Finally, on a lighter note, John discussed his personal weight loss story which included a shift toward vegan life. The weight loss has opened the doors for him to do things like rock climbing and ice climbing. He also has a love for the Japanese flute (music included in the video post above). And, we talked about his association with Blackberry. Can you believe this guy gets 600-700 e-mails a day? Sheesh! Don't forget to rate the show here after listening to it. Have a great weekend!

Dr. A Show 33: Dr. John Halamka

Thursday, May 1st, 2008 at 9pm Eastern Time

Join us tonight for The Doctor Anonymous Show . Our guest will be Dr. John Halamka who is Chief Information Officer of Beth Israel Deaconess Medical Center in Boston. He is author of the blog called Life as a Healthcare CIO. He is also an emergency physician, and apparently, a Blackberry guy. I'll have to ask him some iPhone questions just to be funny.

You can even take part in the chat room. It is truly "The show within the show." You can even call in and say hello. A great opportunity to interact with medbloggers you've only read about. 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!