Wash Your Hands!

Do you wash your hands before your leave the restroom? C'mon, be honest. I won't tell anyone. Well, it seems that in a recent study, less people are washing their hands compared to 2005. Ew! What's up with that? The article is from WebMD.

Researchers who discretely observed men and women in public restrooms found that only 77% washed their hands with soap and water -- a 6% decline from 2005.

But not many people are admitting to slipping up: In a separate telephone survey, 92% of Americans claimed they always lather up in public restrooms. The findings were reported at a meeting of the American Society for Microbiology (ASM).

Who is more to blame? Men or women? What do you think? Here's the answer from the article.

The blame lies squarely with the men, says Brian Sansoni, a spokesman at the Soap and Detergent Association, which cosponsored the survey with the ASM.

The percentage of men observed washing their hands fell from 75% in 2005 to 66% in 2007. In contrast, hygiene habits basically stalled among women: 90% washed up in 2005, compared with 88% in 2007.

Now, as compared to yesterday when I talked about things like lab coats and neckties potentially spreading bacteria, I'm a huge advocate of hand washing in the hospital setting, before leaving the restroom, and other situations where bugs can spread. So, do us all a favor and just wash your hands, would ya?

Dr. A Live - 9/20 @ 4pm ET

I'm happy to announce that the next edition on the Doctor Anonymous Live show will occur on Thursday at 4pm ET. Mark your calendars now! I think (finally) that I've worked out the technical glitches so that I can focus (mostly) on show content. I'm excited about this project again!

Blog Talk Radio unveiled an entirely overhauled site on Monday morning (like the new logo?). I have got to tell you that it looks very nice! I encourage you to check it out.

There are also a few new features that I hope to be trying out for the show on Thursday. For example, they have installed a group chat function. Now you'll have to register as a BTR listener to enter the chat, but I think it would be fun if we got a few people in there chatting away during the show.

BTL has really added a social networking feel to their site now. You can now designate "friends" and sign up as "listeners" to specific shows (don't forget to do that to me when you get your BTL name!). You can also add text comments to specific shows and to my profile, if you like. Plus, there's a rating system for individual shows from 1-5. Hope you can join me in a couple of days!

Grand Rounds

Grand Rounds 3.52 is now up and running over at Six Until Me. Kerri has done a great job at putting this together. I encourage you to head on over there and check it out. It's been a while since I have submitted anything to GR. Thanks so much for including my post this week...

I need to warm up. Off to the bakery, where I can grab a nice, hot coffee. The lady in front of me is yapping away on her cell phone - doesn't she know too much cell phone use could cause cancer? Dr. Anonymous should give this lady a call (on her landline).

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, GR moves to the one and only Kevin, M.D. Enjoy!

Doctors failing pregnant patients

Here's another glowing review of American health care. This time, docs fail to warn pregnant patients of the dangers of continuing prescription medications during pregnancy. (image credit) Here's the start of this AP article:

Philadelphia - Doctors aren't doing a very good job of warning young women to avoid getting pregnant when they're taking prescription drugs that can cause birth defects, a new study suggests.

Nearly half of the women taking the medicines didn't get counseling from their doctor about using contraceptives or other birth control measures, University of Pittsburgh Medical Center researchers found in a study of nearly 500,000 women.

Now, this didn't make any sense to me. I get asked a lot about prescription meds during pregnancy by my patients. And, I know during medical school and residency training, the issue of meds during pregnancy is emphasized heavily.

Later in the article, the glaring limitation of this study is exposed...

The researchers noted that the study might overestimate the problem because the data is from health plan billing codes, which don't have the same detailed medical histories as patient medical charts. Some doctors may have provided counseling but didn't bother to mark it with a billing code.

Ah HA! Of course, this study overestimates the problem - thereby falsifying their data. What kind of researcher would use billing codes from a physician office to track counseling? Everyone knows that insurance companies do not pay for most (if not all) counseling sessions done my medical physicians. That's the reason they're on on the billing form.

Now, some of you out there are probably saying, "Those greedy doctors. If they don't get paid for counseling, then they won't do it." On the contrary, counseling does happen. It's documented in the medical record (which the researchers here didn't bother to check). In addition, since insurance companies don't pay a counseling charge, as with other charges not paid by insurance, the bill would subsequently go to the patient. Who wants that to happen?

Don't get me wrong. Docs can do a better job in discussing medication reactions in pregnant patient. But, to come out and accuse docs of doing a bad job for patients and then have bad research data? That's disingenuous and lying to the public, but par for the course for the American press.

UK Physician Fashion Police

If you're a doctor in a British hospital, don't even think about wearing a necktie, long sleeves and jewelry to work. You can't even wear your traditional white coat. I've talked about docs wearing ties and lab coats in the past.

According to this AP article, the Department of Health in England issued a hospital dress code on Monday banning the above clothing. They say that it will decrease the spread of infection.

"Ties are rarely laundered but worn daily," the Department of Health said in a statement. "They perform no beneficial function in patient care and have been shown to be colonized by pathogens."

The new regulations taking effect next year mean an end to doctors' traditional long-sleeved white coats, Health Secretary Alan Johnson said. Fake nails, jewelry and watches, which the department warned could harbor germs, are also out.

I guess docs will have to dress like Dr. McDreamy above. (You knew I just had to bring back that picture at some point. Remember this post?) Getting back to this article, US physicians will not have to worry about silly dress codes like this...

Infection control societies in the U.S. don't recommend similar dress restrictions because there is no strong evidence that health care workers who don't wear ties or jewelry reduce the risk of infection, said Dr. James Steinberg, an Emory University infectious disease specialist.

Steinberg said that doctors and nurses who don't adequately wash their hands pose a far bigger risk to patients and that hand-washing should be the focus of infection control efforts in hospitals.

The [CDC] does have guidelines advising doctors and nurses against wearing artificial nails in operating rooms and around high-risk patients. It says there is evidence that health care workers who wear fake nails have more germs on their fingertips both before and after hand-washing than those with natural nails.

Now, let me get this straight. I can keep my tie and lab coat. But, I have to get rid of my artificial nails? What's up with that?

Hillary health care (part 2)

The press is abuzz today hyping up the fact that Hillary is going to unveil her health care plan today. (Of course, I'm a hypocrite for not only point this out but also making this a post of my own.) Here's the beginning of the AP article.

Des Moines, Iowa - Democratic presidential candidate Hillary Rodham Clinton is unveiling a sweeping health care proposal Monday that would require everyone to carry health insurance and offer federal subsidies to help reduce the cost of coverage.

Fulfilling a pledge to bring health care to all, Clinton's "American Health Choices Plan" has a price tag of about $110 billion per year. It represents her first major effort to achieve universal health coverage since 1994, when the plan she authored during her husband's first term collapsed.

Here's an interesting quote from today's CNN article citing why her first plan didn't work out...

As first lady in 1993 and 1994, Clinton spearheaded an effort that would have overhauled the provision of health care. Critics compared her plan to socialized medicine, and it was killed by opposition from special-interest groups -- including doctors and pharmaceutical companies.

I just love when docs are lumped together with pharmaceutical companies - and then blamed for the reason that the United States does not have "universal" health care - this is very Michael Moore-like. (Aside: It's always enjoyable to see MM being taken on by the main stream media like CNN and ABC.)

In case you were wondering, here is a decent AP article outlining the stated positions of the other presidential candidates. I'm no political pundit. But in just talking with people around town (supposed grassroots America), I believe that health care is the number one domestic issue that will shape next year's presidential election.

Terry Fox

Before I even thought of making medicine a career -- before I even was a teenager -- I remember seeing this movie about a guy - an amputee -- try to run across Canada -- for cancer research. "What's cancer?" I asked my parents.

They gave me some kind of explanation which I could not understand. What I did know is that "the cancer" caused this guy to lose his leg. I still remember this story, even today.

According to this article from CTV, the 27th annual Terry Fox Run was today in Toronto. I didn't know this, but his foundation has raised over $400 million worldwide for cancer research. Here is some background information, if you're not familiar with this story.

Fox set out on his Marathon of Hope in St. John's on April 12, 1980, to raise awareness for amputee capability and cancer funds. Born in Winnipeg and raised in Port Coquitlam, B.C., he was first diagnosed with bone cancer at the age of 18.

Three years before he started his run, Fox's right leg was amputated 15 centimetres above the knee, in an attempt to stop the disease from spreading throughout his body. He ran 42 kilometres a day through the Atlantic Provinces, Quebec and Ontario; the equivalent of a full marathon everyday.

After 143 days on Canadian roads, Fox was forced to stop running near Thunder Bay, Ont., because the cancer had reached his lungs. He passed away in June of 1981 at the age of 22.

Even as a child, I didn't understand why someone so young had to pass away from an illness. The youtube video above tells a little more of the inspiring, yet tragic story of this Canadian hero.

Dr. A Live: The Stealth Show

I just finished the latest edition of the Doctor Anonymous Live show. What? You didn't hear about it? Well, that's because I didn't advertise it. To be honest, I was embarrassed by the last show and the technical difficulties that I had.

I think I isolated what the problem, because I did not get kicked off the site this time. I only did a 15 minute show tonight to test things out and everything seemed ok. So, check it out in the sidebar and leave a comment to let me know what you think. Hopefully, next week, I can get back to full steam ahead!

Cell phones cause cancer?

These rumors have been flying around for years. Over the past ten years or so (maybe even longer than that), study after study has been released that proves or disproves the assertion that cell phones cause cancer. The latest study has been done in the UK. This is actually an interesting article from BBC News.

The long-term cancer risk of mobile phone use cannot be ruled out, experts have concluded. A major six-year research programme found a "hint" of a higher cancer risk.

But the UK Mobile Telecommunications and Health Research Programme (MTHRP) did rule out short-term adverse effects to brain and cell function.

Researchers are now expanding the programme to look at phone use over 10 years, and the specific impact on children, which has not been studied.

Research is a funny business in that if you don't like the result, you either extend out the time of the study until you get the result that you want. Or, you amplify the very small results that you have and hypothesize the results that you really wanted in the first place.

In this article, since the six year data didn't get them their result, the article states things like "Cancers do not normally appear until ten to 15 years after exposure." I also love this quote, "With smoking there was no link of any lung cancer until after ten years." Here is the key passage to the entire article:

The team found that there was a slight excess reporting of brain and acoustic neuroma (ear) cancers. Researchers said this was on the borderline of statistical significance.

Translation: "Borderline of statistical significance" means no statistical significance. So, at this point in time, this study failed to make the connection between cell phone use and cancer. The debate will definitely continue. But for now, feel free to continue using that cell phone! But, please, be careful text messaging while driving.

Conservative/Liberal brain activity

Now, I know the most cynical of you out there are saying, "In politics, there is no brain activity." (image credit) And, I bet there are a good percentage of Americans that agree with you. But, I thought that this was an interesting study reported by AFP.

Conservatives tend to crave order and structure in their lives, and are more consistent in the way they make decisions. Liberals, by contrast, show a higher tolerance for ambiguity and complexity, and adapt more easily to unexpected circumstances.

The affinity between political views and "cognitive style" has also been shown to be heritable, handed down from parents to children, said the study, published in the British journal Nature Neuroscience.

In this study, they took 43 right-handed subjects and asked them to perform a series of computer tasks to see how they would do when they had to break from a well-established routine.

The match-up was unmistakable: respondents who had described themselves as liberals showed "significantly greater conflict-related neural activity" when the hypothetical situation called for an unscheduled break in routine.

Conservatives, however, were less flexible, refusing to deviate from old habits "despite signals that this ... should be changed."

Whether that is good or bad, of course, depends on one's perspective: one could interpret the results to mean that liberals are nimble-minded and conservatives rigid and stubborn.

Or one could, with equal justice, conclude that wishy-washy liberals don't stick to their guns, while conservatives and steadfast and loyal.

The late night comedians will have a field day with this. For me, there are just too many jokes around (pointed both at conservatives and liberals) for me to pick from. Maybe I'll come up with something later....