Monthly Archives: November, 2008

For The Most Honest and Ethical Job, the Winner is….

In its Annual Honesty & Ethics of Professions Survey this year, Gallup has placed the winner as, for the seventh straight year,  nursing. In its latest results released Nov 24th,  84% of Americans surveyed gave a high or very high rating for nurses as the most honest and ethical profession.nurse1

This shouldn’t come as a surprise, for all the reasons I mentioned in my earlier posting- “Nursing – the ‘In’ Profession”. Long derided by medical doctors as ‘glorified hand-maidens’ and the subject of countless bawdy humour, the nursing profession has lately regained a lot of prestige and has been hailed as one of the ‘in’ professions, what with the acute shortage worldwide and a more-defined career pathway  which can lead one up to  becoming a hospital CEO even.

carsalesman1

And who are at the bottom of the list? Car salesmen. 55% said they have low or very low ethics. No other profession comes close to this level of disparagement. This is not a new finding; car salesmen have been at the bottom every year they have been included in the list, except for the three occasions when telemarketers were included and essentially tied car salesmen for that unwelcome distinction. How many times have you heard this : “Hey,buddy, you look like a nice guy. I’m here as your partner in making this important decision!”

Here’s the ranking of the other professions:

2006 Honesty and Ethical Ratings Summary

Very high/High

Average

Very low/Low

NET HIGH

%

%

%

Nurses

84

14

2

82

Druggists or pharmacists

73

23

4

69

Veterinarians

71

23

2

69

Medical doctors

69

26

6

63

Dentists

62

34

4

58

Engineers

61

33

3

58

College teachers

58

32

7

51

Clergy

58

29

9

49

Policemen

54

34

11

43

Psychiatrists

38

42

12

26

Bankers

37

52

10

27

Chiropractors

36

48

10

26

Journalists

26

48

25

1

State governors

22

52

26

-4

Business executives

18

53

27

-9

Lawyers

18

42

38

-20

Stockbrokers

17

56

23

-6

Senators

15

49

35

-20

Congressmen

14

45

40

-26

Insurance salesmen

13

51

34

-21

HMO managers

12

45

37

-25

Advertising practitioners

11

49

35

-24

Car salesmen

7

36

55

-48

Are Vitamins That Beneficial?

Time after time, doctors have been exhorting on the usefulness and benefits of vitamins, over and above the minimum daily requirements. As much as scientific studies have tried to confirm this, a slew of recent findings have failed to confirm the benefits.

Take a look at some of them:

  1. A large clinical trial of almost 15,000 male doctors taking vitamins E and C for up to 10 years has found that neither supplement had any effect on cancer rates, including cancer of the prostate.
  2. 14,000 doctors took vitamins C & E for 8 years but found they were of no help in heart diseases.
  3. Last month, a major trial studying whether vitamin E and selenium (the SELECT Trial) could lower a man’s risk for prostate cancer ended amidst worries that the treatments may do more harm than good.
  4. Researchers at Memorial Sloan-Kettering Cancer Center in New York studied the effects of vitamin C on cancer cells. As it turns out, the vitamin seems to protect not just healthy cells, but cancer cells, too.
vitamins

Megadoses of vitamins - bane or boon?

I’m not saying vitamins are no good – everyone needs these nutrients to ensure proper body function, but the amounts for this purpose are often adequately found in the normal diet. What we are referring to is the ingestion of mega-doses of vitamins with the hope that its anti-oxidant effects will be good enough to mop up the harmful free radicals produced by the body. There are many patients I know who will swear by large doses of vitamin C to ward off an impending cold (there’s some truth in this, though).

Despite a lack of evidence that vitamins actually work, consumers appear largely unwilling to give them up. And this view appears quite justified as there is a perception that these scientific researches are poorly-designed. And that’s not helped by the recent revelation that many journalists and even radio hosts have benefited from financial incentives from drug companies. Take a look here.

Why People Doze Off During the Day.. Daytime Drowsiness Dissected

sleepA commentator wrote in and asked what the difference was between a person with narcolepsy and Obstructive Sleep Apnoea(OSA). Well, quite a bit..although people suffering from these conditions would manifest as extreme drowsiness during daytime.

sleep2

Daytime Snooze...normal or pathological?

Lets get some facts straight. The most common cause of extreme daytime drowsiness is insufficient sleep. Whether its due to a late social night out, a late football game or recent matrimonial bliss, if one does not get the required amount of beauty sleep (which varies from person to person, 6-8 hours generally), the next day will reflect on the previous night’s activities.

That aside, if we look at those who are blessed with sufficient hours for sleep at night, but yet show excessive daytime drowsiness, many health practitioners would want to entertain 2 important causes. One of them is Obstructive Sleep Apnoea(OSA), which was covered by an earlier post here. People with this condition have been known to doze off during an important Board meeting (not out of boredom, for sure) or crashed their car while falling asleep at the wheel. This recently-recognised medical condition has become more and more prominent in recent years as its awareness increases. Thanks to new techniques, this condition has become eminently curable.

The other condition causing prominent daytime drowsiness is narcolepsy. This little-known condition manifests in 5 different ways:

  • excessive daytime drowsiness,
  • cataplexy (loss of muscle function in response to emotional extremes),
  • sleep paralysis (temporary inability to talk or move on waking up),
  • hypnagogic hallucinations (vivid dreams while sleeping or waking up) and
  • automatic behaviour (continuing normal fuctions while sleeping, like sleepwalking).

Apart from the above sleep disorders, we should not forget also that some medications can cause drowsiness. A good example is antihistamines, often used to combat allergies or motion sickness. There are some diseases that can cause sleepiness as well, in particular hypothyroidism and hyponatremia.

If you do have such sleeping disorders, go through this quick checklist to see if you are having any of these maladies- click here.

Spam, the Cancer, Goes Into Remission

Was it my imagination, or was it real, that the size of my junk-mail box had gotten less over last week? I seem to be missing (the irony of it all) all those mails exhorting the use of various pills to make my ‘partner deliriously happy’ and  the use of one’s ‘tool’ to perform wonders which defy medical science.

Global spam levels have dropped by as much as 75 per cent following the shutdown of a US web host that spam1provided the backbone for most of the world’s spam. The web host, McColo, based in California, counted customers including “international firms and syndicates that are involved in everything from the remote management of millions of compromised computers to the sale of counterfeit pharmaceuticals and designer goods, fake security products and child pornography via email”, The Washington Post reported.

For those techies, spammers typically use botnets of hacked computers that they surreptitiously control and use to send their spam messages. This makes it harder for them to be traced and allows spammers to harness the internet bandwidth of potentially hundreds of thousands of computers.

This appeared to be part of a multinational swoop coordinated by Interpol in nine countries targeted against internet drug peddlers. Interpol’s internet message is simple: Do not buy prescription-only medicines over the Internet without a prescription.

I can only reiterate this message because there’s no way you can prove the drugs are safe and effective. In many cases they can be harmful, when unknown chemicals may be added.

However, as in some cancers, the drop in junk mails is expected to be a temporary lull as spammers adapt and find new areas to set up their operations again, possibly in Eastern Europe. Will the cancer spread again? Will spam, the scourge of the Internet, make its reappearance?

The Melamine Milk Mess – Where Did All The Stuff Go?

After the melamine scandal surfaced and reported here in September 2008, the Chinese health authorities have seized tons of contaminated milk from local manufacturers as well as received even more from rejected foreign shipments.

melamine-disposal

One Easy Way of Disposal - workers squeezing milk into a drainage ditch leading to a sewage plant(AP photo)

The problem with the Chinese Health Ministry now is how to dispose off the tens of thousands of tons of melamine-stained milk which had been seized so far. Well, some of it was buried and mixed with coal while one trash company in Guangzhou actually dumped it into a river, turning the waters a frothy white!

Nobody’s saying how much exactly has been seized, but to give an idea, last month some 32,000 tons – enough to fill up 23 Olympic swimming pools – were disposed off in the province of Hebei alone, according to local news agencies.

Another ingenious method was to icinerate the contaminated milk powder in 3000 degree heat and convert the residue to cement, a technique which was claimed  to be environmentally friendly. In fact, this method is one of two officially approved by Beijing, the other being to dispose them into official land-fills.

So, it looks like the official Chinese government stand is.. burn it or bury it!

Teenager Wins Right To Die

A terminally-ill teenager has won the right to die after she was taken to court by her local hospital in an attempt to force her to have a heart transplant against her wishes.

13 year-old Hannah Jones of Hereford,England had been suffering from a rare form of leukemia since the age of 5 and subsequent high-dose chemotherapy for the leukemia  had caused a hole in the heart to form; so much so, she had to stop the drug therapy to prevent further damage to the failing heart. She was offered a heart transplant by NHS-run Hereford Hospital but decided against it because of the high surgical risk and possibility that the leukemia would resurface due to  her lowered immunity. Read more here.

hannah_jones_1111420c

13 year-old Hannah Jones - a patient's decision-making rights override that of medical personnel's

Hereford Hospital then applied for a High Court order to forcibly remove the patient from her parents because they were “preventing her treatment”. However, after interviews with the Child Protection Team from the hospital, Hannah convinced the barristers at the High Court that she did not want the transplant and wanted to die in dignity. The court order was thrown out.

This case illustrates, among other things, that patients, provided that they are old enough to sufficiently understand and are made aware of the risks and benefits of a line of treatment, are entitled to decide for themselves whether to opt or not for that treatment(what the lawyers call informed self-determination).

For doctors, it is rather unsettling that, being trained to heal the sick and to prolong and enhance life,  they have to question why a young person would want to ‘throw away’ her life. Ultimately, the consent to pursue a line of treatment rests entirely upon a fully-informed patient, and medical personnel have to respect that.

Whatever it is, in Hannah’s case, we must applaud her bravery – in facing the disease, in undergoing the trials of treatment, and in making up her mind the way she did.  And what next for Hannah? Despite being terminally ill, she has expressed her dying wish to visit Disneyworld in Florida.

The Top Ten Irritating Phrases

Life is stressful enough without one encountering, time after time, cliches or phrases which tend to irritateirritation the reader. Quite a number come to mind..take for example, waxing lyrical, a favourite among travel mag writers.

Apparently the irritation has gotten so significant, according to the UK Telegraph,  that Oxford University has compiled a list of what it considers the all-time most annoying ones. Here goes:

1 – At the end of the day

2 – Fairly unique

3 – I personally

4 – At this moment in time

5 – With all due respect

6 – Absolutely

7 – It’s a nightmare

8 – Shouldn’t of

9 – 24/7

10 – It’s not rocket science

Cutting Healthcare Costs Without Cutting Corners (Part 4) – Choosing When to be Hospitalised

hospital-costsIf you have to be admitted to a hospital, try and avoid going in on a weekend. Yes, I know, if its an emergency, fair enough, you have to get in. You can’t choose your dates when you get sick and when that happens,you need to be hospitalised straightaway.  But, in the case of when you have a choice of when to get into hospital (such as for an elective surgery or for an extensive checkup), it would be wise to plan ahead and choose a weekday.

Why? For several reasons:

  1. Many hospitals cut off what is deemed as ‘non-essential services’ for the weekend. You will not find a dietician or full physiotherapy services on a weekend. This means waiting for Monday before anything happens.
  2. Many specialists take off for the weekend (doctors are human,too), leaving just a specialist on call who may not be the person you are looking for. Sometimes, the appropriate specialist may not be available and the patient may end up being seen by a specialist who may not be a subspecialist in the desired field.
  3. It may sound unfair, but the majority of private hospitals levy an overtime surcharge for lab tests, imaging studies or usage of operation theatres if these are utilised on weekends. Even though you did not choose  to get sick on a weekend, you may be surcharged up to 50% over and above the usual rates.
  4. The support staff, like nurses and technicians, are usually kept to a bare minimum on weekends to reduce overheads and sometimes, on a busy day with lots of emergencies, optimum care may not always be available.

See other postings on cutting healthcare costs:

Buy generic

Take health insurance

Seek treatment at lower cost centres

For Those Studying Medicine..(5)

“A journey of a thousand miles begins with a single step.”

-Confucius (551-479 BC), Chinese philosopher and founder of Confucianism

Its often been said that studying to be a doctor is a calling, as opposed to many other professions when its just involves studying to obtain an occupation. To become a doctor not only involves studying hard but it involves a change in one’s lifestyle and attitude towards life, in the pursuit of the maxim ” to cure sometimes, to heal often and to comfort always”.

Many medical students appear daunted at the long tortuous years of study ahead of them but this is often made easier if, before taking that first step, that you have the right aptitude and attitude. In my book, you do need some brains (though not as much as a rocket scientist), but more important, the three paramount qualities that you need are :

  • a desire to help others
  • a love for learning
  • a curiosity towards how diseases affect people

If its money you’re after, there’s a lot of other careers which are more lucrative; minus the sacrifice, effort and responsibilities of becoming a doctor!

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