Michael on the Heritage Foundation’s crap calculations : publishing papers with statistically non-significant results, and then telling people to “decide for themselves.” A new low, the stats community should be outraged.

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Medblogger Robert Centor got an Op-Ed published in USA Today . Congrats!

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I guess this breaks the whole anonymity of Savage Love, but who cares. I’m excited! I got published in this week’s Savage Love !

Q. You missed an opportunity in a recent column to talk about HPV and its association with anal cancer. It’s 35 times more common in the gay male population and isn’t being screened for very well. In fact, it’s now more common in gay men than cervical cancer is in women. If anal cancer is diagnosed early, mortality rates are much lower. Please let your readers know! —STANFORD MED STUDENT

A. Now they know, SMS.

(We had the world expert on anal cancer come talk to our class about HPV. He’s featured as having the worst science job: anal wart researcher. )

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Last time I checked, schizophrenia wasn’t that funny . But I guess if we’re going to go after the mentally ill:

Once I met a patient with post-traumatic stress disorder from killing people in the Vietnam War. His disorder was destroying his family and his ability to function at work. He thought everyone in his town was out to attack him.

Isn’t that hilarious ?

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Welp, in 48 hours I’ll be done with my USMLE Step 1. At this point it’s mostly just trying to keep information as fresh in my head as possible and keeping myself positive.

If you’re looking for something to keep you studying a little harder when you get sick of First Aid, try this site ; it’s First Aid in question form. Good luck to everyone taking it this year!

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I’ve kind of learned it’s easier for my OCD/hypochondriac/med student syndrome self to just stop trying to diagnose myself, stop Googling every symptom, and stop palpating nodes, thinking that one will turn out to be Hodgkin’s (and still secretly knowing deep down that it won’t). But every time I read Effect Measure , I start to get a little scared. It’s a public health blog that’s doing some awesome blogging following the Avian flu virus (Influenza A H5N1).

A perfect example of a freak-out post . I really don’t think the writer is being alarmist; I get the sense he’s pretty well read, experienced with public health, and (gasp) uses data and facts for the basis of his posts. I’m mainly scared about this bird flu for my own personal concern: the flu seems to be hitting people in my age group . Combine that with the fact that that I’m an official first responder, starting work in the hospital in July, in California, in the Bay Area, with a constant huge influx of people from Vietnam and other bird flu hotspots, and you can color me nervous.

Yes, I know, it’s one of the risks I take as a future physician, but I think it’s absolutely ridiculous that this isn’t a bigger story in the news, or that our government is doing less for preventative measures. I guess that’s what happens when you’ve got a war going on to protect our security. My bet: when the bird flu hits, and if it hits as hard in the US as Effect Measure is reporting, “health security” will be a new buzzword, and could be the tipping point for a national health insurance system in the US. If there’s one thing the US is good at, it’s reacting once a problem has already hurt us. Go primary prevention!

The UK has ordered enough antiflu meds for 25% of its population; the US: 2%.

Sweden has ordered enough for half a million and tens of millions more doses have been ordered by Norway, Canada, Australia, New Zealand, Finland and France. The US has only ordered 2.3 million and may increase that to 6 million (enough for only 2% of our population). The UK is more ambitious with plans a $385 million for a quarter of its population. London wants 100,000 for its police fire and transport workers. WHO is trying to establish a “mobile stockpile” of 120,000.

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I just laughed out loud in the library reading this piece from the NEJM :

Words never seem more needless to a busy resident than those elicited from a somatizing patient during a complete review of systems. All the compulsiveness nurtured in medical school evaporates before the onslaught of bewildering trivial complaints that have presumably found, finally, a sympathetic ear. How to shut off the torrent of words?

The conventional strategy is to ask questions that have simple yes-or-no answers, but this rarely hinders the determined somatizer from expanding a yes response into an intricate account of the details of his or her belly pain or dizziness. Long ago, a creative fellow resident invented the only effective method I know of for dealing with a patient with an all-positive review of systems, though I hesitate to recommend it. We called it the “Corning couplets” in his honor. Typical couplets might be “Have you ever had constipation or syphilis?” and “Do you have headaches or lice?”

[via kevinmd ]

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From Dr. Quentin Young in today’s Trib , comes a nice editorial for single-payer. Not only has General Motors moved much of its production to Canada, even Lifesavers moved their Michigan plant to Canada for lower costs:

On April 19, General Motors Corp. blamed its dismal first-quarter results (a $1.1 billion loss) on its $5.6 billion annual health-care tab. On top of that, the company carries $63 billion in unfunded health-benefit costs. The future certainly looks bleak.

Clearly a disaster is looming not only for GM and its workforce, but also for the entire American economy. America’s other largest corporations also face skyrocketing health-care costs; General Electric Co., Boeing Co., Lucent Technologies Inc., IBM Corp., Verizon Communications Inc., SBC Communications Inc. and Ford Motor Co. have a combined $150 billion in future health-benefit obligations. Their future looks bleak too.

Ominously, non-competitive American products are sending our jobs abroad.

From candy to autos, Canadians can produce goods more cheaply because of their markedly lower health-benefits costs. For example, in Canada a Ford costs $1,400 less to make than it does to produce in Michigan. Lifesavers shaved $4 per hour off its labor costs by boarding up its hometown factory in Holland, Mich., and heading for Canada.

Alert pundits are, at long last, calling U.S. business to account.

They are pointing out what has been obvious to all industrialized democratic nations around the world for some time now: Employer-based health-care benefits are a bottomless pit. Seventeen American steel manufacturers have declared bankruptcy and terminated their retirees’ health benefits.

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Steven Pinker has a great Op-Ed in the NYT about the so-called “Gay Gene”:

Just as puzzling is the existence of homophobia. Why didn’t evolution shape straight men to react to their gay fellows by thinking: “Great! More women for me!” Probably the answer lies in a cross-wiring between our senses of morality and disgust. People often confuse their own revulsion with objective sinfulness, as when they dehumanize people living in squalor or, in the other direction, engage in religious rituals of cleanliness and purification. An impulse to avoid homosexual contact may blur into an impulse to condemn homosexuality.

Cultural conservatives like the talk-show host Dr. Laura Schlesinger ostensibly condemn homosexuality for another reason – that it is a “biological error.” Actually, it is she who has made the biological error. What is evolutionarily adaptive and what is morally justifiable have little to do with each other. Many laudable activities – being faithful to one’s spouse, turning the other cheek, treating every child as precious, loving thy neighbor as thyself – are “biological errors” and are rare or unknown in the natural world.

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Kylie Minogue was just diagnosed with breast cancer at age 36. She’s huge in the dance music world; her stuff is always on the radio. If you still don’t know who she is, she sang Locomotion in the 80s.

The average age of breast cancer presentation is usually post-menopausal early 60s, so I’m wondering if she has the familial form of breast cancer, caused by the BRCA1 and BRCA2 genes. Breast cancer usually presents much earlier in those women. If so, Kylie’s sister may be at risk, too.

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