Monthly Archives: July 2012

Robots in Medicine? On the Rise

Posted on by

By Karin Krisher

robots in medicineThis post isn’t necessarily meant to offer advice, or too much insight. We just think advances in medical technology are really cool, and that these are ones you should definitely know about.

Robots in medicine are on the up and up. Just yesterday, news broke that RP-VITA (Remote Presence Virtual + Independent Telemedicine Assistant) will begin making bedside visits. And today, the FDA approved a robotic system to perform remotely controlled angioplasty.

If there’s fear these two robots will replace human docs, let’s dispel it now. Today’s tech is designed to make the doctors’ and patients’ experiences more successful and simple. It’s for us, not against us. In fact, both advents still involve patient/doctor interaction:

The former is designed to make rounds simpler. The robot’s head is a video screen that features the visiting doctor, who could be home sick in bed himself. High-definition camera eyes allow the clinician magnification and angular perspective so she or he doesn’t miss a beat or slight pupil dilation. RP-VITA also features a microphone that relays the doctor’s voice. Overall, it’s an incredible opportunity to allow more staff to attend to emergency or critical situations.

Clinical trials showed that the latter robot, named the CorPath 200, is 97.6 percent successful in its endeavor: holding open an artery and placing a stent. On top of that, it reduces lead exposure (to the surgeon) by 95 percent and gives doctors better precision and visualization. Patients should be more comfortable having a doctor who isn’t exhausted from standing on his or her feet draped in a lead cape for an hour or two, and doctors should feel good about added precision and mental acuity.

It’s no question that medical technology no longer refers solely to an EKG. Times are changing, and RP-VITA and CorPath 200 are just the newest reminders of how innovation will continue to shape the landscape of medicine as far as the eye can see.

What do you see for the future of robots in medicine? Are you excited, nervous, or even enthralled? Tell us in a comment!

Talk to Your Patients About Probiotics

Posted on by

Karin Krisher

Talking to your patients about probiotics might be just the kick start they need on their path to everyday health. Going with your gut means more than just following your heart. With the ever-emerging understanding of digestive health as it relates to food consumption, we’ve been able to embrace the idea that the gut can have a huge effect on total health—including a significant one on neurological wellness.

Probiotics are a hot news topic, and we couldn’t resist jumping on the bandwagon for this discussion. Here, we tell you about the talking points you and your patients should cover.

  1. Explain why probiotics exist in the first place.

The gut is the most biologically active area in the body—more plentiful microorganisms that are more active than other microorganisms reside here. Further, bacteria in the body outnumber cells 10 to one. Zoom outward with your patients—ask them to view the gut as it’s own living system, an organism that needs specified care. Probiotics, either in food cultures or in supplement form, can provide that support.*

     2. Talk about antibiotics.

The New York Times summarized a large scale study and report on probiotic use in comparison to antibiotic use. The researchers and reporters concluded  that probiotics support microbial balance, even that which is otherwise affected by antibiotics. Intuitively, that makes sense: pro plus anti equals balance. But your patients might need some of the facts to back up the potential benefits.

      3. Talk about natural sources.

Now, new information tells us what isn’t not be so obvious: even red wine may act as a probiotic delivery system. Fermented foods (like yogurt) have long been touted for their probiotic content, but wine’s relatively novel, and while the Times is quick to caution us that no doctor would recommend alcohol solely for its potential digestion supportive properties, we’ll leave that up to you. At least you can let your patients know that this is an option. Which brings us to our next talking point.

      4. Talk about the options.

While we’re yogurt fans, many people are not—and that’s OK. For those who are interested in supplementing their diets with probiotics, there are a million options. Our favorites, of course, come from the DaVinci line. Mega Probiotic ND, Mega Probiotic ND with Digestive Enzymes Chewable and NonDairy Probiotic 50+ all offer something slightly different from one another.

Choosing one is tough, we admit, but your patients should have all of the information about each before they pick. Our chewable probiotic includes digestive enzymes for support of nutrient absorption and utilization.* It also tastes delicious, which is always beneficial to compliance. Our Mega Probiotic ND is a nondairy formula with 5 billion CFU per capsule, alongside fructooligosaccharides, a prebiotic. Finally, DaVinci’s new probiotic, NonDairy 50+, features over 50 billion CFU of beneficial bacteria per serving, FOS, and multiple bacteria strains, making it the most concentrated and diverse option.

       5. Talk about the connection.

Which connection? The connection. Let your patients know that whatever is going on in their minds is so affected by microbial balance that the thread is often referred to as “the gut/brain connection.” So instead of asking them to plunge headfirst into the mysteries of their current mental states, ask them to think about what they ate last night.

As Scrooge so famously professed to the ghost of his dead business partner, “You may be an undigested bit of beef, a blot of mustard, a crumb of cheese, a fragment of underdone potato. There’s more of gravy than of grave about you, whatever you are!”

And he was probably right.

How to Manage Online Doctor Reviews

Posted on by

By Karin Krisher

doctor reviewRemember that patient with the back pain whom you helped set up a supplement regimen last week? She gave you four stars. Remember that patient who came in yesterday to get his ears checked right after your wife called and told you the dog was missing? He’s giving you just two.

 

Remember that patient who you could have tomorrow, but won’t because they only read the second doctor review? Wait a minute….

Because doctors provide a service that people expect to be comforting and effective, the average person will ask their coworkers or neighbors for a recommendation before choosing a practitioner. In a virtual environment, any information is up for grabs—especially opinion. Reviews of doctors are becoming wildly popular, and you should be prepared for influx or backlash. How?

1. Know the common online doctor review sources. Check them. Often.

Angie’s List (a paid service), healthgrades.com, vitals.com, zocdocs.com and rateMDs.com are among the top sites for medical practitioner reviews. Health grades focuses on large data groups, but your name (or practice, or hospital) probably has a spot reserved.

2. When you do see yourself on a site, pay attention.

It’s normal to get upset at a bad review. (We’re not saying you’ll get them, but it’s important to be prepared.) But instead of getting upset, make a positive change. Take steps to ensure the patient’s concerns are addressed. Of course, this doesn’t mean that you should change everything based on one patient’s assessment, only that if you see a trend, you adjust accordingly. If ten patients hated your waiting period, it might be time to adjust your hours so you have enough wiggle room to ensure you see people in a timely manner.

3. Prevention is key.

You want good reviews. If you trust a longtime patient, let them in on the virtual review secret. Chances are, they’ll take the lead and give you a great review.

If you’re not comfortable with that idea, simply talk to them about what you can do to improve your services. Take the good advice. It’s important to listen to your patients from the beginning, so bad reviews are few and far between. Remember—the Internet is a constantly evolving archive. While you do have the ability to change your ratings through actual improvement, you also don’t have the ability to take back what one ornery patient wrote. Don’t let that happen—give good service all the time.

4. Field questions.

If a patient brings up a bad review with you (this assuming he or she chose to ignore it enough to make it to your office) ensure him or her that you’re taking steps to improve that aspect of your practice. Then follow through. If a patient asks for the reason for the complaint, it’s ok to admit a fault of your own. It’s also OK not to. People can generally sense sincerity.

5. There are things you shouldn’t do.

Unless the circumstances are dire (e.g. someone insists you used a rusty tool during surgery—and it’s a lie) don’t subpoena the names of your bad reviewers, stop providing services to people whom you know have given you a poor review, or make your patients sign contracts that say they won’t submit a bad review. It’s tempting to cover yourself, but it’s also unfair.

Opinion-based speech is still speech, regardless of platform. You would not ask your patients to sign a contract that says they will never tell a friend about the quality of your appointments—the Internet is now a space where the same type of interaction occurs. The only real difference is proximity. Further, suing or blacklisting implies you have something to hide—and that, surely, will end up in a review somewhere.

Have you had experience with patients submitting to doctor review sites? What were your results?

Talk to Your Patients About Chronic Pain

Posted on by

By Karin Krisher

Chronic PainThe phrase “It’s all in your head,” really might bear some credence. Researchers at the Northwestern University Feinberg School of Medicine have shown for the first time that cross chatter in two regions of the brain is related to the persistence of pain. In other words, chronic pain is related to the brain’s original response to the pain.

Ten years of research led the team to conclude that in relation to chronic back pain, the injury itself was not enough to explain the pain, but the injury combined with brain state might very well be. The pain’s persistent nature could be related to an emotional response.

The study relied on fMRI scans to detect brain changes that happen early. The two parts of the brain involved, the insula and the nucleus accumbens, exhibited a much higher level of cross talk between them in study participants whose pain continued than in the participants whose pain faded. While the insula is active when people have an emotional response to an event or environment, the nucleus accumbens region is involved in teaching the brain how to respond to environmental changes.

The amazing part? The scientists found that their initial scans could predict the chronic nature of pain with 85 percent accuracy, suggesting that the more emotional the initial reaction to the injury was, the longer the pain will last. Further, the study found that participants with chronic pain lost gray matter density over time.

What does this mean for the future of pain? The researchers hope to develop new therapies for chronic pain based on the findings. Many medical endeavors are now leaning sharply toward the neurological, and pain is no exception. Pain is the main reason for medication, a driving factor behind disability, and some estimates note that in the United States, its chronic form could cost up to $635 billion per year.

Perhaps approaching pain from a neurological standpoint can help your patients who don’t even have chronic pain. Addressing this concept now could give patients the information they need to make rational decisions at the time of an injury, thereby avoiding the emotional burden and response chronicled in the study participants.

What kinds of chronic pain do you treat most often? What is your main course of treatment? Is there something you would suggest to other practitioners?