We don't care if it's against your conscience

Looks like the White House will be reversing Bush's federal conscience clause rule. This move makes me more optimistic about the direction Obama is taking us. I often fear that he gives into the other side too much (especially, the religious side) and with his support of faith-based initiatives, I didn't think he'd do much about the conscience clause. This is great, but a lot of states (.pdf)* have their own conscience clause rules.

BTW, the caption of the picture on the article I linked from the Washington Post, has some reverend talking about how this "raises skepticism about the White House's talk of common ground." It seems to be the right wing's MO now... 1) Whatever Obama does, be against it. 2) Complain that whatever Obama is doing is anti-bipartisan.

*Wow, according to this, West Virginia has the least restrictive conscience rule (almost heaven?). Healthcare providers can't even legally refuse to participate in abortions.

I wonder if it helps their depression?

Apparently crocodiles can find their way back to their territories even if they've been moved miles away using the Earth's magnetic field. So, to keep them from returning to their former, human-inhabited territories, Florida officials take them deep into the swamp and attach magnets to their heads, making them lose their sense of direction. Cool, maybe next time I go to Florida, I'll bring a TMS machine with me (or at least a magnetic therapy bracelet).

Buy more beer

According to Nate Silver alcohol sales (mostly beer) are down almost 10% in the last quarter. That's the most by far in the last 50 years (the previous low was 3.7% down in 1991). Not sure why people aren't buying beer anymore, but if there's any sign that we're entering a deep depression, that's gotta be it. How do you deal with a depression without beer?

Oh no... quackery counts as medical education

Here's a recent "opportunity" from our medical school:

Traditional Chinese Medicine Rotation—Preliminary Announcement



I am pleased to announce that we are again able to offer a rotation in traditional Chinese Medicine (TCM) during the Spring of 2010. This month-long rotation is possible through the exchange program between the Department of Family Medicine and FuXing Hospital in Beijing. In addition to didactic instruction in the principles and techniques of TCM (acupuncture, massage, herbal treatment), students will observe how TCM is practiced in Chinese community health centers and hospitals. Limited hands-on training in acupuncture and/or massage may also be provided.

Now that (yet another) scientific review says that acupuncture is nothing but a glorified placebo effect (and I won't even bother with the rest), aren't there more important (more proven) medical techniques that medical students should be educated in? Does the medical school really think that spending an entire month (of the mere 18 months of clinical rotations that makes up an MD) on traditional (i.e. fake) medicine will really add to their students' educations? Come on medical educators... you can't teach your students about evidence-based medicine and then allow this to count as a month's worth of credit at the same time.

For those who'd rather have measles, diphtheria, pertussis, polio ... still around

There are too many otherwise intelligent people risking their kids' lives by buying into the unfounded idea that vaccines cause autism. It's one of those issues that, for some reason, makes proponents blind to any chance of actual reasoning. I get upset with it too easily (after all, I pretty much consider it child abuse) to be very patient with the anti-vaccine crowd. However, a fellow MD-student at her blog, Heal Spiel, has an amazing rebuttal to an anti-vaccine proponent. Glad to see support of reason in the medical field.

It's against my conscience

Our former (yay!) president's administration really pushed to make conscience clauses for health professionals a federal law (and unfortunately, they succeeded). This lets healthcare professionals avoid treatment, misinform and pressure patients using the excuse of "It's against my conscience." The goal of the proponents for this is obviously to limit access to reproductive services like contraception and abortion, and there are enough nuts in medicine that it has already become a problem. The most common problem is physicians not informing their patients of the option of abortion (or refusing to refer them to another physician), pharmacists refusing to fill Plan B or birth control prescriptions. But it could get even worse, it may protect healthcare professionals when they remove birth control devices, refuse to treat LGBT patients like straight patients, refuse to treat someone based on the hunch that she might have had an abortion, or even refuse to drive a seriously ill patient to the nearest hospital because it performs abortions. It is an amazing disrespect to the autonomy of the patient. It goes against the objective healers healthcare professionals should be... and it deeply disturbs me that there are so many people in my future profession that see no problem with it (or rather, welcome it).

Hopefully our new president (yay!) will reverse the worst of it, but the nuts are out there and the politicians are on their side (many states have had their own conscience clauses for a while). I think what people should do (spread the word my two loyal readers) is to proactively question their healthcare providers about their beliefs on sensitive topics like abortion, contraceptives, ending life support, etc. If they say something you don't like, find someone else to treat you. It's better to find out by asking them now, then later when its already too late (plus it sends a nice message to the medical community).

Magnetic Quackery

I was browsing through a book store a few days ago and I came across Kevin Trudeau's line of Natural Cure's They Don't Want You to Know About books (I must have been in the convicted fraudsters section). I usually see Kevin Trudeau on late night TV raving about the benefits of some untested treatment or another that "they" (hey that's me) are hiding from you. He's made millions and the gullibility of the American public is demonstrated by the fact that his books are always on a best seller list. Anyway, I thought I might get a laugh if I saw what's inside. I turn to a random page and what do I see? Magnetic therapy!!! Being an expert in training in real magnetic therapy, I started reading. Alas, it wasn't the 2 Tesla focused rapid brain stimulator that I work with. He was talking about wearing a small magnetic bracelet around your wrist for treating pain (and if I had read further I'm sure he would have said it will cure your heartburn, get rid of that tumor that's been bothering you and make you have a better sex life). This isn't the first time that I've encountered this form of "therapy." Several times when I've told people that I research magnetic brain stimulation, the response has been, "Oh, I know. It's like those magnetic bracelets!"

Well, I'm here to say that this:

does not work.

Let me quickly tell you why. Although our bodies have molecules that could potentially be affected by magnetic fields, biological tissue is amazingly unresponsive to static magnetic fields. The device pictured above (which you could have for a mere $17.95+sh) according to the manufacturer (if we actually believe them) contains 2 x 1000 Gauss static magnets. Magnetic fields aren't additive so let's say we're working with 1000 Gauss (or 0.1 Tesla) - though a JAMA article actually measured their surface field strengths and found them to be more like 30 to 250 Gauss. The problem is that a 0.1 Tesla static magnet (about the strength of the magnet in a small speaker) doesn't do anything to tissue. The magnetic therapy proponents say things like it affects your circulation by interacting with hemoglobin or it stimulates nerves (if they don't first say it aligns your chi). But nonetheless, valuable tax dollars were spent to test the claim that magnetic therapy is a natural cure that we don't want you to know and several studies (here are 4: 1 2 3 4) have found that it's no better than placebo at treating pain (their main use). The reason why magnetic brain stimulation works is that a very large magnetic field (around 2 T) is being delivered over a very short period of time (<250 microseconds). It's this rapidly changing magnetic field that affects biological tissue (induces current). Even then, unless you get it at the right intensity, frequency, target, angle, duration, etc, it has very subtle effects. So, unless the magnet on the bracelet produces a rapidly changing magnetic field (and if it did it would cost way more than $17.95 and would probably not be so portable), it won't do anything to nerves and it won't treat pain.