Screening mammography is widely used throughout the U.S. and is thought of as a great success in the prevention of breast cancer deaths.

But what does the evidence say? Are we getting what we are paying for with mammography, or simply shouldering the extra cost of false positives and overdiagnosis? We examine these issues and more on this episode of 2 Docs Talk.

References:

What does the U.S. Preventive Services Task Force (USPSTF) do?

USPSTF current (2009) breast cancer screening recs 

USPSTF proposed (2015) breast cancer screening recs

American Cancer Society updated breast cancer screening recs

American College of Obstetricians and Radiologists breast cancer screening recs

American College of Radiology breast cancer screening recs

Switzerland’s stance on screening mammography

Cost of false positive mammograms

BMJ study that showed no benefit from screening mammography performed in 1980’s

JAMA Oncology study on ductal carcinoma in situ (DCIS)

An excellent (and long!) discussion of overdiagnosis and screening mammography

Be sure and subscribe in iTunes or Stitcher if you haven’t already.  And you know we’d appreciate it so much if you would tell your friends about 2 Docs Talk!

Listen on iTunes

Listen on Stitcher

Now Available on Google Play Music!

Physician burnout is a big issue in the medical community. According the the Medscape Lifestyle Report 2017, over half of physicians report burnout. But physician burnout isn’t just a problem for physicians. It is a problem for patients, for other medical staff, and for the health care economy.

Today we dig into the causes of physician burnout and how it can be addressed. Here’s a hint: It doesn’t involve meditation or counseling.

Resources:

Medscape Lifestyle Report 2017

2 Docs Talk About Pricing Transparency

2 Docs Talk About Medicare for All

2 Docs Talk About Drug Pricing

Be sure and subscribe in iTunes or Stitcher if you haven’t already.  And you know we’d appreciate it so much if you would tell your friends about 2 Docs Talk!

Listen on iTunes

Listen on Stitcher

Now Available on Google Play Music!

If you watch any tv at all, it’s likely you’ve seen a drug ad. These ads generally show seemingly healthy people living normal lives, the message being the drug did this for them.

But are the drug ads telling the whole story? And should they even be advertising directly to consumers to begin with? We discuss this issue on today’s episode.

Resources:

Nivolumab Research from New England Journal of Medicine

What the FDA has to say about drug ads

Be sure and subscribe in iTunes or Stitcher if you haven’t already.  And you know we’d appreciate it so much if you would tell your friends about 2 Docs Talk!

Listen on iTunes

Listen on Stitcher

Now Available on Google Play Music!

With the recent release of the Netflix series, 13 Reasons Why, depression and suicide have been getting a lot of press time. In this episode, we talk about depression, what it is, how it is treated and what’s on the horizon for this far too common disorder.

We also talk a bit about the Netflix series and the problem of suicide. Take a listen and see what you think.

If you think you may be depressed please seek help from a trusted healthcare provider. And if you are contemplating suicide, there is help for you – please contact the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK). Someone will answer your call and help you find the resources you need to deal with your depression.

Brains of people with depression are different

Brain imaging reveals different types of depression

Summary of effectiveness of SSRIs and other antidepressant medications

Be sure and subscribe in iTunes or Stitcher if you haven’t already.  And you know we’d appreciate it so much if you would tell your friends about 2 Docs Talk!

Listen on iTunes

Listen on Stitcher

Now Available on Google Play Music!

Historically, cervical cancer has been one of the major killers of young women. But since the advent of the pap smear, death from the disease has dropped dramatically. However, treatment of lesions identified on pap smear can lead to significant issues including infertility. And in other parts of the world where screenign is not easily accessed, cervical cancer remains a significant cause of death for women in the prime of life.

As with any disease, prevention is better than treatment, and this is where the HPV vaccine comes into play. Known mainly by its trade name, Gardasil, the vaccine has been on the market for over a decade. That’s long enough to provide data to draw reasonable conclusions about its safety and efficacy.

Resources:

Prevalence of HPV after introduction of vaccine

Population-Based Incidence Rates of Cervical Intraepithelial Neoplasia in the Human Papillomavirus Vaccine Era

Safety Resources:

https://www.ncbi.nlm.nih.gov/pubmed/21907257

https://www.ncbi.nlm.nih.gov/pubmed/23027469

https://www.ncbi.nlm.nih.gov/pubmed/24108159

http://jamanetwork.com/journals/jama/fullarticle/1886177

https://www.cdc.gov/vaccinesafety/pdf/data-summary-hpv-gardasil-vaccine-is-safe.pdf

Be sure and subscribe in iTunes or Stitcher if you haven’t already.  And you know we’d appreciate it so much if you would tell your friends about 2 Docs Talk!

Listen on iTunes

Listen on Stitcher

Now Available on Google Play Music!

Thousands of people die each year from influenza. The CDC recommends that almost all people (with a few rare exceptions) receive the flu vaccine every year. But the disease and the vaccine are poorly understood. In this episode, we discuss the flu, its treatment and its prevention.

Resources:

Influenza vaccine effectiveness in preventing outpatient, inpatient, and severe cases of laboratory-confirmed influenza

Oseltamivir treatment for influenza in adults: a meta-analysis of randomised controlled trials.

Be sure and subscribe in iTunes or Stitcher if you haven’t already.  And you know we’d appreciate it so much if you would tell your friends about 2 Docs Talk!

Listen on iTunes

Listen on Stitcher

Now Available on Google Play Music!

Kendall and Amy are in agreement that hospice care is an important, compassionate aspect of healthcare that humanizes what can be a very clinical, impersonal process. We've both experience with hospice - personally and professionally. 

Sadly, like most aspects of healthcare, the potential for profit has introduced some ugly practices into what should be focused solely on the needs of dying patients and their families.

Today, Kendall and Amy talk about the good and the bad of hospice as it exists in 2017.

Resources:

Be sure and subscribe in iTunes or Stitcher if you haven’t already.  And you know we’d appreciate it so much if you would tell your friends about 2 Docs Talk!

Listen on iTunes

Listen on Stitcher

Now Available on Google Play Music!

Medicaid is the subject of a lot of talk in today's political environment. Sadly much of what is said isn't based in fact, or it focuses on parts of the program that represent a tiny portion of its cost. 

Today, 2 Docs Talk about Medicaid, who it serves, and how it was affected (or, rather, supposed to be affected) by the Affordable Care Act.

End stage renal disease, ESRD, is a growing problem in the U.S. When Medicare began covering renal dialysis, there were on 16,000 patient who required that type of care. Today that number exceeds 650,000 and continues to grow.

Today, 2 Docs Talk about what causes end stage renal disease, how can it be treated, and, most importantly, how can it be prevented. 

Be sure and subscribe in iTunes or Stitcher if you haven’t already.  And you know we’d appreciate it so much if you would tell your friends about 2 Docs Talk!

Listen on iTunes

Listen on Stitcher

Now Available on Google Play Music!