One thing I look forward to each day is looking through my medical feeds that keep me up to date with medical research. Most of this content ranges from bogus to unhelpful (in my opinion), but every once in a while, a truly game-changing article appears. Over the years, I have noticed that most of the game changing articles are debunking articles. They show that something that is commonly done in medicine actually has no value. I love these! Not only do they improve the medical care of my patients, they also make me more cost-effective. As I have said before, the main way to save money in Correctional Medicine is to eliminate (and stop paying for) medical practices that have no value—or even worse, are harmful to patients.Continue reading
I recently ran across this news article on NPR (found here) about the problem of treating the large number of opioid addicted patients who are coming to our jails. There is a growing movement that all opioid addicted patients should be offered Medication-Assisted Treatment (MAT) while in jail–meaning one or more of three drugs: methadone, Suboxone or Vivitrol. The article does a good job in pointing out that this is a complicated problem. Having been on the front lines of this problem for many years in my own jails (and so having that great teacher–experience), I would like today to present my own thoughts on using MAT in jails. (MAT in prisons is a separate subject that I will address later).Continue reading
A frequent complaint in jails comes from inmates who request extra food for various reasons–they are underweight, they are just way hungry, whatever. Continue reading
In my previous post on Rethinking Diabetic Snacks for Type 2 Diabetics, I mentioned that there are two theoretical justifications for the practice or prescribing bedtime snacks for type 2 diabetics. I would like to expound on these two issues here and also comment on another issue that I failed to mention in the first article but that is important: the non-medical security issues of having diabetic snacks.
Myth: Four Meals are Better than Three for Type 2 Diabetics
The first justification for diabetic snacks is the idea that if Type 2 diabetics eat several small meals rather than 3 big meals, there will be more even absorption of calories and carbs. This would cause smaller blood sugar spikes at meals. In other words, four meals (counting the bedtime snack) is better than three meals. Continue reading