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View count:11,652
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Dislikes:4
Comments:47
Duration:33:34
Uploaded:2015-04-29
Last sync:2018-11-25 17:30
Leave any questions you have in next week's video: https://www.youtube.com/watch?v=y4pZYtXwZdA

00:35 - Start!

2:05 - Is there an ethical way to harness the placebo effect? What are your thoughts on placebo surgeries or sugar pills that actually increase the patients sense of well being?

3:30 - JoneseyBanana I often chew a lot of sugar free gum when studying to prevent myself grazing on junk food. Are there any potential downsides to this, especially dentally or to the jaw itself? (Our video on artificial sweeteners: https://www.youtube.com/watch?v=Mf82FfX-wuU)

4:36 - In the Guns and Physicians vid (https://www.youtube.com/watch?v=nXJmdMoNuY4), you said you get a physical every year. I remember you told John Green elsewhere that annual physicals (for men) are probably not necessary. Can you elaborate?

6:27 - How are you able to keep up with all the new research on such a wide range of topics? And how do you make any judgements on areas of conflicting research?

8:36 - What are your thoughts on accutane (isotretinoin) and its continued use on people as an acne medication?

10:09 - Do we know anything about brain freezes? What causes them, how to prevent them, and how to stop them once they've happened?

11:19 - Can you talk about ozone therapy and Aloe Vera products (such as forever living products)! Both are promoted as miracle treatments! Any research? Any results? Your opinion?

12:55 - What's the actual research on best hand washing practices? Length of time? Best type of cleanser? Water temperature? (Link to antibacterial soap video: https://www.youtube.com/watch?v=FS3LcIURelY)

15:00 Can you talk about what adults who had their vaccinations as kids should do in areas where there are measles outbreaks?

15:55 - How can a hypochondriac, like myself, do from having anxiety attacks and annoying his/her doctor? How can we separate real pain from psychosomatic pain?

17:20 - My wife and daughter have celiac disease, and we're planning another child. Should we introduce our new child to gluten early?

18:16 - What is your stance on moderate alcohol consumption by pregnant and breast feeding mothers? Is there any available research?

21:06 - How do you Feel about the CHIP program? It seems to me like it insures a lot of kids for a very low price. Can we expand it?

22:58 - Codeine is available over the counter in most other countries. Why is that not the case in the US?

24:19 - How do you feel the field of mental illness (specifically depression, anxiety disorders and so on) has changed since you became a pediatrician?

25:03 - Does long-term use of prescription amphetamines affect cardiac or mental health in later life?

26:07 - Why is eating mostly processed food bad for your health? (Aaron's NYT piece: http://www.nytimes.com/2015/04/21/upshot/simple-rules-for-healthy-eating.html?abt=0002&abg=1)

27:36 - Which SPF Factor should I use if I live in the UK and how often should I apply it if it is 20 degrees C and sunny? I have been told buying SPF 50 sun cream is pointless. Thank you! (Our episode on sunscreen: https://www.youtube.com/watch?v=bvG4sy_YfXM)

29:03 What does the research show for long-term risks associated with secondhand smoke exposure? For someone who was heavily exposed during childhood, is there any way to mitigate those risks as an adult?

29:53 - What is being done to address publication bias by the pharmaceutical industry? Just how effective are some of the most commonly used drugs, relative to their original FDA trial data? (Our video on conflict of interest: https://www.youtube.com/watch?v=UJtLUaeEkbk)

30:19 - Regarding Diet soda, is there any danger to drinking it in larger amounts (NOT the aspartame)?

31:18 How healthy is Honey in reality? Is it actually as good for you as it is made out to be?

Oh, also, we've got merch :) http://dft.ba/-HCTMerch

Next Wednesday we'll be live at 11:30a ET: https://www.youtube.com/watch?v=y4pZYtXwZdA
We're live - hey! Welcome to Healthcare Triage Live! I think we're live. Um, we try to do this every once, we're trying to do this now once a week, we're trying to get a regular time, and we appreciate the many, many, many questions that people put in the comments ahead of time for today's show, which let us sort of queue them up so you'll be able to see them ahead of time.

Um, however, many of these questions are just pumping in right this second, so a lot of these will be, ah, we'll see if I know the answers, and you will hear me say, "I don't know," if I don't, um, but this is our weekly show where we try to answer many of your questions live. You can try tweeting them to the Healthcare Triage account, but even better, you can put them in the comments section of this video.

Afterwards, this video will still remain up and you can watch it, but don't continue to put questions in the comments section for this video. Put them in next week's Healthcare Triage Live. Once we shut down today, we're not going to pull any more questions from the comments below. But for the moment, you know, feel free to keep going.

Um, I've been asked by our technical expert and now lawyer, Mark, to remind you that we're not giving medical advice on this show, that you should not take anything I say and go out and do it. If there's any actual medical questions, you should talk to your doctor! And you should - oh, look at this - you should get, ah sorry, I was just distracted by a picture right here, ah, you should get medical advice from your doctor. But let's stop with all this and begin.

First question from datapirate, "Is there an ethical way to harness the placebo effect? What are your thoughts on placebo surgeries or sugar pills that actually increase the patient's sense of well being?"

Of course it's ethical to use the placebo effect. We do it every day. Um, any time you give your kid a hug and a kiss on the boo-boo and tell them that it's going to be better, you're of course using the placebo effect. All the time! You know, when my kids have rashes, we will put, like, moisturizer on it and tell them it's "cream" that's gonna help it make better. Even if they have pain, you put a Band-aid on it to make it feel better. That's placebo effect.

If you're asking if we can medicalize it and charge people for it, that's another story. And charging people for it, especially, is where it gets squirrely. But there are many things that even doctors do every day that it's placebo, you know, whether it's consoling someone if they're in pain, or you're sympathizing or empathizing. A lot of those things help, even if they're not... and every therapy that we give out, as we talked about in our episode on the placebo effect, has both a biologic and a placebo effect. The question as always is, is the biologic effect greater than the placebo effect, or how much is the relative contribution.

Surgeries? Well now you're actually potentially giving people harm, and so a placebo surgery is a little more complicated. But we should not be under the illusion that we're not using the placebo effect in everyday medicine all of the time. Because we are.

Next question, from jonesybanana. "I often chew a lot of sugar free gum when studying to prevent myself grazing on junk food. Are there any potential downsides of this, especially dental or to the jaw itself?"

You will see lots of sites will try to tell you that the artificial sweeteners are dangerous, and they're not! Watch our episode on artificial sweeteners. But, um, and you'll actually even see the groups like the ADA, the American Dental Association, promote the use of sugar-free gum because it increases saliva and it actually can pull some of the bad bacteria off of teeth. It shouldn't replace brushing, but it actually can reduce the chance of getting a cavity in some ways. And so there are not many downsides. I don't know of any long-term downside effects specifically to the jaw. Of course if your jaw gets tired, stop. You know, as with anything, if your body's giving you a signal that something is bothering you, don't keep doing it. But no, sugar-free gum is actually, might be on the side of things where it helps, not harms. And so there really is no good reason to keep avoiding it.

Next question comes from benjaminalexander. He said, "In the Guns and Physicians vid, you said you get a physical every year. I remember you told John Green elsewhere that annual physicals (for men) are probably not necessary. Can you elaborate?"

Yes I can! Most of what I was talking about in that video is about kids, 'cause I'm a pediatrician, and we talked specifically about anticipatory guidance and protecting kids, with suicide and things like that. And with respect to children [audio glitches out briefly] that they should be having at least annual physicals, and especially when they're babies and younger, even more often. We have to do vaccines, we have to do a lot of parenting advice, we have to do a lot of behavioral talk, you know, where do parents learn to be good parents? Where do they ask their questions? Pediatricians' offices, mostly, most often the best thing. Tons of anticipatory guidance, but injury prevention is performed in a physician's office. A lot of this stuff, you've got to talk through with parents developmentally and check if kids are developing normally and screen them for developmental delays and for autism and for ADHD and for everything else you want to do. A lot of this happens in the yearly visit for pediatrics. Could we do a better job at being more effective and efficient in the pediatric well care visit? Absolutely! I, for one, would like to see less of a focus on the physical exam and more of a focus on parenting. Um, that's me. I was just talking about that this weekend at the Pediatric Academic Society meeting with a lot of my colleagues.

But with respect to adults, it, you know it's not as clear how much of a benefit the annual physical exam is giving, especially for males who are young, in their twenties and thirties. Um, that's what we were talking about with John. 'Cause John is a, you know, a male in his twenties or thirties. And so for him, perhaps a physical exam wouldn't, but for children, which is what that video is about, yes, they are different. That's my elaboration.

Question four, from dash574. "How are you able to keep up with all the new research on such a wide range of topics? And how fo you make any judgments on areas of conflicting research?" (6:35)