A new study from Yale shows that 75 percent of physicians in training surveyed do not understand the statistics used in medical literature. The study surveyed internal medicine residents at 11 programs across the country.

The residents scored an average of 41% correct on the test and the senior residents scored worse than the junior residents, possibly reflecting a loss of knowledge over time.

Practically all of the residents surveyed agreed that it is necessary to know something about statistics in order to be able to read medical literature and 77 percent expressed an interest in learning more about the field.

According to the corresponding author, Dr. Donna M. Windish, "If physicians cannot detect appropriate statistical analyses and accurately understand their results, the risk of incorrect interpretation may lead to erroneous applications of clinical research."

A review of 33 studies by The Cochrane Collaboration found that giving patients checklists and providing coaching in the doctor's office can help them ask more questions of their physician and receive more useful information in return.

These coaching interventions were most effective if they took place immediately before a consultation. Such coaching increased patient satisfaction and decreased patient anxiety.

The review also examined the value of refresher courses in communication skills for doctors. According to the review, doctors often underestimate their patients' needs for information. Also, physicians are sometimes reluctant to give information they feel could be disturbing or harmful when treating patients with serious or life-threatening illnesses.

In addition, studies have shown that patients talk for only 30 seconds before doctors cut in and take over.

What has your experience been regarding doctors and their communication skills? What advice would you give patients to make the most of their visits?

Following up on my post about what patients want upon their first meeting with a doctor (to be called by name, sometimes to shake hands), another study came out this week about another people issue among physicians: physicians who gab too much about themselves.

In a study where actors posed as new patients in secretly recorded visits, doctors talked about themselves in 34% of the encounters.

The researchers wrote in a report in Archives of Internal Medicine, "We found that physician self-disclosures were often non sequiturs, unattached to any discussion in the visit, and focused more on the physician's than the patient's needs."

In 79 percent of the encounters where the doctor went off 'gabbing' about himself or herself, the conversation never returned to the original topic and 11 percent of the time in these encounters, the doctor said things that competed with or offended the patient in some way.

I've met some chatty physicians and nurses. I appreciate the chatter if it is light, small talk designed to put me at ease. And like any other life situation, too much chatter, can be, well, too much.

An article in the New York Times Magazine from June 17th by Tina Rosenberg profiles the conviction of a pain doctor, Dr. Ronald McIver, for drug trafficking and offers a nuanced analysis of the complexities of his trial. According to the article, there were some patients that were using McIver's prescriptions for reasons other than for pain, but there were also testimonies from other patients who claim that McIver was the only doctor who offered them any real relief from their pain.

The author concludes that the Drug Enforcement Agency, (DEA) should follow their own standard, that "for a criminal prosecution to occur, a doctor must have broken the link between the opioid and the medical condition." Reckless behavior, or being otherwise incompetent as a physician, should be dealt with by state medical boards.

The author admits that some 'pill-mill' doctors might get away with their crimes under such a standard. However, this might be a small price to pay to ensure that pain patients, including cancer patients, get the relief they need and prospective physicians are not scared off from pursuing the specialty of pain management.

Over 75% of patients want to shake their doctor's hand upon meeting them for the first time and about half would like to be called by name, according to a report in the June 11 issue of Archives of Internal Medicine, head authored by Gregory Makoul, Ph.D., at Northwestern University Feinberg School of Medicine, Chicago.

Unfortunately, in this study, in over 50% of encounters, doctors did not mention patient's name at all upon meeting.

On the flip side, over half of patients would like doctors to introduce themselves using their first and last names, followed by about 30% who would like doctors to use only their last name.

When I meet a new doctor, I do like to be greeted by name, but just my first name is fine. As far as shaking hands, for me, that isn't necessary.

A study published in Cancer, a peer reviewed journal of the American Cancer Society, found that cancer survivors are more likely to seek out support groups than individuals with other chronic conditions. They stated that one in four survivors participate in a support group after diagnosis.

According to the study, treating physicians seemed to recognize that support groups are helpful but only one in ten cancer patients studied had received a recommendation to seek out a support group. Support groups are widely available but seem to be poorly handled by the physicians.

Dr. Jason Owen, co-investigator in the study, says "This study sheds light on which individuals with cancer use (support) services. It will help clinicians recognize the importance of support groups for cancer patients. Assistance in identifying and accessing support groups should be a standard of care for all patients receiving curative, follow-up, or palliative care for cancer".

Technology has come a long way over the years -- and now the technology behind digital mammography is allowing life-saving screenings for the toughest patients to diagnose with breast cancer.

This is no small technological breakthough. It is a critical component for lowering the breast cancer death rate the American Cancer Society reports has declined 2.3 percent each year between 1990 and 2002. Since breast cancer is a treatable disease if caught early, digital mammography will up the odds of survival for women with this disease.

Digital mammography operates according to a computer-based technique that allows for digital manipulation of a breast X-ray. It exceeds the capability of film mammography -- and is much like the comparison between digital photography versus film photography. Both work. But one works better.

Studies show digital mammograms have a lot to offer. They detect tumors better in young women with dense breast tissue, for example. They allow for ease of storage and retrieval of images. And they can easily become part of a woman's electronic medical record.

There are still benefits of traditional mammography and women are still urged to use this less expensive option. They are also urged to conduct self-breast exams and to report for clinical exams with physicians. It's the whole package that contributes to comprehensive breast health, not just one isolated test. When used in combination with all other screening methods, digital mammography makes for a more accurate overall picture.

Smoking is the biggest risk factor for lung cancer -- and 90 percent of all lung cancer cases are related to smoking. But family history is a risk factor too and can nearly double the risk of developing the deadly disease.

A study published in the October issue of Chest found by studying a population of Japanese adults that people with a first-degree relative -- mother, father, or sibling -- who had lung cancer had a 95 percent higher risk of contracting the disease. Those who smoked had the greatest risk, but those who did not smoke were still at risk. And women were more at risk than men. The type of lung cancer most associated with family history is squamous cell carcinoma.

The results of this study do not yet translate into recommended guidelines for screening. But those with a family history of lung cancer should make their physicians aware of their history. And perhaps one day people with family history will be identified as high-risk for lung cancer and will be included in further studies. In the meantime, these individuals should avoid all contact with all inhaled and second-hand smoke and should protect their children from all forms of tobacco smoke.

The U.S. Centers for Disease Control and Prevention estimates that more than 180,000 cases of lung cancer are diagnosed each year. About 170,000 die from the disease every year. It's the second leading cause of death for men and the third leading cause of death for women.

Kim Taylor is a 45-year-old single mother who lives in Suwannee County, Florida and is proud to have successfully raised one daughter -- a graduate of the University of Florida. Kim enjoys outdoor activities like camping as well as sewing, crafting, and carpentry projects. She is most at peace spending time with her family, working as a youth volunteer -- and raising awareness for breast cancer. It's a interest she acquired just two years ago, compliments of a personal encounter with the disease that has taught her to let the little things go, to appreciate every sunrise, to make every moment matter.

It does not surprise me that the Cleveland Clinic Cancer Center is among the best in the nation -- with internationally recognized physicians -- because I have always known this hospital to be the one stop where all medical difficulties and mysteries might be best managed -- in Ohio anyway. Growing up just an hour away from this facility, I thought maybe this was just the best Ohio hospital and that people headed here when other area hospitals could not deliver the best care. But now I know that the Cleveland Clinic is a destination for people from many states and countries. U.S. News & World Reports names the Cleveland Clinic one of the nation's top three hospitals, the clinic's heart program is ranked number one, it boasts a highly successful Children's Hospital, and cancer patients travel from all over the world for leading-edge cancer care at the Cleveland Clinic Taussig Cancer Center. There is even a Cleveland Clinic location in Florida. This hospital -- that I once believed was nothing more than a local healing place -- has quite a reach. And quite a reputation.

On May 24, 2006, The Vegetarian and Vegan Foundation will be launching White Lies, a campaign to raise awareness of the health risks of consuming dairy products. Why You Don't Need Dairy, an event to mark the beginning of the campaign, will feature Heather Mills McCartney as a speaker who will call for milk to be dropped from the nation's diet. At the same time, the Physicians Committee for Responsible Medicine, PCRM, a nonprofit health organization comprised of physicians and nutritionists, will be asking consumers to eliminate dairy from their diet for three weeks to see if they notice an improvement in health.

In three short weeks, PCRM is confident those who take the dairy-free challenge will notice immediate benefit in better digestion, easier breathing, better sleep, a lessening of headaches and for sufferers of acne or dermatitis -- clear skin. Health benefits that are not immediately noticeable but of significant value is a reduction in the risk of prostate and ovarian cancer. Research had proven the link between dairy and these two cancers. Because dairy products such as cheese, ice cream, milk, butter, and yogurt all contain high levels of fat, it is reasonable to assume there might be a dairy link to other cancers as well.

The Nutrition Resource Centre of the Ontario Public Health Association, has published Non-Dairy Sources of Calcium, available as a PDF document online, with food suggestions that offer plenty of calcium.

Can you teach empathy and compassion? If you are a parent, the answer is yes. As a parent, you teach empathy and compassion to your children by the example of treating them with empathy and compassion; and in involving them in acts of compassion in the care for others. I believe caring for a pet in the home is one of the traditional ways of helping children learn empathy and compassion. Another is family participation in volunteerism and community-betterment projects.

Can you teach empathy and compassion to medical students as a university course? Medical schools are willing to try, and are hiring actors to train doctors good bedside manners when they have to give bad news. "A lot of these medical students are brainiacs who can absorb all the information they learn in class, but they don't know how to talk to people,'' says Joshua Stager, program coordinator at Columbia University College of Physicians and Surgeons in New York.

I think that is an over-generalization, and slightly less-than-generous statement in reference to the character and demeanor of all medical students -- but then again -- if you have watched the television show House, maybe a course in bedside manner is a very good thing for some medical students. Medical schools see enough of a need for education in empathy and compassion they are requiring these classes as part of medical training. Interestingly, a new section of a medical student's national licensing exam now includes tests on bedside manner.