Saturday, 31 August 2013

Calcium for healthy bones?

It’s one thing when my patients tell me that they are eating extra calcium to help their fractures heal or prevent new ones, but when my colleagues are advising them the same thing, its time to correct the bias. Taking calcium and/or vitamin D to heal fractures and prevent new fractures is another case of something that sounds good and is easy to believe, but doesn’t work as advertised.

Monday, 19 August 2013

Hiding in the herd

I had a conflict of interest while operating the other day. I had a patient with a hip fracture that needed surgery, and a knee fracture (on the same side) that would normally be fixed surgically but according to my criteria (decent evidence), it wasn’t necessary. I would not have been criticised for doing the surgery (in fact, my trainees had already consented the patient, thinking that I would). Further, I expected some criticism for not doing the surgery, and I would have felt terrible if the result of my non-operative treatment had been poor. The conflict? I would have been paid a lot of money to do the surgery, and got paid nothing for treating it non-operatively. I was tempted to hide in the herd.