Physician Medical Blog

Kate Scannell, MD

Medical Writer

Recent Newspaper & Online Columns by Kate Scannell MD

The nocebo effect -- When negative expectations can make you ill

July 20, 2014

Tags: nocebo effect, placebo effect, Jodi Halpern

By Dr. Kate Scannell, Syndicated columnist
First published in print: 07/20/2014


As far as I know, my grandmother never used the term "nocebo effect," but she did understand its meaning. "Expect things to go badly, and they will," she'd caution.

More formally, the Oxford English Dictionary defines "nocebo effect" as, "A detrimental effect on health produced by psychological or psychosomatic factors such as negative expectations of treatment or prognosis, cultural beliefs about illness, personality traits, etc." (more…)

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Tips for quitting tobacco from former smokers -- a CDC summer sequel

July 6, 2014

Tags: antismoking, smoking, tips from former smokers, CDC, Lucy Popova, Center for Tobacco Control Research and Education

By Dr. Kate Scannell, Syndicated columnist
First published in print: 07/05/2014

On Monday, coming to a theater near you -- and to TV, radio, online sites, newspapers and billboards as well -- the newest sequel to the national anti-smoking media campaign, "Tips from Former Smokers."

Produced by the CDC (Centers for Disease Control and Prevention), the upcoming sequel again features actual former smokers whose lives were damaged or endangered by tobacco products. Their painfully true stories are regularly disturbing and consistently grim. In their telling, each participant hopes to encourage other smokers to quit, and to discourage prospective smokers from ever lighting up. Collectively, their messages provide a deadly serious reminder of the many -- and, perhaps, surprising -- ways that tobacco can disfigure a body, ruin a life, and cause human suffering. (more…)

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Cheerleading -- Gimme an 'S' for safety and sport!

June 24, 2014

Tags: Cheerleading, sport, Title IX, safety, CheerSafe, NCAA, AMA, AAP, National Women's Law Center, Cheerleading Quotes

By Dr. Kate Scannell, Syndicated columnist
First published in print: 06/20/2014

U can hold me, u can luv me,
u can kiss me, and u can touch me,
but don't u dare say cheerleading is not a sport!!!
-- From: Cheerleading Quotes, by Allie, NJ


At its annual meeting last week, the AmericanMedical Association (AMA) approved designating cheerleading as an official school sport. An official statement said: "The AMA recognizes the potential dangers now associated with cheerleading and believes steps should be taken to ensure the health and safety of individuals who participate in the time-honored tradition." (more…)

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Do doctors die differently? It's problematic that doctors offer end-of-life treatment that they would reject for themselves

June 9, 2014

Tags: how physicians die, advance directives, Stanford study, Periyakoil, end of life, advance directives, do doctors die differently

By Dr. Kate Scannell: Syndicated columnist
First published in print: 06/08/2014

The cancer had spread throughout her body. Fast-growing metastases had invaded her brain, lungs and bones despite multiple rounds of chemotherapy and radiation treatments. She spent the last few weeks of her life "trying everything," all the while explicitly acknowledging that "everything" would do "nothing" to make her better.

She was right.

The so-called treatments sapped her energy and aliveness, depleting her capacity to think and interact with loved ones. She gagged at the mere sight of food, and her breathing became painful and laborious. Her hair gone, her skin peeling off at various places, her eyes dulled -- when she died, she was barely recognizable as her former self.

"She" was a doctor, someone I'd known as a friend. (more…)

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C-Sections and maternal mortality -- new data, new concerns

June 5, 2014

Tags: C-sections, maternal mortality, Kirsten Saleem MD, unnecessary C-sections, cesarian sections, ACOG

By Dr. Kate Scannell, Syndicated columnist
First published in print: 05/25/2014

The last few months have proved fertile ground for newsworthy reports of universal interest concerning the health of pregnant women and newborns, the likely overuse of C-sections, and the role of hospitals and health care providers in shaping parental decisions about childbirth. (more…)

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Doctors must wrestle with ethical dilemma presented by unnecessary testing

May 18, 2014

Tags: unnecessary medical tests and procedures, ABIM Foundation, Choosing Wisely, investigation momentum, defensive medicine

By Dr. Kate Scannell, Syndicated columnist
First published in print: 05/18/14

It's often said "life is a test" that reveals how a person reacts to the various situations they encounter. That view holds that our character and convictions are being tested constantly by the trials and tribulations in our daily lives. In this light, we're also offered ongoing opportunities for personal and spiritual growth. Therefore,for many adherents of this perspective, understanding life as one long test also means that nothing in one's life is insignificant.

I was thinking about this philosophical sensibility while reading the results of a new nationwide survey that explored the views of 600 doctors on ordering tests and procedures for patients. Released May 1 by the ABIM Foundation, they seem to suggest that life as a patient may also entail being tested a lot -- but often with medical tests and procedures that are insignificant to their health. (more…)

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Last Week's Health Bytes_MERS, Dirty Money, and All Hail to Massachusetts!

May 12, 2014

Tags: MERS, first US case of MERS, dirty money, Massachusetts death rate, health insurance and longevity

By Dr. Kate Scannell, Syndicated columnist
First published in print: 05/11/14

All hail to Massachusetts!
In its official (if perhaps somewhat thudding) state song, Massachusetts has long hailed itself both as "the home of the bean and cod" and "the land of opportunity in the good old USA, where men live long and prosper."

Yet it wasn't until last week that we could so confidently believe its latter claim. That's when a new study published in the Annals of Internal Medicine provided convincing evidence that fewer people were dying in Massachusetts. Indeed, researchers reported a 2.9 percent drop in the state's overall death rate during the first four years of its mandatory health coverage law that was passed in 2006 under then-Gov. Mitt Romney. (more…)

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Impoverished thinking about health care and poverty

May 4, 2014

Tags: poverty, healthcare, insurance, National Quality Forum, Obamacare, Affordable Care Act

By Dr. Kate Scannell, Syndicated columnist
First published in print: 05/04/2014

Two weeks ago, my friend finally saw a doctor for diagnosis and treatment of her fever and shortness of breath. Concerned she had pneumonia, I'd been prodding her for days to seek medical attention.

But she was uninsured, impoverished and unwilling to accept my help. She instead planned to "hold out" until obtaining health insurance through her state's insurance exchange program that operated in concert with the Affordable Care Act.

Although given no guarantee that her application was accepted, she expected to receive coverage by May.

Unfortunately, her illness didn't wait that long. It swiftly worsened, and she finally broke down -- almost literally -- and sought medical care.

There's not enough space in this column to contain my rage over my friend's subsequent fate and that so many other Americans have likewise suffered because they couldn't pay for basic health care.

Now, as millions of such Americans await their first opportunity to be insured under the ACA, my rage focuses on anyone standing in their way. (more…)

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A view of autism -- Making sense of the numbers

April 15, 2014

Tags: autism, incidence of autism, prevalence of autism, Young-Shin Kim, ASD, autism spectrum disrders

By Dr. Kate Scannell, Syndicated columnist
First published in Print: 04/04/2014

We live in a world of Big Data, spending much time searching for meaning in its vast shadows and often emerging from those shadows drawing wildly different conclusions. But the hard facts of Big Data become so soft and malleable in varied human hands, and solid data points often transform into flexible storylines.

Two weeks ago, another vast shadow of Big Data drifted over U.S. media outlets when the Centers for Disease Control and Prevention reported its upwardly revised prevalence of autism spectrum disorders, or ASD. Its 2010 surveillance of 8-year-old children identified 1 in 68 -- 1 in 42 boys, and 1 in 189 girls -- as having ASD.

Emerging from that report, media headlines often concluded that autism rates were "surging." Others heralded the data as proof of an incremental jump in the number of children living with autism.

But what was true? (more…)

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Zohydro: The pained debate over approval of a new painkiller

March 23, 2014

Tags: Zohydro, hydrocodone, palliative care, pain treatment, opiate abuse, debate, Amy Haddad, Robert V. Brody

By Dr. Kate Scannell, Syndicated columnist
First Published in Print: 03/23/2014

For a powerful new pill that's supposed to ease pain, Zohydro is causing major headaches for an increasingly vocal group of critics.

Zohydro is a potent extended-release formulation of hydrocodone, an opiate painkiller that's been in use for decades and the primary analgesic ingredient in drugs like Vicodin. However, unlike other formulations of hydrocodone, Zohydro is uniquely free of added medications like aspirin (as in Azdone and Lortab ASA), ibuprofen (Vicoprofen), or acetaminophen (Vicodin and Norco). That means that Zohydro can be prescribed as stand-alone hydrocodone -- free from worry about aspirin allergy and side effects, ibuprofen kidney and GI toxicities or acetaminophen overdose and liver damage.

This improved patient safety profile is what makes Zohydro an appealing alternative to traditional hydrocodone-combination drugs. Additionally, because Zohydro is engineered in an extended-release form, it need be given only twice a day -- a convenience for patients requiring chronic opiate therapy.

And yet these same selling points are cited by critics in advancing arguments against Zohydro's release. That's because with Zohydro, if you're not forced to take a dose of acetaminophen or aspirin every time you swallow a hydrocodone tablet, the amount of hydrocodone you can take is no longer limited by side effects from acetaminophen or aspirin. Critics insist that will encourage excess intake of hydrocodone, worsen the epidemic of opiate-drug abuse, and lead to higher death rates from overdose. They've petitioned the FDA to withdraw its approval of Zohydro, and bills have been filed in the House and Senate to remove Zohydro from the market. (more…)

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Selected Works

Fiction -- Interconnected Short Stories
Torrential rains pour into Thalburg Canyon, California. Flooding ensues, and a universal human drama unfolds as the interconnected stories of the canyon residents are acted out on center stage.
Nonfiction, Physician Memoir
The author begins her medical career as a young physician caring for people who are dying with AIDS during the 1980s.
Book Reviews -- Examples
Journalist Rebecca Skloot’s new book is a gripping read that embodies all abstractions about research ethics in a compelling tale about Henrietta Lacks – a woman whose microscopic cancerous cells shook the world’s medical establishment in 1951.
Newspaper and Online Opinion and Medical Columns
Since 2000 -- Syndicated medical opinion columns about the sociopolitical and ethical dimensions of American health care.
Medical Essays
Documentary, executive producer
DVD -- Journey by Heart -- an engaging and intimate view of Alzheimer's Services of the East Bay.