Kate Scannell, MD

By Dr. Kate Scannell, Syndicated columnist; First Published in Print: 03/31/2012

Two studies published in last week's New England Journal of Medicine generated much media attention and hope that maybe, just maybe, a swift surgical fix could cure two notoriously chronic and intertwined medical conditions that affect millions of people worldwide: obesity and Type 2 diabetes. But it would be wise -- and healthy -- to scale back any unbridled enthusiasm about that until many more facts weigh in.  Read More 

By Dr. Kate Scannell
First Published in Print: 07/10/2011

A FEW weeks ago, I visited a hospitalized friend who was recuperating from hip-replacement surgery. While unpacking the deli items I promised to bring, he said, "Too bad! You just missed my orthopedic surgeon. He invented my hip replacement!"

"Really?" I said, almost spilling a carton of matzo ball soup.

"Yeah, he designed and patented it!" my friend bragged. "And he uses it in all of his hip surgeries!"

But I didn't feel as hip-hip-hooray about the news. An orthopedic surgeon inserting his patented, royalty-generating medical device into my friend's body as though it were an ATM card?

As a rheumatologist who'd cared for many arthritic patients needing joint replacements, I knew that the medical-device market was already steeped with tried-and-true hip replacement models. How could my friend have possibly evaluated the safety and efficacy of his surgeon's new -- and, undoubtedly, more expensive -- device? Was he aware that it had no known or knowable track record? What authentic choice did he truly have when consulting with his one-hip-wonder surgeon?  Read More 

By Dr. Kate Scannell, Syndicated Columnist
First Published in Print: 04/02/2011

BY NOW, most of us know what a "GPS" is -- at least those of us who tend to get lost and require a "global positioning system" to navigate us toward our desired destination. But how many of us are familiar with the "CPGs" our doctors use to navigate our medical care?

A CPG is a "Clinical Practice Guideline," and it functions like a GPS for doctors and patients. For example, when a medical decision must be made for a diabetic patient, the doctor might consult a "CPG for diabetes" to select a course of management among several options. Depending on that course, the CPG could navigate doctors toward ordering certain tests or prescribing particular medications.

CPGs are created by a hodgepodge of private and public organizations that share some interest in the focus of the CPG. So, for example, the American Diabetes Association creates CPGs regarding diabetes management. The Academy of Ambulatory Foot and Ankle Surgery issues guidelines concerning ingrown toenails. More than 1,000 CPGs exist, spanning a vast array of medical disorders including heart disease, arthritis, thyroid problems, high blood pressure and various cancers.

Ideally, organizations volunteering to create guidelines do us a favor, because it is impossible for most doctors to keep up with the thousands of new research findings published each year in medical journals. We doctors tend to welcome CPGs that are written by groups of professionals who have expertly reviewed, analyzed, distilled, synthesized and translated complex research findings into useful clinical practice recommendations.

It's important to understand about CPGs because doctors frequently rely upon them to determine what happens to you when you're sick.  Read More