It’s All in the Counseling …

Physicians have a lot of power over patient choices. In theory, physicians present patients with choices and then patients make informed decisions. In practice, this almost never happens. A physician can manipulate a patient into doing almost anything by counseling patients in a biased and skewed way; a doctor may even tell the truth, but…

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OB Potpourri 4.0

Stop the tilt I haven’t used a left lateral tilt during Cesarean delivery in years. There has never been any robust scientific data that tilting the table or tilting the mother with a rolled blanket or pillow to approximately 15° has any effect on fetal outcomes. Still, the practice is widespread and most practitioners believe…

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Dieting Myths

Have you ever heard a weight loss plan like this? Start eating clean. Avoid gluten, salt, and sugar. Use cinnamon and apple cider vinegar. Detox with natural antioxidants. Make sure you eat fat-burning pineapple every day. Eat only organic food. Make sure most of your diet comes from good calories, from whole foods and not…

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Where Does the Fat Go?

How do we lose weight? Yes, I know, diet and exercise. But where does the weight actually go? This was a question asked in a short article in 2014 in the BMJ, which you can read here. The authors point out that many people have misconceptions about this question, believing perhaps that fat is “converted…

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Antenatal Testing

A patient of mine moved out of state after her last pregnancy. She’s pregnant again and doing fine at about 12 weeks. Yes, I’m sad that she left me. But she e-mailed me recently wondering why I didn’t do a bunch of antenatal testing that her new doc says she must have. Specifically, the new doctor…

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Prophylactic Salpingectomy?

Should we perform prophylactic salpingectomy whenever possible to reduce the risk of ovarian cancer? Over the last five years, many gynecologists have made it routine practice to perform bilateral salpingectomies at the time of hysterectomy whenever possible to reduce the risk of ovarian cancer, and some have extended this to making bilateral salpingectomies their method…

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Fake News (aka, Ob/Gyn Clickbait)

I think a lot about how and where doctors get the information that informs how they practice medicine. In medical school, doctors learn information in the basic sciences that is often a few years out of date. They usually have too much belief in the principles they learn in the basic sciences, because that information…

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The Facts Speak For Themselves

I recently went to an ACOG-endorsed educational activity in Washington DC. The speaker, from a nearby local university, fancied himself an expert on the subject matter. The subject matter itself is quite controversial, so his opinions about it are not the opinions of all experts. At one point, he presented two papers which disagreed with his…

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