5-Shot Friday 6/3/16

Hello, this is Peter Kim MD, and welcome to 5-Shot Friday, part deux.

1)  Disaster Prep Can Be Fun, Sort Of

Disaster Prep Can Be Fun

There are any number of ways to approach disaster prep. It depends on how you define “disaster.” Nuclear winter? Long lines at Disneyland? Jerry’s Dogs closing some locations? (The departure of Jerry’s Dogs had me reeling, I must admit.)

If the end of your worldly comforts means catastrophe, as in “serious disruption of major services across a wide area,” you could do worse than getting pointers from The Department Of Homeland Security.

DHS’s READY website covers Natural Disasters, including Earthquakes (with a video by Dwayne “The Rock” Johnson), Extreme Heat, Home and Wildfires, Floods, Tsunamis and Space Weather (which I had to look up), Tech and Accidental Hazards (power outages, hazardous materials accidents, and nuclear power plants), Terrorist Hazards (bio, chem, cyber, bombs, nuclear blasts and radiation dispersion)…

(deep breath)

…Making Your Emergency Plan, Building An Emergency Supply Kit, Planning For Your Business, Educating Your Kids, and then there are the getting involved, preparing your community, and social media links.

Wow. It seems like preparedness overkill, until you realize that in California, we’ve experienced pretty much every disaster on that list.

If you would like to focus on quakes, another great site is SF 72’s, based in San Francisco, arguably the American earthquake experts. Any kind of preparation against Cataclysms is a Good Thing.

(BTW, a tip for iPhone users: you may want to turn off the Amber Alert notifications, but don’t turn off the WEAs (Wireless Emergency Alerts, which are unaffected by network congestion. You may not be able to make calls during an emergency, but if the cell towers are still operational, you’ll get the emergency alerts.)

2)  Arthur’s Inspirational Transformation

Arthur Boorman’s YouTube video has been viewed nearly 13 million times. In 4 minutes and 54 seconds, it demonstrates THE prime principle of exercise, activity, and losing weight, but most importantly, of starting down the path to transformation.

Start Where You’re At.

Discouraged that you can’t run for 20 minutes – because you can barely walk to the mailbox without getting winded? Walk halfway to the mailbox, every day. Then to the mailbox when halfway gets easier. Then to the mailbox plus 10 feet. Repeat and extend when able.

Can’t lift a 5 lb. dumbbell? Start with a 1 pounder. Don’t have any dumbbells? Grab a can of soup.

Great is the enemy of good, said Voltaire. The only guaranteed failure is never getting started because you can’t do “it” perfectly, or because the little bit you can do is “pointless.” Start wherever you’re at and you’ll build.

3)  Choosing Wisely

Choosing Wisely


We live in conflicted times, with many more “powers that be” than ever before. In my parent’s generation it was almost unheard of to question your own doctor, because you assumed he knew the medical science and would always act in your best interests. With the onslaught of news releases, pharma campaigns, and political doublespeak, your doctor’s advice has become just one of many pings on your personal wellness radar.

Worse, you may wonder if your personal physician is an accomplice to larger organizations who want to hoodwink you for their own gain, hiding behind “science” and “studies” to justify whatever profits them. The recent pushbacks against statin medications to lower cholesterol, and of course, vaccinations, are but two examples. The biggest casualties may be your faith in your doctor and in the reliability of science itself.

Choosing Wisely is a campaign aimed at reversing this death spiral.

The American Board of Internal Medicine Foundation joined Consumer Reports to create the CW campaign, now partnered with more than 70 medical societies, to educate patients and physicians about the best tests, treatments, and procedures. Many of its recommendations advise against actions that would financially benefit a doctor, medical institution, or specialty group, because of unbiased analysis that reveals what truly helps patients, even if there’s a more expensive but less effective option. You may not need an annual physical, just because it’s time; most >respiratory infections are not helped by antibiotics; and whole-body CT scans aren’t so great for cancer screening. The website contains a searchable list of conditions that explain whether common medical practice (or patient expectation) may or may not be the best choice.

The ABIM Foundation was founded by the ABIM in 1989, as a charity “to advance the core values of medical professionalism as a force to improve the quality of health care.” With initiatives like Enhancing Primary Care (as opposed to far more profitable specialty care), Improving Care Transitions (where most “falling through the cracks” occurs: leaving the hospital or skilled nursing facility), and Addressing Conflicts Of Interest (oh yeah, ye who sell your trust for coin), the Foundation and its Choosing Wisely campaign are trying to clean house.

4)  Snowball In A Blizzard


Snowball In A Blizzard


A chance to peek into the complexities of proverbial “brain surgery” that I mentioned in last week’s 5-Shot Friday, Snowball In a Blizzard is one physician’s eloquent discussion of why medical science is Complicated with a capital “C.”

As one reviewer on Amazon put it:

“In today"s world, both professional and lay person alike are bombarded with information. As humans we are predisposed to fit that information into a category of true/untrue. While this mode of thinking has many advantages (speed, simplicity) it also leads to placing too much confidence in some information and not in others which can in turn lead to bad choices.

“More and more we live in a society that deifies the role of the expert. When faced with a question outside of our own particular milieu, we place near 100% faith in the recommendations of one or more selected experts without appreciating the level to which that expert is or should be confident in that recommendation. In this book, Dr. Hatch helps us to identify when this type of mistake is likely to happen and provides us with a framework (the "spectrum of uncertainty") to place this information in a more rational context. Let"s hope we listen.”

Medicine tries to give specific advice – for you as the individual patient – based on studying lots of other individuals like you, but each with their own quirks, special circumstances, dietary differences, etc. It’s different from scientific fields where each thing is like every other thing in the known universe (H2O is still H2O, in your backyard or on Mars).

Medicine goes from the specific, to lots of specifics, to the general, and then back out again to the specific – like starting with a slab of beef, going to a herd of cattle, getting a jar of bouillon cubes, and finally using it to make a beef stew taste just the way your mom used to make it. It’s a complex process I wouldn’t wish on my worst enemy in the 9th circle of hell, and if there were any other way to find what works and what doesn’t in medicine, medical scientists would have adopted it a loooong time ago.

5)  From @jessicahagy: I drew a gross thing. To post or not to post?

I Drew a Gross Thing


“Okay. I warned you,” she said.

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5-Shot Friday


Peter Kim, MD

Dr. Kim,  is the Medical Director of Family Care Centers, Former Chair of the Department of Family Medicine at Hoag Hospital, and a recipient of the Physicians of Excellence award from the Orange County Medical Association. He is Board Certified in Family Medicine, and has been practicing in our community for over 20 years. He is an excellent, caring, and well­qualified physician who is dedicated to providing you with superior health care. A native of Los Angeles, he graduated from UCLA and received his medical training at the LAC­USC Medical Center. After completing his residency in Family Medicine, he accepted a sports medicine fellowship at San Jose Medical Center, an affiliate of Stanford University. He enjoys working with patients and families who are training or want to get back into an active lifestyle. Review Dr. Kim on: Facebook Google+ Yelp WebMD

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