Pak Doktor a.k.a. Mr Doctor!

Even if your doctor doesn’t have the best beside manner, you’re probably willing to excuse her behavior as long as she treats your condition and makes you healthy again, right?

Well, you might not want to be so forgiving. It turns out that rudeness and incivility among doctors, in particular in the operating room, can actually lead to poorer health outcomes and even higher death rates among patients.

Dr. Andrew Klein, director of comprehensive transplant center at Cedars Sinai in Los Angeles, and his colleague Pier Forni, founder of the Johns Hopkins Civility Project at Johns Hopkins University, collected data on previous studies of surgeons’ behavior in the operating room and the subsequent outcomes of the patients on whom they performed procedures. They found that when doctors were more courteous to operating room staff, their patients were more likely to survive and avoid complications than the patients of docs who were O.R. boors.

And the legacy of incivility didn’t stop in the operating arena. In studies of medication orders at hospital pharmacies, the researchers found that 75% of pharmacists and nurses prefer not to confront difficult physicians to ask about potential medication interactions or errors in the prescription. If a doctor who may be making a prescribing mistake goes unchallenged, patients may wind up getting the wrong type or amount of drug — with potentially disastrous consequences.

But it’s the O.R. where manners are worst, and two particular features of the setting conspire to up the obnoxiousness ante. One is the stress of having a patient’s life hang in the balance with every decision, and two, the anonymity of the surgical attire. “Everyone is wearing gowns, gloves, and masks, and it’s a terrific camouflage,” says Klein, who as a surgeon admits to falling into the incivility trap. “Often you don’t know the people you are working with, and you don’t know their names. So if you ask for a clamp and what you get is a clip, the response in many cases is to throw the thing on the floor, maybe with an expletive, and say ‘I said clamp, not clip.’ However, if you knew the person who had handed you the clip, or knew something about his or her family, you wouldn’t act the same way.”

Still, rudeness isn’t entirely the doctors’ fault, since much of it stems from a medical culture in which the surgeon is captain of the ship in the operating room and the doctor on the ward is the arbiter of all medical decisions. The problem is, that structure means that “we are essentially training the next generation of surgeons to be bullies,” Klein warns. In fact, in a recent survey of 1,500 medical students, 42% claimed they had been harassed by superiors and 84% reported being belittled. And other psychosocial studies have shown that people who are humiliated or embarrassed are more likely to want to inflict similar feelings upon others, becoming bullies themselves.

Long before those next generation effects can take hold, incivility infects the hospital culture as a whole, breeding resentment and lack of loyalty. As medical care becomes increasingly complicated, requiring cooperation among health care providers of different specialties, the fractured care that may result doesn’t do the patient any good. In some cases, lives may even be lost. “The challenge for us,” says Klein, “is to nurture the very important surgical traits — ego strength and competence, and a strong work ethic — but in a way that doesn’t abandon our commitment to being civil to one another. “

One way to do that may  involve educating surgeons and physicians in positions of authority to accept that their power does not have to be exercised all the time, and that difficult situations and crises can often benefit from a cooperative rather than a dogmatic approach. That’s not an easy lesson for doctors to learn, but it may be a critical one if we want to provide the highest quality health care to patients in the most economically responsible way. “It doesn’t cost anything in terms of taxpayer dollars to be civil,” says Klein. “And if you assume that people in a certain environment will function with civility, then there comes a cost or penalty to those who are not civil.”

Alice Park is a writer at TIME. Find her on Twitter at @aliceparkny . You can also continue the discussion on TIME’s Facebook page and on Twitter at @TIME.

By David Sobel, MD

Let’s say there’s a new medication that could make you live longer, feel more positive, and improve your overall quality of life.

It’s an elixir that doesn’t have side effects. It’s effective. And it doesn’t cost a penny.

It’s out there. Really.

It goes by many names — healthy living, wellness, prevention. Its components are happiness and health — because the two are intertwined and have a direct effect on each other.

Here are some scientific data to back that up: People who are happier and enjoy greater satisfaction with life report feeling 50 percent healthier, and their good health lasts. They are less likely to report poor health two years later.

So where can you sign up?

First things first. You can’t control all of your happiness — because your genes determine about half of it. 

And major events, such as a new baby, a new spouse or a new home, influence about 10 percent of your happiness.

The good news is, this leaves about 40 percent of your well-being that you are able to influence — by your thoughts and actions.

Ok, so that’s easy enough. Right? Just go out buy a new car or get a new, better-paying job. Maybe win the lottery. Instant health and happiness.

Not so fast. Those things can bring a smile to your face, but usually only for a short while. They aren’t usually the keys to lasting happiness and health.

Despite what many people think, money doesn’t “buy happiness.” Money can make a huge difference to people who are poor. When your basic life needs are met, money alone doesn’t boost happiness by very much.

How you spend your money is the key to lasting happiness. If you spend it going out with friends, traveling or on other experiences for you and those around you, it will bring more lasting joy than if you spend money on material items. According to one study, regular vacations can lower cardiovascular risk by 30 percent. Even small vacations can make a difference, so it needn’t be a huge investment.

You can also increase happiness — and by extension, your health ­— by doing small things for yourself throughout the day.

Here are some scientifically proven mood-enhancers.

• Savor simple, fun activities such as spending time outdoors, eating your favorite foods, and relaxing to music.

• Look for humor in your life — and feel the healing power of laughter.

• Practice gratitude by writing lists of things for which you are thankful, things you take for granted, and people who mean a great deal to you. Studies have shown that doing this for two weeks leads to measurable improvement in life satisfaction.

• Write notes to people you are grateful for knowing and be as specific as possible in your praise — the details make a big difference in elevating your mood, and theirs.

• Indulge your senses. Studies show looking at nature, taking short naps, and receiving a massage can have positive effects on your health.

• Focus on something else or a living creature besides yourself. When you connect with faith or philosophy, for example, or care for plants or pets — you actually improve your health and survival.

• Watch what you tell yourself. Evidence suggests that optimistic people are happier, live longer, and enjoy life more. If you are not inclined to have a rosy outlook, you can train yourself to focus on the positive.

So here’s my prescription for you: Go on a vacation, take a siesta, watch a funny movie and write thank-you notes. You might be surprised with what happens.

For more information about mind/body health, go to www.kp.org/mindbody (select Northern California as your area.)

David S. Sobel, M.D., M.P.H., is Medical Director of Patient Education and Health Promotion for The Permanente Medical Group, Inc. and Kaiser Permanente Northern California. He also is a practicing physician in adult medicine at Kaiser Permanente Medical Center in San Jose. He is coauthor of eight books including: Living a Healthy Life with Chronic Conditions, The Healing Brain, Healthy Pleasures, and The Healthy Mind, Healthy Body Handbook. 

Energy drinks consumed to increase stamina do more harm to health than good and can lead to addiction to alcohol, a study released by NGO Centre for Science and Environment said. 
The CSE had tested two samples each of eight popular energy brands sold in India and found 44 % of the

samples breached the safety limit of 145 particles per million (ppm) of caffeine prescribed under the Prevention of Food Adulteration Act, 1954.

Caffeine is a psycho-stimulant and can lead to seizure, strokes and even death. “These drinks are touted to have major health benefits but could be doing irreparable harm instead, mainly to the young ones,” the CSE said in a statement on Monday. Other sources of caffeine are tea and coffee.

The energy drink industry is worth 250 crore in India and is estimated to be growing at a rate of 20 % per annum. Most of the energy drinks are consumed with alcohol in India, which the study says causes dependence on alcohol.

Red Bull, one of the biggest manufacturers of energy drinks in India, however, refused to comment on the study. The company had, however, got a stay on Food Safety and Standards Authority of India’s 2009 notification of prescribing 145 ppm as safety limit of caffeine for propriety drinks.

The authority is now working on new standard of 320 ppm of caffeine for drinks having caffeine, CSE said. Some

In absence of proper standards, the CSE found that 25 per cent of the samples did not mention the caffeine content on the label. And, 38 % of the samples tested breached the caffeine limit mentioned on the label. This indicated that lack of standards is not helping the consumers in taking a proper decision before buying energy drinks.

Chandra Bhushan, associate director of CSE said: “What’s more worrying is that these so called ‘energy’ drinks are being confused with sports drinks – this is how they are marketed and projected. But studies show that these drinks are not made to re-hydrate and replenish the body. In fact, consumed during intense physical activity, they can lead to dehydration.”

Marco Secchi/Getty Images

Even in Italy, healthy peasant fare like the fresh vegetables and fruits at this market stall in Venice isn’t cheap, leading many there to abandon the famously healthful Mediterranean diet.

We tackle health claims galore on the podcast this week.

First up is an ad campaign from the California Milk Processor Board aimed at saving long-suffering men from the tyranny of premenstrual syndrome. Really? Yep. The remedy: regular doses of milk for the women in their lives. The milk board cites research that suggests taking a lot of calcium may help reduce the symptoms of PMS. We check it out.

Now some beverage marketers are touting organic water. But how can good ol’ H₂0, with nary a carbon atom in it, be organic? And what about the claims tied to that purported status? We’re take a look.

In other health news, we hear about alternatives to surgery for treating the eye disease keratoconus, a distortion of the cornea that can damage vision. Doctors have figured out a way to slow the onset of the disease using the vitamin riboflavin and ultraviolet light to make the internal fibers of the cornea knit themselves together more tightly.

And in a rare look into the often painful decisions surrounding birth defects, reporter Richard Knox profiles a family with the chance to correct their baby’s spina bifida — before it’s born. He goes with them into the OR as doctors perform a new but promising surgery to reverse the birth defect while the fetus is still developing.

We also bring a bit of summer into the mix. It’s tick time — July is peak season for ticks the risk of catching Lyme disease.

Fresh, summery cuisine is at the heart of the so-called Mediterranean diet, which was given credit for the long life and health of Italians by early 20th century food scientists. But Italians have taken a turn away from their traditional eating habits and recently weighed in as the fattest country in Europe. What happened?

Imperial, California (NAPSI) – Because science is continually making new discoveries, a medication many people took to help them with one condition can be found to cause another.

A case in point is a medicine that’s been used to combat type 2 diabetes and balance good and bad cholesterol.

The U.S. Food and Drug Administration warns that use of the drug Actos (pioglitazone) by Takeda Pharmaceuticals for more than a year may be associated with an increased risk of bladder cancer. The risk seems to be considerably higher for those who take the drug at higher cumulative doses and for longer periods of time, as much as 24 months or more.

Information about this risk will be added to the Warnings and Precautions section of the label for pioglitazone-containing medicines. The patient Medication Guide for these medicines will also be revised to include information on the risk of bladder cancer.

What To Do

That’s why if you or a loved one has developed bladder cancer after taking Actos, you may want to consult with your doctor and then get in touch with a lawyer.

To help people who took the drug, the law firm of Weitz Luxenberg is currently investigating cases in which Actos may have potentially caused bladder cancer and may be able to help you understand your legal options.

It’s one of America’s largest trial law and products liability law firms, representing injured persons and winning billions of dollars in total verdicts and settlement in such national litigations as asbestos injuries, defective medical products and medicines, environmental toxic torts and others. Its philosophy is that every client’s case is the most important case, and that each client is entitled to its very best work.

Free Consultation

For a free consultation or more information, call (888) 411-LAWS (5297) or visit www.weitzlux.com.