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By Dr. Paul Kivela

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Month: May 2016

Medically Sound

With Dr. Paul Kivela

The End of the Road for Antibiotics? 

  May 29, 2016

First, physicians were blamed for ordering too many CT scans, then it was writing too many opiate prescription.  Are antibiotics prescriptions, the next thing that physicians will be under the gun.  Recently the CDC came out and stated one if every three antibiotic prescriptions are unnecessary.    Now, U.S. researchers are identifying bacteria that are resistant… Read More


Time to buy an electric bike?

  May 27, 2016

Tesla’s entry into the electric vehicle (EV) space invigorated not just the electric car but also the entire car industry and may even evoked a culture change. Now, a new manufacturer is entering the electric bicycle market with hopes of doing the same for the bicycle industry and culture. Several months ago, my wife bought… Read More


US Government Study: Cell Phones May Cause Cancer

  May 27, 2016

For over two decades, ever since the cell phone first surfaced on the retail market, the question has been whether cell phones can cause cancer.  The U.S. government’s official position is “No” and that the weight of scientific evidence hasn’t indicated any health risks.  However in 2011, the World Health Organization (WHO)  indicated cellphone radiation… Read More


Use Lactated Ringer’s for Acute Pancreatitis

  May 25, 2016

I just listened to a great lecture at Dartmouth-Hitchcock Medical Center.  Dr. TJ Lydon spoke about pancreatititis.  He talked about how to decrease morbidity and mortality. He believes that fluid management and even choice of fluids can significantly effect outcomes and even mortality.  He recommends using LR instead of NS.  Initially, one should start with… Read More


Obamacare sticker shock: Price hikes are on the...

  May 24, 2016

Health plans are looking to dramatically increase the cost of health insurance plans that fall under the health insurance exchanges set up by the Accountable Care Act.  The health plans are claiming that they suffered substantial losses on exchanges in the last two years.  Health plans such as UnitedHealth (UNH) is threatening to leave from 27 of the… Read More


Subpoenaed as a fact witness then converted to...

  May 17, 2016

  Expert testimony: Know your rights.   Some attorneys are using a strategy of subpoenaing physicians for fact testimony and then asking them opinion questions that amount to expert testimony. To fight this subpoena abuse, here’s a primer on expert witness court precedent that I wrote several years ago. In general, if you are subpoenaed… Read More


Too many antibiotic prescriptions?

  May 17, 2016

Antibiotic resistance has been an issue for many years and multiple studies have shown that most cases of otitis media are viral.  Sinusitis has also been shown to rarely benefit from antibiotics.  This article examines the potential overprescription of antibiotics.  The CDC believes at least one in every three antibiotic prescription may be unnecessary.  This study examines the… Read More


Caramel Color in Soft Drinks (4-Methylimidazole) May Cause...

  May 5, 2016

    Are soft drinks safer in California then New York because of regulation?  This story is either reassuring if you drink sodas in California or disconcerting if you drink that same soda in New York.  The idea that a chemical additive that many people don’t know is potentially dangerous and may be in your soda that can cause… Read More


Reduce ER overcrowding by controlling the OR

  May 4, 2016

This story from the May 2, 2016 Chicago Tribune discusses Eugene Litvak’s theory that managing the OR is the key to decreasing hospital overcrowding.  The former Soviet mathematician and system engineer believes that managing the predictable nature of elective surgeries can better control the unpredictable nature of emergency medicine. Some hospitals have reportedly reaped millions of dollars… Read More


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