Despite what you may have seen on the streets, the following combinations DO NOT go together and should be avoided:

1. A nose ring and bifocals.
2. Spiked hair and bald spots.
3. A pierced tongue and dentures.
4. Mini skirts and support hose.
5. Ankle bracelets and corn pads.
6. Speedo's and cellulite.
7. A belly button ring and a gall bladder scar.
8. Unbuttoned disco shirts and a heart monitor.
9. Midriff shirts and midriff bulge.
10. Bikini's and liver spots.
11. Short shorts and varicose veins.
12. Inline skates and a walker.

13. Thongs and depends.

It's well known that a healthy doctor/patient relationship can be therapeutically positive. These investigators interviewed 40 physicians and ten non-physician clinicians who were judged by their peers to be especially good at sustaining excellent doctor/patient relationships. Eight themes emerged and these clinicians talked about how they maintained healing relationships with their patients.

1. Do the little things, i.e. smile, shake hands.
2. Take time to listen.
3. Be open.
4. Find something to like (be interested in your patients).
5. Remove barriers i.e. acknowledge power differentials, avoid physical objects, sit down or get at eye level with your patients.
6. Let the patient explain.
7. Share authority. Ask permission, support patients autonomy.
8. Be committed and trustworthy. Be the patients advocate.

All of us could learn from honing these critical clinical skills that can help us build healthy physician/patient relationships. (ANN Intern Med 2008 November 18; 149:720)

Vitamins E and C are among the most common supplements that are taken. Some observational studies have suggested that antioxidant supplements may prevent cancer or reduce cancer mortality. Now two large studies looking at Vitamins E and C in the prevention of prostate and total cancer in men and another looking at the effects of selenium and Vitamin E on the risk of prostate and other cancers shed more light on whether these products are helpful. The Physician Health Study looked at male physicians for a mean of 8 years. It was randomized, double-blinded and placebo controlled. Over 14,000 male physicians 50 years or older were in the study. Neither Vitamin E or C supplementation reduced the risk of prostate or total cancer and the authors suggest that there is no support for the use of these supplements in the prevention of cancer in middle aged or older men. Likewise, another study with selenium and Vitamin E alone or in combination looked at prostate cancer and colorectal and other primary cancers. It too showed no benefit in preventing prostate cancer with the use of either selenium or Vitamin E in this population of relatively healthy men. (JAMA January 7, 2009 - Vol 301, No. 1)

An Op-Ed piece in the January 9th issue of the Wall Street Journal by Deepak Chopra, Dean Ornish, Rustum Roy and Andrew Weil entitled "Alternative Medicine is Mainstream" suggested that life style and diet are the best cures for our worst diseases such as heart disease, diabetes, prostate cancer, breast cancer, and obesity which accounts for 75% of healthcare costs. They especially take issue with cardiology and the many angioplasties and coronary bypass surgeries that are done in our medical care system. They suggest that when you "eat a healthier diet, quit smoking, exercise, meditate, and have more love in your life then your brain receives more blood and oxygen so you think more clearly, have more energy, need less sleep. Your brain may grow so many new neurons that it could get measurably bigger in only a few months". Lifestyle choices certainly impact our health and who today isn't aware that smoking, obesity and lack of exercise may be inimical to long life. They also suggest that it will take serious government funding to find out that alternative medicine is the answer. These authors are widely read and influence the public. Before medicine embraces their ideas they must meet the same scientific scrutiny of any evidence based study.

John J. Mohr, MD