Unpopular medical specialties: exploring the concept that "the customer knows best".

Background: Healthcare systems often face shortages of certain medical specialists due to lack of interest among medical students. We questioned a common "one solution fits all" approach to this problem which involves monetary incentives to lure students to these specialties. Instead, we used the marketing principle the "consumer knows best" to explore ways of elucidating the reasons and proposing solutions for such shortages.

Adverse pregnancy outcomes including gestational diabetes and preeclampsia: Do primary care physicians refer to them in their medical files?

Pregnancies complicated with gestational diabetes mellitus (GDM) or preeclampsia should be considered risk factors for subsequent morbidity later in a women's life. Appropriate screening tests have been recommended for these women. We sought to evaluate whether primary care physicians document diagnoses of GDM or preeclampsia in the medical files during the post-partum period and to elicit whether appropriate screening tests were performed.

[FALSE POSITIVE AMBULATORY BLOOD PRESSURE MONITORING: CHALLENGES IN ACCURATE DIAGNOSIS OF MASKED UNCONTROLLED HYPERTENSION.].

Masked uncontrolled hypertension (MUCH), describes a mismatch between normal office measurements and out of range home blood pressure. Although it is often underdiagnosed, it is associated with high risk of hypertensive complications and morbidity. Ambulatory blood pressure monitoring (ABPM) is defined as the "reference standard" for diagnosing hypertension and is especially effective in cases of MUCH.

Hypothesis: Persistently normal TSH levels may be used to recognize patients with transient forms of hypothyroidism and to suggest treatment withdrawal.

There are no text-book recommendations on when or if treatment should or could be stopped in patients with a diagnosis of hypothyroidism, and these patients usually receive lifelong thyroxine therapy (despite the fact that some of them may have forms of transient hypothyroidism that will later recover function). Since TSH fluctuations during thyroxine treatment are common and a lack of this fluctuation might be used to identify patients who no longer need thyroxine treatment, we hypothesize that by offering patients with persistently controlled TSH levels a withdrawal trial of thyroxine treatment we may identify those who no longer need life-long treatment.