Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

Are MDs More Effective At Running Hospitals Than MBAs?

It’s been more than five years since Henry Mintzberg released the enlightening book ‘Managers, not MBAs’, a well-reasoned criticism of prevailing management education that basically revolves around Master in Business Administration (MBA) programs. Financial crisis was not even in sight but Mintzberg, a professor at McGill University in Montreal and one of the most important guiding lights in the questionable field of management, already pointed out that it was a serious danger for modern organizations to rely on professionals that had just finished their MBAs as the prime source for senior managerial positions.

Mintzberg focused his criticism on two essential aspects. First, most programs are aimed at people with no previous experience or knowledge about organizations and how they look like from the inside… and these same people then storm into companies believing that the real world works exactly as business school taught them it does. The second point is that many of these business schools spread a perverted set of values, such as the hunt for short-term profit, the belief that a good aim justifies any means and the urge to translate all human behaviors into accountable figures (the ‘countophrenia’ depicted by Vincent de Gaulejac in his must-read ‘La Société Malade de la Gestion’).

Then the crisis rose, and many CEOs of the biggest organizations had their share of responsibility for it, as they were enjoying multi-million dollar bonuses while taking their companies to the edge of bankrupcy. Most of them came from the most famous business schools in the world. I have outlined in the past the outrageous conflict of interests of many of these institutions, starting with Harvard, as Charles Ferguson perfectly displayed in his brilliant documentary ‘Inside Job’.

‘Social Science and Medicine’ published in its August issue a very interesting work by Amanda Godall, professor at the IZA Institute for the Study of Labor in Bonn, Germany. Godall’s is the first empirical research on the correlation between hospital results and having MDs in their top managerial positions. Read more »

*This blog post was originally published at Diario Medico*

CDC Outlines The Steps For Investigating Disease Outbreaks

With the release of the movie Contagion, I thought it would be appropriate to post my cheat sheet on how to investigate a disease outbreak. Aspiring disease detectives take notes!

Scientist in biocontainment suit examining a dead ratWhat do you think of when you hear the word “outbreak”?  Maybe you envision a population decimated by a terrible, novel, and incurable disease like in the aformentioned movie Contagion or you think of Dustin Hoffman roaming around California in a blue biocontainment suit with Rene Russo trying to protect folks from a tiny monkey and narrowly preventing an airstrike by the US military?

Hollywood has done their best to capture what an outbreak is…but here are the facts. An outbreak, or epidemic, occurs when there are more cases of disease than would normally be expected in a specific time and place.  The disease may be something doctors have already seen before just in a new form or abnormally high numbers, such as foodborne or healthcare-associated infections, or it may be an emerging disease that we don’t know much about like SARS.  Either way, we need to investigate to determine why it is happening and how to prevent other people from getting sick or dying. Several people in biocontainment suits collecting samples outside a building

Outbreaks are usually noticed by an astute clinician, such as those who first noticed AIDS in New York City and San Francisco, but there are also many high tech disease detection systems available to help us spot any increase in illness. PulseNet is a laboratory network that uses PFGE (pulsed-field gel electrophoresis) to help identify foodborne outbreaks by monitoring the genetic make-up of the bacteria causing what may otherwise look like unrelated illnesses. In the recent events of the Salmonella outbreak in ground turkey, PulseNet and the National Antimicrobial Resistance Monitoring System helped identify the cause of the outbreak as well as determine how widely it had spread. Programs such as Biosense and First Watch monitor the chief complaint or reason that someone called 9-1-1 or went to the hospital (aka syndromic surveillance).  We also monitor news media for reports of outbreaks and websites such as Google Flu trends, which tracks circulating viruses and illnesses. With new technology ordinary citizens can also increasingly report outbreaks in their communities too.

The Magic Formula

So how do you figure out the who, what, when, and where of a disease outbreak? Read more »

*This blog post was originally published at Public Health Matters Blog*

The Beneficial Effect Of Laughter On Your Health

I stumbled upon the article ‘Laughter: gender-specific variations’ in Revista Clínica Española (‘Spanish Clinical Journal’) and I can’t help thinking about the need for taking this into account to improve doctor-patient relationships. The text can actually be read as a guide to understand how every person laughs and how to use it in clinical practice.

Table 1. Laughter effect on health Read more »

*This blog post was originally published at Diario Medico*

CDC Outlines Injury Prevention Strategies In Extreme Weather Conditions

Photo: the sun.It may seem rather unusual to talk about injuries and weather in the same context, but extreme weather can pose significant risks for many kinds of injury.  Currently, many parts of the United States are experiencing a major heat wave, with record-setting heat and heat indices over the next few weeks.  As we have seen in the recent past, deaths are occurring from heat-related and possibly from participation in outside activities that increase the risk of heat-related illness.

During the month of August, many athletes train for the fall sports season, sometimes participating in two practices a day over the course of a few weeks.  While training is necessary and important for athletes to build up their stamina and to improve their performance, health consequences can be deadly if Read more »

*This blog post was originally published at CDC Injury Center: Director's View Blog*

Medical Tourism: A Lot Of Sellers But Not Many Buyers?

I must confess that I have a weakness for medical tourism. Patients have always been ready to go on a pilgrimage to find the world’s leading expert (we call it ‘key opinon leader’ now) hoping to find a cure. As long as traditional leaders in the field of Medicine have been the Germans, the French and the English -with some occasional Austrian and Spanish name in the mix- traffic of wealthy patients across Europe is nothing new.

Since we entered the antibiotics era, these leaders started to be located mainly in the United States, the cradle of modern, technology-driven Medicine. Thus hi-tech centers got ready to welcome foreign patients, building strong International Customer Support departments. A random example -by no means the only one- would be the Mayo Clinic. On their website you can see that their wealthy patients speak Arabic or come from Latin America. These healthcare services have a long tradition of client-oriented work because they work for private clients that pay for their treatment (sometimes the client is not the patient himself but his family). The important thing was never the price, but the patient. Read more »

*This blog post was originally published at Diario Medico*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »