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The Simple Truth About Cholesterol

The New York Times recently ran a piece that wondered if doctors were treating patients with cholesterol-lowering medication unnecessarily because a web-based calculator over estimated a person’s risk. The program was proudly sponsored by the pharmaceutical roundtable and was available at the American Heart Association.

The implication was obvious. Simple tool determines an individual’s risk for heart attack or death from heart attack. It over estimates risk. Patients treated unnecessarily. To be also clear, the program did underestimate risk as well.

Unfortunately, the article missed an important point. While the simplified calculator may not be as accurate as the more complex algorithm used by the National Cholesterol Education Program, the truth is doctors are likely to be overtreating patients not because the former program is presented by the pharmaceutical roundtable, but for another reason. Read more »

*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*

Who Should Get A Flu Shot? You Should

It’s that time of year again. Children back at school. Football season is underway and baseball playoffs to start soon. The television networks are rolling out their new shows.

And it’s also time to think about getting flu shots. I just got mine today as I have done annually since going to medical school.

Compared to last year, there isn’t as much news about the flu or the flu vaccine. This year the Centers for Disease Control and Prevention (CDC) gives clear guidelines that everyone aged 6 months and older should get the influenza vaccine. 

This month the American Academy of Pediatrics recommends that all healthcare providers should be required to get the influenza vaccine.

And one fact that hasn’t gotten much attention is whether the 2009 H1N1 virus is included in the 2010-2011 vaccine: Is it? Yes, it is. This year’s vaccine will be as safe as vaccines in past years as the production process is unchanged. Inclusion of the 2009 H1N1 virus will not be a problem. Read more »

*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*

Patient Empowerment: Is It What Americans Really Want?

Empowered patient. Consumer driven healthcare. Transparency. Access to their full medical records online. Review the latest news and you’ll discover more books and articles recommending patients be advocates for themselves. The pitch? The only way to get the best care is to be thorough, informed, and always asking questions.

This perspective is understandable because advocates have observed a healthcare system that provides inconsistent quality, too many preventable medical errors, and overtreatment resulting in unnecessary injuries and deaths. Even I’ve written a book saying the same thing, and I hate to write. 

The public is urged to take charge of their health and their healthcare. When they have a problem, ask the doctor questions. Do research. If they need a procedure, shop around to get the best deal. Adopt good habits. Eat more fruits and vegetables. Stop smoking. Maintain a healthy weight. Exercise regularly. These will improve health and be less costly in the long run.  

But is this what Americans really want? Do they want to be empowered patients? Can they be empowered patients? Frankly, no. Read more »

*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*

Driving Safe Cars Can Save Lives

New England Patriots NFL quarterback Tom Brady was on his way to practice when he crashed into a minivan which allegedly ran a red light. His Audi S8 car T-boned the other vehicle a few blocks from his home. A relieved New England Patriots owner Bob Kraft noted after the accident:

“[Tom] arched and prepared himself and we’re just lucky with the glass and angles. We have a lot to be thankful for. It was really a miracle…We’re very, very lucky. Patriot Nation is lucky he had his seatbelt on.”

Was it simply luck or good car design and mechanical engineering? Crumple zones and the passenger cage of a car when built for maximum safety decrease injury. Yet, unfortunately, there is significant variability among safety in cars. Brady walked  away from the accident for a variety of reasons.

As a future hall of fame quarterback, Brady has lightning fast reflexes when analyzing defensive blitzes and options when throwing the football. Quickly bracing himself for impact may have helped. Wearing a seatbelt definitely helped. What may have helped the most was the type of car he drove. Read more »

*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*

About Concierge Or “Boutique” Medicine

A recent piece in The New York Times wondered if the few patients who can afford to pay for additional attention and access to their primary care doctors in a concierge medicine or boutique medicine practice might be ethical since the extra dollars are used to support the traditional primary care practice that the vast majority of patients currently receive. 

Questions you might ask are:

– What is a concierge medicine or boutique medicine practice?
– Is it worth the money?
– Is the care better quality?
– Is it possible to get similar access and care by doctors not in a concierge or boutique medicine practice?

When you think of a concierge, you think about a fancy hotel staff person who answers questions and speaks various languages, books reservations to restaurants, events, and tours (even sold-out attractions) — right? The hotel concierge is your insider, someone who possesses intimate knowledge of the city and recommends must-see sites like a true local. You are personally cared for and pampered. Imagine, then, your physician providing the same attentive service. Read more »

*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*

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…

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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…

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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…

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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…

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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…

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