December 30th, 2011 by BruceCampbellMD in Opinion
Tags: Cancer, Cancer Care, Cancer care providers, Christmas, Diagnosis, Healers, Holidays, Hospitals, Life disruption, Pace, Surgery
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“Do any human beings ever realize life while they live it? —Every, every minute?”
-Thornton Wilder
His cancer was growing and his symptoms were progressing alarmingly. As holiday music played in the background, I searched the calendar to see how rapidly his surgery could be scheduled. The young man and his wife first looked relieved when we found a surgical opening in the coming week, but their faces fell as they realized that he would spend December 25th in the hospital. Family plans were to be put on hold that year. The future was uncertain.
It has always seemed to me that ”cancer” causes more life disruption during this time of year. The quickened pace of life and the family expectations, particularly when small children are involved, push people to their limits.
On the other hand, Read more »
December 30th, 2011 by Steve Novella, M.D. in Opinion, Quackery Exposed
Tags: Alternative Medicine, Antivaccine, Antivaxer, Attitudes, Effectiveness, Evidence, Fear Mongering, Labels, Mercury, Misinformed, Opinions, Propaganda, Safety, Scare Tactic, Science Based Medicine, Skeptical, Vaccinations, Vaccines
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Labels are a cognitive double-edged sword. We need to categorize the world in order to mentally capture it – labels help us organize our mental maps of the overwhelming complexity of things and to communicate with each other. But labels can also be mental prisons, when they substitute for a thorough, nuanced, or individualized assessment – when categorization becomes pigeon-holing.
We use many labels in our writings here, out of necessity, and we try to be consistent and thoughtful in how we define the labels that we use, recognizing that any sufficiently complex category will be necessarily fuzzy around the edges. We have certainly used a great deal of electrons discussing what exactly is science-based medicine, and that the label of so-called alternative medicine is really a false category, used mainly for marketing and lobbying (hence the caveat of “so-called”).
We get accused of using some labels for propaganda purposes, particularly “antivaccinationist” (often shortened to “antivaxer”). Also “denier” or “denialist”, as in germ-theory denier. Even though we often apply labels to ourselves, no one likes having an unflattering label applied to them, and so we have frequent push-back against our use of the above terms.
As with many such terms, Read more »
*This blog post was originally published at Science-Based Medicine*
December 29th, 2011 by KerriSparling in Opinion
Tags: bottle, Cost, Diabetes, Endocrinology, Expensive, healthcare, Humalog, insulin, Insurance, Money, pricey, Pump, three month supply, Type 1
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Back when I was a young bird with type 1 diabetes, insulin cost about $70 dollars per bottle. (And I had to walk uphill both ways to the endocrinologist’s office.) I had no concept of this cost, or how it played into my family’s finances, at the time. I would just open the fridge door, grab the bottle, uncap the orange top to a 1cc syringe, and take the units my mom would yell to me from the kitchen sink.
“Two. Two of Regular should do it. Rotate to your right arm this time, okay?”
“Okay!” (And then I’d proceed to jab it into my left arm because I’m right-handed and also stubborn.)
Now, twenty-five years later, insulin has taken a bit of a price hike. I just ordered a three month supply of Humalog from Medco and the total for the insulin came to six hundred and ninety-seven dollars. For six bottles of Humalog that will be all gobbled up by early March. (And thanks to a high, but manageable-on-paper deductible, we’re responsible for the full cost this round.) Almost seven hundred dollars worth of insulin.
We’re lucky that we’re able to pay for that cost without panicking, but knowing what these bottles cost without the assistance of insurance makes me look at everything through a diabetes lens. When three days are up on my insulin pump site, I am very aware of Read more »
*This blog post was originally published at Six Until Me.*
December 29th, 2011 by Peggy Polaneczky, M.D. in Opinion
Tags: 16 & Pregnant, Advertisement, Big Pharma, Birth Control Pill, Contraception, Family Planning, IUD, Mirena, MTV, Patch, Product Placement, Promo, Ring, Side Effects, Teen Mom, teen pregnancy
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In this week’s episode of Teen Mom 2, Kailyn heads to her gynecologist for birth control and leaves with a Mirena IUD in her uterus.
The entire encounter, obviously edited, ran more like a commercial for Mirena than a contraceptive counseling session. Other contraceptives were mentioned generically only -”a patch”, “a ring”, “the pill” – but when it came to the IUD, all we hear is the word Mirena – six times, to be exact, during the entire 2 and a half minute encounter with the doc.
DOC: If you don’t like the birth control pill, you do have other options. You know that there’s a birth control patch.
KAILYN: (suspiciously) Yeah
DOC: There’s a once a month vaginal ring. The ring itself is not uncomfortable. (Hands her the ring) They’re one size fits all – Right Isaac? (Baby plays with Nuvaring) They’re cool, right?
KAILYN: I just feel like me putting something in myself is all that much more room for error.
DOC: There’s also the Mirena.
KAILYN: Whaaaat is Mirena? Read more »
*This blog post was originally published at The Blog That Ate Manhattan*
December 27th, 2011 by GruntDoc in Health Policy, Opinion
Tags: Expenditure, Health Insurance, Hole, medicaid, Medicare, NEJM, New England Journal of Medicine, Percentage, Physician Payment, Policy, SGR, Specialities, Sustainable Growth Rate, Washington Post, Wonkblog
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This article and its graph (from the NEJM), and its interesting, informative but probably useless graph, was referenced today on twitter, via the Washington Post’s Wonkblog,
Recently, the Centers for Medicaid and Medicare Services announced a scheduled cut in Medicare physician fees of 27.4% for 2012. This cut stems from the sustainable growth rate (SGR) formula used by the physician-payment system. …
To illustrate the level of inequity in this system, we broke down the national spending for Medicare physician services by state and by specialty and determined which states and specialties have contributed most to the SGR deficit between 2002, when the program was last balanced, and 2009. Although SGR spending targets are set on a national level, we computed state targets by applying the SGR’s national target growth rate to each state’s per capita expenditure, using 2002 as the base year. Our analysis is an approximation, because, unlike the SGR, we do not adjust for differential fee changes. …
We compared the state targets for the years 2003 to 2009 to actual state expenditures and added the annual difference between these figures to get a cumulative difference between the state’s spending and the SGR target. This cumulative difference was Read more »
*This blog post was originally published at GruntDoc*
