March 4th, 2007 by Dr. Val Jones in News
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In a recent poll, 80% of consumers (along with the British Medical Association) preferred a simple “stop light” food label to a long list of percentage figures of recommended daily amounts. The stop light icon simply categorizes food as containing low (green), medium (yellow), or high (red) levels of the following ingredients:
- Fat
- Saturated Fats
- Sugar
- Salt
The guideline daily amounts (GDA – the rough equivalent of America’s RDA system) supporters argue that the stop light is an oversimplification, and does not effectively convey all the important nutritional value of food.
What do you think? Would you like to see this sort of labeling in the US?
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
March 3rd, 2007 by Dr. Val Jones in Medblogger Shout Outs
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Well, twinkies are made of petroleum (among 38 other ingredients), and gasoline is also a type of petroleum product! This gives “food as fuel” a new meaning.
Dr. Charles, a young family physician, reviews the ingredients of twinkies in his recent blog post amusingly called “Reduce Twinkie Consumption and Dependence on Foreign Oil.”
This reminded me of the shock I felt when watching a documentary about America’s oldest citizens recently. I clearly remember them interviewing a man who was about 105 years old, who lived alone and used a golf cart to get around outdoors. The interviewer couldn’t resist asking the man why he thought he had lived so long in such good health.
The man said, “Well, I eat pretty good, get enough sleep, and I don’t worry about much.”
The interviewer then asked a probing question, “What do you eat?”
And I leaned in towards the TV screen, curious as could be.
And the elderly gentleman said, “Well, I eat a bowl of cornflakes for breakfast and then I usually eat a twinkie later on…”
Either the segment didn’t plan enough seconds for further investigation, or that was the sum total of his nutritional advice.
I was dumbfounded. For some people, it seems, good genes and good luck take them a long way.
But I’m still not going to eat petroleum products.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
March 3rd, 2007 by Dr. Val Jones in Health Policy
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Improving quality in healthcare is an important fundamental goal. New “pay for performance” measures initiated by the Center for Medicare and Medicaid services is a well meaning attempt to provide financial incentives to physicians who demonstrate improved patient outcomes. Unfortunately, this incentive program could backfire.
A recent article in Medical Economics (via Kevin MD) raised the question of “cherry picking and lemon dropping” your way to higher pay. In this frightening scenario, physicians would be tempted to select healthier, more compliant patients for regular treatment in their practices. In this manner, they can demonstrate better outcomes, since the sicker, poorer, or less compliant patients no longer factor into their performance measures. And with the upcoming physician shortage, it really is a seller’s market.
It is critically important for the government programs to allow physicians to accurately risk stratify their patients so that they are not financially penalized for taking care of sicker patients bound to have below average outcomes. The same goes for surgeons, who should not be discouraged from undertaking potentially lifesaving surgeries for patients who are critically ill.
Dr. Kellerman, the president of the American Academy of Family Physicians, reminds us that quality of care is vastly improved by having a central medical home (i.e. one physician who can coordinate care for patients, so they’re not left with a group of disconnected specialists ordering duplicate tests and prescriptions). I personally think that a centralized EMR/PHR controlled by the patient (and located at an Internet based “medical home” complete with disease management tools and the ability to email a physician as needed) would go a long way to improving quality.
What do you think?
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
March 3rd, 2007 by Dr. Val Jones in News
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A Canadian news story piqued my interest today – apparently, a man living near Edmonton, Alberta was bitten by a bat during his sleep. Curiosity got the better of me as I tried to recreate the scenario in my head. First of all, “vampire bats” (the kind that feed on the blood of livestock) don’t live in Canada, so this little guy was probably a generic “brown bat.” Brown bats are shy creatures who live on insects primarily, so we know that this bat was in a pretty wacky frame of mind to boldly mistake a sleeping human for a beetle.
Stranger than the behavior of this culinarily confused little mammal, was the behavior of the sleeping victim. Apparently he was unconcerned by the bite and went back to sleep afterwards, never seeking medical attention. I don’t know about you, but if I woke up in the middle of the night with any wild animal sinking its teeth into my flesh, I’d probably not shrug and roll over.
Anyway, the sad news is that this man didn’t get his life-saving rabies shots. Rabies is a very serious condition with a 50% mortality rate! The rabies virus (transmitted through infected animal saliva) wreaks havoc on the brain and nerves. The CDC describes it:
Early symptoms of rabies in humans are nonspecific, consisting of fever, headache, and general malaise. As the disease progresses, neurological symptoms appear and may include insomnia, anxiety, confusion, slight or partial paralysis, excitation, hallucinations, agitation, hypersalivation, difficulty swallowing, and hydrophobia (fear of water). Death usually occurs within days of the onset of symptoms.
Isn’t it strange that “fear of water” is part of the rabies syndrome? I’d like to get an explanation of that one from a neurologist…
Anyway, human cases of rabies are quite rare (about 7000 cases/year in the US) and are usually caused by raccoon or skunk attacks. So if you come face to face with a raccoon or skunk “gone wild” my advice is to run away. But if you do get bitten, please go to the hospital immediately and get your rabies shots. You can prevent progression of the disease.
Now, if you’re curious to see if you’re in a rabies “hot zone” check out the CDC’s skunk and raccoon tracking maps (can you believe that someone’s job is to create these?)
And for a good spoof of dangerous animals – check out Dr. Rob’s recent warnings against the common goat. You can tell that he must enjoy Monty Python style humor.
Are you an animal lover? Know of some funny websites or links about animal antics? Do share!
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
March 1st, 2007 by Dr. Val Jones in Medblogger Shout Outs
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Dr. Rob, the author of “Musings of a Distractible Mind,” is really good at explaining difficult concepts. If you haven’t read his description of healthcare’s coding system, you should take a peek. It explains why documenting care is so complicated, how doctors try to “game the system” and what happens to them if they do.
Here’s a small excerpt:
“You see, what you get paid for an office visit is not based on what you do at that visit, it is based on what you document. The more you can document, the higher you can bill… There are several responses to this situation by physicians:
· Undercode to avoid the accusation of fraud
· Use EMR to document more and bill at a more appropriate level
· Code at the higher level without documenting higher and risk audit, jail, etc.
· Stop accepting insurance and just accept cash up front based on your own criteria
· Do other things besides office visits – such as surgical procedures, labs, x-rays, or other procedures that pay much better than the office visit. The pay for EKG with interpretation is nearly as high as that of the decision making that the physician makes that may save the life of the patient.”
So next time your doctor is delayed in seeing you… she’s probably trying to document all the right check boxes and codes for the last patient she treated!This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
