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News You Should Know: Distracted Driving, Nurse Strike, And ADHD

distracted driving, cell phone, reporting on health, car accident, riskDistracted Driving: Studies of driving while talking on a cell phone may have overestimated the risk of car crashes, new research suggests, Amy Norton reports for Reuters Health.

Nurse Strike: Some 4,000 nurses are expected to strike for one day at eight Sutter Health hospitals in California on December 22, John S. Marshall reports for the Associated Press. We predict a less than peaceful holiday for patients and hospital staff.

ADHD: Read more »

*This blog post was originally published at Reporting on Health - The Reporting on Health Daily Briefing*

The Surprising Economic Burden Of ADHD (Attention-Deficit Hyperactivity Disorder)

It is estimated that as many as 10 million U.S. adults have ADHD (Attention-Deficit/Hyperactivity Disorder).  A recent research study (publication-pending) suggests that the economic burden of ADHD on America could be as high as $250 billion annually. I attended a recent briefing on Capitol Hill and interviewed one of the study’s co-authors: Tufts economist, Dr. Peter Neumann as well as congressman (and psychologist) Tim Murphy about ADHD in America.

I learned from Dr. Neumann that cost these high cost estimates are most strongly influenced by reduced productivity in adult workers with ADHD rather than direct costs of treating children with the disorder. Productivity costs include absenteeism, and reduced work output due to difficulty focusing. Dr. Neumann explained that ADHD has many “spill over effects” in that it impacts the educational system, the justice system, the healthcare system, and our work environments. Please check out our interview video for the full story.

Congressman Tim Murphy is a clinical psychologist with three decades of experience in treating people with ADHD. He is also Co-chair of the Mental Health Caucus and GOP Doctors Caucus where he regularly works to raise awareness of healthcare accessibility needs. I had the chance to interview him also at the event.

I learned from Rep. Murphy that the costs of ADHD multiply when patients are untreated.  Getting the correct diagnosis is critical, because impulsivity and problems with focusing are not always caused by ADHD. These symptoms can be caused by lead poisoning, damage to the limbic system of the brain, metabolic disorders, or even sleep apnea. Children who are inattentive should not be put on medications for ADHD without first confirming the diagnosis by ruling out other possible causes.

Rep. Murphy recommends a team approach to the management and treatment of ADHD and he believes that costs related to ADHD are escalating because some physicians are not managing children holistically, but resorting to prescribing medications without involving counselors and family directly. He sees lack of health insurance coverage for behavioral health services as a threat to comprehensive and effective ADHD treatment.

Please watch the video for the full interview with congressman Murphy.

*Please note that the panel event, and Better Health’s participation, was made possible by a grant from Shire Pharmaceuticals.

Is The Adderall Shortage A Harbinger Of Future Drug Supply Problems?

Today, most- if not all- Doctor’s offices are strained by the shortage of some prescription medication or vaccine.  A month ago, President Obama signed his executive order, directing the FDA to take steps to reduce drug shortages as the White House stated that drug shortages have nearly tripled over the past five years reaching the stunning number of 178 in 2010.  These shortages make regular news:  Cancer patients without the chemotherapy needed to keep them alive, antibiotics unavailable to treat life-threatening infections, or intravenous nutrition to support the critically ill fighting to live while medical teams and families search for elusive remedies.

As this new reality plays out in hospitals and homes the media is provided a steady stream of drama for our morning paper or evening news.  Meanwhile, time and focus is repeatedly stolen from physicians, patients, and parents in a myriad of ways.  Currently, my medical practice- in primary care Internal Medicine- has been negatively affected by the shortage of Adderall, a medication used to treat Attention Deficit Hyperactivity Disorder (ADHD).  What this medical condition may lack in dramatic news-worthiness it more than makes up for in sheer numbers with an estimated 4.5 million Americans living with this condition today.

I had my first inkling several months ago of the affect the Adderall shortage would have on my practice after one of my patients called frustrated  that their pharmacy did not have their Adderall at the prescribed dosage.  By calling several pharmacies I was able to find their medication at a smaller dose. Advising my patient to “double-up” I wrote another prescription and had to direct my patient to return to my office to pick up the rewritten  prescription- a time-consuming process that doctors and patients can ill afford to repeat on a regular basis.

Unfortunately, this scenario -initially thought an exception- has now become the rule monopolizing my own time while draining the daily resources of my staff, nurse, and medical partner.  Most ironically though, Read more »

Study Provides Reassuring Evidence Regarding ADHD Drugs

If your child is being treated for attention deficit hyperactivity disorder (ADHD), you may have one less thing to worry about today. A study involving 1.2 million children and young adults provided reassuring evidence that the drugs used to treat ADHD do not increase the risk of death from heart disease.

Researchers, who published their results yesterday in the New England Journal of Medicine, analyzed medical records from a nationwide private insurance plan along with health plans based in Tennessee, California, and Washington State. They compared children taking stimulant drugs (like Ritalin and Adderall) that are commonly used to treat ADHD to children not taking these drugs.

Among all of the children, heart attack, stroke, or sudden death were rare, affecting a little more than 3 in every 100,000 children per year. Cardiac problems were no more common among children using a stimulant as among those not taking one.

The study Read more »

*This blog post was originally published at Harvard Health Blog*

Three Common Ailments That Can Be Treated With Regular Exercise

It’s Wednesday, so I would like to tell you about some cool things I learned this past week about the science of how exercise can be used as a treatment for three common ailments.

First, some background about exercise: The great thing about exercising every day that you eat is that this magic potion is not a shot or a pill. It does not involve a doctor burning or squishing anything in your body. There are no HIPAA forms, no insurance pre-certifications, and not even a co-pay. It’s as we say, easy and free. And drum roll please…exercise is active—not passive.

Here’s the Mandrola take on how exercise might treat three specific medical conditions: Read more »

*This blog post was originally published at Dr John M*

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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