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Why Hospitals And Physicians Should Get Serious About Patient-Centered Care

Health care professionals are a cynical lot.   We joke about the “fad or buzz word of the month”…usually some vague concept heralded by the powers on high.   Our job is to promote the idea…knowing full well that the “next big thing” is probably right around the corner.

Take “Patient-Centered”…it sure feels like a buzz word.   I suspect most hospital and physician executives, and their ad agency partners, would agree.  But this time things are very different.

Why Hospitals and Physicians Should Get Serious About Patient-Centered Care

Reason #1 – Patients Are Starting To Discover That Their Doctors & Hospitals Are Read more »

*This blog post was originally published at Mind The Gap*

A FICO Score For Medication Compliance?

In Keeping Score on How You Take Your Medicine, Tara Parker-Pope of the New York Times, reports on a new initiative from the Fair Isaac Corporation (FICO) known previously for its credit score ratings.  FICO has developed a Medication Adherence Score, using publicly identifiable information (like employment status, age and gender) to determine a patient’s score, which it says “can predict which patients are at highest risk for skipping or incorrectly using prescription medications.”

Parker-Pope reports, “By the end of the year, an estimated two million to three million patients will have been given a FICO medication adherence score and a total of 10 million patients are expected to be scored during the next 12 months…FICO officials say insurance companies and other health care groups will use the score to identify those patients who could benefit the most from follow-up phone calls, letters and e-mails to encourage proper use of medication.”

The FICO medication adherence score has not received a universally warm reception: e-Patient Dave and Society for Participatory Medicine member Alexandra Albin point out that the score only accounts for whether prescriptions are purchased, not whether the pills have actually been taken.

In a related effort, Geisinger Health Systems and CVS Caremark are conducting a study to assess whether enhanced doctor-pharmacist communication can help with medication adherence.  Shefali S. Kukarni reports in Tracking Down Patients Who Skip Their Drugs that, “The 18-month investigation will track a prescription from the moment it is submitted electronically to the pharmacy until it reaches the patient. If the patient does not pick up the prescription a ‘red flag’ or some form of notification will be sent to the doctor.”

But as Jessie Gruman recently blogged, there is no magic pill to cure poor medication adherence.   Read more »

*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*

How To Ensure Productive Interactions Between Clinicians And Patients

I sat in a dingy pharmacy near the Seattle airport over the holidays, waiting for an emergency prescription.  For over two hours I watched a slow-moving line of people sign a book, pay and receive their prescription(s). The cashier told each customer picking up more than one prescription or a child’s prescription to wait on the side.  In minutes, the harried white-haired pharmacist came over to ask the person if they were familiar with these medications, described how to take them, identified the side effects to look out for and demonstrated the size of a teaspoon for pediatric medications.  Then he asked the person to repeat back – often in broken, heavily accented English – what he or she had heard and patiently went over the parts they didn’t understand.

I was impressed. This is what every pharmacy should be like – except, of course, for the dinginess, the creeping line and the fact that it was so crowded I could overhear these conversations.  Maybe if we got federal legislation enacted requiring pharmacists to offer counseling with each prescription filled, this kind of attention would be the norm, adherence to medication regimens would improve and drug-related injuries would be reduced.

Wait a minute.  Someone already had that good idea.  It was Read more »

*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*

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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