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Bulimic Baby Boomers? New Study Reveals Eating Disorders In Over Fifty Crowd

American Medical News drew my attention to a recent study published in the International Journal of Eating Disorders. Among the surprising findings, 62% of women surveyed (all over the age of 50) said that their weight or shape negatively impacted their life, and 13.3% had eating disorders. About 7.5% of respondents admitted to trying diet pills to lose weight, while 2.2% used laxatives, and 1.2% vomited to reduce their weight (aka bulimia).

Eating disorder treatment facilities have noticed a surge in older patients, including one center that experienced  a 42% increase  in the number of women older than 35 seeking treatment at its clinics nationwide over the past decade.

Healthcare providers should be aware that eating disorders are not just a problem for young women. Women of all ages are now struggling with a rail-thin beauty ideal in a country of rising obesity rates, sedentary lifestyles, and ubiquitous junk food. And for older women with eating disorders, the health risks of osteoporosis, stomach ulcers, and cardiovascular abnormalities are much higher.

Perhaps primary care physicians should include an eating disorder questionnaire in their regular visits with boomers? We may be surprised by the prevalence of this issue, and I bet that many of our patients will be glad we asked.

AHRQ: Healthcare Access And Racial Disparities Not Improving

According to American Medical News, the U.S. health system is demonstrating better performance on most measures of health care quality, but it’s failing to improve access to care or cut racial and ethnic health disparities, according to two reports released in February by the Agency for Healthcare Research and Quality.  “Quality of care continues to improve, but at a slow rate,” said Ernest Moy, MD, leader of the team at AHRQ that produced the reports.  ”In contrast to that, focusing on issues of access to care, not much has changed.  Focusing on disparities in care, not much changed…Those are bigger problem areas than overall quality of care.”  Measures related to hospital quality are showing the most improvement.  For example, in 2005, just 42% of patients with heart attacks received angioplasties within the recommended 90 minutes of arriving at the hospital.  That figure improved to 81% by 2008.

While the quality improvement indicators are encouraging, the disappointing access and disparities numbers are not very surprising.

The US health care system is still largely focused on acute hospital based care.  It says we are doing better at what we are doing. Read more »

*This blog post was originally published at CFAH PPF Blog*

Pain Contracts: Do They Threaten The Doctor-Patient Relationship?

Doctors today are wary about treating chronic pain. One of the main worries is precipitating fatal opioid overdoses. Indeed, according to the CDC, and reported by American Medical News, “fatal opioid overdoses tripled to nearly 14,000 from 1999 to 2006 … [and] emergency department visits involving opioids more than doubled to nearly 306,000 between 2004 and 2008.”

Requiring chronic pain patients to sign pain contracts is a way to mitigate this risk. But how does that affect the doctor-patient relationship?

Indeed, a contract is an adversarial tool. Essentially, it states that a patient must comply with a strict set of rules in order to receive medications, including where and how often they obtain controlled substances, and may involve random drug testing. Break the contract and the patient is often fired from the practice. Read more »

*This blog post was originally published at*

American Medical News: “Welcome To Our Archives”

Via the American Medical Associations’s American Medical News article “Welcome to our archives“:

Now, our extensive online archive, paired with search and article collections by topic, puts thousands of stories at your fingertips.

Add to that a growing collection of Web-only content, such as our interactive tool for tracking health-plan earnings and a “Vault” page that will take you directly to articles and multimedia on topics of enduring interest (

Most of that older content has been behind an access-control wall. By knocking down that barrier, we are making available 10 years of full content and several years more of selected earlier articles. All told, about 15,000 articles now can be searched and read.

We invite our readers to visit the archives and link to our articles from their own sites, blogs and posts.

Thanks, AMedNews! I suppose an I told you so would be rude, so I won’t.

*This blog post was originally published at GruntDoc*

Health IT And Job Security

Hospitals nationwide are racing against the clock to ensure their health IT systems meet meaningful use guidelines. The incentive? Money, of course. Systems that meet certain criteria make doctors eligible for up to $44,000 in bonus money from the government.

As mentioned on this blog previously, implementing an electronic health system is difficult. The usability of the current generation of electronic health records (EHRs) is still relatively primitive, especially when compared to other industries, and the disruption in workflow is undeniable. Worse, there seems to be a lack of trained IT professionals to do the job.

In a recent piece from American Medical News:

60% of hospital IT executives believe tech staffing shortages, which some estimate to be a shortfall of 50,000 qualified IT professionals, will definitely or possibly affect their chances to achieve meaningful use.

It’s a problem. Read more »

*This blog post was originally published at*

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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