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How Your Medication List Makes You The Perfect Pharma Target

Give me your medication list and I’ll tell you your health problems. It happens every day in emergency rooms across the country as confused elderly patients present for an acute problem unable to describe their past medical history, but equipped with a list of medications in their wallet:

Metformin = Type-2 diabetes

Synthroid = Hypothyroidism

Lipitor + Altace + Lasix + Slo-K = Ischemic cardiomyopathy

Lexapro = A little anxious or depressed

Viagra = Well, you know…

I bet I’d be right better than 90 percent of the time. Now, imagine you’re a pharmaceutical company wanting to target people with those chronic diseases. Where might you find them?

No problem. Just pay the insurers to provide you patients’ drug lists. No names need be exchanged in keeping with HIPAA requirements. But the drugs list attached to folks’ cable TV box? Perfect. You’re in — with no legal strings attached. Then, according to the Wall Street Journal, just fire away with that targeted direct-to-consumer advertising on TV, courtesy of your local healthcare insurance provider.

No wonder our healthcare industry movers and shakers love the electronic medical record. Healthcare privacy? What healthcare privacy?

-WesMusings of a cardiologist and cardiac electrophysiologist.

*This blog post was originally published at Dr. Wes*

5 Tips On How To Be A Healthcare Survivalist

There are plenty of “survivalists” out there who stock their basements with canned goods, getting ready for some unexpected (and unlikely) apocalypse. Meanwhile there are things that are much more likely to happen to you — like getting sick — which many of us don’t prepare for at all. So to help you get started, here are five important tips on how you can become a healthcare survivalist:

1.  Take care of your chronic conditions. Whether it’s high blood pressure, diabetes, high cholesterol, depression, asthma or any other kind of ailment, do what it takes to manage your own care. Take your medications and follow your doctors’ instructions. Why? Because if you don’t, your condition can get worse and lead to even more serious problems. As much of a pain as it may (literally) be, there’s a reason the old saying “an ounce of prevention” still resonates today — because it’s true.

2.  Live a healthy lifestyle. Everyone gives you this advice, but with studies showing that 42% of Americans will be obese by 2050, it doesn’t seem to be getting through. Denial can wonderfully appealing;  but when it comes to your health, it can also kill you. Stop smoking, exercise, and eat right. You may find that your employer has programs in place that will help you do all of those things, and many of them work. Why not give one of them a try? You can’t improve your life all at once, but you can start. Your life will be happier if you keep yourself healthy. So rather than whistling past the graveyard, jog past it. Read more »

*This blog post was originally published at See First Blog*

Basic Health Education: Not So Basic

The past two weeks I’ve been the “dayfloat” resident on the cardiology inpatient service. With the 30-hour-shift work “restrictions” placed on medical residents, there has been a need for new systems of care to ensure the safety of newly admitted patients and cardiology dayfloat is one of them. My job is to round with the post-call team, help them get out of the hospital on time, and then take care of their patients through the end of the work day. It’s a fairly easy rotation, as they go, though because I “float” from one team to another without patients of my own, it’s also not the most satisfying.

Towards the end of my two week rotation, I was paged by a nurse because a patient’s husband wanted an update on his wife’s condition. Glancing at my “signout” — a one-page synopsis of the patient’s presenting illness and hospital course — I learned that Mrs. FN (as I will call her) was admitted to the hospital for heart failure secondary to “medical noncompliance.” It appeared that she had not had any of her medications for well over a week, which likely precipitated the shortness of breath and fluid overload that led to her admission. On top of this, the patient had a number of “dietary indiscretions” including eating Chinese food, which likely only exacerbated her condition. Read more »

*This blog post was originally published at BeyondApples.Org*

Failure For A Doctor

I went to a patient’s funeral this past weekend. I generally don’t do that for people whose relationship I’ve built in the exam room. It’s a complex set of emotions, but invariably some family member will start telling others what a nice doctor I am and how much the person had liked me as a doctor. It’s awkward getting a eulogy (literally good words) spoken about me at someone else’s funeral. This patient I had known prior to them becoming my patient, and his wife had been very nice to us when we first moved here from up north.

But that’s not why I am writing this. As I was sitting in the service, the thought occurred to me that a patient’s funeral would be considered by many to be a failure for a doctor. Certainly there are times when that is the case — when the doctor could have intervened and didn’t, or intervened incorrectly, causing the person to die earlier than they could have. Every doctor has some moments where regrets over missed or incorrect diagnosis take their toll. We are imperfect humans, we have bad days, and we don’t always give our patients our best. We have limits. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

A Doctor’s Letter To Patients With Chronic Disease

Dear Patients:

You have it very hard — much harder than most people understand. Having sat for 16 years listening to the stories, seeing the tiredness in your eyes, hearing you try to describe the indescribable, I have come to understand that I, too, can’t understand what your lives are like. How do you answer the question, “How do you feel?” when you’ve forgotten what “normal” feels like? How do you deal with all of the people who think you are exaggerating your pain, your emotions, your fatigue? How do you decide when to believe them or when to trust your own body? How do you cope with living a life that won’t let you forget about your frailty, your limits, your mortality?

I can’t imagine.

But I do bring something to the table that you may not know. I do have information that you can’t really understand because of your unique perspective, your battered world. There is something that you need to understand that, while it won’t undo your pain, make your fatigue go away, or lift your emotions, it will help you. It’s information without which you bring yourself more pain than you need suffer. It’s a truth that is a key to getting the help you need much easier than you have in the past. It may not seem important, but trust me — it is. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

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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