Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

Choosing The Best Health Care For You: What Information Helps You Decide?

Our ailing economy has boosted the number of people who are unemployed, without health insurance or with minimal coverage. The popularity of high deductible health plans is soaring as employers and individuals look for affordable insurance.  Twenty-nine percent of bankruptcies are said to be caused by medical bills. Many of us now choose health care services and providers carefully, trying to stay within tight budgets.

The American people, long protected from the price of health care by insurance, are now forced to act as consumers.  This situation is a free marketer’s dream.  According to this model, we will rationally calculate the price/quality trade-offs of each doctor visit, procedure, test and drug.  We will stop overusing services. We will demand better care. And the result will be reduced health care costs for the nation while the quality of care and the health of individuals will remain the same, if not improve.

There’s nothing like a good theory.

But the theory can only be tested if a) It’s easy to find publicly reported, relevant quality information about the services we need, matched with what we would pay out of pocket; and b) We use that information as the basis of our health care decisions. Neither of these conditions can be met today.

A new Cochrane review Read more »

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

Consumer Reports Promotes Alternative Medicine With Questionable Research

Ever since I was a teenager, I’ve intermittently read Consumer Reports, relying on it for guidance in all manner of purchase decisions. CR has been known for rigorous testing of all manner of consumer products and the rating of various services, arriving at its rankings through a systematic testing method that, while not necessarily bulletproof, has been far more organized and consistent than most other ranking systems. True, I haven’t always agreed with CR’s rankings of products and services about which I know a lot, but at the very least CR has often made me think about how much of my assessments are based on objective measures and how much on subjective measures.

Until now.

I just saw something yesterday on the CR website that has made me wonder just how scientific CR’s testing methods are, as CR has apparently decided to promote alternative medicine modalities by “assessing” them in an utterly scientifically ignorant manner. Maybe I just haven’t been following CR regularly for a while, but if there’s an article that demonstrates exactly why consumer product testing organizations should not be testing medical treatments; they are ill-equipped to do so and lack the expertise and knowledge. The first red flag was the title, namely Hands-on, mind-body therapies beat supplements. The second red flag was the introduction to the article: Read more »

*This blog post was originally published at Science-Based Medicine*

Doctors And Patients Wish Their Relationship Was Better

Physicians said in a survey that noncompliance with advice or treatment recommendations was their foremost complaint about their patients. Most said it affected their ability to provide optimal care and more 37 percent said it did so “a lot.”

Three-quarters of patients said they were highly satisfied with their doctors. But they still had complaints ranging from long wait times to ineffective treatments.

Those are just some of the findings from two surveys, the first a poll of 660 primary care physicians conducted by the Consumer Reports National Research Center in September 2010 and the second a poll of 49,000 Consumer Reports subscribers in 2009. The magazine reported its results online.

In the doctors’ poll, physicians named these top challenges:

– 76 percent of doctors said when it came to getting better medical care, forming a long-term relationship with a primary care physician would help “very much.”

– 61 percent said being respectful and courteous toward doctors would help “very much,” while 70 percent said respect and appreciation from patients had gotten “a little” or “much” worse since they had started practicing medicine. This was a two-way street, since patients reported the same feelings.

– 42 percent physicians said health plan rules and regulations interfered “a lot” with the care they provided.

Also noted in the poll, 37 percent of physicians thought they were “very” effective when it comes to minimizing pain and discomfort for their patients, though 97 percent thought they were “somewhat” effective. But, 79 percent of patients said their doctor helped to minimize their pain or discomfort, according to the Consumer Reports blog. The gap might be explained by doctors thinking of their overall effectiveness with all of their patients, including those with chronic pain conditions that are difficult to diagnose and treat, and who are as a group less satisfied with their physicians. Read more »

*This blog post was originally published at ACP Internist*

“Dollars For Doctors”: Is Your Doctor Being Paid By A Drug Company?

An historic piece of journalism was published today. Six news organizations partnered on the “Dollars for Docs” project — ProPublica, NPR, PBS’s Nightly Business Report, the Chicago Tribune, Boston Globe and Consumer Reports. They examined $258 million in payments by seven drug companies in 2009 and 2010 to about 18,000 healthcare practitioners nationwide for speaking, consulting, and other tasks.

This webpage can be your gateway to the project, with links to a database searchable by doctor’s name or by state, and links to the journalism partners’ efforts:

Boston Globe
“Prescription for Prestige”
The Harvard brand, unrivaled in education, is also prized by the pharmaceutical industry as a powerful tool in promoting drugs. Its allure is evident in a new analysis of all publicly reported industry payments to physicians.

Consumer Reports
“Consumers Wary of Doctors Who Take Drug-Company Dollars”
Most Americans are skeptical of financial relationships between doctors and companies, according to a new, national from the Consumer Reports National Research Center.

Chicago Tribune
“Doctors Draw Payments From Drug Companies”
Follow drug company money in Illinois, and it leads to the psychiatry department at Rush University Medical Center, a prominent headache clinic on the North Side of Chicago, a busy suburban urology practice and a psychiatric hospital accused of overmedicating kids.

PBS
“Nightly Business Report”
A doctor talks about quitting drug company money when their marketing tactics crossed the line.

NPR
“Drug Companies Hire Troubled Docs As Experts”

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

Patients Are Splitting Pills To Cut Healthcare Costs

Patients are pill-splitting more to trim back healthcare costs, according to a poll by Consumer Reports. In the past year, 39 percent took some action to cut costs.

The poll of more than 1,100 people found that 45 percent of people take at least one prescription drug and average four. But 27 percent said they didn’t always comply with a prescription, and 38 percent of those younger than 65 without drug coverage didn’t fill prescriptions at all.

Just over half of patients felt that doctors didn’t consider their ability to pay when prescribing a drug, while nearly half blamed drugmaker’s influence for physicians’ prescribing habits. (HealthLeaders Media)

*This blog post was originally published at ACP Internist*

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…

Read more »

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…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

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…

Read more »

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…

Read more »

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…

Read more »

See all book reviews »