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Latest Posts

Getting Doctors And Patients On The Same Team: A Basketball Metaphor For Health Care

It is tough playing man-to-man when coaches on the sideline keep insisting your team plays zone.

Such is it with health care.

For doctors, the man-to-man defense never ends. Stay with them. Glue to them. Move with them. Run with them. Defend against the bounce pass, or the dribble to avoid the admission. Hands up! Watch their waist, ignore the head fake. You shift your coverage to accommodate their needs. One on one, mana-a-mano.

But for the business of medicine, it’s all about the zone. Defend the admission basket against as many people as possible with the least number of defenders. Stay in your position. Work it 2-1-2, 2-3, or if you’re really adventurous: 1-2-2. Stick to Read more »

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

Diabetes: An Expensive Disease

Back when I was a young bird with type 1 diabetes, insulin cost about $70 dollars per bottle.  (And I had to walk uphill both ways to the endocrinologist’s office.)  I had no concept of this cost, or how it played into my family’s finances, at the time.  I would just open the fridge door, grab the bottle, uncap the orange top to a 1cc syringe, and take the units my mom would yell to me from the kitchen sink.

“Two. Two of Regular should do it.  Rotate to your right arm this time, okay?”

“Okay!”  (And then I’d proceed to jab it into my left arm because I’m right-handed and also stubborn.)

Now, twenty-five years later, insulin has taken a bit of a price hike.  I just ordered a three month supply of Humalog from Medco and the total for the insulin came to six hundred and ninety-seven dollars.  For six bottles of Humalog that will be all gobbled up by early March.  (And thanks to a high, but manageable-on-paper deductible, we’re responsible for the full cost this round.)  Almost seven hundred dollars worth of insulin.

We’re lucky that we’re able to pay for that cost without panicking, but knowing what these bottles cost without the assistance of insurance makes me look at everything through a diabetes lens.  When three days are up on my insulin pump site, I am very aware of Read more »

*This blog post was originally published at Six Until Me.*

Money For Nothing: Capitation Medicine

My dad’s wife called to ask if I could see a friend of my brother’s. This 30 year old woman had been “put through the ringer” by her HMO dermatologist. He looked at her nose diagnosed a “pre cancer” and treated her with freezing. Then he put her on a cream. The “wart” is still there and she can’t get in to see the doctor (actually a physician’s assistant) for 2 months.

Welcome to capitation medicine.

This evil creation of your local managed care plan pays a doctor Read more »

*This blog post was originally published at Truth in Cosmetic Surgery*

Kim Jong Il’s Health At The End Of His Life And Other Hot Topics In Medical News

kim jong il, north korea, health, reporting on healthKim Jong Il: Of course we’re going to highlight the lowlights of the North Korean leader’s health: CNN has the scoop on the dictator’s cause of death and previous illnesses. Knight Science Journalism Tracker’s Paul Raeburn rounds up previous analyses of Kim Jong Il’s psychological profile.

Breast Cancer: Companies are trying to build a better mammogram as they compete for a bigger slice of the $6 billion-and-growing medical imaging market, Sierra Jiminez reports for Fortune. Nearly 300,000 American women have been diagnosed with breast cancer this year.

Health Reform: The U.S. Supreme Court will devote an unprecedented week of oral argument over health reform when Read more »

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

Can Effective Health Care Reform Occur In This Geographically Varied Country?

There is a romantic view of America as a homogeneous nation – a nation that is flat. But the real America has high peaks of affluence and deep valleys of poverty and a varied landscape of health care spending. It is a hilly terrain of income inequality.

The Affordable Care Act was based on homogeneity. Not only would its provisions be disseminated equally, but smoothing the peaks and valleys of health care utilization would liberate the funds necessary to finance it. Under reform, Newark would come to resemble Grand Junction CO, and Mayo would be the model for Manhattan. No longer would Los Angeles, home to the nation’s largest concentration of poverty, consume more resources than Green Bay, WI, where poverty is infrequent. Regional variation in income and poverty could be ignored all together. The problem is “practice variation,” and health care reform will fix that.

Of course, the US  is not homogeneous, and poverty cannot be ignored. In fact, Read more »

*This blog post was originally published at PHYSICIANS and HEALTH CARE REFORM Commentaries and Controversies*

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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