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Leading Healthcare Systems Collaborate On Best Practices For Common Conditions

Six of the nation’s leading healthcare systems will collaborate on outcomes, quality, and costs across eight common conditions or procedures in an effort to share best practices and reduce costs with the entire healthcare system.

Cleveland Clinic, Dartmouth-Hitchcock, Denver Health, Geisinger Health System, Intermountain Healthcare, and Mayo Clinic will to share data among their 10 million patients with The Dartmouth Institute, which will analyze the data and report back to the collaborative and the rest of the country, according to a press release.

The collaborative will focus on eight conditions and treatments for which costs have been increasing rapidly and for which there are wide variations in quality and outcomes across the country. The first three conditions to be studies are knee replacement, diabetes, and heart failure. They will be followed by asthma, weight loss surgery, labor and delivery, spine surgery, and depression.

*This blog post was originally published at ACP Internist*

The Heart And The Holidays

The human heart resides in a lighltless 98.6-degree chest cavity. Its contracting muscles are further cushioned by the well-lubricated glistening smooth pericardial sac. One wouldn’t think that the heart could sense the time of year. The heart’s rhythm should remain independent of the holiday season. But then there is December in the EP lab. They are as busy as the malls.

Is it the depressing weather? Or the short days? Or a post-Thanksgiving hangover? It’s hard to say, but every year for as many as I can remember, the EP lab rocks in November and December. And with the advent of deductible health plans, this holiday phenomenon has only intensified.

The I-90 of the heart, the AV node, seems to give out more in the holidays. I’ll never forget the Saturday in December many years ago when I did five “urgent” pacemakers — and neither will the pacemaker rep. Read more »

*This blog post was originally published at Dr John M*

Depression: Is It A “Character Issue” And A Disqualifier For Leadership?

When the Republicans took back the House of Representatives [recently], John Boehner, the presumptive new Speaker and current Senator from Ohio, unleashed a “sob heard round the world.” As The New York Times quotes:

“I’ve spent my whole life chasing the American dream,” (Boehner) said, beginning to cry. He swallowed and tried again. But describing all the bad jobs he had once led to near sobbing when he got to the line, “I poured my heart and soul into running a small business.”

Boehner has cried in public many other times, the recent election night being only the largest stage to date. The tears also flow at his annual golf tournament, or while watching a child pledge allegiance to the flag, listening to a Republican colleague speak about his Vietnam War experiences, the unveiling of a statue of Ronald Reagan, while accepting various awards, during a rendition of “America the Beautiful,” etc. Could these tears be signs of major depression? Should melancholy be a disqualification for leadership? Were Clinton’s tears any better? Read more »

*This blog post was originally published at The Examining Room of Dr. Charles*

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*

Brain Damage, Behavior, And Football

In psychiatry, we’ve had a hard time drawing precise links between brain pathology and psychiatric disorders. We can do it for groups of people: “Disease X” is associated with changes in brain structure of “Brain Area Y” or metabolic changes in “Brain Area Z.” But it’s groups, not individuals, and it’s an association, not a cause-and-effect, or a definite. We still can’t use this information for diagnosis, and there are still patients with any given psychiatric diagnoses who will have brains where “Area Y” is the same size as those without the disorder. We’re learning.

From what I read in this New York Times article, Owen Thomas was a bright, talented young man with no history of psychiatric disorder and no history of known concussion. In April, he committed suicide — a tragedy beyond words.

Sometime people commit suicide and everyone is left to wonder: There was no depression, no obvious precipitant, no note left behind, and every one is left to wonder why. The guilt toll on the survivors is enormous, as is the grief for their families and communities. In this case, according to the Philadelphia Inquirer, the young man was apparently struggling with the stress of difficult school work and concerns about his team and employment.

Owen’s family donated his brain to Boston University’s Center for the Study of Traumatic Encephalopathy. They discovered that Owen’s brain showed damage similar to that seen in older NFL players — he had a condition called chronic traumatic encephalopathy. Read more »

*This blog post was originally published at Shrink Rap*

Latest Interviews

The Surprising Economic Burden Of ADHD (Attention-Deficit Hyperactivity Disorder)

If you can read this you need to download a more recent browser It is estimated that as many as million U.S. adults have ADHD Attention-Deficit Hyperactivity Disorder A recent research study publication-pending suggests that the economic burden of ADHD on America could be as high as billion annually. I…

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Is The Adderall Shortage A Harbinger Of Future Drug Supply Problems?

If you can read this you need to download a more recent browser Today most- if not all- Doctor’s offices are strained by the shortage of some prescription medication or vaccine. A month ago President Obama signed his executive order directing the FDA to take steps to reduce drug shortages…

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Latest Book Reviews

Book Review: The First Step To Improve Health Care Is A Close Examination Of How It’s Delivered

My friend and former Chair of the CFAH Board of Trustees Doug Kamerow has written a book that I think you will like. Besides being a mensch and witty as heck Doug is a family doctor and a preventive medicine specialist. In his new book Dissecting American Health Care Commentaries…

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“Your Medical Mind” Explores Factors That Influence A Patient’s Medical Decisions

Recently I had a conversation with Shannon Brownlee the widely respected science journalist and acting director of the Health Policy Program at the New America Foundation about whether men should continue to have access to the PSA test for prostate cancer screening despite the overwhelming evidence that it extends few…

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Book Review: Food Truths, Food Lies

Food Truths Food Lies written by family physician Eric Marcotte M.D. may be the most refreshingly evidence-based diet book of the decade. You will not find a single mention of super-foods magical berries or supplement must-haves in the entire book. What you will find is the cold hard truth about…

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