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

Latest Posts

Eye Health As A Predictor Of Future Disability

The idea that the eyes are a window to the soul traces back through history in many forms, but the idea that the eyes might reveal medical secrets didn’t fall far behind the metaphor.

The clues lie on the retina, which reflects the same microvascular changes that might be seen elsewhere in the body from cardiovascular changes and other diseases. The question now is how to associate retinal changes to specific diseases.

To assess potential associations between retinal microvascular changes with disability in performing activities of daily living, researchers conducted a prospective cohort study of 1,487 community-dwelling, disability-free participants in the Cardiovascular Health Study.

The main outcome measure was Read more »

*This blog post was originally published at ACP Internist*

Disability Insurance And The Differences Between The Payment Types

I have now completed three weeks at my new job with the Disability Determination Services office.  I sort of knew there were two types of disability payments under SSI:  Title II and Title XVI.  Now I understand the differences much clearer.

I would urge everyone who can afford it to purchase disability insurance.  As the person training me put it, “If you are disabled, you are still ‘costing’ your family in addition to not contributing to the family income.”

The big difference between the two (II and XVI) is that Read more »

*This blog post was originally published at Suture for a Living*

Certain People Have Special Needs

Oh, we’re not kiddy shrinks, so this post is not really about children.  But I like the term, it implies that the person needs something more, that they have special– presumably increased– needs.  It says nothing about potential.  I use the term often, and sometimes with a bit of humor, to remind people that the playing field is not always level.  There are people who start any given race with a handicap– a learning disability, dyslexia, major health problems, mental illnesses, horrible childhoods, addictions — and these set them on a slightly different course.

Some people overcome tremendous adversity.  They function ‘as if’ they had no special needs.  They have stories that would let you understand if they didn’t do very well in life, stories that would explain burying their heads in the sand, or crawling under a large rock.  Sometimes these special needs people are Read more »

*This blog post was originally published at Shrink Rap*

Considering Your Options When The Insurance Company Stops Paying

Blue Cross just advised a twenty-six-year old woman I know that it will cut off payments for the physical therapy that was making it possible for her to sit at a keyboard for eleven hours a day.  Her thirty sessions were up.

The young woman has an overuse injury to both of her arms that causes so much pain she can’t even mix up a salad dressing.  “I am not getting any better,” she said.  “To do that I would have to stop working or scale back the number of hours required by my job.”  Those physical therapy sessions offer strengthening exercises that reduce swelling and inflammation and make it possible for her to keep working.

Shifting Medical Costs to Patients

One cannot entirely fault insurance companies for trying to clamp down on medical costs, but rather than actually lowering the underlying costs of medical services, their solution is to Read more »

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

New WHO Report: More Than 1 Billion People Are Disabled – Could You Be Next?

The World Health Organization (WHO) and the World Bank just revealed the first-ever global estimate of disability. The report suggests that at least 1 billion people are currently disabled, and about 1/5 of those are experiencing significant difficulties with their activities of daily living. Since  people with disabilities experience poorer health, lower educational achievements, fewer economic opportunities and higher rates of poverty than people without disabilities, this vulnerable segment of the population needs much closer attention.

I’m a physical medicine and rehabilitation (PM&R) specialist by training, and there are only about 8000 of us in the United States. Some have called PM&R specialists: “primary care physicians for the disabled” and I think that’s a reasonable description. The task before us is daunting – with hundreds of millions of people who are not living their lives at maximum functional capacity, rehab physicians should be in great demand.

My experience is that while the demand is great, funding is limited. I’ve seen tragic cases of children being denied critical wheelchair parts, and Read more »

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 »