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Latest Posts

Becoming A Savvy Healthcare Consumer: A “Difficult Science”

Dr. Kent Bottles is in the midst of a very thoughtful multi-part blog post under the heading, “The Difficult Science Behind Becoming a Savvy Healthcare Consumer.”

Part I examined “the limitations of science in helping us make wise choices and decisions about our health.”

Part II explores “how we all have to change if we are to live wisely in a time of rapid transformation of the American healthcare system that everyone agrees needs to decrease per-capita cost and increase quality.”

Both parts so far have addressed important issues about news media coverage of healthcare. Read more »

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

Going Against Medicine: Courageous Or Foolish?

Every once I awhile a story catches my eye as I scan the news websites. There was one this morning on CNN with this catchy title: “Mom Defies Doctor, Has Baby Her Way.” The article describes a story where a mother was going to have her fourth baby. Her previous three were born via C-section. Mom did not want another C-section done, and “defied” her doctor’s order for the procedure. “You’re being irresponsible,” the patient was told.

The middle of the article talks about the current thinking and statement of the American College of Obstetrics and Gynecology saying that “it’s reasonable to consider allowing women who’ve had two C-sections to try to have a vaginal delivery.” Of course, there’s risks with proceeding with a vaginal delivery and risks of another C-section.

What’s always interesting to me are the comments following the article. I applaud the physicians who are fighting back the anti-physician sentiment and those who are pushing (no pun intended) the only home birth agenda.

In the article, this person is being held up as a hero — as someone who defied the paternalistic medical establishment and did it her way. Good for her — or is it? What if that 0.4-0.9 percent possibility of severe complication occurred and there was a problem with mom and/or the baby? What would happen then? Read more »

*This blog post was originally published at Doctor Anonymous*

Health 2.0: Is It A Threat To The Medical Profession?

The Internet has threatened journalism. Clay Shirky has said that everyone is a media outlet. An Internet connection and blogging platform makes everyone a publisher. Can the mass professionalization of journalism be applied to medicine or health? Can access to a broadband connection outfit a citizen to think and act like a physician?

There are pieces of what physicians do that can be replicated, and other pieces that can’t. The technical things that doctors do can’t be replaced. Removing an appendix or replacing a heart valve, for example. Tough to pull off on CureTogether.

But what about the thinking? After all, patients have access to the same information, references, and literature as physicians. Unfettered access to information can create an illusion. It can give us a false sense of control. Read more »

*This blog post was originally published at 33 Charts*

Patient-Centered Outcomes Research: Will Patients Be Involved?

A year ago Gangadhar Sulkunte shared his story here about how he and his wife became e-patients of necessity, and succeeded, resolving a significant issue through empowered, engaged research. As today’s guest post shows, he’s now actively engaged in thinking about healthcare at the level of national policy, as well – and he calls for all patients to speak up about this new issue. – Dave

I recently came across a Pauline Chen piece in the New York Times, “Listening to Patients Living With Illness.” It refers to a paper by Dr. Wu et al, “Adding The Patient Perspective To Comparative Effectiveness Research.” According to the paper and the NY Times article, Dr. Wu and his co-authors propose:

  1. Making patient-reported outcomes a more routine part of clinical studies and practice and administrative data collection.
  2. In some cases requiring the information for reimbursement.

Patient-Centered Outcomes is outcomes from medical care that are important to patients. The medical community/research focuses on the standard metrics related to survival and physiological outcomes (how well is the part of the body being treated?). In the patient-centered outcomes research, they will also focus on outcomes important to patients such as quality of life. In other words, the care experience will be viewed through the eyes of the patients and their support groups to ensure that their concerns are also addressed. Read more »

*This blog post was originally published at e-Patients.net*

Healthcare Transparency: Patient Experts At Medical Conventions

Interviewing Dr. Emile Mohler from the University of Pennsylvania at AHA Scientific Session 2010We are invading their home turf. Increasingly, in among the thousands of doctors, scientists, and medical industry marketers at the largest medical conventions you are finding real patients who have the conditions discussed in the scientific sessions and exhibit halls. Patients like me want to be where the news breaks. We want to ask questions and — thanks to the Internet — we have a direct line to thousands of other patients waiting to know what new developments mean for them.

I vividly remember attending an FDA drug hearing a few years ago and how there were stock analysts sitting in the audience, BlackBerries poised for the “thumbs up” or “thumbs down” on whether a proposed new drug would be recommended for approval. (At that session it was thumbs down.) When the analysts got their thumbs moving, a biotech stock tanked in minutes and before long the company was announcing layoffs. Those analysts were powerful reporters.

Now patients are reporters, too, and their thumbs are just as powerful. So are their video cameras and microphones. These folks are a different breed than the folks from CNN or the scientist/journalists from MedPageToday. Their questions are all-encompassing: “What do the discussions about my disease or condition here mean for me? What should change in my treatment plan? What gives me hope? What’s important for my family to know?” Read more »

*This blog post was originally published at Andrew's Blog*

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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