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Medical Devices Injure 70,000 Kids Each Year

FDA researchers have published a study in Pediatrics that analyzed patient records from child and teen ER visits in 2004 and 2005. The investigators are reporting that 70,000 kids each year go to the ER because of issues caused by medical devices.

About a quarter of the injuries were from contact lenses, while the other major contributors were needles, wheelchairs, braces, and obstetric exam tools. The study also looked at the devices most likely to cause hospitalization, and they were found to be mostly invasive devices like ostomy appliances and implanted defibrillators. Read more »

*This blog post was originally published at Medgadget*

ER Overuse: Is It A Myth?

Overuse of the emergency department is commonly discussed during the healthcare conversation, especially with the lack of primary care access shunting patients with seemingly routine symptoms to the ER. But is this a myth? That’s what two emergency physicians contend in a piece from Slate.

The emergency department is functioning just fine, they say: “Just 12 percent of ER visits are not urgent. People also tend to think ER visits cost far more than primary care, but even this is disputable. In fact, the marginal cost of treating less acute patients in the ER is lower than paying off-hours primary care doctors, as ERs are already open 24/7 to handle life-threatening emergencies.” Read more »

*This blog post was originally published at*

Are Most ER Visits Unnecessary?

Much of the ongoing healthcare reform debate has focused on unnecessary healthcare expenses—specifically, medical bills that rack up without demonstrably improving people’s health. According to Peter Orszag, the director of the Federal Office of Management and Budget, about $700 billion, or 5 percent of the U.S. gross domestic product, is wasted on unnecessary care, such as extra costs related to medical errors, defensive medicine, and just plain fraud.

At the center of this discussion are “unnecessary” ER visits for minor conditions—colds, headaches, and feverish babies—that could be handled more cheaply in doctors’ offices. If we could only convince patients to take their stubbed toes to urgent care clinics or primary care offices instead of ERs, the thinking goes we could save a load and help fix this whole healthcare fiasco. But there are a few problems with this logic. See:

Are most emergency room visits really unnecessary? – By Zachary F. Meisel and Jesse M. Pines, Slate Magazine

It’s a short, well-written article. It makes some good points and being an EM doctor I happen to agree with most of them, specifically that a lot of money is spent in medicine on procedures of uncertain (at best) benefit. The fix is probably correct, too, though I don’t see Americans jumping on changing their sedentary, easy lifestyles (that includes me.) 

*This blog post was originally published at GruntDoc*

How CTs and MRIs Drive The Cost Of Healthcare

It’s well known that the use of imaging scans, like CTs, MRIs and PET scans, have been growing at an alarming rate. But a recent study provides some stark numbers. According to a recent CDC report, “MRI, CT or PET scans were done or ordered in 14 percent of ER visits in 2007.” That’s four times as often as in 1996. Although a physician called that growth “astounding,” it’s really no surprise.

Emergency departments are becoming more crowded, and with patient satisfaction scores becoming more influential in financial incentives for physicians, sometimes just ordering a test is the path of least resistance. Factor in the spector of defensive medicine which, according to a survey from the Massachusetts Medical Society, accounts for up to 28 percent of tests ordered, it’s a wonder that more scans weren’t ordered.

Imaging scans are a clear cost driver in healthcare, contributing $12 billion to Medicare’s bill. But costs won’t resonate with patients requesting the tests or the doctors ordering them. One encouraging sign is the recent trend of publicizing the harms of scans, like radiation from CTs. I’m finding that patients are becoming increasingly aware of the risk, and making a more informed decision after I explain it to them. It’s a small step forward.

*This blog post was originally published at*

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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