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Latest Posts

High Value Care: Getting The Maximum Health Benefit

The past few months have offered encouraging signs that physicians and physician organizations are belatedly recognizing the need to take an active role in controlling health care costs by emphasizing “high-value” care and minimizing the use of low-value interventions with high costs and few clinical benefits. On the heels of a best practice guideline issued by his organization, American College of Physicians Executive VP Steven Weinberger, MD recently called for making cost-consciousness and stewardship of health resources a required general competency for graduate medical education.

In light of a recently published estimate that the top 5 overused clinical activities in primary care specialties led to $6.7 billion in wasted health spending in 2009, Dr. Weinberger’s call comes none to soon. Below is an excerpt from my post on this topic from April 13, 2010. Read more »

*This blog post was originally published at Common Sense Family Doctor*

Should Med Students Be Taught How To Maintain A Healthy Lifestyle?

Last week I wrote a simple post on eating yogurt with fresh fruit for lunch. It wasn’t until later that I realized why it’s a medical lesson.

It happens that yesterday morning I was up and out early. I saw a former colleague walking along the street. He’d gained weight, and walked slowly. I thought about how hard he works, and what a good doctor I know him to be. And yet any citizen or patient might size him up as heavy, maybe even unhealthy.

The problem is not that he’s uneducated or can’t afford nutritious foods. He knows fully about the health benefits of losing weight and exercise. The problem is the stress and long hours of a busy, conscientious physician’s lifestyle.

When I worked as a practicing doctor and researcher at the hospital, I rarely ate a nutritious breakfast or lunch. My morning meal, too often, consisted of Read more »

*This blog post was originally published at Medical Lessons*

Organic Food: Is It Better For You?

In 1952 Martin Gardner, who just passed away this week at the age of 95, wrote about organic farming in his book Fads and Fallacies in the Name of Science. He characterized it as a food fad without scientific justification. Now, 58 years later, the science has not changed much at all.

A recent review of the literature of the last 50 years shows that there is no evidence for health benefits from eating an organic diet. The only exception to this was evidence for a lower risk of eczema in children eating organic dairy products. But with so many potential correlations to look for, this can just be noise in the data.

Another important conclusion of this systematic review is the paucity of good research into organic food –- they identified only 12 relevant trials. So while there is a lack of evidence for health benefits from eating an organic diet, we do not have enough high-quality studies to say this question has been definitively answered. It is surprising, given the fact that organic food was controversial in the 1950s, that so little good research has been done over the last half-century. Read more »

*This blog post was originally published at Science-Based Medicine*

Some Good Things About Healthcare Reform

The large healthcare bill has some very good elements in it that should help the average American.

One is a provision that will kick in in 2011 that says all health insurers will need to spend 85 percent of the premium dollar on actually providing care. This means people may actually receive benefits they pay for. What a concept! Read more »

*This blog post was originally published at EverythingHealth*

Healthy And Fit Without Ruining Your Life?

I consider myself a relatively fit person. Of course, “relatively” is still relative. I try to watch what I eat. I usually exercise five days a week. Heck, I’ve even run a couple half-marathons. But the rest of my days are pretty much sedentary. I sit in a climate-controlled office staring at my computer screen. I make dinner in my highly-automated kitchen. After dinner I sit in the living room sipping wine and watching TV or talking to Greta. Then I go to bed and start the process over again.

That’s not a whole lot of activity for a creature that evolved for endurance. Over a 50 mile course, a race between a man and a horse can be quite competitive. Millions of people all over the world do hard manual labor day in and day out. But millions of others don’t set aside any time for exercise. In my half-marathons, I’ve finished in the top half of competitors, so compared to a lot of people, I must be doing something right. Right? Or do my sedentary days outweigh my occasional bursts of activity? I exercise an average of 4 hours per week. That’s less than 4 percent of my total waking time. Is that really enough to stay fit? Read more »

*This blog post was originally published at The Daily Monthly*

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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