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Latest Posts

Reducing Health Care Spending: When Rationing Resources Goes Too Far

A sure-to-be controversial article appears in the Chicago Tribune earlier this asking the sensitive question of ‘Health care at any age, any cost?:’

“If you want to save all lives, you’re in trouble,” said Callahan, co-founder of The Hastings Center, a bioethics research institute in New York, and a faculty member at Harvard Medical School, in an interview. “And if you want to save all lives at any cost, you’re really in trouble.”

Callahan and co-author Nuland, a retired professor of surgery at Yale School of Medicine who wrote the best-selling “How We Die,” were both 80 when the article was published.

“We need to stop thinking of medicine as an all-out war against death, because death always wins,” said Callahan.

The article goes on the make some bold demands of doctors: Read more »

*This blog post was originally published at Dr. Wes*

Casting Light On The Actual Costs Of Medical Care

I really like this idea, but …  well, see after the quote.

It’s easy to compare prices on cameras, vacations, and homes. But in the United States, patients fly blind when paying for health care. People typically don’t find out how much any given medical procedure costs until well after they receive treatment, be it a blood draw or major surgery.

This lack of transparency has contributed to huge disparities in the cost of procedures. According to Castlight Health, a startup based in San Francisco, a colonoscopy costs anywhere from $563 to $3,967 within a single zip code. EKGs can range from $27 to $143, while the price for a set of three spinal x-rays varies from as little as $38 to as high as $162.

When someone else is picking up the tab, mystery pricing is not much of a problem. But these days, Read more »

*This blog post was originally published at GruntDoc*

Giving People Across The World The Best Medical Care They Can Get

Guatemala is a developing country, with great natural beauty, hard-working people and many challenges.  Most Americans look at places like Guatemala and see only the challenges.  Some see opportunity.

I’ve just returned from Guatemala, where I met with our business partners, government officials, and others.   And I can tell you a universal truth.  People across the world want the best medical care they can get.  They aren’t looking for the latest technologies and drugs and treatments – or, rather, they aren’t looking only for those things.  No, what is most important to whoever I meet, no matter where they live, is that they are able to get the right diagnosis, and the right treatment.

It’s a harder thing to get in some places than in others.  Americans don’t realize that Read more »

*This blog post was originally published at BestDoctors.com: See First Blog*

The Rising Price Of Health Care: How Are People Dealing With The Expense?

A couple of weeks ago, I was asked to speak as a patient about “consumers and cost information” while being videotaped for use in the annual meeting of the Aligning Forces for Quality initiative funded by the Robert Wood Johnson Foundation.

RWJF Video - This Costs How Much?

I admire the aims of this initiative – “to lift the overall quality of health care in targeted communities, reduce racial and ethnic disparities and provide models for national reform” – and I think it has taught us some valuable lessons about what it takes to make even slight course corrections in the trajectory of the huge aircraft carrier that is health care.

Plus, I have listened to hundreds of people talk about their experiences with the rising price of health care: who thinks about it when and why, what individuals do to cut back on the expense, where they have been successful and where not. I’ve heard lots of stories, most of them involving Read more »

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

Top 10 Most Dangerous Hospital Hazards: Some May Surprise You

Alarm fatigue is the most dangerous of health care technology hazards, topping even radiation exposure and medication errors from infusion pumps, according to the updated Top 10 list offered by ECRI Institute.

It’s not surprising that alarm fatigue rang in at #1. There can be as many as 40 alarms an hour in some units. Staff modify alarm setting outside of safe parameters, can’t tell the alarm’s importance (or even which device is issuing it) or the alarm isn’t relayed to the paging system, according to ECRI Institute, a nonprofit organization focusing on patient-safety and cost-effectiveness in health care. Its report (registration required) is online. The report includes recommendations and resources for each of the 10 top hazards.

Staff may turn alarms off or down to reduce alarm fatigue, as well as reduce stress on the patient and family, the report notes. And properly setting alarms is complex to begin with, so ECRI offers best practices to reduce alarm fatigue while maintaining patient safety: Read more »

*This blog post was originally published at ACP Hospitalist*

Latest Interviews

Caring For Winter Olympians In Sochi: An Interview With Team USA’s Chief Medical Officer Dr. Gloria Beim

I am a huge fan of the winter Olympics partly because I grew up in Canada where most kids can ski and skate before they can run and partly because I used to participate in Downhill ski racing. Now that I m a rehab physician with a reconstructed knee I…

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How Do Hospital Executives Feel About Locum Tenens Agencies And Traveling Physicians?

I recently wrote about my experiences as a traveling physician and how to navigate locum tenens work. Today I want to talk about the client in this case hospital side of the equation. I ve had the chance to speak with several executives some were physicians themselves about the overall…

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Latest Book Reviews

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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Unaccountable: A Book About The Underbelly Of Hospital Care

I met Dr. Marty Makary over lunch at Founding Farmers restaurant in DC about three years ago. We had an animated conversation about hospital safety the potential contribution of checklists to reducing medical errors and his upcoming book about the need for more transparency in the healthcare system. Marty was…

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