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

Latest Posts

The Worst Healthcare System In The World

The worst healthcare system in the world is the United States, of course. Oh no, wait — it’s Canada. Actually, it could be Germany. Geez, now I think it might be the UK.

You could go on and on like this, but you know what? No matter how good or bad your healthcare system is, there are certain universal truths. Here are four of them that might make you look at global healthcare a little differently:

First, healthcare is getting more expensive, all over the world. A new study by the global consultant, Towers Watson (disclosure: Towers Watson is a Best Doctors client) found that the average medical cost trend around the world will be 10.5 percent in 2011. In the advanced economies costs will rise by an average of 9.3 percent. While Americans tend to think of rising medical costs as a uniquely American problem (they’ll rise by 9.9 percent here), it’s just not true. Canadian costs will rise by 13.3 percent. In the UK and Switzerland, they will increase by 9.5 percent, and in France by 8.4 percent.

Why is it happening? As ever, the main drivers are the increasing availability of new medical therapies — and inappropriate use of care. We see the same phenomenon at Best Doctors in our global experience. Across the world, our data for 2010 showed that just over 20 percent of patients had an incorrect diagnosis, and about half were pursuing inappropriate treatment plans. Read more »

*This blog post was originally published at See First Blog*

Dr. Don Berwick’s “Patient-Centered” Medicine

There’s been a bit of buzz in the health blogs over President Obama’s decision last week to use the mechanism of a recess appointment to be the director of the Centers for Medicare and Medicaid Services (CMS).

Recess appointments, for those who may not be aware, allow a President to put a nominee in place when Congress is in recess in order to have him in place without the messy process of having him approved by the Senate. True, the Senate still has to approve a recess appointment by the end of its term, or the seat goes vacant again, but it’s an excellent way to avoid having nasty confirmation fights during election years. Of course, both parties do it, and the reaction of pundits, bloggers, and politicians tend to fall strictly along partisan lines.

If you support the President, then a recess appointment is a way to get around the obstructionism of the other party. If you don’t support the President, it’s a horrific abuse of Presidential power. And so it goes. Either way, I don’t really care much about the politics of how such officials are appointed so much as who is being appointed.

The man who was appointed last week to head CMS is Donald Berwick, M.D., CEO of the Institute for Healthcare Improvement. His being placed in charge of CMS will likely have profound consequences not just for how the recent health care/insurance reform law is implemented, but for how the government applies science-based medicine to the administration of the this massive bill. Read more »

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

Navigating The New York Publishing World To Help Patients

The book publishing world, largely based in New York City, is in trouble. The fragmentation of the market by electronics large and small has chopped former readers into so many pieces. How can a publisher make a blockbuster buck anymore? The answer may come in translations of Swedish fiction from a newly-found novelist, now dead, to non-fiction ghostwritten for a face everyone knows from the evening news.

In a whirlwind face-to-face series of meeting with publishers on a very recent sunny Tuesday in Manhattan, I got a glimpse of their angst and did my best to convince them that a book – yes, even all sorts of electronic versions and in-the-palm-of-your-hand “apps” – could make them boatloads of money and do the right thing for America’s healthcare consumer (just maybe such a work could be translated into Swedish and do good there in a return of the favor literary effort). Read more »

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

Healthcare Reform: Motivating Self-Responsibility In Patients

Last week I heard a lecture about Accountable Care Organizations by a physician leader working for one of the major hospital systems. His discussion made me realize that large physician organizations and hospitals are spending lots of time solving problems of quality medical care. In my opinion quality medical care has not been adequately defined.

A working definition right now is to decrease hospital stays, efficient medical care for a disease at lower cost, avoidance of medical errors in the hospital, and avoidance of hospital acquired infections. These are important goals. They must be attached to monetary incentives. Many of these problems can be solved now.

The solution demands the development of processes of care. An important question is how much money will process improvement save? I estimate that this process improvement could save an estimated 7 to 10% of the healthcare dollar.

The real question should be focused on how to repair the healthcare system by decreasing costs while improving the health of Americans. Read more »

*This blog post was originally published at Repairing the Healthcare System*

Medical Conventions: More Focus On Patients Needed

Andrew Schorr, host and founder of Patient Power, discusses the hope of changing the focus from products to patients at medical conventions.

Shifting the Focus to Patients at Medical Conventions from Patient Power® on Vimeo.

*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…

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 »