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

Latest Posts

Fixing Healthcare: Bring Shared Decision Making To A New Level

Last week the New York Times reported that some health insurers have applied to regulatory agencies to push premiums sharply higher – usually double-digit increases, while citizens are suffering.  This falls on top of the 11 year history reported last year by the Kaiser Family Foundation: wages and inflation are up ~40%, while health costs and worker contributions were up 138% and 159%:

Kaiser Family Foundation slide on care costs

No wonder we feel squeezed. (Last week’s announcement comes on top of this history.)

This has enormous human impact. Read more »

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

The Virtue Of Unnecessary Care

I case you didn’t hear the news, the American healthcare system is in financial crisis. One of the biggest culprits indicted in this crises is “unnecessary care,” with estimates ranging from $500 to $650 billion (total spending estimate is $2.6 trillion) going toward things labeled “unnecessary.” Personally I think this is an underestimate, as it doesn’t take into account the some big-ticket items:

  • Brand name drugs given when generics would do.
  • Antibiotics given for viral infections (and the additional cost due to reactions and resistance).
  • Unproven costly care considered “standard of care” (PSA testing, robotic surgery, coronary stents).
  • The unnecessarily high price of drugs.

One of the main reasons I am an advocate of EMR is to measure and analyze care, eliminating that which is wasteful, futile, or even harmful. The biggest burden on our system is not the fact that we have a hyper-complex payment system that hides the true cost of care. The biggest burden is the wasteful care that this system agrees to pay for. In fact, I suspect that the main reason our system has become hyper-complex and covert in its spending is to hide this waste from prying eyes.

It sounds easy: Just eliminate costly unnecessary care and save the system. While you are at it, why not bring world peace, eliminate poverty, and make a detergent that cleans, softens, and deodorizes all at once? Read more »

*This blog post was originally published at Musings of a Distractible Mind*

A 3-Point Solution To Long Waits At The Doctor’s Office

I have an easy solution to a vexing problem in today’s healthcare crisis. A problem so widespread that it’s worth hundreds of words in the Wall Street Journal: Long wait times at the doctor’s office.

But first, before I give my simple, pragmatic, master-of-the-obvious solution, let me say something truthful: I try. I try really hard — to run on time, that is.

I’ve been there myself — a patient in a gown, in a cold room with only big pharma-sponsored propaganda on the walls to stare at.

At the risk of a sounding like a…blogger, let it be said that practicing quality medicine in the current luxury of technology is much more complicated than it used to be. Such complexity devours our most precious treasure: Time with the patient. Read more »

*This blog post was originally published at Dr John M*

Most Primary Care Doctors Using Wrong Colon Cancer Screening Test

A recent article found that primary care doctors the United States are providing sub-standard care when it comes to colon cancer screening.

In the Journal of General Internal Medicine, researchers found that 25% of primary care doctors used in-office stool testing to screen for colon cancer. Specifically, doctors do a rectal exam and then swipe the rectal contents off their gloves onto a stool-testing card. A positive test result indicates the presence of blood, which can be invisible to the naked eye. Read more »

*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*

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 »