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

Latest Posts

Massachusetts: A Foreshadow For Healthcare Reform?

Paul Levy, President and CEO of Beth Israel Deaconess Medical Center in Boston, suggests we watch Massachusetts for what might be coming with healthcare reform:

Things are playing out just as one might predict in the Massachusetts small business and individual insurance market. The Insurance Commissioner turned down proposed rate increases, the state’s insurers appealed to the courts, and now they can’t write policies.

Perhaps more concerning is what Dennis Byron, a commenter on Mr. Levy’s blog, says about insurance exchanges:

I care because I am one of those who has been cancelled by my insurer (Fallon), solely, I believe, because I am an individual, have been told to go to the exchange, but the exchange does not work. This is a perfect example of why you don’t want the guys that run the registry running your healthcare.

If nothing else, this exposes the risks inherent to mandating unproven policy initiatives on a national scale that have yet to be even worked out in a single state.

*Sigh*

-WesMusings of a cardiologist and cardiac electrophysiologist.

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

“Behavioral Medicine” To Prevent Skyrocketing Healthcare Costs?

Educating individuals about the costs of healthcare could save money and lead to a more efficient use of the healthcare system, report policy researchers at Tufts University School of Medicine and Boston University School of Public Health.

You mean that people, when faced with facts about cost (and their end of it), choose the less-costly option? When did this start? Oh, yeah — we do it all the time — except in medicine, where our costs will bankrupt the country.

*This blog post was originally published at GruntDoc*

Heard Around The MedBlogosphere, 12.22.08

Here’s my weekly round up of quotable quotes from my peers:

NHS Blog Doctor: Antibiotics do not cure snot. [Please go to the site for a fabulous illustrative photo.]

KevinMD: Since work-hours were restricted in 2003, there are no studies that have shown any marked improvements in patient safety or outcomes. Worse, errors have arisen from the so-called “patient hand-off,” the period of communication where rested doctors replaces those who are fatigued. Does increasing the frequency of patient hand-offs outweigh the benefit of better rested doctors?

Richard Reece, MD: The moral for doctors: Don’t expect as much leverage as in the past when negotiating with hospitals, even though you represent their main revenue stream.

Paul Levy: The medical community in Boston likes to boast about the medical care here, but we don’t do a very good job holding ourselves accountable.

Dr. Wes: Thanks to exorbitant costs of implementing EMRs in physician practices, the Medicare requirements for billing and prescribing electronically, and the prohibitive documentation requirements mandated by CMS in the name of “quality,” independent physician practices of all types will have no choice but capitulate to larger entities that have a fully integrated electronic medical record paired with collection software.

Heart found in a car wash (h/t Dr. Wes)

Ramona Bates, MD: I don’t think I would ever want to be part of doing a posthumous face lift or blepharoplasty or other cosmetic procedure, but I would be willing to debulk tumors if it would help families or individuals say “goodbye” more easily.

WhiteCoat Rants: For $79 you can blow into your iPod and it will play you a song if your blood alcohol is more than 0.08. You know this device wasn’t made for parents.

Just what we need. A bunch of drunk teenagers farting around with their iPods and getting into a “who can get the highest blood alcohol” contest.

The Happy Hospitalist: It frightens me to hear people say they want to work in medicine and work in a similar capacity as physicians, evaluating, diagnosing and managing disease, but not want to put in the time and sacrifice to be residency trained in depth and scope…

Science-Based Medicine: Our soldiers, grievously wounded in combat, deserve only the best science-based therapy available… If I were to propose treating our injured soldiers with bloodletting and toxic metals (both common methods in the 1700s and early 1800s) based on the concept that it would put the “imbalance of the four humors” back into balance, the Pentagon and the military medical establishment would toss me out on my ear as a dangerous quack–and rightly so. But introduce a method that claims “ancient Chinese wisdom” based on somehow magically redirecting the flow of a mysterious “life energy” by sticking small needles into parts of the body that correspond to no known anatomic structures through which “qi” flows, and suddenly the Air Force is funding a program to train medics and physicians treating our wounded soldiers how to do this method based on the same amount of convincing scientific evidence that qi exists as for the four humors (none) and in the face of no strong clinical evidence that it’s any better than a placebo.

Rural Doctoring: Hospitalists, take note: this is an example of why people go ape-sh*t crazy in the hospital:
•    Her right arm is completely immobilized to protect the graft site.
•    Her left arm has a heplocked IV in it.
•    Half her head is shaved because the surgeon took the donor skin from the scalp.
•    She’s vegetarian and the cafeteria sent her chicken for lunch.
•    Dinner was vegetarian but she can’t really cut up a baked potato with only one hand.
•    The hospital has double rooms and is running at capacity, so the staff is harried.
•    Her roommate is an elderly, demented woman who keeps trying to get out of bed by herself and objects to the TV being on. So far, all she’s said to us is “Mind your own business!”

Latest Interviews

The Surprising Economic Burden Of ADHD (Attention-Deficit Hyperactivity Disorder)

If you can read this you need to download a more recent browser It is estimated that as many as million U.S. adults have ADHD Attention-Deficit Hyperactivity Disorder A recent research study publication-pending suggests that the economic burden of ADHD on America could be as high as billion annually. I…

Read more »

Is The Adderall Shortage A Harbinger Of Future Drug Supply Problems?

If you can read this you need to download a more recent browser Today most- if not all- Doctor’s offices are strained by the shortage of some prescription medication or vaccine. A month ago President Obama signed his executive order directing the FDA to take steps to reduce drug shortages…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: The First Step To Improve Health Care Is A Close Examination Of How It’s Delivered

My friend and former Chair of the CFAH Board of Trustees Doug Kamerow has written a book that I think you will like. Besides being a mensch and witty as heck Doug is a family doctor and a preventive medicine specialist. In his new book Dissecting American Health Care Commentaries…

Read more »

“Your Medical Mind” Explores Factors That Influence A Patient’s Medical Decisions

Recently I had a conversation with Shannon Brownlee the widely respected science journalist and acting director of the Health Policy Program at the New America Foundation about whether men should continue to have access to the PSA test for prostate cancer screening despite the overwhelming evidence that it extends few…

Read more »

Book Review: Food Truths, Food Lies

Food Truths Food Lies written by family physician Eric Marcotte M.D. may be the most refreshingly evidence-based diet book of the decade. You will not find a single mention of super-foods magical berries or supplement must-haves in the entire book. What you will find is the cold hard truth about…

Read more »

See all book reviews »