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

Latest Posts

A New Twist On Food Allergies In Kids

The current New Yorker unfolds an engaging story on childhood food allergies. As related by Dr. Jerome Groopman, there’s a shift in how some doctors think about how these conditions  are best managed and, even better — might be prevented. The article feeds into recent discussion that medical science, and even dogma, too-often turns out to be incorrect.

Groopman interviews Dr. Hugh Sampson, director of the Jae Food Allergy Institute at Mount Sinai Medical Center in New York:

…“This increase in the incidence of food allergy is real,” Sampson said when we spoke recently. He cannot say what is causing the increase, but he now thinks the conventional approach to preventing food allergies is misconceived. For most of his career, he believed, like most allergists, that children are far less likely to become allergic to problematic foods if they are not exposed to them as infants. But now Sampson and other specialists believe that early exposure may actually help prevent food allergies.”

I recommend the full read if you can get it: Groopman probes potential causes of discordant food allergy rates in children of different geographic regions. I learned a number of details on how some doctors in the U.S. use protein-breakdown methods to desensitize children to food allergies, how in Israel newly-speaking infants are said to ask eagerly for Bamba, a manufactured, peanut-containing snack (which, for the record, I don’t particularly endorse), and how in some cultures parents chew their young children’s food in a manner that might that might facilitate breakdown of complex proteins by enzymes in saliva.

All interesting. Of course it’s hard to know exactly what’s true in this, and the causes of allergies are likely to vary among children. There’s a randomized LEAP study (Learning Early About Peanut Allergy) in the U.K. that may provide some hard evidence on this, one way or another.

*This blog post was originally published at Medical Lessons*

“The Hot Spotters”: Is Better Care For The Neediest Patients The Answer To Lower Healthcare Costs?

Author-physician Dr. Atul Gawande has done it again with a well-written article in The New Yorker magazine entitled, “The Hot Spotters.” It deals with the fact that 5 percent of people with chronic illness make up over 50 percent of all healthcare costs.

If we can zero in on providing better preventive care for those people, we can finally get our arms around runaway healthcare costs. How great that you don’t even have to have a New Yorker subscription to read it. Here are a few cliff notes until you get to it:

— In Camden, New Jersey, one percent of patients account for one-third of the city’s medical costs. By just focusing attention on the social and medical outpatient needs of those people, they not only got healthier but costs were cut in half.

— Our current system is unable to reign in costs. We need to completely re-design and fund how we do primary care.

— Charging high co-payments to people with health problems just backfires. They avoid preventive care and end up hospitalized with expensive and life-threatening illnesses that are much worse and more costly. Read more »

*This blog post was originally published at EverythingHealth*

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 »

Commented - Most Popular Articles