October 6th, 2010 by AlanDappenMD in Better Health Network, Health Tips, Opinion, True Stories
Tags: DocTalker Family Medicine, Dr. Alan Dappen, General Medicine, Health and Wellness, Integrating Wellness, Internal Medicine, MDHQ EHR, Patient-Centered Care, Patient-Centered Medicine, Patient-Centeredness, Practicing Wellness, Primary Care
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I often am asked how I incorporate wellness in our family medical practice, and I must admit that I’ve mixed feelings when it comes to the question because it implies that I’m not already trying to practice wellness simply by practicing medicine. I feel that the two are synonymous.
To those who want to know more about wellness and primary care, here’s my approach:
• I never try to sell anyone on a “wellness” program.
• I follow specific guidelines on certain chronic illnesses, mostly adhering to evidence-based guidelines and not expert opinion or opinion by committee.
• I offer the best advice I can to patients and try to guide them in the right direction when I feel they are taking pathways that worry me and that could be harmful (e.g. like using megavitamin and nutrient therapies or colonics, to name a few).
• I try to be as cost effective as possible when it comes to treatment.
• I see our patients once a year to comply with the legal definition of “face-to-face visits,” but not because scientific evidence substantiates this time honored ritual as “wellness.”
• I use calendar reminders in our electronic health record, MD-HQ to set up needed labs like cholesterol or Hgba1C or to schedule flu shots based on guidelines.
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October 6th, 2010 by Dinah Miller, M.D. in Better Health Network, Health Tips, Opinion
Tags: Ability To Practice Medicine, Bipolar Disorder, Bipolar Doctor, Doctor's Ability, Doctor's Personal Life, Doctor's Well-Being, Dr. Dinah Miller, Emotional Health, Emotional Well-Being, Mental Health, Personal Illness, Physician Health, Practicing Medicine, Psychiatric Disorder, Psychiatry and Psychology, Psychological Challenge, Psychological Disturbances, Psychological Health, Shrink Rap
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“I have bipolar disorder. Can I be a doctor?” One of our readers asked this. It’s one of those questions to which there is no real answer.
Being a doctor takes a long time, it requires reliability, diligence, and a willingness to learn things you may not want to learn (organic chem anyone?) and do things you may not want to do. It requires endurance and passion. You need to be tolerant of many things: Arrogant supervisors, irritable colleagues, sick people who may not be charming and who may, in their distress, be downright nasty. You have to tolerate a militaristic order and be willing to work with a system that may be very difficult, wrong, and demand your obedience in ways that may be uncomfortable. (Oh, I am so happy to no longer be a medical student or a resident in training.)
So can you do it with bipolar disorder? Can you do it with diabetes? Can you do it with attention deficit problems? Can you do it if you’re disorganized or ugly? Read more »
*This blog post was originally published at Shrink Rap*
October 6th, 2010 by EvanFalchukJD in Better Health Network, Health Policy, Health Tips, Opinion, True Stories
Tags: America's Most Innovative Companies, Best Doctors, Charlie Salter, ConAgra, Cutting Healthcare Costs, Employee Health, Employee Healthcare Benefits, Employees Engaged In Healthcare Decisions, Employees Who Manage Their Own Healthcare, Employer Healthcare Contributions, Employer-Provided Health Coverage, Evan Falchuk, Family Medicine, Flat Healthcare Cost Trend, General Medicine, Health Insurance, Health Plan, Health Savings Account, HSA, Internal Medicine, Large Companies, Large Employers, Navigating the healthcare system, Preventive Health Services, Preventive Healthcare, Preventive Medicine, Primary Care, Real Healthcare Reform, U.S. Corporations, Wrong Diagnosis, Wrong Treatment
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“We want our employees to spend their time on real issues,” said Charlie Salter, VP of Benefits at ConAgra. He means it. Charlie and ConAgra have built their healthcare benefits around some simple concepts that are yielding impressive results. How impressive? Close to flat healthcare cost trend since 2007.
Charlie’s work is part of a growing trend among America’s most innovative companies: Designing healthcare benefits in ways that have a real impact on quality and cost. It’s why I [recently] asked Charlie to share the podium with me in Boca Raton. ConAgra is showing it’s possible to control healthcare costs by helping people do the right thing.
The vision behind ConAgra’s programs is simple: Employees have to be responsible for managing their own care. But, says Charlie, this is easy to say, harder to do. “So we do as much as we can to make it as easy for people to do the right thing.” ConAgra gives its employees a significant financial stake in their well-being, through a health plan that has a $1,500 deductible. ConAgra supplements the plan with a health savings account (HSA) that lets workers use pre-tax dollars to pay for the deductible. Like other HSAs, any money the employee doesn’t spend is theirs to keep. It means employees are more engaged in healthcare decisions. Read more »
*This blog post was originally published at See First Blog*
October 6th, 2010 by BobDoherty in Better Health Network, Health Policy, News, Opinion, True Stories
Tags: ACP Advocate, American College Of Physicians, Bob Doherty, Fred Flintstone, Health Reform Hits Main Street, Healthcare reform, Kaiser Family Foundation, Patient Protection and Affordable Care Act, PPACA, Public Awareness, Public Health Initiative, Public Knowledge, The Flintstones, You Toons
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Like most kids who grew up in the 1960s, I spent many a night watching the adventures of Fred, Wilma, Barney and Betty, the coolest cavemen ever (sorry, GEICO). It is hard to explain the appeal of the Flintstones, which [recently] celebrated the 50th anniversary of its first broadcast. Its animation was primitive, the stories campy and cliché, and it was horribly sexist — but the characters were lovable, the dialogue funny, and who couldn’t love the way it depicted “modern conveniences” (like washing machines) using only stone-age technologies (bones, stones and dino-power?)
What does Fred Flintstone have to do with healthcare? Not much, really, although Fred was the victim of a medical error. According to Answers.com: “A 1966 episode had Fred can’t stop sneezing, so he goes to the doctor for some allergy pills. The prescription gets mixed up with another package of pills which, when taken, transform Fred into an ape! Only Barney witnesses this metamorphosis, and naturally he can’t convince anyone what is happening … until a fateful family outing at the Bedrock Zoo.” (Of course, this all might have been prevented if they had e-prescribing in those days.) Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
October 5th, 2010 by GarySchwitzer in Better Health Network, Health Policy, Health Tips, News, Opinion, Research, Video
Tags: AP, Associated Press, Breast Cancer Prevention, Breast Cancer Research, Breast Cancer Screening, Cancer Journal, Dr. Russell Harris, Evidence-Based Health Reporting, Gary Schwitzer, Government, Health Journalism, HealthDay, HealthNewsReview.org, Inaccurate Health Reporting, LA Times, New York Times, North Carolina School of Public Health, Overtesting, Preventive Health, Preventive Medicine, Preventive Screening, Swedish Mammography Study, Too Much Testing, U.S. Preventive Services Task Force, Unnecessary Testing, USPSTF
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We reviewed four stories on the Swedish mammography study that appeared in the journal Cancer last week. Three of the four stories gave a pretty clear indication that there were methodological concerns about the Swedish research (of the four reviewed, only HealthDay offered no such hint):
• 4th paragraph of AP story: “The new study has major limitations and cannot account for possibly big differences in the groups of women it compares.”
• 1st paragraph of LA Times blog story: “Critics charged that the study was poorly designed and potentially vastly misleading.”
• 2nd sentence of NY Times story: “Results were greeted with skepticism by some experts who say they may have overestimated the benefit.”
But none of the stories did a very complete job of explaining those potential limitations. Because of the confusion that must be occurring in the minds of women — especially those in their 40s — this is a time in which journalism must rise to the need and do a better job of evaluating evidence and helping readers make sense of what appear to be conflicting findings.
I was in Chapel Hill, North Carolina, when the study was published and had the chance to talk about it with former U.S. Preventive Services Task Force member, and a recognized thought leader on issues of prevention and especially of screening tests, Dr. Russell Harris, Professor and Director of the Health Care and Prevention Concentration of the University of North Carolina (UNC) School of Public Health. Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
