October 21st, 2010 by Harriet Hall, M.D. in Better Health Network, Health Policy, Health Tips, News, Opinion, Research, True Stories
Tags: Dr. Harriet Hall, Dr. Mark Crislip, Dr. Steve Novella, Elderly Care, Fluzone, High-Dose Flu Vaccine, Immunization, Immunology, Influenza, Medicare, Older Adults, Patient Options for Preventive Care, Preventive Health, Preventive Medicine, SBM, Science Based Medicine, The Medical Letter, Vaccination, Vaccines
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Dr. Novella has recently written about this year’s seasonal flu vaccine and Dr. Crislip has reviewed the evidence for flu vaccine efficacy. There’s one little wrinkle that they didn’t address — one that I’m more attuned to because I’m older than they are.
I got my Medicare card last summer, so I am now officially one of the “elderly.” A recent review by Goodwin et al. showed that the antibody response to flu vaccines is significantly lower in the elderly. They called for a more immunogenic vaccine formulation for that age group. My age group. One manufacturer has responded. Read more »
*This blog post was originally published at Science-Based Medicine*
October 20th, 2010 by DrCharles in Better Health Network, Health Tips, Opinion, Research
Tags: ACOG, American Congress of Obstetricians and Gynecologists, American Family Physician, CAM, Complimentary and Alternative Medicine, Dietary Supplements, Dietetics, Family Medicine, Fetal Health, Healthy Baby, Healthy Diet, Healthy Pregnancy, Herbal Medicine, Natural Medicines, Nutritional Supplements, Obstetrics And Gynecology, Pregnancy and Childbirth, Prenatal Care, Prenatal Vitamins, Primary Care, The Examining Room of Dr. Charles, Vitamins and Minerals, Women's Health
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What is in a prenatal vitamin? Why do most doctors recommend them? Is there any evidence taking them is worthwhile? I decided recently that I would read through the ingredients of these vitamins, often touted as “essential vitamins and nutrients, crucial for the healthy development of your baby.” Hmmm. Does that mean eating traces of polyvinyl alcohol every day is beneficial?
The fine print ingredients of such brands as “One A Day”, “Centrum Materna”, “Rite Aid” and even the prescription only “Prenate Elite” are a confusing mess of milligrams, international units, RDA’s, and chemicals. As the makers of Centrum explain, “It is very challenging to formulate vitamins and minerals without the use of non-medicinal ingredients which serve to keep the product stable and to prevent the various ingredients from interacting.” They also find fault in the limited number of suppliers of the active ingredients in prenatal vitamins, and therefore claim substances like gelatin are difficult to avoid.
Let’s take a tour of the prenatal vitamin ingredient zoo. Read more »
*This blog post was originally published at The Examining Room of Dr. Charles*
October 20th, 2010 by EvanFalchukJD in Better Health Network, Health Policy, News, Opinion, Research
Tags: Archives of Internal Medicine, Best Doctors, Board-Certified Doctor, Comparative Quality of Physicians, Dr. Danielle Ofri, Evan Falchuk, General Medicine, Healthcare Quality, Healthcare reform, NEJM, New England Journal of Medicine, Non-Certified Foreign-Trained Doctor, Patient-Doctor Relationship, Phony Quality Measures, Quality Medical Care, Quality of Patient Care
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Who do you think is likely to be a better doctor: A board certified graduate of one of the top medical schools in America, or a non-certified doctor trained in a foreign country?
If your answer is “I have absolutely no idea,” then you’re probably spending a lot of time looking at the “report cards” that pass for measures of health care quality. And you’re probably confused.
Researchers in Pittsburgh studied 124 process-based quality measures in 30 clinical areas. These process measures are the state-of-the-art ways in which government and private insurers are checking up on the quality of medical care. They include things like making sure patients with heart problems are prescribed aspirin, and that women get Pap smears. The researchers compared these measures against other, simpler measures, like medical education, board certification, malpractice claim payments, and disciplinary actions.
The result? You couldn’t tell the differences among doctors. Read more »
*This blog post was originally published at See First Blog*
October 20th, 2010 by Shantanu Nundy, M.D. in Better Health Network, Health Policy, Opinion
Tags: Annual Exam, Annual Physical, BeyondApples.org, Disease Prevention, Dr. Shantanu Nundy, Family Medicine, General Medicine, Health and Wellness, Healthcare Maintenance, Healthcare reform, Internal Medicine, Preventative Health, Preventive Care, Preventive Health, Preventive Health Services, Preventive Healthcare, Preventive Medicine, Primary Care, Routine Care, Routine Checkup
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It’s a scene that plays out thousands of times every day in doctors’ offices across the country — the moment the doctor shifts from addressing the concerns that brought the patient into clinic to when he or she attempts to make sure everything else is going okay.
Often this happens at the end of a sick visit, after working up an upper respiratory infection or back pain. Sometimes it happens after following up a chronic medical problem such as high blood pressure or arthritis, and occasionally it happens under ideal circumstances, during an annual physical or routine wellness visit. It doesn’t necessarily happen at the end of the visit. Often it sneaks it’s way into various points in the encounter — as when the doctor places his or her stethoscope over a patient’s chest while evaluating for knee pain.
What I’m referring to is so indistinct that it doesn’t even have an universal name, but rather goes by many titles — “preventive health,” “preventative health,” “preventive medicine,” “preventive care,” “healthcare maintenance,” “routine healthcare,” “routine checkup,” “annual physical,” and “health and wellness” — to name a few.
But whatever you call it nearly everyone agrees how important it is. The healthcare reform debate was ripe with calls for more “health”-care not just “sick”-care, and one of the most welcome measures in the new healthcare legislation across both sides of the aisle are provisions to support it. Outside of Capitol Hill, from cereal boxes to magazine racks and celebrity doctors, messages about staying healthy are everywhere, as is the general belief that “an ounce of prevention is worth a pound of cure.” Read more »
*This blog post was originally published at BeyondApples.Org*
October 20th, 2010 by DrRich in Better Health Network, Health Policy, Opinion
Tags: American Healthcare, Amish Bus Driver Rule, Contractual Enterprise, Covert Rationing Blog, Doctors' Ethics, Dr. Rich, Ethical Enterprise, General Medicine, Healthcare reform, Healthcare Reform: Putting Patients First, Medical Profession, MSNBC, New U.S. Healthcare System, Patient-Doctor Relationship, Personal Convictions of Medical Professionals, Progressive Medical Ethics, Rachel Maddow
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Rachel Maddow, in a discussion related to the provision of abortion services, once proposed that we (society) should invoke the Amish Bus Driver Rule (ABDR) whenever medical professionals invoke their personal convictions in refusing to provide legal medical services.
The ABDR goes like this: If you’re Amish, and therefore have religious convictions against internal combustion engines, then you have disqualified yourself for employment as a bus driver. (Presumably Ms. Maddow would not apply the ABDR to everyone, since it would disqualify, for instance, Al Gore from utilizing horseless carriages and other fossil-fueled contrivances.)
The ABDR would do far more than merely render it okay for doctors to perform abortions and other ethically controversial (but legal) medical services. The ABDR would obligate physicians to provide such services, whatever their personal moral or religious convictions.
The reason DrRich brings this up is not because he considers Rachel Maddow to be the giver of rules for the left, or for the government, or even for MSNBC. Rather, he brings it up because the ABDR is entirely compatible with Progressive medical ethics, and therefore it has a pretty good chance, sooner or later, of becoming the official policy of our new healthcare system. Read more »
*This blog post was originally published at The Covert Rationing Blog*
