October 11th, 2008 by Dr. Val Jones in Expert Interviews
Tags: Obstetrics And Gynecology, Radiology, Technology, Women's Health
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Photo Credit: FUS Foundation
Did you know that one in three women will have a hysterectomy (surgical removal of the uterus) by age 60? It is the second most common surgical procedure among women in the United States. But the question is: are they all necessary? I had a fascinating interview with Dr. Elizabeth Stewart from the Mayo Clinic about some of the reasons behind the potential excess of this type of surgery. You may be surprised to learn that insurance reimbursement guidelines may have something to do with it.
Dr. Val: Women often undergo hysterectomies to treat painful fibroids (benign growths in the uterus). What do women need to know about their fibroid treatment options?
Dr. Stewart: They need to know that they have many different treatment options for uterine fibroids. A hysterectomy is not their only choice. Women should ask their doctor to explain all their options and also make sure that they have the correct diagnosis – menstrual cramping and heavy bleeding doesn’t necessarily mean you have fibroids.
Nowadays we can treat fibroids with hysterectomy, uterine artery ablation, or MRI-guided focused ultrasound surgery (MRgFUS). MRgFUS is a nearly painless procedure where we use focused ultrasound waves to destroy fibroid tissue via heat transfer. I know one woman who went back to work 2 hours after the procedure. Recovery from a hysterectomy or uterine artery ablation can take weeks to months.
Dr. Val: What are some of the advantages and disadvantages of treating fibroids with focused ultrasound? Read more »
October 9th, 2008 by Dr. Val Jones in Expert Interviews
Tags: Neurosurgery, Obstetrics And Gynecology, Radiology, Surgery
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I’ll admit it – when I was a kid, I admired Dr. Bones (McCoy) of Star Trek. He was a no-nonsense kind of guy who was very clear about his areas of expertise (“Damn it, Jim, I’m a doctor, not a spaceship engineer.”) But best of all, Dr. McCoy had special healing gadgets that he could wave over people for diagnostic and therapeutic purposes. Those “tricorders” fascinated me – and I always wished I could have one myself.
And now my dream could actually come true: advances in focused ultrasound technology (FUS) make non-invasive surgical procedures possible. I attended the very first international symposium about this new technology, and learned some very exciting things.
First of all, Dr. Ferenc Jolesz gave a riveting key note address about the history of focused ultrasound technology, and why modern advances have made this treatment modality feasible. Scientists have been fantasizing about heating tissues with sound waves since 1942 when the first ultrasound experiment was conducted on a liver tumor. Unfortunately back then, imaging studies (beyond X-rays) had not yet been developed – so it was virtually impossible to “see” one’s target.
However, now that magnetic resonance imaging (MRI) machines are capable of displaying our innards in exquisite detail Read more »
October 7th, 2008 by Dr. Val Jones in Expert Interviews, Medblogger Shout Outs
Tags: Chronic Disease, Finance, Guest Blogger Post, Hospitals, Politics
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Many thanks to my fellow blogger KevinMD who offered to host me during my period of blog homelessness. In this post, I interview Dr. Ken Thorpe about the real driver of healthcare costs:
About 75% of what we spend on healthcare is associated with chronically ill patients. That’s about 1.6 trillion dollars per year. Chronic disease accounts for the biggest source of spending in the healthcare economy, and it’s also the fastest growing – as more and more people are living with chronic illnesses. If we’re really serious about getting to the bottom of the healthcare affordability crisis, we’ll have to first address the chronic disease issue…
For the rest of the post, please click here.
September 17th, 2008 by Dr. Val Jones in Expert Interviews
Tags: Cardiology, Cardiovascular Surgery, Diabetes, Family Medicine, Internal Medicine, Pharmaceuticals, Podcast
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Peripheral Artery (Arterial) Disease (P.A.D.) is an under-recognized and under-diagnosed condition, yet it serves as an important warning sign for those at high risk for stroke and heart attack. Even though we have an inexpensive and non-invasive test for P.A.D. very few people have the test done. I interviewed Dr. Gary Schaer, Director of the Cardiac Cath Lab at Rush University Medical Center in Chicago, about P.A.D. and also spoke with actor Phylicia Rashad about her family’s trials and tribulations with P.A.D. This post is devoted to Dr. Schaer’s insights on the medical aspects of the disease, and the next post focuses on Ms. Rashad’s personal story. To listen to the entire podcast of our interview, please click here.
Read more »
July 30th, 2008 by Dr. Val Jones in Expert Interviews, Health Policy
Tags: Hospitals, Medicare, Technology
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I recently interviewed former Congresswoman Nancy Johnson about her views on health information technology (IT). She described her vision of an ideal IT solution, and what it should be able to do for physicians and patients. For the full interview, please check out my post at Medpolitics.com
Dr. Val: What would the ideal IT system look like?
Ms. Johnson: It would offer continuously updated evidence-based guidelines at the point of care for physicians. It would give patients clear information about what they should expect. It would enable physician social networks to promote learning and experience sharing with one another. It would promote continuous improvement of care practices, and track outcomes and results to continue refining healthcare delivery. Patients should be given check lists and preventive health guidelines, and be asked to provide feedback on any complications or unanticipated events.
If we could aggregrate deidentified patient information we would gain powerful insight into adverse drug events (or unanticipated positive effects) at the very earliest stages. It could be useful in identifying and monitoring epidemics or even terrorist incidents. This could advance medical science faster than ever before. Until we have all this information at our finger tips, we can’t imagine all the potential applications.
Dr. Val: Are you describing a centralized, national EMR?
Ms. Johnson: Not necessarily. But if systems are interoperable, it could function as one. I imagine it as a series of banks run by local administrators, but with the capability of sharing certain deidentified data with one another.
Dr. Val: Do you think the government should design this information system?
Ms. Johnson: No. You don’t want the government doing it alone. As much as I love the government and have been working in it for decades, it’s simply not good at updating and modernizing systems. You have to have a public-private partnership in this. The government should be involved to protect the public interest, and the private sector should be involved so that the system can be innovative, nimble, and easily updated.
Technology will bring us extraordinary new capabilities to manage our health, prevent illness, minimize the impact of disease on our lives, improve the ability of physicians to evaluate our state of health, allow us to integrate advances in medicine in a timely fashion, and quantify the impact of new inventions and procedures. All this, and IT will help us to promote prevention and control costs associated with acute care.
We have a high quality system now, but because it’s so disorganized, the patient doesn’t receive the quality they should. The incredible advances in technology that we have created should be available to all who need it. Unfortunately that’s not the case now.
If you look at Canada’s use of the specialist and specialist equipment along the US’s border with Canada, it says a lot about government run healthcare.
*See full interview at Medpolitics.com*This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
