January 24th, 2011 by EvanFalchukJD in Opinion, Research
Tags: Best Doctors, Commonwealth Fund, Don't Get Sick, Evan Falchuk, Global Health Rankings, Global Healthcare, Healthcare Consumers, Healthcare Trends, Higher Healthcare Costs, International Health Ratings, National Healthcare Costs, New U.S. Healthcare System, See First Blog, Towers Watson, Worst Healthcare In The World
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The worst healthcare system in the world is the United States, of course. Oh no, wait — it’s Canada. Actually, it could be Germany. Geez, now I think it might be the UK.
You could go on and on like this, but you know what? No matter how good or bad your healthcare system is, there are certain universal truths. Here are four of them that might make you look at global healthcare a little differently:
First, healthcare is getting more expensive, all over the world. A new study by the global consultant, Towers Watson (disclosure: Towers Watson is a Best Doctors client) found that the average medical cost trend around the world will be 10.5 percent in 2011. In the advanced economies costs will rise by an average of 9.3 percent. While Americans tend to think of rising medical costs as a uniquely American problem (they’ll rise by 9.9 percent here), it’s just not true. Canadian costs will rise by 13.3 percent. In the UK and Switzerland, they will increase by 9.5 percent, and in France by 8.4 percent.
Why is it happening? As ever, the main drivers are the increasing availability of new medical therapies — and inappropriate use of care. We see the same phenomenon at Best Doctors in our global experience. Across the world, our data for 2010 showed that just over 20 percent of patients had an incorrect diagnosis, and about half were pursuing inappropriate treatment plans. Read more »
*This blog post was originally published at See First Blog*
January 23rd, 2011 by Peggy Polaneczky, M.D. in Opinion, Research
Tags: Anti-depressants, Breast Cancer Risk, Celexa, Citalopram, Dr. Peggy Polaneczky, Effexor, Escitalopram, Estrogen Replacement Therapy, Gynecology, Hormone Replacement Therapy, Hot Flashes, HRT, JAMA, Journal of the American Medical Association, Lexapro, Menopause, Paxil, Placebo, PMS, Premenstrual Syndrome, Prozac, SNRIs, SSRIs, Tamoxifen, TBTAM, The Blog That Ate Manhattan, Women's Health, Zoloft
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In a well done placebo-controlled study published in this week’s Journal of the American Medical Association (JAMA), use of escitalopram (Lexapro) reduced hot flashes in menopausal women.
Investigators enrolled 205 women, randomizing them to either Lexapro 10 mg or placebo, with instructions to increase to two pills a day if needed after four weeks. Lexapro users experienced about a 60 percent reduction in hot flash frequency over the eight-week study. About half ended up on the larger 20 mg daily dose by study’s end. The drug’s effect was apparent at about one week of use, and it was well tolerated.
As in almost studies of menopausal treatments, the placebo group also experienced a significant reduction in symptoms — about 40 percent — but the difference between placebo and drug groups was significant. Compared to placebo users, Lexapro users had a bigger rebound of symptoms when stopping their treatment, were more satisfied, and more likely to want to continue the study drug, another validation of the drug’s efficacy. Read more »
*This blog post was originally published at tbtam*
January 23rd, 2011 by admin in Opinion, True Stories
Tags: ACP Internist, Age 65, Aging, America's Seniors, American College Of Physicians, Baby Boomers, Doula, Dr. John Schumann, Fountain Of Youth, Geriatrics, Giving Back During Retirement, GlassHospital, Healthcare reform, Longevity, Medicare, Older Adults, Patient Protection and Affordable Care Act, PPACA, Retirement and Health, The Age Of Seniority
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This is a guest post by Dr. John Schumann.
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In 2011, the first wave of baby boomers will turn 65 years old. Sixty-five still has currency because that’s the age at which non-disabled Americans are eligible to be covered under the Medicare program (now itself having reached middle age).
As our economy continues to recover (hopefully) from the Great Recession, the entrance of millions of Americans to the Medicare rolls over the next decade and a half will be a formidable planning challenge. Look at this chart to see how the baby boomers population has surged:
So is the promise of healthcare reform (the “PPACA“), which will enlarge Medicaid by an additional 16 million Americans — about half of the projected growth in coverage for those currently uninsured.
A couple of recent patient encounters got me thinking about these phenomena, and how we are very much in historically uncharted territory. Never have we had so many living so well for so long. We have an entire generation of people reaching “seniority” who will continue to want the most out of life, without many guideposts on how to achieve it. Read more »
*This blog post was originally published at ACP Internist*
January 22nd, 2011 by GarySchwitzer in Health Policy, Opinion
Tags: BMJ, British Medical Journal, Direct-To-Consumer Genetic Testing, Gary Schwitzer, Genetics, HealthNewsReview.org, Irresponsible Medical Marketing, Marketing of Genetic Tests, Overdiagnosis, Overmedicalization, Overtesting, Personal Genetic Testing, Ray Moynihan
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In a recent issue of the British Medical Journal (BMJ), journalist Ray Moynihan wrote: “Beware the fortune tellers peddling genetic tests.” (Subscription required for full access.) Excerpts:
“For anyone concerned about the creeping medicalisation of life, the marketplace for genetic testing is surely one of the latest frontiers, where apparently harmless technology can help mutate healthy people into fearful patients, their personhood redefined by multiple genetic predispositions for disease and early death.
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Again a tool that’s proved useful in the laboratory has escaped like a virus into the marketplace, incubated by entrepreneurs, lazy reporters, and the power of our collective dreams of technological salvation, this time in the form of personalised medicine to treat us according to our individual genetic profiles.
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Evaluating genetic tests is a complex business, requiring assessment of how well the test measures what it claims to measure, how well the genetic variation predicts actual disease, how useful the results are in terms of treatment, and what the social and ethical issues might be. Clearly there’s potential for exaggerating the value of a genetic test, which is one reason Germany has imposed severe restrictions on direct-to-consumer testing. In the United States they’re talking of a new test registry on a government website, raising immediate concerns that it could lend legitimacy to unproved and potentially harmful products. Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
January 22nd, 2011 by admin in Opinion, True Stories
Tags: Dr. Steven Reznick, Patient Advocacy
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This is a guest post from Dr. Steven Reznick.
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Patient Advocacy: It’s Worth The Effort
I have a 61-year-old patient who has been seen in my practice for over thirty years. When she first started developing strange aches and pains as well as abdominal symptoms, her evaluation turned up nothing. At that point she was very active: Playing ball with her two growing sons and dancing the nights away wearing out dance partner after dance partner at community social functions.
When I could not determine the cause of her ills, I asked for help at reputable places including the University of Miami rheumatology division and gastroenterology division. Like so many illnesses, the disease remained a mystery until it was ready to show itself and until technology and progress developed diagnostic tools to allow us to see what is actually there. With the help of a brilliant local gastroenterologist and rheumatologist, and after trips to Johns Hopkins Medical Center and the Mayo Clinic, collagenous colitis and sarcoidosis were documented. In the interim, local medical doctors and her friends branded this poor woman as “another neurotic spouse of a doctor who liked narcotics.”
She developed a peripheral neuropathy, which meant her feet and legs hurt all the time with burning/shooting discomfort exacerbated by walking. She went from dancing the Lindy to hobbling with the assistance of her husband, and a cane from the bedroom to her kitchen. She would then have to sit down, massage her legs, and put on thick-cushioned sweat socks to tolerate the foot and leg discomfort. Read more »
