January 4th, 2011 by AndrewSchorr in Better Health Network, Health Tips, Opinion, Research
Tags: "One Size Fits All" Healthcare, Andrew Schorr, Empowered Patients, General Medicine, Patient Advocacy, Patient Advocate, Patient Empowerment, Patient Power, Personalized Health, Personalized Healthcare, Personalized Medicine, Self-Care
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You are an individual right? To your mom and dad you are/were like no other. Hopefully your family and friends continue to see you as one-of-a-kind. Had you considered your doctor should see you that way too? Not as yet another one with diabetes, or heart disease, or cancer, but as a singular human being with biology that may be different from even the next person through the door with the same diagnosis.
This is the age of “personalized medicine” and it will accelerate in 2011. It is our responsibility as patients to ensure the power of this concept is leveraged for us each time we interact with the healthcare system. This is especially true as we manage a serious chronic condition or a cancer.
Now, in research and in clinical practice there are refined tests to determine what our specific version of a disease is and there are tests to see how a targeted therapy is working in our bodies. In other words, there’s the opportunity to see which therapy might be right for us that might be different than what is right for another person, and then there is the opportunity to monitor the therapy early on to see if it is doing its job. Read more »
*This blog post was originally published at Andrew's Blog*
January 4th, 2011 by PeterWehrwein in Better Health Network, Opinion
Tags: anti-aging, Bisphosphonates, Concussion, CPR Guidelines, Dabigatran, Harvard Health Blog, Harvard Health Letter, Harvard Medical School, Harvard University, Head Injury, Healthcare reform, Lung Cancer Screening, Osteoporosis, Peter Wehrwein, Pradaxa, remote monitoring, Smartphones and Medical Apps, Stem Cell Research, Top Health Stories of 2010, Vitamin D Guidelines, Warfarin
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1. Health care reform
How could the health care reform legislation that President Barack Obama signed into law on March 23, 2010, not be the #1 story of the year? Whether you are for or against it, the Patient Protection and Affordable Care Act is nothing if not ambitious, and if implemented, it will fundamentally alter how American health care is financed and perhaps delivered. The law is designed to patch holes in the health insurance system and extend coverage to 32 million Americans by 2019 while also reining in health care spending, which now accounts for more than 17% of the country’s gross domestic product. The biggest changes aren’t scheduled to occur until 2014, when most people will be required to have health insurance or pay a penalty (the so-called individual mandate) and when state-level health insurance exchanges should be in place. The Medicaid program is also scheduled to be expanded that year so that it covers more people, and subsidized insurance will be available through the exchanges for people in lower- and middle-income brackets. But plenty is happening before 2014. The 1,000-page law contains hundreds of provisions, and they’re being rolled out in phases. This year, for example, the law created high-risk pools for people with pre-existing conditions, required health plans to extend coverage to adult children up to age 26, and imposed a 10% tax on indoor tanning salons. Next year, about 20 different provisions are scheduled to take effect, including the elimination of copayments for many preventive services for Medicare enrollees, the imposition of limits on non-medical spending by health plans, and the creation of a voluntary insurance that will help pay for home health care and other long-term care services received outside a nursing home. Getting a handle on the complicated law is difficult. If you’re looking for a short course, the Kaiser Family Foundation has created an excellent timeline of the law’s implementation (we depended on it for this post) and a short (nine minutes) animated video that’s one of the best (and most amusing) overviews available. The big question now is whether the sweeping health care law can survive various legal and political challenges. In December, a federal judge in Virginia ruled that the individual mandate was unconstitutional. Meanwhile, congressional Republicans have vowed to thwart the legislation, and if the party were to win the White House and control of the Senate in the 2012 election, Republicans would be in a position to follow through on their threats to repeal it.
2. Smartphones, medical apps, and remote monitoring
Smartphones and tablet computers are making it easier to get health care information, advice, and reminders on an anywhere-and-anytime basis. Hundreds of health and medical apps for smartphones like the iPhone became available this year. Some are just for fun. Others provide useful information (calorie counters, first aid and CPR instructions) or perform calculations. Even the federal government is getting into the act: the app store it opened this summer has several free health-related apps, including one called My Dietary Supplements for keeping track of vitamins and supplements and another one from the Environmental Protection Agency that allows you to check the UV index and air quality wherever you are. Smartphones are also being used with at-home monitoring devices; for example, glucose meters have been developed that send blood sugar readings wirelessly to an app on a smartphone. The number of doctors using apps and mobile devices is increasing, a trend that is likely to accelerate as electronic health records become more common. Check out iMedicalapps if you want to see the apps your doctor might be using or talking about. It has become a popular Web site for commentary and critiques of medical apps for doctors and medical students. Meanwhile, the FDA is wrestling with the issue of how tightly it should regulate medical apps. Some adverse events resulting from programming errors have been reported to the agency. Medical apps are part of a larger “e-health” trend toward delivering health care reminders and advice remotely with the help of computers and phones of all types. These phone services are being used in combination with increasingly sophisticated at-home monitoring devices. Research results have been mixed. Simple, low-cost text messages have been shown to be effective in getting people wear sunscreen. But one study published this year found that regular telephone contact and at-home monitoring of heart failure patients had no effect on hospitalizations of death from any cause over a six-month period. Another study found that remote monitoring did lower hospital readmission rates among heart failure patients, although the difference between remote monitoring and regular care didn’t reach statistical significance. Read more »
*This blog post was originally published at Harvard Health Blog*
January 3rd, 2011 by Michael Kirsch, M.D. in Opinion, Research
Tags: Alzheimer's Disease, Dr. Michael Kirsch, General Medicine, Genetics, MD Whistleblower, Missed Diagnosis, New York Times, Overtesting, Quality of Life, Risk Vs. Harm, Risks vs. Benefits, Too Many Medical Tests, Too Much Testing, Unnecessary Medical Tests, Unnecessary Testing, Value Of Medical Tests
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The medical profession’s ability to diagnose far exceeds its ability to effectively treat the conditions discovered. Consider arthritis, Parkinson’s disease, irritable bowel syndrome, strokes, emphysema, and many cancers.
When a physician orders a diagnostic test, ideally it should be to answer a specific question, rather than a buckshot approach. A chest X-ray is not ordered because a patient has a cough. It should be done because the test has a reasonable chance of yielding information that would change the physician’s advice. If the doctor was going to prescribe an antibiotic anyway, then why order the chest X-ray?
Physicians and patients should ask before a test is performed if the information is likely to change the medical management. In other words, is a test being ordered because physicians want to know or because we really need to know the results?
Does every patient with a heart murmur, for example, need an echocardiogram, even though this test would be easy to justify to patients and to insurance companies? If the test won’t change anything, then it costs dollars and makes no sense. Spine X-rays for acute back strains are an example of a radiologic reflex. Read more »
*This blog post was originally published at MD Whistleblower*
January 3rd, 2011 by EvanFalchukJD in Health Policy, Opinion
Tags: Best Doctors, Buying Health Insurance, Commerce Clause, Evan Falchuk, Fixing American Healthcare, Forced To Buy Health Insurance, Government-run Healthcare, Health Reform Law, Healthcare Law, Healthcare reform, Law and Medicine, New U.S. Healthcare System, Unconstitutional, Virginia Healthcare Decision
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Unconstitutional? How can the mandate to buy health insurance be unconstitutional? It must be some kind of misguided resistance to progressivism. Or maybe it’s someone finally taking a stand against a power-grabbing government program.
But it’s actually about something else entirely. And if you don’t know what it is, you won’t understand why the Virginia court ruled the way it did. Here’s the secret:
The U.S. Constitution grants to the federal government certain powers. These are things like raising an army, controlling currency and establishing courts. It also gives it the power to regulate interstate commerce, through something called the “Commerce Clause.” Everything else is the domain of the states.
Notice that the Commerce Clause only gives the federal government power over interstate commerce. The word “interstate,” in 1789, was probably easy to understand. Since the original 13 states were more like little countries, than part of one big country, the idea of trading goods from one state to another was identifiable as a special kind of thing. Read more »
*This blog post was originally published at See First Blog*
January 1st, 2011 by GarySchwitzer in Better Health Network, Opinion
Tags: Gary Schwitzer, Health News Articles, Health News Coverage, Health News Review, Healthcare Journalists, Healthcare PR, Healthcare Public Relations, Healthcare Reporters, HealthNewsReview.org, Medical Reporting, Reporting Health News, Responsible Health Reporting, Responsible Reporting, Year In Review
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Healthcare journalists are buried under a mountain of public relations material sent to them every day of every week of every month. I don’t even work in a traditional news setting, yet I’ve made it onto the distribution lists of countless PR people.
The picture on the left shows a pile of video news releases sent to one TV health news reporter over a relatively short time span.
Here’s my year end look at just some of what was sent to me this year. Imagine what the New York Times, USA Today, the TV networks, and others receive.
I get countless emails from PR people offering interviews with their experts on:
• Seasonal Affective Disorder (SAD) — including an offer of an interview with a “celebrity trainer” who claims to have trained Julia Roberts, Cindy Crawford, Jennifer Aniston, Claudia Schiffer, and Kim Kardashian. (Were they all SAD?)
• A leading NY dermatologist invited me to “sip on champagne” and sample his new “daily nutrition for skin” cream.
• “For the more than 50 million Americans suffering from frequent heartburn, the thought of Halloween celebrations can truly be scary.” — PR for NYC gastroenterologist who is also consultant to makers of a heartburn drug. One of his tips: “Don’t just stock up on treats, prep your medicine cabinet” with the proton pump inhibitor of the company for whom he consults. Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
