November 8th, 2009 by Richard Cooper, M.D. in Better Health Network, Opinion
Tags: Atlas, Dartmouth, Healthcare reform, Outcomes, Poverty, Practice Variation, Quality, Regional Variation
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Is poverty the major factor underlying geographic variation in health care? It assuredly is. There is abundant evidence that poverty is strongly associated with poor health status, greater per capita health care spending, more hospital readmissions and poorer outcomes. It is the single strongest factor in variation in health care and the single greatest contributor to “excess” health care spending. It should be the focus of health care reform but, sadly, many provisions in the current bills will worsen the problem.
Much of this is discussed elsewhere on this blog and in our recent “Report to The President and The Congress.” In this posting, I would simply like to tap into your common sense. We all know that poverty is geographic. There are wealthy neighborhoods and impoverished ones, rich states and poor ones, developed countries and developing ones. Sometimes poverty is regional, as in Mississippi, but sometimes it’s confined to “poverty ghettos,” as in the South Bronx. Read more »
*This blog post was originally published at PHYSICIANS and HEALTH CARE REFORM Commentaries and Controversies*
November 6th, 2009 by Emergiblog in Better Health Network, Opinion
Tags: Best Practices, Blogging, Emergency Medicine, Fired For Blogging, Nurse Expelled, Nursing
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The story of the nursing student who was expelled for blogging got me thinking.
(If you haven’t heard the story, check out What Can Nursing Students Blog About? at Code Blog, with an update at Kevin, MD)
Just what can you write about on your blog?
Well, you can write on just about any topic.
It’s not a case of what you say, it’s how you say it. Read more »
*This blog post was originally published at Emergiblog*
November 6th, 2009 by GruntDoc in Better Health Network, Opinion
Tags: Costs, Finance, healthcare, Just To Be Sure, Unnecessary Testing
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Kevin, MD linked to this, and I really must comment.
Here’s the abstract, and I hope you’ll read it all:
For years I’ve heard friends describe experiences of being caught in a web of excessive and unnecessary medical testing. Their doctors ordered test Z to investigate a seemingly incidental finding on test Y, which had come about because of a borderline abnormality on test X.
I often wondered why test X was done in the first place. As a primary care physician, I would have treated them for the likely diagnosis and done diagnostic tests — especially a series of diagnostic tests — only if they didn’t respond as expected…. Read more »
*This blog post was originally published at GruntDoc*
November 4th, 2009 by KevinMD in Better Health Network, Opinion
Tags: AAP, Autism, Blogs, Ethics, Facebook, Medbloggers, Physicians, Social Media, Twitter, Vaccines
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Some physicians may be hesitant to participate in social media outlets, like Facebook and Twitter.
Well, get over it.
Great post by pediatrician Bryan Vartabedian who addresses this topic. Indeed, physicians have lost control of the online message, especially with, according to recent data, 60+ percent of patients visiting the web first when looking for health information.
Instead, anti-vaccine proponents and homeopaths have embraced the Internet, and now exert tremendous influence on patients. We doctors have no one to blame but ourselves for being so slow to get online. Read more »
*This blog post was originally published at KevinMD.com*
November 4th, 2009 by DrRich in Better Health Network, Health Policy, Opinion
Tags: BMI, Cardiology, Evidence, Otis Brawley, Politics, Preventive Health, Preventive Medicine, Screening
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As a class of human beings, cardiologists do not enjoy subtlety or nuance. Indeed, the reason most of them chose to specialize in cardiology, as opposed to specializing in some other organ system, is that the heart is the most unsubtle organ in the body. Unlike, say, the liver or the kidneys or even the brain (which, after all, just sit there), the heart does something quite obvious, and furthermore it does it 50 – 100 times per minute (so that even a physician with a very short attention span is likely to notice).
So perhaps it is not surprising that cardiologists seem to have entirely failed to mark certain emerging – and quite subtle – currents in the “preventive health” movement, and accordingly, continue to unabashedly seek more and more “preventive tools,” whatever the cost, with all the sensitivity and social awareness of the cousin who obliviously shows up at the funeral of the family priest wearing a pro-choice lapel pin. Read more »
*This blog post was originally published at The Covert Rationing Blog*
