August 6th, 2011 by Dr. Val Jones in Opinion, True Stories
Tags: Advice, Exercise, fat loss, Fitness, Help, High-Protein Diet, Lean Mass, Weight Loss
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I’m feeling rather nauseated today. This is my fifth day of a high-protein, low-fat, low-carb diet, and I have already developed a deep-seated hatred of egg whites. My regimen includes uncomfortable quantities of grilled chicken breast, fat-free cottage cheese, Greek yogurt, and egg protein, occasionally garnished with a lettuce leaf or perhaps a blueberry. Just yesterday I had to drink a plastic test tube of liquid protein to meet my goals (see offending product image to the left). It looked like a blood-tinged albumin sample, and tasted like orange flavor crystals with a splash of soy sauce.
I know that the scientific literature (if we distill it and perhaps oversimplify it a bit) seems to suggest that there may be a short-term advantage to high-protein diets in terms of weight loss, but that this advantage fades after a year. Yet almost every trainer and athlete I’ve encountered keeps telling me that the only way to get “really lean” is to eat unimaginable amounts of protein, avoid refined carbs, dramatically limit the complex carbs, and dial down the fat intake. Essentially, I must be reduced to swilling test tubes of orange-soy “albumin.”
When I strenuously protested the diet plan presented to me by my trainer, she simply said, “If you care what food tastes like then you’re not serious about losing fat.”
“Well how long do I need to consume 50% of my calories as protein?” I asked meekly, assuming that there would be an end point in sight. Read more »
August 5th, 2011 by Jessie Gruman, Ph.D. in Health Policy, Opinion
Tags: Active, Civil Rights Movement, Consumer, Doctor, Employees, Empower, Empowered Patient, Engaged, Health Care Consumer, HIPAA, Informed, Jessie Gruman, Knowledgeable, Medical Home, Patient, Paul Ryan, Uwe Reinhardt
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“There is a better way – structural reforms that empower patients with greater choices and increase the role of competition in the health-care marketplace.” Rep. Paul Ryan (R-WI) August 3, 2011
The highly charged political debates about reforming American health care have provided tempting opportunities to rename the people who receive health services. But because the impetus for this change has been prompted by cost and quality concerns of health care payers, researchers and policy experts rather than emanating from us out of our own needs, some odd words have been called into service. Two phrases commonly used to describe us convey meanings that mischaracterize our experiences and undervalue our needs: “empowered patient” and “health care consumer.”
As one who has done serious time as a patient and who spends serious time listening to talks and reading the literature that use these words to describe us, I ask you to reconsider their use.
“Empowered patient” The fabrication of the verb “to empower” from the noun “power” was used in the civil rights and community development movements to describe a benevolent bestowal of influence on disenfranchised individuals and groups by those who had previously excluded them. When used in relation to health care, the word perpetuates the idea that we are passive entities, waiting to be gratefully endowed by our clinician or a new policy with the right and ability to act on our own behalf. Our “empowerment” takes place not as a result of our own will or preference, but rather because we have been given permission to act in a different way by some external agent.
This word is Read more »
*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*
August 5th, 2011 by AnnMacDonald in Opinion, Video
Tags: Anxiety, Dr. Szymanski, Harvard Medical School, Health, International OCD Foundation, Mental Health, Obsessive Compulsive Disorder, OCD, Psychiatry, Psychology, Psychotherapy, Rituals, The Perfectionist's Handbook, Therapy
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When I leave for work in the morning, I go through my precommute checklist. Train pass, check. Wallet, check. Coffee mug, check. Smart phone, check. Keys to the house, check. Only when I’m sure that I have everything I need do I open the door and head outside.
Sometimes I worry that this morning routine is becoming too much of a ritual. Is it possible that I have obsessive-compulsive disorder (OCD for short)?
Probably not. The fact that I am able to get out the door every morning means that my daily ritual isn’t interfering with my ability to function, says Dr. Jeff Szymanski, a clinical instructor in psychology at Harvard Medical School.
You have OCD when obsessions and compulsive behavior Read more »
*This blog post was originally published at Harvard Health Blog*
August 4th, 2011 by AndrewSchorr in Opinion, Research
Tags: Blood-Thinning, Clinical Trials, Control Group, Coumadin, Deep Vein Thrombosis, Double Blind Study, DVT, Experimental Group, FDA Approval, Hokusai, Leukemia, Pharmaceutical Companies, Quintiles, Warfarin
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There are big companies like Quintiles that run clinical trials around the world. There are local clinics that specialize in clinical trials and make a lot of money at it. There are, of course, pharmaceutical companies and device manufacturers who depend upon the results to gain marketing approval for new products. People in all those groups know a lot about trials.
But the perspective that counts is the view from you and me – patients. Most of us do not enroll in clinical trials. We don’t want to get too up close and personal with anything “experimental.” And often our doctors never tell us about available trials anyway since it can be a lot of paperwork for them. Given that most people don’t enroll in trials and new science is delayed because of it and also because most people in trials are not journalists, I thought I’d put hunt and peck to the computer keyboard and speak out about trials. I am especially motivated because I have participated twice. The first one, a leukemia trial in 2000, I believe, saved my life. And I enrolled in a second one, studying a new drug for clots in the legs (deep vein thrombosis or DVT) just a week and a half ago.
I enrolled in the DVT trial because 1) the first one worked for me and 2) I crow all the time about how patients should always consider being in a trial as a treatment option. I had to put up or shut up. So I signed on the dotted line.
This particular trial, Read more »
*This blog post was originally published at Andrew's Blog*
August 4th, 2011 by StevenWilkinsMPH in Opinion, Research
Tags: Doctor-Patient Communication, Electronic Health Record, Group Health Cooperative, Journal of Internal Medicine, Medical Technology, Medicine, Next Big Thing, Patient, Patient Portal, Patient Satisfaction, Patient-centered service, Physician, Primary Care Physician, Provider-Patient Relationship, Seattle, Test Results
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There seems to be an inverse relationship between the amount of spin one hears about “the next big thing”…and reality. First it was EMRs and virtual e-visits, then social media, and now patient portals seem poised to be next big thing. The drumbeat of vendors and pundits is unmistakable….physicians that don’t adapt will be toast. It can all sound pretty convincing until you ask to see the evidence. What do patients think?
Take the physician patient portal. If you read between the lines, patient portals are frequently being positioned as the new “front door” to physician practices. By signing on to a secure website patients will have real time access to the electronic health record and will be able to communicate with their physicians by e-mail. Additional patient features include being able to schedule an appointment with their doctor, reading their test results and refilling prescriptions. But despite these features, according to John Moore at Chilmark Research, “nationwide use of patient portals remains at a paltry 6%.”
Ok… so now we know what vendors and pundits think about patient portals. What about patients – what do they think? Read more »
*This blog post was originally published at Mind The Gap*
