December 3rd, 2010 by StevenWilkinsMPH in Better Health Network, Health Tips, Opinion, Research
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“I recommend.” These are two word which, when spoken by a physician to a patient have tremendous power to change behavior. That assumes of course a trusting relationship between patient and physician (but that’s a topic for another day.)
Take the colonoscopy. The U.S. Preventive Services Task Force (USPSTF) recommends that adults aged ≥50 years get a colonoscopy every 10 years. In 2005, 50 percent of adults aged ≥50 years in the U.S. had been screened according to these recommendations. Not surprisingly, the rate of colonoscopy screening is much lower than that of other recommended adult preventive services. I was curious: Why?
Here are two interesting facts:
1. Studies show that patients cite “physician recommendation” as the most important motivator of colorectal screening. In one study, 75 to 90 percent of patients who had not had a colonoscopy, said that their doctor’s recommendation would motivate them to undergo screening.
2. In that same study, in 50 percent of patients where a colonoscopy was appropriate but not done, the reason given was that the physician simply did not “bring up” the subject during the visit. Reasons included lack of time, visit was for acute problem, patient had previously declined or forget. Read more »
*This blog post was originally published at Mind The Gap*
December 3rd, 2010 by Linda Burke-Galloway, M.D. in Better Health Network, Health Policy, News
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Women who own individual healthcare policies, please take note. Should you become pregnant in the future, your individual healthcare policy might not cover your pregnancy.
A recent article in the Los Angeles Times by Michelle Andrews was revealing. Andrews described the plight of a North Carolina biology teacher who subsequently left teaching after the birth of her twins. She became a small business owner and was covered under individual health insurance policies. However, when she became pregnant again, she had a rude awakening. Despite paying an insurance premium of $400 per month, her pregnancy wasn’t covered unless she had paid for a special rider, prior to becoming pregnant. Since half of all pregnancies are “unplanned” how can you pay for coverage six months in advance of an unplanned event?
On October 12, 2010, the Committee on Energy and Commerce produced a dismal report that revealed a total disregard and absence of concern for pregnant women and their unborn babies by the insurance industry. The Committee’s chairmen, Congressmen Henry Waxman and Bart Stupak revealed the following: Read more »
*This blog post was originally published at Dr. Linda Burke-Galloway*
December 2nd, 2010 by AnneHansonMD in Better Health Network, Health Policy, News, Opinion, Research
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In California, the U.S. district court has ordered that tens of thousands of prisoners be released to reduce overcrowding. The case, Schwarzenegger v. Plata, was argued this past Tuesday and the transcript is online.
This is relevant to a psychiatry blog because one of the arguments used in support of the releases is the contention that overcrowded facilities reduce access to mental health and medical services and that overcrowding causes mental deterioration and breakdown. The APA filed an amicus brief in the case, but the brief isn’t available online yet. (Keep an eye out for it here.)
The challenge with this case is that there is no (or extremely little) actual research to support the link between overcrowding and psychological problems. Correctional systems have spent a lot of time litigating issues — and experts make a fair amount of money working on these cases — without actual data. Read more »
*This blog post was originally published at Shrink Rap*
December 2nd, 2010 by KevinMD in Better Health Network, News, Opinion
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Medical students today consider lifestyle an essential criteria when choosing a specialty. It’s become a cliche that most are looking towards the ROAD (radiology, ophthalmology, anesthesiology and dermatology) to happiness.
There’s been some recent media attention at how women are lured to specialties that offer a greater balance between their family lifestyle and professional demands. Claudia Golden, a Harvard economics professor, recently noted that,
high-paying careers that offer more help in balancing work and family are the ones that end up luring the largest numbers of women. Surprisingly, colon and rectal surgery is one of these, because of rapid growth in routine colonoscopies that can be scheduled in advance, giving doctors control over their time. Goldin says 31% of colon and rectal surgeons under 35 years of age were female in 2007, compared with only 3% of those ages 55 to 64, and 12% of those ages 45 to 54, reflecting the fact that younger women are flocking to the field.
Of course, what’s not said is the grueling training that it takes to become a colorectal surgeon — but the numbers cited above do not lie. The new generation of doctors — both men and women — want greater control of their time. That means more shift-work and a predictable call schedule. Read more »
*This blog post was originally published at KevinMD.com*
December 2nd, 2010 by DrWes in Better Health Network, Health Policy, News, Opinion, Research
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Imagine having a medical device that is being tested in multiple centers, but one doctor thinks the device has problems. He says so at a national conference despite glowing reviews by others. Should the company sue the doctor for liable and remove him from their investigative panel?
Today, it seems that might not be such a good idea. This is, in fact, what NMT Medical did regarding comments made by Peter Wilmshurst, M.D. regarding NMT’s patent foramen ovale (PFO) closure device called Starflex:
NMT sued Dr. Wilmshurst for libel after he criticized its research at a US cardiology conference in 2007. The doctor vowed to take the case to trial in order to defend scientists’ rights to free academic debate.
The company threatened Dr. Wilmshurst with libel a second time for subsequent comments he made about the case on BBC Radio 4’s Today programme. Read more »
*This blog post was originally published at Dr. Wes*
