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Sugar Consumption: A “Deliciously Disgusting” Ad Campaign

New York City’s war on sugary soft drinks had to balance evidence-based medicine with a short, simple message that would go viral in the community. Going viral won, according to e-mails of internal discussions between the city’s health commissioner, his staff, and the ad agency that crafted the campaign. The statement that soda would cause a person to gain 10 pounds a year is contingent upon many factors, argued the staff, but the desire to produce a media message with impact overruled the details. One nutritionist called the campaign “deliciously disgusting.”

Chocolate may moderate HDL cholesterol in type 2 diabetics, according to the November issue of Diabetic Medicine. High polyphenol chocolate increased HDL cholesterol in diabetics without affecting weight, insulin resistance or glycemic control. Researchers enrolled 12 type 2 diabetics in a randomized, placebo-controlled double-blind crossover study to 45 g chocolate with or without a high polyphenol content for eight weeks and then crossed over after a four-week washout period. HDL cholesterol increased with high polyphenol chocolate (1.16+/-0.08 vs. 1.26+/-0.08 mmol/l, P=0.05) with a decrease in the total cholesterol: HDL ratio (4.4+/-0.4 vs. 4.1+/-0.4 mmol/l, P=0.04). No changes were seen with the low polyphenol chocolate.

With Halloween, sugar will be on everyone’s mind (and in everyone’s stomachs). To find out how many calories and how much fat that pile of Halloween candy totals, try this interactive module. (New York Times, Diabetic Medicine, ABC Chanel 7 News-Denver)

*This blog post was originally published at ACP Internist*

Teen Pregnancy Decline Is Likely As Low As It Will Go

Teen pregnancy rates have declined, but likely bottomed out, according to a report by the Centers for Disease Control and Prevention (CDC).

Teen births dropped by a third between 1990 to 2005, but rose again in 2006 and 2007. The latest figures for 2008 show a decline of 2.4 percent, to 41.5 pregnancies per 1,000 teenagers. Experts told My Health News Daily/MSNBC the dropping rates have bottomed out, and that new strategies are needed to deglamorize teen pregnancy.

Teen birth rates were consistently highest in states across the South and Southwest, and lowest in the Northeast and upper Midwest. In 2008, state-specific teenage birth rates varied widely, from less than 25.0 per 1,000 15-19 year olds (Connecticut, Massachusetts, New Hampshire, and Vermont), to more than 60.0 per 1,000 (Arkansas, Mississippi, New Mexico, Oklahoma, and Texas). Read more »

*This blog post was originally published at ACP Internist*

Implementing An EHR: 5 Quick Tips

Dr. Jay Anders, the CMIO of EHR vendor MED3000, offered a few tips during a Medical Group Management Association (MGMA) session on implementing an EHR successfully:

1. Make a clear communication pathway. Everyone needs to know what’s going on, from the physicians to the receptionist.

2. Clearly identify the needs of every physician who is going to use the EHR. The needs of an internal medicine doctor aren’t the same as a dermatologist. Make sure the EHR meets those needs.

3. Get a physician champion for the EHR who will be responsible for talking about the project to peers and answering questions, and be the first person to implement it. Pay that person for his or her time spent in championing duties.

4. Some people need more time than others. Don’t let a resistant doctor stop the implementation. Develop a plan for dealing with resisters that includes how you’ll respond to negative comments, how to implement other colleagues despite the resister, and how to sell the benefits of the EHR to the resister.

5. Expect the EHR implementation to be time-neutral. Most EHRs don’t save time; their value is in improved patient care and documentation, which leads to better reimbursement.

*This blog post was originally published at ACP Internist*

Nurse Anesthetists: Allowed To Work Without Doctor Supervision?

New Jersey’s state health department is considering a rule that would allow nurse anesthetists to work without a doctor’s supervision, as long as there’s a plan to reach one in case of an emergency. New Jersey would join the 30 states that allow nurse anesthetists to work without direct supervision.

On the other end of the country, a California court upheld the state’s decision to opt out of a Medicare requirement that doctors be present while a nurse anesthetist works in order to be reimbursed. The Centers for Medicare and Medicaid Services have allowed states to opt out of that requirement since 2001.

Since then, there has been no evidence of increased inpatient deaths or complications, researchers reported in the August 2010 issue of Health Affairs. Earlier this month, the Institute of Medicine reported that nurses should have a larger role in medical care, including anesthesiology.

*This blog post was originally published at ACP Internist*

Health Insurance: New Survey Reveals Record Number Of Uninsured

Last month the U.S. Census Bureau released its annual survey on health insurance coverage. The results were startling, yet few politicians seemed to take notice:

— The number of people with health insurance declined for the first time ever in almost two decades. In fact, as reported by CNN this is the first time since the Census Bureau started collecting data on health insurance coverage in 1987 that fewer people reported that they had health insurance: “There were 253.6 million people with health insurance in 2009, the latest data available, down from 255.1 million a year earlier.” The percentage of the population without coverage increased from 15.4 percent to 16.7 percent.

— Almost 51 million U.S. residents had no health insurance coverage at all, a record high, and an increase of almost five million uninsured from 2008.

— Fewer Americans received health insurance coverage through their jobs, continuing a decade-long trend. The number covered by employment-based health insurance declined from 176.3 million to 169.7 million, reports the Census Bureau. Based on the Census numbers, the Economic Policy Institute observes that “the share of non-elderly Americans with employer-sponsored health insurance declined for the ninth year in a row, down from 61.9% in 2008 to 58.9% in 2009, a total decline of 9.4 percentage points since 2000.” Read more »

*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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