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TV Doctors Tout IUDs As The Best Contraceptive Option: Why It May Not Be

That’s the opinion of television’s The Doctors, a syndicated TV Show that appears to be giving Dr Oz a run for his money, in USA Today. In fact, that’s the headline – IUDs: The Best Contraceptive Option.

What you know about birth control: Nearly half of all U.S. pregnancies are unintended; abstinence is the only sure-fire way to prevent pregnancy (and protect you from STDs); smoking while on the Pill may increase your risk of heart attack or stroke; as long as you are still getting a period, you can get pregnant during menopause. But here’s something you may not know:

We think IUDs work best.

This is contraceptive education at its worst. Read more »

*This blog post was originally published at The Blog That Ate Manhattan*

The Evolution of Dietary Supplement Marketing

In 1994 Congress (pushed by Senators Harkin and Hatch) passed DSHEA (the Dietary Supplement Health and Education Act). As regular readers of SBM know, we are not generally happy about this law, which essentially deregulated the supplement industry. Under DSHEA supplements, a category which specifically was defined to include herbals, are regulated more like food than like medicinals.

Since then the flood-gates opened, and there has been open competition in the marketplace for supplement products. This has not resulted, I would argue, in better products – only in slicker and more deceptive claims. What research we have into popular herbals and supplements shows that they are generally worthless (except for targeted vitamin supplementation, which was already part of science-based medicine, and remains so).

A company can essentially put a random combination of plants and vitamins into a pill or liquid and then make whatever health claims they wish for their product, as long as they stay within the “structure-function” guidelines. This means they Read more »

*This blog post was originally published at Science-Based Medicine*

Are The Benefits Of Smoking Cessation Eclipsed By Obesity?

Epidemic by Tobyotter via Flickr and a Creative Commons license

Obesity is filling in for smoking as a cause of death in working class women, concluded researchers after reviewing mortality rates from a nearly 30-year study in Scotland.

In Europe, wealthier people either aren’t starting to smoke or are finding it easier to quit, which accounts for up to 85% of the observed differences in mortality between population groups, researchers noted.

Their analysis showed higher rates of being overweight or obese among those who’d never smoked in all occupational classes, with the highest rates in women from lower occupational classes. Almost 70% of the women in the lower occupational classes who had never smoked were overweight or obese, and severe obesity was seven times more prevalent than among smokers in higher social positions. Among women who had never smoked, lower social position was associated with higher mortality rates from cardiovascular disease but not cancer.

To investigate the relations between causes of death, social position and obesity in women who had never smoked, Scottish researchers conducted a prospective cohort study. They drew from the Renfrew and Paisley Study, a long term prospective community based cohort named for two neighboring towns in west central Scotland from which all residents then aged between 45 and 64 were invited to participate from 1972 to 1976.

Researchers reported their results online Read more »

*This blog post was originally published at ACP Internist*

High Deductible Health Insurance Plans Incentivize Patients To Skip Screening Tests

Almost half of health plans in the US have deductibles of at least $1,000 according to a new study.  It’s called “cost shifting” and it’s a big part of the future of American health care.

There are two major reasons why employers are doing this.

First, higher deductible plans are cheaper, since there is less risk to insure.  Think of your car insurance – why would you make a claim for a ding on your door when it’s cheaper for you to just pay to have it fixed (or fix it yourself)?  The higher the deductible, the lower the premium, even if it means more out-of-pocket cost for you for the small stuff.

Along these same lines is the second reason.  If employees spend more of their own money on health care, maybe they’ll be smarter about how they spend it.

It sounds good – but does it work?

Yes.  And No. Read more »

*This blog post was originally published at See First Blog*

Five Things That Employers Want To Stop Doing

Our survey of employer attitudes about health benefits told us a lot about what employers are doing, and what they want to stop doing.  Here are 5 things employers want to stop doing:

1. Stop paying for bad employee lifestyles. Bad lifestyle choices are big drivers of expense.  Our study shows that employers want to stop being solely responsible for those costs.  More than half (54%) are adopting programs that use incentives — and penalties — to encourage employees to take responsibility for their health.  A study released last week by Watson Wyatt showed similar results.

2. Stop expecting health plans to deliver customized programs. Health plan offerings are popular — there is a nearly 90% adoption rate for core health plan services.  But employers increasingly turn to outside vendors for customized programs to fix bad employee health habits.  Health plans are looked to for value-based insurance designs, with 40% of employers looking to implement VBID or similar programs.

3. Stop paying for programs that don’t work. Fifty-five percent of employers said they were reducing the number of health benefits they offer or focusing on those with a proven ROI.  With 59% saying cost savings are their top priority, it makes sense that they cut costs where they don’t see savings.

4.  Stop confusing employees with too many benefit offerings. Employers have in place 10 or more distinct health benefits, with 60% identifying at least five major programs (EAPs, nurse help lines, health coaching, wellness, etc).  Employers want to implement a single point of contact to navigate their programs, with adoption rates of these services expected to triple in the next 2 years.

5.  Stop thinking bad medical outcomes are because of bad luck. Sixty-five percent of employers said their employees struggle with making the right treatment decisions when sick.  Thirty-five percent said making sure their employees have better quality care was a high priority, with 38% saying they wanted to do more to empower employees to make good health care decisions.

*This blog post was originally published at the See First blog.*

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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