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The Medical Arms Race Heats Up

I have written many times on this blog about one shining example of the medical arms race – the slow (some would say not so slow), steady, proliferation of huge and hugely expensive proton beam radiation facilities in medical centers in the US. I have written about how the proliferation never seems to occur in single units – rarely just one per town – but almost always two simultaneously – the medical arms race among health care institutions and providers at play.

The latest chapter is playing out in San Diego, as captured by HealthLeaders Media Online senior editor Cheryl Clark.

Excerpts:

“As members of the debt reduction “super committee” wrestle to slice $400 billion from Medicare over 10 years, I wonder what they might say about the $430 million proton beam center war now being waged a few miles from my home in San Diego.

This nearly half a billion dollar investment in proton therapy is a big part of Read more »

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

Making A Human Connection: Meeting Other People Dealing With The Same Disease

Remember when people in the waiting room at a doctor’s office were all reading magazines? It was quiet as each person waited for their name to be called. Even if you went to a specialist’s office, no one dared say “I’m here for _____. What brings you here to see Dr. ____?” No one “shared” even if, just maybe, they had a very similar health concern to the person next to them. Makes sense, health is a private matter, right? Well many people I know don’t feel that way. They feel the benefits of connecting with other patients far outweigh the risks.

The other day I was in Atlanta where 30 or so patients attended an educational “summit” for people with a rare form of leukemia, chronic myelogenous leukemia or CML.While the people who came wanted to be informed and hear the latest from medical experts and an oncology social worker, they also wanted to meet others facing the same diagnosis. Particularly in rare conditions like this one, many patients have never met someone else with the diagnosis – and they very much want to make that connection. They want to hear the stories of others and see if they are like their own.

I found that to be true when Read more »

*This blog post was originally published at Andrew's Blog*

Head And Neck Cancer Surgeon Steps Out Of His Comfort Zone And Into Kenya

Traveling makes one modest – you see what a tiny place you occupy in the world.
-Gustave Flaubert

Tumor ImageWe have come to Kenya, expecting to work outside of our “comfort zones.”

Our patient has arrived from miles away, riding on the back of her husband’s bicycle. She has an enlarging, bleeding mass growing off of the side of her neck. There are no pathologists available, so we are uncertain what kind of tumor it is, although it appears to be a cancer. She has been wearing a scarf to hide the mass for the past year; her head covering is speckled with blood.

We are anxious. Unexpected things can happen in an operating room this far from home. We expect Read more »

When A Cancer Patient Might Be Better Off Choosing Hospice Care

Cancer is a dreadful disease. Just dreadful.  Make no mistake: I have tremendous respect for the awesome doctors who treat patients afflicted with it day after day. Still, paradoxically, I can’t help but notice that some of them have just as hard a time as do other doctors with caring for patients at the end of their lives. I believe a large part of their difficulty stems from the ridiculously dysfunctional either/or approach to palliative care and hospice we’re stuck with in this benighted country.

The problem is that in order to qualify for hospice, patients must not only have a certified life expectancy of less than six months, but they must also not be undergoing any active treatment for their malignancy. When you stop to think about it, though, this is actually quite discriminatory. We don’t require people on hospice with other diagnoses to discontinue their life sustaining medications. Patients with COPD are allowed to continue their bronchodilators; CHF patients don’t have to stop their ACE inhibitors and digoxin. But if a cancer patient wants to qualify for hospice, they have to forgo curative treatments like chemotherapy.

So what if the oncologists call it “palliative” chemo instead? Read more »

*This blog post was originally published at Musings of a Dinosaur*

Building Programs For People Living With Serious Conditions

I can’t get the 1989 baseball movie Field of Dreams out of my head. That’s especially true right now as I can’t wait for the seventh game of the World Series. My son, Eitan, and I sat on the couch and watched the sixth game last night and it was probably the most exciting game I’ve ever seen. Plot twists galore. You can bet the audience for tonight’s game will be HUGE.

What’s so cool in thinking back about the movie is the famous line said to the baseball fanatic farmer: “If you build it they will come.” So he built a baseball field behind his house and the greats of baseball history came to play. I have never forgotten that line and have applied it to what we “build” at Patient Power – interview programs for people living with serious health concerns.

In the past few weeks, and continuing from now on, we have been focusing on two blood-related cancers: multiple myeloma and chronic myelogenous leukemia. While there are other educational resources out there, people living with these serious conditions always want more – as well they should. Fortunately, Read more »

*This blog post was originally published at Andrew's 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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