April 7th, 2011 by Davis Liu, M.D. in Health Policy, Opinion
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There are many tips to saving money on medical costs like asking your doctor only for generic medications, choosing an insurance plan with a high deductible and lower monthly premiums, going to an urgent care or retail clinic rather than the emergency room, and getting prescriptions mailed rather than go to a pharmacy.
How about getting your old medical records and having them reviewed by a primary care doctor? It might save you from having an unnecessary test or procedure performed.
Research shows that there is tremendous variability in what doctors do. Shannon Brownlee’s excellent book, Overtreated – Why Too Much Medicine Is Making Us Sicker and Poorer, provides great background on this as well as work done by the Dr. Jack Wennberg and colleagues on the Dartmouth Atlas. Some have argued that because of the fee for service structure, the more doctors do the more they get paid. This drives health care costs upwards significantly. Dr. Atul Gawande noted this phenomenon when comparing two cities in Texas, El Paso and McAllen in the June 2009 New Yorker piece. Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
March 16th, 2011 by Davis Liu, M.D. in Health Tips, Opinion
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Colon cancer screening has a particular personal interest for me — one of my colleagues in residency training had her father die of colon cancer when she was a teenager.
No one should lose a loved one to a disease that, when caught early, is often treatable. But for both men and women, colon cancer is the third most common cancer behind lung cancer and prostate cancer in men, and behind lung cancer and breast cancer in women, it’s the second most lethal.
The problem is that patients are often confused about which test is the right one. Is it simply a stool test? Flexible sigmoidoscopy? Colonoscopy? Virtual colonoscopy? Isn’t there just a blood test that can be done? (No.)
In simple terms, this is what you need to know:
All men and women age 50 and older should be screened for colon cancer. Even if you feel healthy and well and have no family history, it must be done. Note that Oprah’s doctor, Dr. Oz, arguably a very health-conscious individual learned that he had a colon polyp at age 50 after a screening test. Left undetected, it could have cut his life short. This wake-up call caused him to abort his original second season premier on weight loss and instead show the country why colon cancer screening matters. He admitted that if it wasn’t for the show and the need to demonstrate the importance of screening to America, he would have delayed having any test done.
The least invasive test is a stool test. If it is to screen for colon cancer, then the test is done at home and NOT in the doctor’s office. Either the fecal occult blood test (FOBT) or the fecal immunochemical test (FIT) are available to screen for unseen microscopic blood that could be a sign of a colon polyp or cancer. Research shows that when a stool test is done annually, the risk of dying from colon cancer can fall by 15 to 33 percent. If you don’t want any fiber optic cameras in your rectum and lower colon, this is the test for you. You must do it annually.
The next two tests are similar but often confused: The flexible sigmoidoscopy and the colonoscopy. Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
November 3rd, 2010 by GarySchwitzer in Better Health Network, Health Policy, News, Opinion, Research
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Continuing this week’s spontaneous theme (we didn’t make the claims and write the stories) of runaway enthusiasm for various screening tests by some researchers and journalists, HealthDay news service has reported on a study published in the Oct. 28 issue of the journal Nature that they say “provides new insight into the genetics of pancreatic cancer.” In the story, they let one of the researchers get away with saying, almost unchallenged:
“What’s important about this study is that it’s objective data in support of why everyone should be screened for pancreatic cancer.”
Mind you, this was a study that looked at tissue from just seven patients. The story continued with its breathless enthusiasm for the pancreatic cancer screening idea:
“In the future, new imaging techniques and blood tests will offer hope for early detection, the study noted. And just as people have a colonoscopy when they turn 50, “perhaps they should have an endoscopy of their upper gastrointestinal organs that includes an ultrasound of the pancreas,” said (the researcher).”
The very end of the story included some skepticism from Dr. Len Lichtenfeld of the American Cancer Society. Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
September 3rd, 2010 by Jon LaPook, M.D. in Better Health Network, Health Tips, News, Research, True Stories
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Dr. Mehmet Oz just might be the last person on earth people would expect to get a colon polyp. He’s physically fit (he left me in the dust the last time we ran together), he eats a healthy diet, he doesn’t smoke, and he has no family history of colorectal cancer or colon polyps.
But several weeks ago, when Mehmet had his first screening colonoscopy at age 50, I removed a small adenomatous polyp that had the potential to turn into cancer over time. Statistically, most small polyps like his don’t become cancer. But almost all colon cancers begin as benign polyps that gradually become malignant over about 10 to 15 years.
Since there’s no way of knowing which polyps will turn bad, we take them all out. The good news is there’s plenty of opportunity to prevent cancer by removing these polyps while they are still benign. But only about 63 percent of Americans between ages 50 and 75 get screened for colorectal cancer. Read more »
April 28th, 2010 by Davis Liu, M.D. in Better Health Network, Health Policy, Health Tips, News, Opinion, Research
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A recent article found that primary care doctors the United States are providing sub-standard care when it comes to colon cancer screening.
In the Journal of General Internal Medicine, researchers found that 25% of primary care doctors used in-office stool testing to screen for colon cancer. Specifically, doctors do a rectal exam and then swipe the rectal contents off their gloves onto a stool-testing card. A positive test result indicates the presence of blood, which can be invisible to the naked eye. Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
How about getting your old medical records and having them reviewed by a primary care doctor? It might save you from having an unnecessary test or procedure performed.
