December 20th, 2011 by DrWes in Opinion
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“How are you feeling, Ms. Jones?”
“Fine.”
“Have you been more short of breath lately?”
“Not really, just when I exercise.”
“How much exercise?”
“I dunno. But after I go to the mailbox and walk back up to the house, I’ve got to stop now where before I didn’t.”
Exertional dyspnea. It conjures up a large differential of potential cardiovascular or pulmonary causes. And as the above commonly-encountered doctor-patient conversation demonstrates, the problem is a dynamic one: at rest things are often fine, on exertion or with recumbency less so.
Now imagine that the doctor then sees elevated neck veins, hears rales in the lower lung fields, and sees swollen ankles on their patient. Heart failure, right? Read more »
*This blog post was originally published at Dr. Wes*
December 19th, 2011 by PreparedPatient in Opinion, Research
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Who doesn’t think preventive health care is important? Probably nobody if you ask this question abstractly. But when it comes to getting it–well that’s a different matter. Medicare stats show that too few people are getting preventive services even when they are free. It’s darn difficult, it seems, to get people to take good care of themselves.
By mid-November, of the four million or so new beneficiaries who signed up for Medicare this year, only 3.6 percent had had their “Welcome to Medicare” exam. Only 1.7 million of the more than 40 million seniors, most of whom were already on Medicare, had had their “Annual Wellness Visit.” A poor showing indeed given all the hoopla and hype surrounding the preventive benefits that health reform was supposed to bring to seniors.
To review: All new Medicare beneficiaries are entitled to a free physical exam within the first twelve months that their medical, or Part B, coverage becomes effective. It’s a one-time benefit, and Medicare says that seniors are told about the benefit when they sign up. A Medicare spokesperson added that Read more »
*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*
December 14th, 2011 by Dr. Val Jones in Expert Interviews, Health Policy, Research
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It is estimated that as many as 10 million U.S. adults have ADHD (Attention-Deficit/Hyperactivity Disorder). A recent research study (publication-pending) suggests that the economic burden of ADHD on America could be as high as $250 billion annually. I attended a recent briefing on Capitol Hill and interviewed one of the study’s co-authors: Tufts economist, Dr. Peter Neumann as well as congressman (and psychologist) Tim Murphy about ADHD in America.
I learned from Dr. Neumann that cost these high cost estimates are most strongly influenced by reduced productivity in adult workers with ADHD rather than direct costs of treating children with the disorder. Productivity costs include absenteeism, and reduced work output due to difficulty focusing. Dr. Neumann explained that ADHD has many “spill over effects” in that it impacts the educational system, the justice system, the healthcare system, and our work environments. Please check out our interview video for the full story.
Congressman Tim Murphy is a clinical psychologist with three decades of experience in treating people with ADHD. He is also Co-chair of the Mental Health Caucus and GOP Doctors Caucus where he regularly works to raise awareness of healthcare accessibility needs. I had the chance to interview him also at the event.
I learned from Rep. Murphy that the costs of ADHD multiply when patients are untreated. Getting the correct diagnosis is critical, because impulsivity and problems with focusing are not always caused by ADHD. These symptoms can be caused by lead poisoning, damage to the limbic system of the brain, metabolic disorders, or even sleep apnea. Children who are inattentive should not be put on medications for ADHD without first confirming the diagnosis by ruling out other possible causes.
Rep. Murphy recommends a team approach to the management and treatment of ADHD and he believes that costs related to ADHD are escalating because some physicians are not managing children holistically, but resorting to prescribing medications without involving counselors and family directly. He sees lack of health insurance coverage for behavioral health services as a threat to comprehensive and effective ADHD treatment.
Please watch the video for the full interview with congressman Murphy.
*Please note that the panel event, and Better Health’s participation, was made possible by a grant from Shire Pharmaceuticals.
December 4th, 2011 by DrWes in News, Opinion
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A sure-to-be controversial article appears in the Chicago Tribune earlier this asking the sensitive question of ‘Health care at any age, any cost?:’
“If you want to save all lives, you’re in trouble,” said Callahan, co-founder of The Hastings Center, a bioethics research institute in New York, and a faculty member at Harvard Medical School, in an interview. “And if you want to save all lives at any cost, you’re really in trouble.”
Callahan and co-author Nuland, a retired professor of surgery at Yale School of Medicine who wrote the best-selling “How We Die,” were both 80 when the article was published.
“We need to stop thinking of medicine as an all-out war against death, because death always wins,” said Callahan.
The article goes on the make some bold demands of doctors: Read more »
*This blog post was originally published at Dr. Wes*
November 30th, 2011 by GruntDoc in Opinion, Research
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I really like this idea, but … well, see after the quote.
It’s easy to compare prices on cameras, vacations, and homes. But in the United States, patients fly blind when paying for health care. People typically don’t find out how much any given medical procedure costs until well after they receive treatment, be it a blood draw or major surgery.
This lack of transparency has contributed to huge disparities in the cost of procedures. According to Castlight Health, a startup based in San Francisco, a colonoscopy costs anywhere from $563 to $3,967 within a single zip code. EKGs can range from $27 to $143, while the price for a set of three spinal x-rays varies from as little as $38 to as high as $162.
When someone else is picking up the tab, mystery pricing is not much of a problem. But these days, Read more »
*This blog post was originally published at GruntDoc*
