December 3rd, 2010 by StevenWilkinsMPH in Better Health Network, Health Tips, Opinion, Research
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“I recommend.” These are two word which, when spoken by a physician to a patient have tremendous power to change behavior. That assumes of course a trusting relationship between patient and physician (but that’s a topic for another day.)
Take the colonoscopy. The U.S. Preventive Services Task Force (USPSTF) recommends that adults aged ≥50 years get a colonoscopy every 10 years. In 2005, 50 percent of adults aged ≥50 years in the U.S. had been screened according to these recommendations. Not surprisingly, the rate of colonoscopy screening is much lower than that of other recommended adult preventive services. I was curious: Why?
Here are two interesting facts:
1. Studies show that patients cite “physician recommendation” as the most important motivator of colorectal screening. In one study, 75 to 90 percent of patients who had not had a colonoscopy, said that their doctor’s recommendation would motivate them to undergo screening.
2. In that same study, in 50 percent of patients where a colonoscopy was appropriate but not done, the reason given was that the physician simply did not “bring up” the subject during the visit. Reasons included lack of time, visit was for acute problem, patient had previously declined or forget. Read more »
*This blog post was originally published at Mind The Gap*
November 30th, 2010 by Elaine Schattner, M.D. in Better Health Network, Health Policy, News, Opinion, Research
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Over the long weekend I caught up on some reading. One article* stands out. It’s on informed consent, and the stunning disconnect between physicians’ and patients’ understanding of a procedure’s value.
The study, published in the Sept 7th Annals of Internal Medicine, used survey methods to evaluate 153 cardiology patients’ understanding of the potential benefit of percutaneous coronary intervention (PCI or angioplasty). The investigators, at Baystate Medical Center in Massachusetts, compared patients’ responses to those of cardiologists who obtained consent and who performed the procedure. As outlined in the article’s introduction, PCI reduces heart attacks in patients with acute coronary syndrome — a more unstable situation than is chronic stable angina, in which case PCI relieves pain and improves quality of life but has no benefit in terms of recurrent myocardial infarction (MI) or survival.
The main result was that, after discussing the procedure with a cardiologist and signing the form, 88 percent of the patients, who almost all had chronic stable angina, believed that PCI would reduce their personal risk for having a heart attack. Only 17 percent of the cardiologists, who completed surveys about these particular patients and the potential benefit of PCI for patients facing similar scenarios, indicated that PCI would reduce the likelihood of MI.
This striking difference in patients’ and doctors’ perceptions is all the more significant because 96 percent of the patients “felt that they knew why they might undergo PCI, and more than half stated that they were actively involved in the decision-making.” Read more »
*This blog post was originally published at Medical Lessons*
November 22nd, 2010 by Bryan Vartabedian, M.D. in Better Health Network, Health Policy, News
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A new policy on professionalism in the use of social media was [recently] adopted by the American Medical Association (AMA). The AMA Office of Media Relations was kind enough to share a copy of the policy:
The Internet has created the ability for medical students and physicians to communicate and share information quickly and to reach millions of people easily. Participating in social networking and other similar Internet opportunities can support physicians’ personal expression, enable individual physicians to have a professional presence online, foster collegiality and camaraderie within the profession, provide opportunity to widely disseminate public health messages and other health communication. Social networks, blogs, and other forms of communication online also create new challenges to the patient-physician relationship. Physicians should weigh a number of considerations when maintaining a presence online:
(a) Physicians should be cognizant of standards of patient privacy and confidentiality that must be maintained in all environments, including online, and must refrain from posting identifiable patient information online.
(b) When using the Internet for social networking, physicians should use privacy settings to safeguard personal information and content to the extent possible, but should realize that privacy settings are not absolute and that once on the Internet, content is likely there permanently. Thus, physicians should routinely monitor their own Internet presence to ensure that the personal and professional information on their own sites and, to the extent possible, content posted about them by others, is accurate and appropriate. Read more »
*This blog post was originally published at 33 Charts*
November 14th, 2010 by Davis Liu, M.D. in Better Health Network, News, Opinion, Research
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The Associated Press ran a provocatively-titled piece recently, “Family health history: ‘best kept secret’ in care”, which noted how a geneticist at the Cleveland Clinic discovered that asking about family members and their history of breast, colon, or prostate cancer was better than simply doing genetic blood testing.
Surprising? Hardly. This is what all medical students are taught. Talk to the patient. Get a detailed history and physical. Lab work and imaging studies are merely tools that can help support or refute a diagnosis. They provide a piece of the puzzle, but always must be considered in the full context of a patient. They alone do not provide the truth. Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
November 13th, 2010 by EvanFalchukJD in Better Health Network, Health Tips, Research
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There are plenty of “survivalists” out there who stock their basements with canned goods, getting ready for some unexpected (and unlikely) apocalypse. Meanwhile there are things that are much more likely to happen to you — like getting sick — which many of us don’t prepare for at all. So to help you get started, here are five important tips on how you can become a healthcare survivalist:
1. Take care of your chronic conditions. Whether it’s high blood pressure, diabetes, high cholesterol, depression, asthma or any other kind of ailment, do what it takes to manage your own care. Take your medications and follow your doctors’ instructions. Why? Because if you don’t, your condition can get worse and lead to even more serious problems. As much of a pain as it may (literally) be, there’s a reason the old saying “an ounce of prevention” still resonates today — because it’s true.
2. Live a healthy lifestyle. Everyone gives you this advice, but with studies showing that 42% of Americans will be obese by 2050, it doesn’t seem to be getting through. Denial can wonderfully appealing; but when it comes to your health, it can also kill you. Stop smoking, exercise, and eat right. You may find that your employer has programs in place that will help you do all of those things, and many of them work. Why not give one of them a try? You can’t improve your life all at once, but you can start. Your life will be happier if you keep yourself healthy. So rather than whistling past the graveyard, jog past it. Read more »
*This blog post was originally published at See First Blog*
