June 26th, 2010 by KevinMD in Better Health Network, Health Policy, Health Tips, Opinion, Research
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It’s time to ask patients whether they text and drive. An important perspective piece from the New England Journal of Medicine urges doctors to include that question during preventive health exams. The data surrounding texting and driving is grim:
Although there are many possible distractions for drivers, more than 275 million Americans own cell phones, and 81% of them talk on those phones while driving. The adverse consequences have reached epidemic proportions. Current data suggest that each year, at least 1.6 million traffic accidents (28% of all crashes) in the United States are caused by drivers talking on cell phones or texting. Talking on the phone causes many more accidents than texting, simply because millions more drivers talk than text; moreover, using a hands-free device does not make talking on the phone any safer.
The author of the piece, Amy Ship from Boston’s Beth Israel Deaconess Hospital, says that doctors should update traditional preventive questions to keep up with the times. The simple question, “Do you text while you drive?” is a way to start this important conversation. Read more »
*This blog post was originally published at KevinMD.com*
June 23rd, 2010 by DrRob in Better Health Network, Health Policy, Opinion, True Stories
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He came in for his regular blood pressure and cholesterol check. On the review of systems sheet he circled “depression.”
“I see you circled depression,” I said after dealing with his routine problems. “What’s up?”
“I don’t think I am actually clinically depressed, but I’ve just been finding it harder to get going recently,” he responded. “I can force myself to do things, but I’ve never have had to force myself.”
“I noticed that you retired recently. Do you think that has something to do with your depression?” I asked.
“I’m not really sure. I don’t feel like it makes me depressed. I was definitely happy to stop going to work.”
I have taken care of him for many years, and know him to be a solid guy. “I have seen this in a lot in men who retire. They think it’s going to be good to rest, and it is for the first few months. But after a while, the novelty wears off and they feel directionless. They don’t want to spend the rest of their lives entertaining themselves or completing the ‘honey do’ list, but they don’t want to go back to work either.”
He looked up and me, “Yeah, I guess that sounds like me.” Read more »
*This blog post was originally published at ACP Internist*
June 22nd, 2010 by StevenWilkinsMPH in Better Health Network, Health Policy, News, Opinion, Research
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The New York Times reported recently on efforts by providers and payers to increase patient medication adherence through the use financial incentives paid to patients. The article cited the use of small financial payments (<$100), awarded via lotteries, to patients that take Warfarin –- an anti-blood clotting medication.
There is certainly nothing wrong with financial incentives. Incentives have been proven successful in changing selected provider (quality and safety improvement) and patient behavior (stop smoking, weight loss and taking health risk surveys). But paying patients to take their medication is different. Actually, the evidence suggests that it is a just plain stupid idea for a whole lot of reasons. Read more »
*This blog post was originally published at Mind The Gap*
June 16th, 2010 by Toni Brayer, M.D. in Better Health Network, Health Tips, Opinion, True Stories
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It’s important to have an open relationship with your primary care physician because the more he or she knows about your health and lifestyle, the better able he or she is to diagnose illnesses as they come up.
You wouldn’t take your car to a mechanic and not tell him that the brake is sticking, and a human organism is thousands of times more complicated than a car. But patients are shy. They’re embarrassed. They don’t want you to think badly about them, so they often leave out important information that’s critical for the physician to know. Read more »
*This blog post was originally published at EverythingHealth*
May 26th, 2010 by StevenWilkinsMPH in Better Health Network, Health Policy, Health Tips, Opinion
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What if the average patient (person) knew what healthcare insiders, providers and expert patients know?
Take the process of looking for a new personal physician. Conventional wisdom tells people that when looking for a new physician they need to consider things like specialty, board certification, years in practice, and geographic proximity. Online services like Health Grades allow you to see and compare the satisfaction scores for prospective physician candidates.
But industry insiders know different. Consider those patient satisfaction scores for physicians. In reality, “one can assume that the quality of care is actually worse than surveys of patient satisfaction would seem to show,” according to a 1991 lecture by Avedis Donabedian, M.D.:
“Often patients are, in fact, overly patient; they put up with unnecessary discomforts and grant their doctors the benefit of every doubt, until deficiencies in care are too manifest to be overlooked.”
Given the constant drumbeat about the lack of care coordination and medical errors, it would seem that some people (patients) are beginning to reach the breaking point alluded to by Dr. Donabedian. The empowered among us are starting to compare physicians (and the hospitals that employ them) to a higher standard — a higher standard that reflects the nature and quality of the medical services physicians actually provide. Empowered patients today are “being taught to be less patient, more critical, and more assertive.” Read more »
*This blog post was originally published at Mind The Gap*
