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“The Hot Spotters”: Is Better Care For The Neediest Patients The Answer To Lower Healthcare Costs?

Author-physician Dr. Atul Gawande has done it again with a well-written article in The New Yorker magazine entitled, “The Hot Spotters.” It deals with the fact that 5 percent of people with chronic illness make up over 50 percent of all healthcare costs.

If we can zero in on providing better preventive care for those people, we can finally get our arms around runaway healthcare costs. How great that you don’t even have to have a New Yorker subscription to read it. Here are a few cliff notes until you get to it:

— In Camden, New Jersey, one percent of patients account for one-third of the city’s medical costs. By just focusing attention on the social and medical outpatient needs of those people, they not only got healthier but costs were cut in half.

— Our current system is unable to reign in costs. We need to completely re-design and fund how we do primary care.

— Charging high co-payments to people with health problems just backfires. They avoid preventive care and end up hospitalized with expensive and life-threatening illnesses that are much worse and more costly. Read more »

*This blog post was originally published at EverythingHealth*

Big Breakfast, Big Calories: Rethink Your Morning “Fuel Up”

Haven’t we all learned that breakfast should be our biggest meal? “Start the day with ‘fuel’ and you can burn it off as the day goes on.” “Eat a big breakfast and you’ll eat fewer calories all day long.”

This advice is probably not true, and in fact a new study published in the January 17th issue Nutrition Journal shows that people ate the same at lunch and dinner regardless of what they had at breakfast. If a person ate 1,000 calories at breakfast (which is easy to do with bacon, eggs, toast, hashbrowns, and juice), he or she had a total increase in calories eaten throughout the day by 1,000 calories.

This doesn’t mean we should be skipping breakfast. The problem may be what we historically think of as an “American” breakfast. It might have worked for the farmer in the past or the laborer hauling lumber, but it’s just too many calories for our current level of activity. Read more »

*This blog post was originally published at EverythingHealth*

Chewable Birth Control

Just in time for the new year, the FDA has approved the first low-dose chewable birth control contraceptive. 

The daily chew will be marketed by Watson Pharmaceuticals, Inc. Fred Wilkinson, executive vice president of Global Brands said: “We believe this product is an important addition to the oral contraceptive category, and that its characteristics will make it a desirable choice for women.”

I have to ask myself: “Why?”

Most birth control failures occur because the woman forgets to take the pill. Will a chewable be more reliant? Is it aimed at gals who just love chewing gum? I don’t get the concept.

Marketing for this breakthrough will begin the in the second quarter of 2011.

*This blog post was originally published at EverythingHealth*

Know Thy Calories: Nutrition Labeling Guidelines For Restaurants

As part of the new healthcare legislation (Affordable Care Act), the FDA has now published its guidelines for restaurants to inform consumers of the calorie counts of food. It establishes requirements for nutrition labeling of standard menu items for chain restaurants and chain vending machine operators.

This is important because Americans now consume an estimated one-third of their total calories from foods prepared outside the home. Consumers are generally unaware of the number of calories they consume from these foods, and being overweight or obese increases the risk of a number of diseases including heart disease, type 2 diabetes, stroke, and cancer.

Here’s what the guidelines say:

— Restaurants with 20 or more locations must disclose the number of calories in each standard menu item on menus and menu boards (have 19 chain locations? You get a pass. Daily specials also get a pass.)

— Additional written nutrition information must be available to consumers upon request (total fat, saturated fat, cholesterol, sodium sugars, carbs, fiber, protein, etc.)

— The menu must say that the additional nutritional information is available. Read more »

*This blog post was originally published at EverythingHealth*

Book Review: The Immortal Life Of Henrietta Lacks

If you like science, true history, and an engaging story, pick up the new book by journalist Rebecca Skloot, “The Immortal Life of Henrietta Lacks” and prepare for a great read. I knew nothing about the young black woman whose cells were taken back in 1951 by a scientist at Johns Hopkins Hospital and how those cells have revolutionized modern cell biology and research.

The HeLa (named after HEnrietta LAcks) cells were taken as she lay dying on the “colored” ward at Johns Hopkins Hospital of aggressive cervical cancer at age 30. Everyone who studies basic cell biology has heard of HeLa cells because they were the first human cell line to be successfully grown in culture and they are alive today. HeLa cells were sent to researchers all across the globe and have been used to develop the polio vaccine, viruses, cloning, gene mapping and in-vitro fertilization. Billions of the same immortal HeLa cells are used by researchers fighting cancer, multiple sclerosis, heart disease, and diabetes. Read more »

*This blog post was originally published at EverythingHealth*

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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