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Funding Tobacco Control Programs: A Dollar Well Spent

The Centers for Disease Control (CDC) identified tobacco use as the single biggest cause of premature death in every state in the U.S. They recommended in 2007 that New Jersey state government should spend $120 million per year on tobacco control ($13.75 per person per year, and 12% of total tobacco-related revenue to the state).

Here in New Jersey, our Comprehensive Tobacco Control Program (CTCP) started in 2000, with annual funding of just over $30 million via the Master Settlement Agreement (MSA). The program was set up to follow CDC guidelines to have components for media, evaluation, community activities, youth prevention, and smoking cessation. With the post 9/11 recession causing severe budget problems for the state, funding was drastically cut by 66% to $11 million in 2004 and then in 2009 it was cut again to around $8m. The state brings in approximately $1 billion per year from tobacco sources (MSA plus tobacco taxes) and so New Jersey has recently been spending around 1% of tobacco revenues on tobacco control. Despite being drastically underfunded, the New Jersey CTCP has had many noteable achievements. Here’s just a few. Read more »

This post, Funding Tobacco Control Programs: A Dollar Well Spent, was originally published on Healthine.com by Jonathan Foulds, Ph.D..

Healthcare Reform And The “Time Will Tell” Camp

So, the healthcare reform bill passed in the House. Some people want to embrace this moment as a victory because any healthcare bill that becomes law is better than nothing. I heard a lot of “this was a long time coming,” “finally,” “it was our time yesterday,” and comments like that. I also heard a great deal of “time will tell,” “who’s the really winner?,” “is it a victory with a country and government so divided?,” “is this the right path?,” and comments like that.

I’m uncertain. As a physician, I so wanted to be able to feel good about it. I so wanted to believe that the “win” would push the healthcare industry in a positive direction, even if in baby steps and even if in just the insurance industry. But I have to be skeptical about a plan that doesn’t address the needs of American’s paying high co-pays today and having trouble getting timely doctors appointments today.

As a physician, I see too many patients not filling prescriptions and going without seeing doctors for these reasons. As a patient these have been my recent concerns, and I don’t see those being addressed. Do you? Read more »

*This blog post was originally published at Dr. Gwenn Is In*

Personal Health Record Service: Who Does It Best?

A personal health record (PHR) has been touted as a way for patients to better keep track of their health information. Google Health and Microsoft HealthVault lead the way. But what happens if the company storing your data gets bought, goes bankrupt, or simply decides to discontinue their system?

Well, those who stored their data with Revolution Health are finding out first hand. The troubled company, which started off with so much fanfare yet died in a whimper, recently announced they’re shutting down their personal health record service. According to American Medical News: “Industry insiders say Revolution joins a long list of vendors who launched PHRs with a big splash, only to find little interest from consumers.”

Most of my patients don’t use a personal health record, and prefer that I enter the data in myself, or export it from from my electronic record system. The problem is: a) there isn’t enough time in a 15-minute patient visit to help patients enter in their data (apart from what I already do in my own system), and b) many online personal health record sites aren’t compatible with the systems doctors are using.

Leaving the data entry to the patient is inefficient, and a sure way to minimize the adoption rate. Indeed, “the most successful PHR-type systems have been created by healthcare organizations and have benefits to patients, such as e-mailing with physicians, online appointment scheduling and the ability to look at information entered by their physicians.”

That means a successful personal health records have to be well-integrated with or designed by existing hospital and physician systems, making it harder for a third-party system, such as the defunct Revolution Health service, to gain traction.

*This blog post was originally published at KevinMD.com*

When Hospital Business Comes Before Patient Care

When hospitals mandate where patients are treated, it can lead to conspiracy and racketeering charges. Here’s an excerpt from a letter from the Chairman of the Board of Citizens Medical Center to one of the cardiologists filing suit:

While it is certainly your right to exercise your medical judgement as you see fit, likewise, it is the responsibility of the Board of Directors at Citizens Medical Center to exercise their judgement as to what is in the interest of the business of Citizens Medical Center and its patients and Medical Staff. It is the Board’s firm belief that it is in the best interest of Citizens Medical Center for patients who are capable of being treated at Citizens Medical Center to be treated at Citizens Medical Center and not be transferred elsewhere.”

Business interests before doctor-patient interests? Ouch.

-WesMusings of a cardiologist and cardiac electrophysiologist.

*This blog post was originally published at Dr. Wes*

Healthcare Reform: Just The Facts

With the vote on the healthcare reform legislation behind us, it’s nice to believe that we can now move to the stage where people begin looking at what the legislation will and will not do — not based on speculation or the political rhetoric, but what is actually in the legislation itself.

I realize that this is unlikely, since we all tend to engage in cognitive dissonance when confronted with information that does not square with our own pre-conceived notions, political leanings, and philosophical bent. I know I do it (as much as I try not to) and I’m sure this is true of just about all of us. Still, there are trusted and highly-credible sources of information that I hope will be of value to anyone who is open to learning more about the new healthcare legislation and its potential impact. Read more »

*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*

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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