December 22nd, 2010 by John Mandrola, M.D. in Better Health Network, Health Tips, News, Opinion, Research
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It’s the time of the year when dietary temptations lurk around every corner of the hospital. And since completely abstaining is not always possible, the best antidote for this holiday deluge of inflammation is obvious: Exercise.
No doubt, within the boundaries of common sense, all exercise is good. But is there a best time of day to exercise?
Tara Parker-Pope’s New York Times piece suggests that the most “productive” time of day to exercise is before breakfast. In concisely reviewing a Belgian exercise physiology study, Ms. Parker-Pope points out that, in blunting the undesirable effects of a high fat and sugar diet, pre-breakast (fasting) exercise was metabolically more efficient than was exercise later in the day. That’s really good news for the overweight middle-agers who consistently say: “I really don’t eat very much. I must have a slow metabolism.”
Scientific studies are one thing, but are they validated in the court of real life? Read more »
*This blog post was originally published at Dr John M*
December 13th, 2010 by BobDoherty in Better Health Network, Health Policy, News, Opinion
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One of the canards slung at the Affordable Care Act is that it creates “death panels” that would allow the government to deny patients lifesaving treatments, even though two independent and non-partisan fact-checking organizations found it would do no such thing.
I don’t bring this up now to rehash the debate, but because the New York Times had a recent story on Arizona’s decision to deny certain transplants to Medicaid enrollees — “death by budget cuts” in the words of reporter Marc Lacey. His story profiles several patients who died when they were unable to raise money on their own to fund a transplant. Lacey quotes a physician expert on transplants who flatly states: “There’s no doubt that people aren’t going to make it because of this decision.”
Arizona Medicaid officials told the Times that they “recommended discontinuing some transplants only after assessing the success rates for previous patients. Among the discontinued procedures are lung transplants, liver transplants for hepatitis C patients and some bone marrow and pancreas transplants, which altogether would save the state about $4.5 million a year.” Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
December 6th, 2010 by Glenn Laffel, M.D., Ph.D. in Better Health Network, Health Policy, News, Opinion
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Flush from their big win in the midterms, the Boehners are vowing to repeal and replace the Big O’s health reform law. They pose a legitimate threat, but an even larger one lies in the courts, where suits challenging the constitutionality of the law have been popping up like fireflies on a late August night.
In Virginia for example, Republican-appointed Federal District Court Judge Henry Hudson has indicated that the Individual Mandate — a key provision of the law that has been challenged in a suit filed in his court by the state’s Republican Attorney General — might not pass his sniff test.
Hudson said he’d rule on the matter this month. If he deems the provision to be unconstitutional, he might (it’s unlikely, but he might) enjoin the law altogether until higher courts rule on the matter. Holy Kazakhstan, Batman!
An official at Camp Obama, who spoke with the New York Times under the condition that his name not be WikiLeaked, acknowledged that Hudson’s thumbs appear to be pointing downward, indeed. Read more »
*This blog post was originally published at Pizaazz*
December 5th, 2010 by DavedeBronkart in Better Health Network, Health Policy, Health Tips, News, Opinion, Research
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A year ago Gangadhar Sulkunte shared his story here about how he and his wife became e-patients of necessity, and succeeded, resolving a significant issue through empowered, engaged research. As today’s guest post shows, he’s now actively engaged in thinking about healthcare at the level of national policy, as well – and he calls for all patients to speak up about this new issue. – Dave
I recently came across a Pauline Chen piece in the New York Times, “Listening to Patients Living With Illness.” It refers to a paper by Dr. Wu et al, “Adding The Patient Perspective To Comparative Effectiveness Research.” According to the paper and the NY Times article, Dr. Wu and his co-authors propose:
- Making patient-reported outcomes a more routine part of clinical studies and practice and administrative data collection.
- In some cases requiring the information for reimbursement.
Patient-Centered Outcomes is outcomes from medical care that are important to patients. The medical community/research focuses on the standard metrics related to survival and physiological outcomes (how well is the part of the body being treated?). In the patient-centered outcomes research, they will also focus on outcomes important to patients such as quality of life. In other words, the care experience will be viewed through the eyes of the patients and their support groups to ensure that their concerns are also addressed. Read more »
*This blog post was originally published at e-Patients.net*
November 29th, 2010 by Happy Hospitalist in Better Health Network, Health Policy, News, Opinion
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Have you ever wondered how hospitals get paid by Medicare? The New York Times has an excellent and simple explanation of this highly complicated process. It’s simple really.
First the hospital labor component is adjusted for geographic location and then added to the capital depreciation expenditures adjusted for geographic location and then a medical severity adjusted diagnosis related group multiplier is added (MS-DRG).
Once this adjusted payment rate is calculated, the hospital is given a bonus to cover the costs incurred if they are a teaching hospital, through the indirect medical education payment. Added to that is the disproportionate share payment for hospitals that see a lot of uninsured or Medicaid patients (strange that Medicare subsidizes Medicaid, isn’t it?) If you have a patient that is extremely sick or spends mulitple extra days in the hospital, they may get an extra outlier payment. Read more »
*This blog post was originally published at The Happy Hospitalist*
It’s the time of the year when dietary temptations lurk around every corner of the hospital. And since completely abstaining is not always possible, the best antidote for this holiday deluge of inflammation is obvious: Exercise.
