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Dr. Val Talks to iHealthBeat about Consumer Driven Healthcare

I had a really great conversation with iHealthBeat reporter Kate Ackerman recently. She summarized our conversation in an online article and I’ve copied some of it here. Please check out the full article for the entire interview.
Consumer Demand Fueling Online Health Care Market
by Kate Ackerman, iHealthBeat Associate Editor

As patients increasingly turn to the Internet for health care information and online tools to manage their health, many companies, both new and old, are stepping up to meet the consumer demand.

It is still too early to tell which companies will be successful and how the Internet-savvy health care consumer will transform the patient-physician relationship, but the trend has captured the interest of many health care insiders.

Val Jones, senior medical director of Revolution Health and author of a blog called “Dr. Val and the Voice of Reason,” spoke to iHealthBeat about the online health care market, physician concerns about patients relying on the Internet and the role of medical blogs.

A recent Harris Interactive survey found that the percentage of U.S. adults who looked for health care information online increased from 72% in 2005 to 84% in 2007. Why do you think more and more consumers are turning to the Internet for health information?

I think it’s partially because more and more consumers are turning to the Internet for information, period. Online information is incredibly convenient, served up lightning fast and has revolutionized how we research everything from buying toasters to finding a doctor. Of course, health is much more serious and complicated than purchasing products, so consumers should be very wary of the source of their health information.

Do you see a generational divide in the people using Revolution Health?

We primarily appeal to everyone between the ages of 20 and 60, though women conduct more health searches than men. The only age gaps are related to the medical subjects being researched. Clearly, not too many 20-somethings are reading about menopause, and not too many 50-year-olds are reading about college stress. Otherwise, all of our community tools and groups are fair game for people of any age. We have 60-year-olds blogging and enjoying discussion groups, and 20-year-olds posting forum questions too. It’s wonderful to see the generations interacting online and learning from one another.

New York orthopedist Scott Haig in November wrote an essay in Time Magazine complaining about patients who research their symptoms, illnesses and doctors online before seeking treatment. What are the downsides to patients searching for health care information online?

I think Dr. Haig’s essay has been somewhat misinterpreted because he was focusing on a specific patient with a serious disorder. My favorite quote from Dr. Haig’s article is that “the role of the expert is to know what to ignore.” I think the major downside for patients searching for health information online is that it can be difficult to figure out what’s contextually relevant to them. Aside from that, the next major downside is that there are snake-oil salesmen out there preying on the frustrations that we all have about our broken health care system and promising “miracle cures” and fueling mistrust in doctors.

What can be done to ease concerns from physicians, like Haig, about consumers relying on the Internet for health information?

Educated patients are a pleasure to work with, but misinformed patients require lots of extra help. The hours we spend every week dispelling urban legends and Internet-fueled medical myths is really mind-boggling. Physicians are naturally protective of their patients and don’t want them to be duped or misled.

From Google to Microsoft, companies are beginning to recognize an opportunity in the online health care market. Is there enough room for all of these companies? What will make successful ventures stand out from the rest of the pack?

There’s as much room as consumer demand will fuel. However, only the largest and most innovative companies will ultimately survive long term. While we’re all waiting for the government to create standards for health information and the creation of interoperability rules, successful companies will meet the needs of today’s consumer. Small but practical tools and innovations will keep the companies solvent while we work toward the holy grail of a common health information platform for all the stakeholders.

Medical blogs seem to have taken off in recent years. Who do you think the intended audience is?

Actually, while there are an estimated 70 million blogs out there, only a few hundred doctors are blogging. That’s a huge discrepancy, and I don’t think we’re even at the beginning of the wave of medical blogging that will inevitably occur as doctors enter the Web 2.0 world. The first pioneers of the medical blogosphere are writing mostly for their peers, though patients find their blogs very engaging and read them as well. Very few medical bloggers write specifically for consumers.

What are your predictions for the online health care market in 2008 and beyond?

With decreasing access and increasing patient loads, I think we’re going to see the consumer-driven health care movement take center stage. Patients are going to need to “do it themselves” a lot of the time (meaning manage their own health information, teach themselves about disease management and make financial plans to take care of their own needs if the government cannot afford to do so).

Another trend I have my eye on is the retainer medicine movement. As primary care physicians continue to be squeezed out of existence by decreasing Medicare reimbursements, they are beginning to join an “off-the-grid” group of providers who simply do not accept insurance.

As more PCPs create retainer practices, I think IT solutions will really take off. Online tools that simplify their practices and speed up their patient communication will be welcomed and encouraged.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Genetics and the War on Viruses

I spent a year working in a vaccine research laboratory at the Mayo Clinic. My project involved analyzing the DNA of military personnel who had died of the measles in the early 20th century. Strangely enough, the military saved small pieces of their flesh embedded in paraffin wax (and frozen) for future study. I guess that “future study” was my research project.

I must admit that I felt a little bit creepy as I cut tiny slivers of tissue out of the waxy fossils. I wondered about the lives of the tissue’s original owners. Who were these soldiers? Did their families still think of them? Did they leave wives and children behind?

Well, as it turned out, most of the tissue samples had a little piece of DNA in common and it was pretty exciting to discover what may have been a genetic susceptibility to this particular virus. Figuring out why some people survive the measles while others are overcome and die from it can be the turning point in understanding how to protect future generations from its ravages.

Today I read about some new research linking susceptibility to the influenza virus to certain family lineages. This makes perfect sense, since our body’s ability to defend itself against disease is largely based on our genetic code. However, we’re only just beginning to unwrap the subtle role of each piece of DNA code in our immune function. The complex interactions of microscopic proteins and chemicals in our bodies is much more difficult to interpret and predict than we can even fathom. Nonetheless, it’s really exciting that we’re inching closer to being able to protect ourselves from scary viruses. We’ve won a few battles, but haven’t yet won the war.

And on another front, some researchers are working on modifying the ebola virus so as to render it harmless to humans. I’m not sure I’d want to sign up for THAT research project, frankly. I have a lot of respect for those who work in labs with such risky pathogens – but let’s just say I wouldn’t want to invite those folks out for a beer.

Let’s keep an eye on scientific discoveries in the field of virology. With the bird flu and other threats looming on the horizon, our lives may one day depend on it!This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Dannon Sued For Exaggerated Yogurt Claims

I loved yogurt when yogurt wasn’t cool.

In fact, I grew up on a small dairy farm in Canada where our sole product was yogurt. My parents bought a cow (Daisy) “in an unguarded moment” and ended up having to get creative to get rid of all the extra milk that she produced for our family. One thing led to another – and I wound up as the VP of Sales and Marketing for a growing yogurt company taking Canada by storm. So when I saw today’s news release about Dannon being sued for exaggerated health claims for their yogurt, my dairy ears perked up.

First of all, if it’s true that Dannon is claiming that their yogurt has greater health benefits than other yogurts with active cultures, that’s false advertising.

I also think it’s pretty sneaky that they (allegedly) ran ad campaigns exaggerating the health benefits of yogurt, and then marked up their product by 30% to make consumers feel that they were getting added value from what was there all along. Typical big business move, right?

Secondly, yogurt bacteria do have beneficial uses (eating yogurt may decrease colon infection rates in hospitals, and can reduce the chance of vaginal yeast infections after antibiotic use). There is no conclusive evidence that yogurt treats or prevents diarrhea. However, it’s silly to extrapolate that these friendly bacteria will improve the health of your entire immune system – so you’ll never be sick – or that they will perfectly regulate your bowels – regardless of your underlying disease. As with many foods that have been shown to have some specific health benefits (green tea, blueberries, flax seeds) the media tends to blow them out of proportion.

And finally, what should you know about yogurt? Know that for those who are not allergic to milk products, it is a healthy nutritional option (especially the low fat variety without too much sugar) that may be especially important if you’re in the hospital or have received any antibiotics recently. Yogurt contains protein and calcium, which are important components of a healthy diet. But beyond this nutritional benefit (and the infection reduction in at-risk populations), I wouldn’t ascribe any particular magic powers to this tasty treat – as much as I’d like to.

1. Look for the “active cultures” sign on yogurt containers. The National Yogurt Association (NYA) established its own criteria for live and active culture yogurt in conjunction with its Live & Active Culture seal program. In order for manufacturers to carry the seal, refrigerated yogurt products must contain at least 100 million cultures per gram at the time of manufacture. Don’t pay extra for a yogurt because they have live cultures. The majority of them do!

2. Yogurt bacteria don’t live forever in your gut, so you’ll need to eat yogurt (or take active cultures) regularly to repopulate the colonies. I can’t find any data to support an exact consumption frequency. I guess it also depends on how many bacteria are contained in the yogurt or supplement you’re taking.

3. Acidophilus pills (one of the most popular yogurt bacterial strains) are available at health food stores for those who’d rather not eat yogurt but still want the benefits of the culture. These pills must be refrigerated to keep the culture alive (kind of like keeping milk cool) – and make sure you check the expiration date too. For more information on acidophilus, check out this supplement database.

4. The most common side effect of eating live yogurt cultures (in pill form or in yogurt form) is bloating and gas.

So don’t be surprised if you encounter it!

And I think that’s a nice thought to end on.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Dr. Val: Best New Medical Blog of 2007!

I am very pleased to announce that this little blog of mine has won the highly coveted “Best New Medical Blog, 2007” award from MedGadget.com. Please go to the MedGadget site to check out all the other finalists and winners – I am truly honored to be counted among them.

If you’d like to peruse the best of my blog posts from this past year, simply click here.

If you’d like to check out some of my cartoons, please click here.

If you’d like to lose weight (yes, that’s right – Dr. Val is leading a weight loss group complete with activity tracker tools and a vibrant discussion board) please click here.

A heartfelt thanks to those of you who voted for me. I was touched that MedGadget mentioned that my blog provides “a human approach to medicine, balancing news and research with anecdotes and humor.” I think that sums up my style nicely.

Hope to see some of you in my weight loss group!This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Is It Hip To Be Fat?

The New York Times reported on a growing number of bloggers who identify themselves as “fat” and are proud of it. Their message is clear: accept yourself as you are, be proud of your body, and don’t feel forced to conform to the “thin is in” crowd. The Times continues:

Smart, sassy and irreverent, bloggers with names like Big Fat Deal, FatChicksRule and Fatgrrl (“Now with 50 percent more fat!”) buck anti-obesity sentiment. They celebrate their full figures and call on readers to accept their bodies, quit dieting and get on with life.

The message from the fatosphere is not just that big is beautiful. Many of the bloggers dismiss the “obesity epidemic” as hysteria. They argue that Americans are not that much larger than they used to be and that being fat in and of itself is not necessarily bad for you.

And they reject a core belief that many Americans, including overweight ones, hold dear: that all a fat person needs to do to be thin is exercise more and eat less.

What do I make of this? I think that the so-called fatosphere has hit on some important issues: discrimination against the obese, media pressures to be rail thin, and excessive yo-yo dieting are all unfortunate and perhaps dangerous aspects of our culture. Self-esteem can be rapidly eroded by unrealistic beauty ideals, and young women are particularly vulnerable. I whole heartedly agree with the fatosphere’s rage against the collateral damage of anorexic values. But I also think that the fatosphere goes too far in arguing that obesity is not a health problem and that some people are unable to lose weight and should stop trying.

First of all, there is no scientific doubt that obesity contributes to increasing type 2 diabetes and heart disease rates. Now, it’s true that some people’s bodies can handle extra fat without becoming diabetic or perhaps having a heart attack, but why take the risk?

Second, I agree that the jury is still out regarding how “dangerous” being overweight is (as opposed to being obese), and that people with BMIs <30 may indeed be physically fit with no obvious increases in morbidity and mortality. Yes, there is one controversial study that suggests that a little extra fat may actually be protective. But let’s not exaggerate those findings. It was a “little extra fat,” (i.e. being overweight) not obesity.

Third, I don’t believe that people are “doomed” to be obese. The National Weight Control Registry keeps a running list of thousands of Americans who have lost over 30 pounds of fat and kept that weight off for at least 5 years. Long term weight reduction is possible, and believing that it IS possible is important for success. So what do these successful folks have in common? No surprise here: long term, consistent calorie reduction and regular physical activity.

I have been cheering on my friend and blogger, Fat Doctor, as she works towards getting her weight out of the obese range. I do think that her voice is very much needed in the fatosphere: she acknowledges that weight loss is very difficult, she is honest about her struggles, she does not support discrimination against the obese or the pursuit of excessive thinness, but she knows that she must lose weight for her health, and she is getting medical help to achieve her goals.

If any of you out there would like to follow in Fat Doctor’s footsteps, there’s a weight loss group right here at Revolution Health (led by yours truly – and yes, I have some weight to lose!) that may help to get you back on track with regular exercise and healthy eating. Sixty percent of Americans are overweight or obese, which makes chubbiness pretty trendy. But we are not doomed… we can reverse this trend one person at a time. Let’s do it!This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

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