September 22nd, 2011 by Jessie Gruman, Ph.D. in Health Policy, Opinion
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Every day in the U.S. countless experts discuss plans and policies to contain the cost of health care using words and concepts that run counter to our (the public’s) experiences with finding and using care. Most of us ignore the steady stream of proposals until one political party or the other crafts an inflammatory meme that resonates with our fears of not getting what we need. At which point, we leap into action online, in town meetings and in the voting booth. As Uwe Reinhardt noted in his Kimball Lecture at the recent 2011 ABIM Foundation Forum, researchers and policy makers “cannot even discuss the cost-effectiveness of health care without being called Nazi(s).”
Our discomfort with the array of private and public sector proposals to improve health care quality while holding down costs should not be surprising. Most of us hold long-standing, well-documented beliefs about health care that powerfully influence our responses to such plans. For example, many of us believe that:
… if the doctor ordered it or wants to do it, we must need it.
… talking about less expensive treatments makes us feel that others are trying to bargain-shop our care and that scares us.
… clinical care does not vary much among our own doctors and hospitals.
… when we talk about the “quality” of health care we are referring to Read more »
*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*
September 11th, 2011 by DavedeBronkart in News
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Big news from Down Under: the Sydney Morning Herald reports that a group of fifty consumer health advocates has unanimously backed an “opt-out” process for enrollment in electronic health records, reversing their previous position.
The issue is whether by default all patients have an EHR. “Opt-out” means you’re in by default – your records will be stored electronically – and you can opt out if you want. “Opt-in” means you do not have an EHR unless you specifically ask for one.
The group, the Consumer Health Forum, cites evidence from the neighboring country of New Zealand, in which Read more »
*This blog post was originally published at e-Patients.net*
July 19th, 2011 by PreparedPatient in Opinion
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Glenn Laffel, M.D., Ph.D., of Pizaazz hypothesizes about why we often don’t make changes that would benefit our health. He says:
“Somewhere in the course of our daily lives, though, most of us do exhibit behavior that suggests at least some disregard for our health. We don’t change our diet, though we know we should. We don’t floss, take medications as prescribed, or get the screening tests we’re supposed to.”
He knows multiple complex causes exist for this and questions whether being diagnosed with a chronic condition motivates people to improve health behaviors exploring whether the delay between health behaviors and health outcomes contributes to unhealthy behavior. After looking at attrition rates in a diabetes self-management program, he concludes:
“It calls attention to a key distinction behavioral psychologists like to make in explaining human motivation: there’s a difference between awareness of the need to act, and the volition to act.”
Family doctor Kenny Lin, M.D., previously recommended that people “tackle one behavior at a time.” He says: Read more »
*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*
July 7th, 2011 by admin in Research
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Nearly forty years ago, President Richard Nixon famously declared a “War on Cancer” by signing the National Cancer Act of 1971. Like the Manhattan Project, the Apollo program that was then landing men on the Moon, and the ongoing (and eventually successful) World Health Organization-led initiative to eradicate smallpox from the face of the Earth, the “War on Cancer” was envisioned as a massive, all-out research and treatment effort. We would bomb cancer into submission with powerful regimens of chemotherapy, experts promised, or, failing that, we would invest in early detection of cancers so that they could be more easily cured at earlier stages.
It was in the spirit of the latter that the National Cancer Institute launched the Prostate, Lung, Colorectal, and Ovarian Cancer (PLCO) Screening trial in 1992. This massive study, which eventually enrolled more than 150,000 men and women between age 55 and 74, was designed to test the widespread belief that screening and early detection of the most common cancers could improve morbidity and mortality in the long term. Not a few influential voices suggested that the many millions of dollars invested in running the trial might be better spent on programs to increase the use of these obviously-effective tests in clinical practice.
They were wrong. As of now, the PLCO study is 0-for-2. Read more »
*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*
June 10th, 2011 by DavedeBronkart in Opinion, Patient Interviews
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Ten days ago a post here mentioned the 14th ICSI / IHI Colloquium. I said the Society for Participatory Medicine was well represented, including:
- Jessie Gruman, four time cancer patient and founding co-editor of our journal, gave an important breakout session, about which I’ll be writing soon. (Jessie is founder and president of the excellent Center For Advancing Health.)
Jessie’s talk was so good it had me going nuts on Twitter – I couldn’t keep up with all the “tweet-worthy” things that came out of her mouth.
Well, I’ve just re-read her text, and it brought back why I went nuts. I was going to write about it, but I’m just going to post the full text.
For those who don’t know, last fall Jessie underwent surgery for her fourth cancer; she has some experience. Read more »
*This blog post was originally published at e-Patients.net*
