April 21st, 2011 by Richard Cooper, M.D. in Health Policy, Opinion
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In a recent op-ed in the San Francisco Examiner, William Dow, a professor of health economics at UC Berkeley, commented on the importance of education as a means of enabling more people to afford health care insurance. In my view, education is important not simply because an educated population can more easily pay for health care. The main importance is that educating children will allow those children and their children to have healthier childhoods, less burden of disease as adults, access to more personal and communal resources to deal with whatever disease they have and less need for health care, and that translates into less health care spending. Let me frame this in terms of the San Francisco Bay Area.
In a series of articles in the Contra Costa Times last year, Susanne Bohan and Sandy Kleffman described the striking differences in life expectancy in poor vs. wealthy ZIP codes in East Bay. Life-expectancy in Walnut Creek (94597) was 87.4 years, but it was only 71.2 years in Sobrante Park (94603), where household incomes are about half and poverty >20%. That’s a gap of 16.2 years. We find that, in addition to a shorter life-expectancy in Sobrante, the inpatient hospital utilization rate is double the rate in Walnut Creek. Poverty is not only tragic. It’s expensive. Read more »
*This blog post was originally published at PHYSICIANS and HEALTH CARE REFORM Commentaries and Controversies*
April 16th, 2011 by Shadowfax in Health Tips, Opinion, Research
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There was an interesting study published this week in the journal Radiology:
Rising Use of CT in Child Visits to the Emergency Department in the United States, 1995–2008 (Abstract)
The results are not surprising to anyone who has been working in medicine in the US over the last fifteen years. Basically, in 1995, a kid visiting the ER had a 1.2% likelihood of getting a CT scan, and by 2008, that number was 5.9%.
I had written about this general phenomon not too long ago, in defense of the general increase of CT utilization in the ER, largely on the basis that CT is a better tool: it provides diagnoses in a rapid and timely manner, and excludes many potential life threats, saving lives and mitigating malpractice risk. That was largely relevant to the adult population, though, and kids are not, as they say, just little adults. The increase in scanning children is more dramatic, especially given the generally lower incidence of disease in kids compared to adults and the chonrically ill. Read more »
*This blog post was originally published at Movin' Meat*
April 10th, 2011 by DrWes in Humor, True Stories
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He must have been about eight at the time. I had made the mistake of watching doctor shows on TV with him and he had probably heard my wife and I describe the challenges of my doctor lifestyle at times over dinner. For the most part, he seemed oblivious and liked the things that most young boys at that age do: sports, jungle gyms, mud, and bicycles, but he had never seen his Dad at work.
So the day came when my wife was doing errands and stopped by the hospital with the kids to drop off my pager which I had inadvertently left at home. As timing would have it, I had just scrubbed in a case, so she was kind enough to bring the pager to the electrophysiology lab control room where the technicians could retrieve it for me. My son, realizing how close he was to my workplace asked within earshot of the technician, “Mom, could I see?” She looked at the technician, and he nodded agreement. Cautiously, they entered the control room just to wave “hi” briefly through the glass. Read more »
*This blog post was originally published at Dr. Wes*
April 10th, 2011 by PeterWehrwein in Health Policy, Health Tips
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Opening Day, the first day of the 2011 major league baseball season, was March 31st. The first pitch was thrown a little after 1 p.m., and sometime after that baseball fans heard the first crack of the bat of a brand-new season.
Even nonfans can rejoice at this sign of spring, and a promise that summer days are ahead.
But you won’t hear the crack of the bat very much these days from other diamonds—Little League, high school, and college. It has been replaced by pings and thunks as most players at those levels now use metal bats or composite ones, which that are made with a mixture of materials, including graphite.
Players started using metal (usually aluminum) bats about 30 years ago. They last longer than wooden bats and send the ball farther. The composite models have come on strong more recently.
But there’s growing concern that nonwood bats may pose a safety hazard to fielders—especially pitchers— because they make a hit baseball go faster. The added speed gives fielders less time to react and, if they are hit, increases their risk of injury. Read more »
*This blog post was originally published at Harvard Health Blog*
April 3rd, 2011 by Bryan Vartabedian, M.D. in Opinion
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Patient care is increasingly under third party control. And as a consequence I make fewer decisions regarding the brand of medication used in my patients.
So the role of a pharmaceutical rep comes into question. If I don’t choose which medication my patients will use, why would a representative call on me? And as American medicine becomes more centralized and standardized, I wonder how and why industry will connect with treating physicians. Pharma it seems is asking the same question: Of the core medications I prescribe, I see far fewer reps these days and our relationships are markedly different from a decade ago.
I don’t miss the pitch. But I find the element of human support to be important. For example, recently the FDA issued a black box warning for the concomitant use of Remicade and 6-MP. My representative visited to be sure that I was aware of the changes in the product insert. Sure the information was in my mailbox – along with 6 inches of pulp spam. It’s basic attenionomics: I’m more likely to hear a person than a letter. Read more »
*This blog post was originally published at 33 Charts*
