September 17th, 2008 by Dr. Val Jones in Expert Interviews
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Peripheral Artery (Arterial) Disease (P.A.D.) is an under-recognized and under-diagnosed condition, yet it serves as an important warning sign for those at high risk for stroke and heart attack. Even though we have an inexpensive and non-invasive test for P.A.D. very few people have the test done. I interviewed Dr. Gary Schaer, Director of the Cardiac Cath Lab at Rush University Medical Center in Chicago, about P.A.D. and also spoke with actor Phylicia Rashad about her family’s trials and tribulations with P.A.D. This post is devoted to Dr. Schaer’s insights on the medical aspects of the disease, and the next post focuses on Ms. Rashad’s personal story. To listen to the entire podcast of our interview, please click here.
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September 8th, 2008 by Dr. Val Jones in Uncategorized
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Last week I attended a press conference about healthcare reform at the National Press Club. The most interesting of the 4 speakers was Grace-Marie Turner, president of the Galen Institute. In a recent editorial in the Wall Street Journal, Ms. Turner argued that,
The complex problems in our health sector are best cured by a bigger dose of market competition, not more government intervention.
I had the chance to interview Ms. Turner after her lecture.
Dr. Val: You’ve said that “we’ve got to come to a uniquely American solution to our healthcare crisis.” What does that mean?
Ms. Turner: I speak a lot in Europe, and they really believe that we have a permanent underclass of 47 million people who never have access to our healthcare system. They imagine that they’re bleeding in the streets. We know that’s not the case. Everyone has access to healthcare through emergency rooms – but this is an inferior way to access healthcare. People end up getting treatment at the end of an illness rather than the beginning when things could be better treated, and it’s much more expensive. We need to solve the problem of health insurance.
The movement of “consumerism” is something the world is looking to us to figure out. In other countries their concept of “innovation” is adopting diagnostic codes and payment structures for a system of treatment. We’ve had that for over 20 years in America. When we talk about innovations we mean new ways to respond to consumer needs. The fact that we don’t have so many rules and regulations guiding the entire structure of the healthcare experience means that we can innovate. We can create diversity of care options.
Most of the major research-based pharmaceutical innovations occur in America because we don’t have price controls and we don’t have restrictions on access to care. These are unique aspects of the American healthcare system, and even though Europeans criticize us, they’re always looking to learn from us.
Dr. Val: Why are “medical homes” important?
Ms. Turner: In this increasingly complex healthcare system, people need to have a place to go where their care will be coordinated. That may be a physician’s practice, but it can also be an electronic medical home where people have their medical records kept in one place, and where they have access to different specialists that they can use to coordinate their care. The medical home is really a beacon for more accurate, coordinated and more productive use of our healthcare system.
Dr. Val: You mentioned that there is a “workforce crisis” in our healthcare system — that there are not enough primary care phsyicians to meet demands. Yet you also said that If people could buy health insurance across state lines we could solve a lot of the access issues. How can both be true?
Ms. Turner: It’s a chicken and egg problem. We’ve got to increase access to health insurance. We can’t have 45 million people feeling that they’re blocked from predictable access to healthcare. Once you get tens of millions more people into the healthcare system, then you’re going to start to see a lot of pressure to better utilize the resources that are currently in the system. For example, people don’t always have to go to a doctor for something that a mid-level medical professional could provide them.
I predict that more people will begin to purchase high deductible insurance in case of major accidents or catastrophic events – but they’ll want more control over their routine access to the system, including convenient care clinics and complementary and alternative medicine. If we allowed cross-state health insurance purchasing, it would force the system to meet the needs of consumers for more affordable and convenient care.
Dr. Val: You said that increasing access to complementary and alternative medicine is about giving people “more choices.”
Ms. Turner: I’ve heard so many stories about people who were getting their care through their health insurance providers – guided through a predictable pattern of specialist care. And then when they swithched to a health savings account, they could access the system the way they wanted to. So many of our health issues are behavior-related, and it seems that alternative medicine practitioners can have success in helping people modify their behaviors. The more we have top-down regulatory prescription of what the system will pay for or not, the more you eliminate the alternative practices that might be very helpful to people. I’d like to see a lot more pluralism in our healthcare system, and expanding government intervention is not going to help us achieve that goal.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
August 29th, 2008 by Dr. Val Jones in Uncategorized
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Here’s my weekly list of things that caught my eye in the medical blogosphere:
Vaccines
With all the misinformed parents opting out of vaccinating their kids, could polio make a comeback the way measles has? Dr. Doug Farrago speculates about the new wave of paralyzed children that may be on the horizon.
Bloggers
What kind of person blogs? A new study suggests that bloggers are more likely to be both “open-minded” and “neurotic” by nature.
Drugs of Abuse
Steroid abuse can lead to a severe form of disfiguring acne. KevinMD found this example.
How NOT to forge a prescription for pain medicines. Thank you, Dr. White Coat.
The Healthcare System
Barack Obama says that a government-run single payer healthcare system makes sense for America. Now THAT’s scary.
Thousands wait in line for a free health clinic, staffed by volunteer physicians in Apalachia.
The government clamps down on pharmaceutical gift pens and paper to doctors while welcoming millions in sponsorship from them for political causes. Wow.
Gadgets
How about this new gadget? A clock that you can wear on your thumb nail.
Weird Anatomy
Would you like a vase shaped like your elbow or knee? Why not?
Are men with wider faces more likely to be violent? Dr. Joe presents the latest research.
This artist takes old fashioned anatomical drawings and makes them “joyful.”
Some serious exophthalmos from Happy Hospitalist.
The Cutest Animal Photo EVER
Sorry, I couldn’t resist. Thanks, Medgadget.com
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
August 10th, 2008 by Dr. Val Jones in True Stories, Uncategorized
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A psychiatrist friend of mine (we’ll call him “Dr. X”) treats urban patients who have substance abuse problems and often live in homeless shelters. Here are some recent conversations that had me scratching my head:
Mr. P: [recovering from crack cocaine, alchohol, and heroin abuse] Doc, I’ve been feeling really depressed lately and the therapy sessions aren’t helping.
Dr. X: I know that we’ve done all we can to manage your depression conservatively. You may want to consider trying a small dose of an anti-depressant medication. It could really help.
Mr. P: [Eyes bulging, jaw dropped] But, Dr. X, those anti-depressant medications might affect my MIND!
***
Dr. X: Ms. P, why aren’t you taking your prenatal vitamins?
Ms. P: [actively smoking crack while pregnant] I don’t trust that stuff. I think it could harm my baby.
***
Dr. X: Ms Y, I know you’ve been struggling with pain related to your broken leg. Why not let me prescribe some pain medications for you?
Ms. Y: Oh, no – I don’t want any prescription medicines. I don’t trust those.
Dr. X: Well how are you going to manage your pain, then?
Ms. Y: My sister has some pills that I take.
Dr. X: What pills?
Ms. Y: Darvocet and Vicodin.
***This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
July 16th, 2008 by Dr. Val Jones in Medblogger Shout Outs
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A non English-speaking husband and wife went to a rural ER because the wife had chest pain. The ER staff was unable to understand their language and did not have an interpreter. Since the husband was trying to explain his wife’s chest pain to the doctors, they thought he also had chest pain. Both patients were admitted to rule out MI (a heart attack). They stayed overnight and both had a full, negative cardiac workup. The husband complied with the workup, figuring he was getting free care and a place to stay next to his wife. His wife’s symptoms resolved on their own. (via Rural Doctoring)
Did you know that there are medical diagnosis codes for almost everything under the sun? Yes, even an “accident involving a spacecraft injuring the occupant of the spacecraft.” (via KevinMD)
A hospital pharmacy cancelled a surgeon’s order of antibiotics after a young patient survived a ruptured appendix (with pus in the abdomen). They were adhering to a new protocol that required all antibiotics to be discontinued 24 hours after any surgery. If the surgeon hadn’t noticed the inappropriate application of this new rule, his patient could have become septic and died. This is just another example of the oversimplification of medicine that is becoming more and more common these days. (via Buckeye Surgeon)
The ACP Internist blog posts a weekly “Medical News of the Obvious.” Here are two goodies:
Parents of twins report more anxiety and sleeping difficulties in the year after birth than parents of single children, according to a study presented at the 24th annual meeting of the European Society of Human Reproduction and Embryology (via Science Daily). I wonder why?
This study, courtesy of the Washington Post, finds that auto deaths decline as gas prices rise because– ta da!– there are fewer people on the road to kill or be killed. And that is especially the case for those subgroups (like teenagers) who don’t have as much money to burn on gassin’ up.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
Peripheral Artery (Arterial) Disease (P.A.D.) is an under-recognized and under-diagnosed condition, yet it serves as an important warning sign for those at high risk for stroke and heart attack. Even though we have an inexpensive and non-invasive test for P.A.D. very few people have the test done. I interviewed Dr. Gary Schaer, Director of the Cardiac Cath Lab at Rush University Medical Center in Chicago, about P.A.D. and also spoke with actor Phylicia Rashad about her family’s trials and tribulations with P.A.D. This post is devoted to Dr. Schaer’s insights on the medical aspects of the disease, and the next post focuses on Ms. Rashad’s personal story. To listen to the entire podcast of our interview, please click here.
