September 13th, 2011 by PJSkerrett in Health Tips, True Stories
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It isn’t easy to get rid of a harmful habit like drinking too much, or to make healthy changes like losing weight and exercising more. Media stories about people who run marathons a year after surgery to bypass cholesterol-clogged arteries or who climb Mt. McKinley after being diagnosed with diabetes are interesting, but they don’t resonate with me. Mostly it’s because they often leave out the hard work needed to change and the backtracking that invariably accompanies it.
I ran across a truly inspiring story the other day in the American Journal of Health Promotion—one that shows how most of us ultimately manage to make changes that improve our lives. The journal’s founder and editor, Michael P. O’Donnell, wrote a moving essay about his father, Kevin O’Donnell. Once an overweight workaholic who smoked and drank heavily, ate mostly meat and potatoes, and didn’t exercise—and who eventually needed a double bypass—Kevin O’Donnell gradually made changes to improve his health. Now, at age 85, he has the cardiovascular system of a 65 year old and is working on a house-building project in North Korea.
How did Kevin O’Donnell engineer such a remarkable transformation? Read more »
*This blog post was originally published at Harvard Health Blog*
August 16th, 2011 by Happy Hospitalist in Opinion, Research
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Association of Hospitalist Care With Medical Utilization After Discharge: Evidence of Cost Shift From a Cohort Study.
That’s the title of the latest medical study making the viral rounds. I had an opportunity to read the study in full. I called Happy’s hospital library and Judy had the pdf article in my email in less than 24 hours. Now, that’s amazing. Thanks Judy for a job well done. You deserve a raise.
Presented in the August 2nd, 2011 edition of the journal Annals of Internal Medicine, Volume 155 Number 3 Page 152-159, the study concludes that decreased length of stay and hospital costs associated with hospitalist care are offset by higher medical utilization and costs after discharge.
In summary, hosptitalist patients had an adjusted length of stay 0.64 days shorter and $282 less than patients cared for by primary care physicians, but total 30 day post discharge costs were $332 higher. These additional charges were defined as 59% from rehospitalization, 19% from skilled-nursing facilities, and 22% from professional and other services.
OK fair enough. Let’s come to that conclusion. Let’s say Read more »
*This blog post was originally published at The Happy Hospitalist*
August 9th, 2011 by RyanDuBosar in Research
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People with exceptional longevity have the same bad lifestyle habits as the rest of us, suggesting that their genes may interact with environmental factors differently than others. There’s not much you can do if you’re not one of the lucky ones born with superior genes. For the rest of us, a healthy lifestyle is still the best option to live longer.
To assess lifestyle factors including physical activity, smoking, alcohol consumption, and diet in men and women with exceptional longevity, researchers conducted a retrospective cohort study of community dwelling Ashkenazi Jews with exceptional longevity defined living independently at age 95 and older. The Ashkenazi population descended from tens of thousands of Jews originating in the 15th Century who eventually moved to or were born in the U.S. before World War II.
The researchers compared Read more »
*This blog post was originally published at ACP Internist*
August 7th, 2011 by Happy Hospitalist in Opinion, Research
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I’ve been telling my smoking patients for years that nothing I do for them is going to make an ounce of difference until they quit smoking for good. And the Italians are out to prove me right. The American Journal of Cardiology reported July 11th, 2011 on the Effect of Smoking Relapse On Outcome After Acute Coronary Syndrome.
In a study of just under 1,300 patients, Reuters reports that just over 1/2 the patients started smoking within 20 days of hospital discharge, despite in-hospital smoking cessation consultation for all patients. Researchers also found that resuming smoking increased death 3-fold compared with those that did not relapse and quitting smoking had a similar lifesaving effect as taking cholesterol and blood pressure medications. And I’m sure these folks all landed themselves back into the hospitals for a very expensive dying process.
That’s why billing the patient or their insurance for smoking cessation (CPT® 99406 and 99407) is so important. And that’s why I give many of my smoking patients my smoking lecture. You know how much Medicare pays for a ten minute consultation to help cardiac patients quit smoking right now? Read more »
*This blog post was originally published at The Happy Hospitalist*
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*
