To Your Healthtag:blog.news-record.com,2008:/staff/health//342008-07-17T14:56:13ZA checkup on health, medicine and related issues.Movable Type 3.34Meaningful health-care reform: DOA?tag:blog.news-record.com,2008:/staff/health//34.261272008-07-17T14:48:28Z2008-07-17T14:56:13ZIs serious reform of our health-care system dead before it's even introduced in Congress next year? Yeah, probably, writes Brian Klepper at The Health Care Blog. Why? Well, as the songwriter Randy Newman once pointed out, it's money that matters....Lexhttp://blog.news-record.com/staff/health/
writes Brian Klepper at The Health Care Blog.
Why? Well, as the songwriter Randy Newman once pointed out, it's money that matters. Industry lobbyists have spent tens of millions of dollars in contributions to congresscritters. It's a lot of money to you and me, but negligible to the industry when hundreds of millions, or even billions, in revenue may be on the line for them.
That system's ramifications affect not just the health-care system but also people's health, as Klepper notes in his analysis of the U.S. obesity epidemic (31% of Americans are obese, compared with distant runners-up Mexico (24%) and Britain (23%). There are a lot of reasons for that, but money is the predominant one, Klepper writes. And here's the most depressing part:
... since weight is important to fitness, fitness is important to overall health, health is an important component of productivity, and productivity drives competitiveness, the US' future prospects are already lousy and headed south. In terms of our health AND our competitiveness, we're committing slow suicide.
Anyone looking for cheaper or better health care will find the post depressing. Klepper offers a couple of solutions but says they're both improbable.
Is he missing something? Is the situation as dire as he says? Are solutions as few in number and as unlikely to be achieved as he says?]]>
Breast self-exam: Yes or no?tag:blog.news-record.com,2008:/staff/health//34.261242008-07-17T14:15:27Z2008-07-17T14:39:13ZIt has become conventional wisdom that women should examine their breasts regularly to feel for lumps or other irregularities that could be, or become, cancerous. But is this really an effective approach? Some researchers say no, and Al Tompkins at...Lexhttp://blog.news-record.com/staff/health/
lengthy list of links to articles and resources on the subject. (You might also want to read the comments on t Tompkins' post. There are two as I write this, both defending breast self-exams.)
Coincidentally and quasi-relatedly, my article on how the local nonprofit Friends for an Earlier Breast Cancer Test's grant kicked off some research into breast-cancer detection at the Mayo Clinic ran here today.]]>
Global warming = more kidney stones?tag:blog.news-record.com,2008:/staff/health//34.260692008-07-15T16:37:45Z2008-07-15T16:41:35ZThat's what this article at NewScientist.com is saying. OK, strictly speaking, it's saying that global warming = more cases of dehydration, with dehydration being a known cause of kidney stones. But even as a lay person, I've got a problem...Lexhttp://blog.news-record.com/staff/health/
is saying.
OK, strictly speaking, it's saying that global warming = more cases of dehydration, with dehydration being a known cause of kidney stones. But even as a lay person, I've got a problem with this claim, that being this: Even if overall global temps are going up, that doesn't mean they'll necessarily increase significantly enough to cause increased numbers of dehydration cases sufficient to cause the kind of increase in kidney-stone incidence that the writers are claiming (an additional 2.5 million cases per year).
But I could be wrong. What do you think?
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Gun control as individual right ... and as public-health issuetag:blog.news-record.com,2008:/staff/health//34.260042008-07-11T14:19:38Z2008-07-11T14:30:15ZThe New England Journal of Medicine, whose concerns about striking down the District of Columbia's 1976 gun-control law I noted here and here, is now saying that in the wake of the Supreme Court's June ruling in District of Columbia...Lexhttp://blog.news-record.com/staff/health/
here and here, is now saying that in the wake of the Supreme Court's June ruling in District of Columbia v. Heller that barring certain exceptions, individuals do, indeed, have a Second Amendment right to bear arms.
That ruling, the journal says in an editorial, now embarks the nation on a de facto experiment in seeing what effect the lack of strict gun control has on the numbers/rates of gun deaths of all types. The journal is not optimistic:
If there is a widespread loosening of gun regulations, we will learn over the next few years — in a before-and-after experiment — whether the laws we had in place had a significant impact in mitigating death and injury from handguns. In our opinion, there is little reason to expect an optimistic result; research has shown and logic would dictate that fewer restrictions on handguns will result in a substantial increase in injury and death. ...
The journal insists that the first clause of the Second Amendment places the right of gun ownership within the context of a "well-regulated militia," not individuals -- an argument weighed in Supreme Court deliberations and found wanting by the majority.
So, do you think there are, or will be, public-health ramifications from this ruling? Why or why not?]]>
It should never happen ... but it doestag:blog.news-record.com,2008:/staff/health//34.259832008-07-10T16:10:59Z2008-07-10T16:24:32ZOne of the phrases currently in vogue in medicine is "never events," which refers to things, particularly mistakes, that are so preventable that they should never happen. Insurance companies are even threatening to refuse to reimburse hospitals for costs incurred...Lexhttp://blog.news-record.com/staff/health/
blog post about one such "never event" that took place this week at Beth Israel Deaconess Medical Center there. The nature of the procedure hasn't been disclosed, but in general what happened was that the wrong side of a patient was operated on. Fortunately, the patient is recovering and will suffer no lasting damage.
The Health Care Blog republishes a memo sent to hospital staff that is remarkable for its openness. It says two important things: 1) There are procedures in place to prevent this type of mistake from happening, and 2) in this case those procedures were not followed.
Medical professionals and patients alike can learn from this. The pros are reminded that these procedures exist for a reason and must be followed without exception. Patients are reminded that they need to ask questions of those who care for them to ensure that "right patient, right procedure, right side" is where the operation goes. (When I underwent shoulder surgery several years ago, the surgeon put a big X on the appropriate shoulder before surgery. I asked if that was to make sure the wrong shoulder didn't get operated on, and his response was something along the lines of, "You're darned right."
Some patients have taken it upon themselves to mark or label the wrong side with phrases like "Other side, please" or "Not this one." Some do it as a joke, but as this incident shows, it ain't funny. If the patient in question had been, say, having a cancerous kidney removed, he'd be in serious trouble.
I should stress that these events are very rare. But the potential consequences could be deadly. Procedures are in place for a reason. Docs, nurses and patients need to know about them and make sure they're followed.]]>
Be nice or ... what, exactly?tag:blog.news-record.com,2008:/staff/health//34.259732008-07-09T21:37:09Z2008-07-09T21:43:24ZThe Wall Street Journal's health blog reports that the Joint Commission, the group that accredits hospitals, is requiring hospitals to come up by Jan. 1 with policies dictating "unacceptable behavior" and how it will be dealt with. This goes beyond...Lexhttp://blog.news-record.com/staff/health/
reports that the Joint Commission, the group that accredits hospitals, is requiring hospitals to come up by Jan. 1 with policies dictating "unacceptable behavior" and how it will be dealt with.
This goes beyond lying/stealing/malpractice/sexual harassment to get into more day-to-day interpersonal relationships. Why? Various kinds of miscommunications are behind about 70% of "sentinel events" -- preventable serious injuries or deaths of patients, the blog says. And if, say, a doctor routinely yells at and otherwise verbally abuses nurses, the chance that a miscommunication will occur increases.
So the requirement sounds good until you realize that the Joint Commission doesn't define "unacceptable behavior" or lay out what the consequences might be for tolerating it.
It seems plausible that bad behavior of this type could lead to potentially serious miscommunications. But it's far from clear how big a problem this is, let alone what will happen to hospitals where it goes on.]]>
Doctors who don't take insurancetag:blog.news-record.com,2008:/staff/health//34.259532008-07-09T14:30:15Z2008-07-09T14:35:05ZMaggie Mahar at The Health Care Blog writes about physicians who no longer accept any kind of health insurance. How does it work? From the physician's standpoint, it means less time and resources devoted to insurance paperwork, which in turn...Lexhttp://blog.news-record.com/staff/health/
writes about physicians who no longer accept any kind of health insurance.
How does it work? From the physician's standpoint, it means less time and resources devoted to insurance paperwork, which in turn means more time with patients. The down side? It's likely that fewer people will get health care because they can't afford it. Still, for certain types of practices (primarily primary care) it might work. Take a look at her post and tell me what you think.
Also: Do you know of any physicians locally who aren't taking any insurance? Please let me know.]]>
Sad newstag:blog.news-record.com,2008:/staff/health//34.259252008-07-08T19:41:25Z2008-07-08T19:48:11ZCathy Rose, the nonsmoking woman I wrote about who was dying of lung cancer and spent her last weeks advocating for more spending on lung cancer research, died this morning. My condolences to her family....Lexhttp://blog.news-record.com/staff/health/
wrote about who was dying of lung cancer and spent her last weeks advocating for more spending on lung cancer research, died this morning. My condolences to her family.
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Cancer trial: How to sign uptag:blog.news-record.com,2008:/staff/health//34.257532008-06-30T18:56:14Z2008-06-30T19:03:13ZOn Sunday I wrote about a human trial that Wake Forest researchers are about to begin on using a certain type of white blood cell to try to fight cancer. The print edition included a link to a site where...Lexhttp://blog.news-record.com/staff/health/
wrote about a human trial that Wake Forest researchers are about to begin on using a certain type of white blood cell to try to fight cancer. The print edition included a link to a site where you could get more information on being a trial participant or volunteer to be tested as a possible donor for the trial. Unfortunately, the online version didn't include that link, so here it is.]]>
E-mail about proposed breast-cancer hospitalization law: Is it for real?tag:blog.news-record.com,2008:/staff/health//34.257512008-06-30T17:46:35Z2008-06-30T18:03:51ZMy colleague Lorraine Ahearn forwarded to me an e-mail that, to judge from its indenting, has been sent to many places. It says insurance companies are trying to make mastectomies for breast cancer an outpatient procedure. It says women who...Lexhttp://blog.news-record.com/staff/health/
Snopes.com. I searched on the bill name mentioned in the e-mail, "Breast Cancer Patient Protection Act," and sure enough, Snopes had an entry.
There is such a bill, Snopes said, linking to both House and Senate versions. Similar bills have been introduced in previous Congresses but have died in committee. The current versions, H.R. 119 in the House and S. 459, are indeed sitting in committees, with no major action on either since their referral to committees earlier this year.
The petition referred to in the e-mail can be signed on a Web site run by the women-oriented cable network Lifetime TV here. That page also indicates that a House subcommittee had held a hearing on the bill May 21. That hearing is not reflected on the House link above, but that might just mean that that Web site doesn't consider a hearing, without a vote, to be a "major action."
Anyway, the petition is there if you want to sign it. (For the record, being no expert on breast cancer, I have no opinion on the bills.) Snopes also says, and I agree, that if you want movement on the bills, you probably also should get in touch with your congresscritter and senators. If you're not sure who they are, you can find out at House.gov and Senate.gov, respectively.]]>
It's medical. Basically.tag:blog.news-record.com,2008:/staff/health//34.256922008-06-26T17:44:47Z2008-06-26T17:45:48ZY'all go have some fun with this. But you'll want to finish lunch first....Lexhttp://blog.news-record.com/staff/health/
this. But you'll want to finish lunch first.]]>
Making money from obesitytag:blog.news-record.com,2008:/staff/health//34.256802008-06-26T14:30:34Z2008-06-26T14:36:01ZVia the Wall Street Journal comes news of a Credit Suisse report noting that as corporations become more aware of the financial implications of fast-growing obesity, investing in companies that, one way or another, fight obesity might be good for...Lexhttp://blog.news-record.com/staff/health/
the Wall Street Journal comes news of a Credit Suisse report noting that as corporations become more aware of the financial implications of fast-growing obesity, investing in companies that, one way or another, fight obesity might be good for your own personal business. In fact, the report authors have created an unofficial stock index called the "Healthier Living 15," whose products and services range from fitness centers to a device used in bariatric surgery.
Given the financial, medical and lifespan implications of obesity, I'll pass on the "growth-industry" puns here. But is this kind of investment morally OK? For that matter, is it good business?]]>
Possible dangers of military anthrax vaccinestag:blog.news-record.com,2008:/staff/health//34.256592008-06-25T16:15:37Z2008-06-25T16:29:01ZI have been contacted by an area woman whose son, serving in the Army, does not wish to receive the mandatory (for soldiers such as he who are being deployed to high-risk areas) vaccination against anthrax. He is worried not...Lexhttp://blog.news-record.com/staff/health/
I have been contacted by an area woman whose son, serving in the Army, does not wish to receive the mandatory (for soldiers such as he who are being deployed to high-risk areas) vaccination against anthrax. He is worried not only about reports of problems associated with that vaccine, particularly because he has a history of adverse reactions to other vaccines, including a seizure after a childhood DPT injection, the mother says.
I've found some Web sites and blogs that SAY the vaccination is dangerous, but so far I've not found any journal articles or government reports that address the safety question directly. Meanwhile, the soldier, who has received the first of three injections, is planning to refuse the others even at the risk of likely disciplinary action.
(In case it matters, I should point out that according to the mom, this soldier sought and received a transfer from the reserves to the regular Army specifically because he wanted to serve in Iraq. Not all soldiers must receive the anthrax vaccine, but those being sent to actual or potential trouble spots, such as the Middle East and Korea, must do so. This soldier's mom, however, says the recruiter told her son that the vaccination was purely optional. I have no evidence on that claim either way at this point.)
Can anyone out there point me in the direction of some disinterested research into the issue of anthrax-vaccine safety, or recommend experts to whom I can speak?
Study: Public health insurance cheaper than privatetag:blog.news-record.com,2008:/staff/health//34.256542008-06-25T14:47:50Z2008-06-25T14:59:01ZPublic health insurance, such as Medicaid and State Children's Health Insurance Program, results in significantly lower health-care costs compared with private insurance, even when tax subsidies for the latter are thrown in, according to a study published by the journal...Lexhttp://blog.news-record.com/staff/health/
here; full text here; chart summary of findings here.)
The savings were of particular advantage to consumers, the study found, because much of the savings occurred in consumers' out-of-pocket costs. But the study also found savings in costs paid by public insurers vs. private insurers.
Take a look and tell me what you think.
(Via Health Affairs blog)
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Local health-care professionals: Come join in the journalismtag:blog.news-record.com,2008:/staff/health//34.255702008-06-20T14:39:54Z2008-06-20T19:11:53ZBack in January, I invited local doctors and other interested health-care professionals to help the News & Record improve its coverage of medical and health-care issues, via e-mail to me and participation on this blog. Through the good graces of...Lexhttp://blog.news-record.com/staff/health/
invited local doctors and other interested health-care professionals to help the News & Record improve its coverage of medical and health-care issues, via e-mail to me and participation on this blog. Through the good graces of Dr. John Lusk and Wilma Bailess of the Greater Greensboro Society of Medicine, that invitation is being extended more formally today through the society's newsletter.
That participation could take the form of commenting on stories we've published, but I'll also try to post here about stories that I'm working on so that you can offer suggestions on angles to look at, sources to talk to, records to peruse and questions to raise. I am trying to create a dialogue between me and you local health-care professionals to improve our journalism, but I also hope that the dialogue will sometimes take the form of a discussion among commenters, with this blog serving as an online gathering place for you.
The GGSM newsletter goes primarily to doctors, but I'm interested in hearing as well from nurses, office managers, psychologists and anyone else working in the field of health care. You can leave a comment here or e-mail me. I look forward to hearing from you.
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