As someone who advocates for less medical care, I’m always thrilled to see physicians and others in the health care industry step forward to protest over-testing, over-screening, over-diagnosing, over-treating and over-charging.
Here are some of my favorite health care blog posts and news articles from the last week.
Dr. Lamberts is embracing the newest trend in primary care: the direct-pay model. He does not accept health insurance, but rather charges a modest (age-based) monthly fee per patient. Booting the insurance companies not only lowers his overhead costs considerably, but frees him from so many … Continue reading
The unloved woman
I recently read two books that provoked my thoughts. The first was Twelve Patients: Life and Death at Bellevue Hospital by Dr. Eric Manheimer, the medical director of what is probably the largest public hospital in America.
Located in New York City, Bellevue sees patients from all demographics—incarcerated, homeless, undocumented, uninsured, mentally ill, addicted—and treats the worst trauma cases in the city.
Dr. Manheimer sees it all, and he writes compelling stories about the patients and their situations. He also comments on America’s health and health care in general.
His chapter entitled “The Unloved Woman” struck me … Continue reading
Flight delayed? Learn CPR!
For the next six months, Dallas-Fort Worth airport is hosting a trial program to teach “hands-only” CPR to travelers. An automated kiosk, developed by the American Heart Association in partnership with American Airlines, guides passengers through a simplified CPR technique using video instructions and a manikin torso. If the program is successful, it will be expanded to other airports.
Hands-only CPR does not require rescue breaths and is as effective as regular CPR. It sounds like a useful way to pass some time, and I’d love to try it if I’m ever in one … Continue reading
Living with joy
I am not obsessed with my death, but I am always aware that one day I will surely die. As a physician once said, “Life is 100% fatal.”
In the normal course of events, we don’t choose either the manner or time of our death, but I like to think that I might have some control over the final months, weeks, days of my life. (Unless I’m hit by a bus or something equally sudden.)
Perhaps my wish for control is in response to all the horrible, mercilessly-prolonged (and outrageously expensive) deaths I’ve witnessed in intensive … Continue reading
That’s a good question!
H. Gilbert Welch, MD, the author of Overdiagnosed: Making People Sick in the Pursuit of Health, wrote a recent op-ed in the New York Times in which he wonders at what point will the high costs—and profits—of medical care in America be considered “a crime”?
Medical care is intended to help people, not enrich providers. But the way prices are rising, it’s beginning to look less like help than like highway robbery. And the providers — hospitals, doctors, universities, pharmaceutical companies and device manufacturers — are the ones benefiting.
The crime of perverse incentives
Although … Continue reading
The classic black comedy of medical training
The emotional and physical traumas of interns are well documented (if hilariously exaggerated) in The House of God by Samuel Shem. The “best medical students” become “terns,” the lowest of the low in the hospital hierarchy, and yet are expected to save lives on a daily basis, usually with little sleep and little or no supervision.
Shem, the pen name of a Harvard-trained physician, published “The House of God” in 1978 to provoke the medical education establishment and speak out against “the brutality of medical training.”
July 1, the hospital New Year
This … Continue reading
The cyberchondriac. Cyberchondia is a term that’s been coined to describe a person who self-diagnoses using the internet, and then experiences acute anxiety when confronted with the grim details of possible afflictions.
Rash? Probably lupus. Upset stomach? Stomach cancer, of course.
I’ve done it. Admit it, you’ve done it, too.
WebMD’s Symptom Checker feature is so inconclusive in its results that it’s basically useless. For example, submit “headache” and after a few more refining questions you still get a list of over 50 possible conditions that have headache as a symptom. Migraine and tension headache are at the … Continue reading
How are farming and medicine alike?
I just finished reading a thoughtful and informative book by Harvard-educated physician, Daphne Miller, MD. In Farmacology: What Innovative Family Farming Can Teach Us About Health and Healing, she makes an analogy between the “complex and dynamic” systems of soil and modern farming practices, and the human body and modern medicine.
After reading a book about soil ecosystems, Dr. Miller was struck by the similarities of the chemical processes that occurred in soil and those that happened in our own intestines.
Like our own biosystems, it [soil] too depends on bacteria and fungi
… Continue reading
What are avulsions?
Avulsions are wounds where a chunk of tissue (all layers of the skin) has been partially or completely torn away. An amputation is a form of an avulsion.
Avulsions can be minor, such as slamming a finger in a door and crushing the tip, or life-threatening, such as the amputation of an arm or leg in an industrial or motor vehicle accident.
As you can tell from the picture, even a minor avulsion can be pretty ghastly to look at. But if you act quickly, you might be able to save the victim’s finger, toe or … Continue reading
Ready, Set, . . .
With the implementation of the Affordable Care Act (ACA) fast approaching, and summer deadlines for insurance companies that want to offer plans on the new insurance exchanges, this week has seen a lot of news stories related to Obamacare.
California revealed its new exchange plans and the first look seems to indicate that premiums will be much lower than anticipated, even though several of the largest insurance companies opted out of participating in the exchanges.
But a closer look at the plans reveals two important considerations:
- The plans are “narrow-network” plans. To keep costs
… Continue reading
Stock up on DEET?
Any report that contains the word “deadly” gets the attention of the media, and this report by the Centers for Disease Control (CDC) was no exception. Last year 5,674 cases of the mosquito-borne virus were reported, and 286 people died. In comparison, only 43 deaths were recorded in 2011.
Weather conditions that favored the mosquito – warm and humid – were probably factors in last year’s increase in cases.
This news reminds me that I want to spend some time researching insect repellents and then write a post about them. Does anything work as well as … Continue reading
I’ve finally realized there are just too many health-related news stories every week for me to comment on in a timely manner. And some news tidbits are interesting or funny, but really not worth a whole post.
But I would still like to share with you the stories that caught my eye over the week, so on Fridays I will start posting a weekly summing up, or “rounds” to use health care lingo, of what I have found of interest.
Don’t grocery shop when you’re hungry. Really?
In the did-we-really-need-a-study-to-tell-us-this? file, a research letter published in Journal of the American … Continue reading
Sometimes drastic change is required
Last night I watched a truly inspiring documentary, a testament to the power of a healthy diet.
Fat Sick & Nearly Dead chronicles Australian filmmaker Joe Cross’s journey to health. Fat, fortyish, and suffering from an autoimmune disease, Joe spends 60 days traversing America. But no fast food stops for Joe—his mission is to drink only fresh fruit and vegetable juice (he travels with his own juicer) for the entire 60 days. Joe believes fasting on juice will allow his body to heal from the inside out.
We all know the typical American diet (and … Continue reading
I suggested last week that taking a first aid class is a good idea. Buying a good first aid manual for reference is helpful, too.
But I thought I would supplement that advice by posting a few basic first aid tips for a variety of common injuries, and also provide a short—frugal—list of first aid items you might want in a first aid kit. Making your own first aid kit rather than buying one can save money because you only include the few items you really need.
Today’s post focuses on minor cuts, scrapes and bruises. Other than soap and … Continue reading
I mentioned in a previous post that three years ago my husband almost died from a series of medical, um, misjudgments, let’s say. I know sometimes things go wrong for no reason, but I also know his three-day ICU stay could have been prevented.
He never received a “mea culpa” from the doctors or hospital; all we got were the medical bills. Our insurance, a catastrophic/health savings account (HSA) plan, paid 100% of the costs after we met our deductible and out-of-pocket maximum ($10,000). At that point we stopped receiving bills, so I don’t know the exact total of … Continue reading