Choosing Wisely – Use less healthcare

My goal for 2017? Use as little healthcare as possible

How will healthcare change under a new president and political party?

That’s a question I can’t answer. As I wrote in my last post, both candidates had multiple-point plans to tweak/improve/repeal/replace the Affordable Care Act, aka the ACA or Obamacare.

But I don’t know what will change or when.

What I know for sure is that for 2017 my premiums will be 20% more expensive, my co-insurance and co-pays will be higher, and my current primary care doctor will no longer be in-network.

I can and will shop around … Continue reading

“Bridge Over Diagnosis”

I’m going with an overdiagnosis theme this week.

Here’s the latest healthcare parody video from pharmacy professor James McCormack, as he continues his much-appreciated effort to raise awareness of overscreening, overdiagnosis, and overtreatment in this country.

As usual, this video is full of supporting statistics and excerpts from leading healthcare journals, so take time to pause the video and really understand the information being shared.

As I said in a previous post, overdiagnosis and the resulting unnecessary treatments cost hundreds of billions of dollars every year.

Equally bad, if not worse, I think, is … Continue reading

Risk Benefit Theater – Screening mammograms

I’m all about high-value, evidence-based healthcare.

I’ve written a lot of posts about the problems, including high costs, of overscreening and overtreating. (We spend hundreds of billions of dollars every year on unnecessary healthcare!)

So I love this video by Andrew Lazris, MD, and Erik Rifkin, PhD. They use the visual of 1000 women sitting in a theater to illustrate why screening mammograms are not the life savers many women think they are.

A picture (or video) is worth a thousand words, isn’t it?

I understand Lazris and Rifkin want to create more videos to … Continue reading

Don’t reach for Life Line screenings

I first posted about Life Line screenings two years ago. I’m re-posting today as this post still gets a lot of traffic and I wanted to reopen the comments. 

life line screeningsOvertreating, overspending

I just received an invitation in the mail!

Not to a party or a wedding or anything fun, but to a Life Line Screening event being held at a local church. The letter says they’re holding a spot for me on this particular date, but I must call NOW to confirm and register, because spaces are LIMITED!

“These aren’t just routine medical procedures—they can help save your life”

Oh, … Continue reading

How to read your pathology report

Last week  I posted that you should always ask for a copy of your medical reports.

One of the downsides, of course, is that those reports are often written in medical language that can be confusing or alarming.

But in response to a more savvy patient population, the College of American Pathologists has made a video to explain how the system works and to encourage patients to be involved in obtaining and understanding their pathology reports.

You can watch the video here on the medical website KevinMD.

They also created a two-page educational brochure to guide a patient through … Continue reading

Always ask for your medical test results

An error of omission

A few weeks ago there was a lot of news about how medical mistakes are the third leading cause of death in the US, behind heart disease and cancer.

A medical error is defined as “an unintended act (either of omission or commission) or one that does not achieve its intended outcome.”

And now a Philadelphia paper is highlighting one very common mistake: when you and/or your doctor are not informed about a serious finding on a medical test.

The article explains that a well-known local musician (which is why this story is popular on … Continue reading

Healthcare journalist Peggy Girshman writes her own eulogy

I’ve been a fan of Peggy Girshman’s science and healthcare writing for a long time, so it was with great sadness that I read about her death in March at the young age of 61.

But in tribute to her award-winning journalism career, which included long stints at both NPR and Kaiser Health News, she actually wrote her own eulogy!

She wanted to share a few simple lessons she had learned from her years on the job of reporting healthcare-related stories. Because they resonate with my own view that we need more health and less medicine, I wanted … Continue reading

Screening kids for lead poisoning

The high lead levels in Flint, Michigan’s water supply have been news for several months. There’s been a lot of finger pointing and congressional hearings and such, but the bottom line is that because an agency didn’t do its job properly, the health of many kids was put at risk.

Lead poisoning is especially serious in infants and young children, as it interferes with brain development.

Sadly, the situation in Flint is not unique. Washington, DC, had a similar crisis a few years ago, and just last week my home state, Washington, reported that 34 water systems had lead … Continue reading

The S-RAY – Dental imaging without radiation

One of the great things about living in Seattle is that because we are home to so many biotech companies, I often hear about innovative devices before they’re on the market.

I like to see (sometimes) where health technology is taking us.

I just saw a news report on a new dental imaging x-ray that actually isn’t an x-ray because it doesn’t use radiation. Instead it uses ultrasound, and it’s called the S-RAY.

I’ve posted before about the dangers of too much radiation from imaging studies, including dental x-rays. Dentists frequently order x-rays every year, even though the American … Continue reading

Be informed – PSA screening tests

PSA stands for Prostate-Specific Antigen. It’s a blood test used to screen for prostate cancer.

Doctors used to recommend an annual PSA test for men over 40. But now we know that the PSA is not a good screening tool. It results in a high number of false positives, and not all forms of prostate cancer need to be treated.

Too many men have received unpleasant, expensive treatment they didn’t need.

In an excellent YouTube video, Dr. Mike Evans explains more:

In 2012 the United States Preventive Services Task Force (USPSTF) recommended against Continue reading

Overuse of CT scans is dangerous and expensive

I read two articles yesterday that complemented each other:

In Kaiser Health News (KHN) Heavy Use Of CT Scans Raises Concerns About Patients’ Exposure To Radiation

And on KevinMD two radiologists posted The financial costs of treating CT-induced cancer

Each underscores the fact that CT scans are significantly overused in American healthcare.

Although CT scans are an essential diagnostic tool, the Food and Drug Administration reports that an estimated 30 to 50 percent of imaging tests are believed to be medically unnecessary.

Considering we spend tens of billions of dollars every year on diagnostic imaging, that’s a lot of wasted … Continue reading

Are you really allergic to penicillin?

When my son was about 10 years old he got an infected blister on his foot. I took him to the pediatrician to have the abscess drained, and then he was given a prescription for Augmentin, a fancy and expensive form of amoxicillin.

(If I knew then what I know now, of course, I would have 1) questioned whether an antibiotic was really necessary, and 2) wasn’t there a cheaper alternative to a brand name drug?)

Within 24 hours of taking the Augmentin, my son developed a terrible case of hives starting on his infected foot and eventually running up … Continue reading

Be informed – “The Patient’s Playbook”

the patient's playbookI’ve spent most of the holiday weekend happily engaged in reading through a pile of health care books.

And the one I absolutely have to recommend to everyone is The Patient’s Playbook: How to Save Your Life and the Lives of Those You Love by Leslie D. Michelson.

Michelson is not a physician, but has worked in the health management field for more than 30 years, helping individuals and companies navigate our crazy health care system.

Based on his experience, he has organized his book into three sections. Each chapter ends with a helpful “Quick Guide” of the most crucial … Continue reading

Sad but true – CYA medicine works

A few months ago I posted about CYA—Cover Your Ass—medicine being one reason why too many diagnostic tests are ordered and health care costs are high.

CYA medicine is when the doctor or doctors are pretty sure what your problem is, but they order extra scans and x-rays and blood tests anyway because “failure to diagnose” is one of the leading causes of medical malpractice suits. They aren’t going to take any chances, and who can blame them?

Related story from KevinMD: This is why doctors practice cover your ass medicine

Besides, they don’t pay your resulting medical bill, so … Continue reading

Confused by mammogram guidelines?

October is Breast Cancer Awareness Month, so I can’t let it pass without commenting on the American Cancer Society’s (ACS) recently updated screening mammogram guidelines.

Before, the ACS recommended annual mammograms starting at age 40.

Now they recommend annual mammograms for ages 45 to 54, with screening mammograms done every other year after age 55.

But, they add, women should still have the choice to start screening at age 40 and have yearly mammograms thereafter.

The confusion arises not only because the ACS is a bit wishy washy on its guidelines, but because the American College of Obstetricians and Gynecologists … Continue reading