Target BPs are much lower
Last week the American Heart Association (AHA) and the American College of Cardiologists (ACC) published new guidelines in the diagnosis and treatment of high blood pressure.
What are the new numbers and what do they mean?
Many people will be surprised to find out they now have “elevated” high blood pressure, which could be a reading as low as 120/70, or Stage 1 hypertension at 130/80 rather than 140/90 (the old threshold).
The new blood pressure guidelines are:
- Normal: Under 120 over 80
- Elevated: Top number 120-129 and bottom less than 80
- Stage 1: Top
… Continue reading
Rethinking LDLs (low-density lipoproteins)
I’ve posted a couple of times about my husband’s high LDL level and his attempts to lower it through diet and exercise.
I’ve also said that because he doesn’t have any other risk factors for heart disease, we aren’t too worried about it. But the engineer in him likes the challenge of seeing how low he can get his LDL.
When I saw this recent YouTube video, however, I had to ask him to watch it. What if everything we think we know about LDL levels is wrong? What if so-called bad cholesterol isn’t really … Continue reading
Unnecessary tests = unnecessary expense
This is a follow up to my last post about the dangers of too much medical care.
One of the biggest doors leading to an overabundance of healthcare and healthcare costs is the annual exam and all the “routine” lab work that is ordered almost without thought.
Doctors’ offices strive to be efficient. They have a lot of patients to see every day, after all.
One way they streamline their practices is to set up routine or “standing” orders for common lab tests, such as an electrocardiogram (EKG), complete blood count (CBC), urinalysis (UA), … Continue reading
What is deprescribing?
As an advocate for less medicine and better health, I love the latest healthcare trend of “deprescribing,” or cutting down the number of prescription drugs a patient is taking.
Dr. Aaron Carroll of Healthcare Triage explains the importance of deprescribing in this video:
Polypharmacy—taking multiple prescription drugs—has become much more common over the last couple of decades. There are more drugs than ever on the market, and the drug companies are spending billions of dollars to make sure we know all about them.
Related post: Bohemian Polypharmacy
The elderly are especially … Continue reading
Cutting the waste
I’ve posted several times about the Choosing Wisely campaign.
Developed by Consumer Reports and the American Board of Internal Medicine, Choosing Wisely hopes to educate both physicians and patients, and cut back or eliminate unnecessary medical tests, procedures and treatments.
Over-testing and over-treatment are estimated to cost about $200 billion every year. I think that’s a conservative figure, as the financial—not to mention emotional—consequences of too much medicine can be difficult to quantify.
Bringing about change in our behemoth, for-profit healthcare system is a daunting task, and I’m always happy to see signs that it’s catching … Continue reading
How rudeness affects your healthcare
I just read an article in the New York Times by Perri Klass, MD: Rude Doctors, Rude Nurses, Rude Patients.
Rudeness all around!
Dr. Klass, a pediatrician, refers to a recent study published in a pediatric medical journal. The study looked at how rude or disparaging comments (by an actor playing the part of an infant’s mother) affect the performance of doctors and nurses.
The study’s conclusion?
Rudeness has robust, deleterious effects on the performance of medical teams. Moreover, exposure to rudeness debilitated the very collaborative mechanisms recognized as essential for patient care and
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Papillary thyroid cancers are overtreated
In 2010 my husband almost died while being treated for a small papillary thyroid cancer.
Papillary tumors are by far the most common type of thyroid cancer, and are typically very slow growing. Most doctors I know say that if you have to get cancer, papillary thyroid cancer is the one to pick!
My husband didn’t choose to get thyroid cancer, of course, but once his primary care physician found the lump during a routine physical, he was put on a fast track to being overtreated.
Back then, we just didn’t know any better.
I … Continue reading
A hospital puts profits over patient safety
First do no harm.
That’s part of every medical school graduate’s oath. It should be the motto of anyone working in healthcare.
But I just read a disheartening piece of investigative journalism in my local newspaper, the Seattle Times, about a hospital where I trained, worked, and received care. The story highlights how the perverse financial incentives in healthcare (do more, get paid more) undermine patient care and safety.
…the aggressive pursuit of more patients, more surgeries and more dollars has undermined Providence’s values — rooted in the nonprofit’s founding as a
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This guest post is from a good friend of mine. She’s not in the healthcare industry, but she is one of the most savvy healthcare consumers I know. When she was telling me about some of her recent dealings with providers and insurance, I immediately asked her to write up her experiences to share with my readers!
I don’t willingly part with my money, especially when I see a healthcare provider.
I question unnecessary tests, and I don’t want the office staff to be cavalier about spending my money. I expect the office to be familiar with my insurance plan, … Continue reading
Happy New (Calendar) Year!
It’s the start of a new year or, in health insurance lingo, the start of a new calendar year deductible. I’m reposting this from last January, because this month is the best time to start trying to schedule that annual exam or annual wellness visit (it could take weeks, after all, to get an appointment!).
I usually advise people to get any screening tests or annual exams done early in the year, just in case an abnormality is found and more testing/treatment is necessary.
Especially with the current trend towards enormous deductibles (up to $14,300 for … Continue reading