Harken Health – Betting on primary care

I just read about health insurance giant UnitedHealth’s bold but risky new insurance plan, Harken Health:

UnitedHealthcare is betting $65 million that it can profit by making primary care more attractive.

With little fanfare, the nation’s largest health insurer launched an independent subsidiary in January that offers unlimited free doctor visits and 24/7 access by phone. Every member gets a personal health coach to nudge them toward their goals, such as losing weight or exercising more. Mental health counseling is also provided, as are yoga, cooking and acupuncture classes.

At this time, Harken Health is only available in Chicago … Continue reading

Electronic health records and medical mistakes

I just read a funny-not-funny post on the health care blog KevinMD: This doctor orders pregnancy tests on men. You’re probably doing it too

The author, a physician, laments that his hospital’s electronic health records system (EHR or EMR) makes it way too easy to make mistakes, such as ordering pregnancy tests on male patients.

Now this may sound funny to you, and I know the nurses love to read me the riot act when I do it, but truthfully this is no laughing matter.

As easy as it is to order a pregnancy test on a man, it is

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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

Decreasing the overuse of antibiotics

Finally some good news!

I’ve posted many times about the problems of over prescribing antibiotics. Not only does it increase health care costs, but patients are at risk of side effects from the antibiotics, and overuse of antibiotics leads to drug-resistant bacteria—a big concern for everybody.

Many times the patient insists on an antibiotic and the doctor complies; sometimes doctors just over prescribe out of habit.

But I just looked at the results of a study that revealed a relatively easy way to encourage physicians to prescribe fewer antibiotics—and it works!

For 18 months, 248 clinicians from 47

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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

A naturopath denounces naturopathy

I’ve never been supportive of alternative health care providers, such as chiropractors and naturopaths, and would never recommend one to friends or family members.

I believe their limited “medical” training is not grounded by evidence-based principles. Also, inconsistent accreditation standards and self-regulation allow for them to provide care well beyond the scope of their training.

That’s my opinion, anyway.

Even so I was rather stunned (but delighted) by a post I read in KevinMD in which a naturopath strikes out at her profession: The shocking confessions of a naturopathic doctor

I quit practicing naturopathic medicine after discovering my former boss,

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The “financial toxicity” of cancer

We’ve all heard the phrase “cancer kills.”

But guess what? So can the high cost of treatment.

I just read about a study that came out of the Fred Hutchison Cancer Research Center here in Seattle.

The results won’t surprise anyone familiar with how much cancer treatment costs (a lot!), but researchers found:

…cancer patients who go bankrupt are nearly 80 percent more likely to die than patients who don’t, and some cancers had significantly higher mortality rates. Prostate cancer patients who filed for bankruptcy were almost twice as likely to die; bankrupt colorectal cancer patients were 2.5 times more

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Tips for the doctor’s office

A pediatrician posted some useful advice to parents on KevinMD: 4 mistakes parents make in the pediatrician’s office

With office visit’s getting shorter, and co-pays getting costlier, it’s more important than ever to make sure each visit counts, and communication is efficient.

What struck me when reading her post was that these tips easily apply to patients of all ages, and any doctor in any specialty.

I encourage you to read the whole post, but in short her tips are:

1. Come prepared.

[W]e aren’t mind readers, and we have a limited amount of time. It’s frustrating when people don’t

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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

A physician’s own end-of-life story

I’ve always believed that if I were diagnosed with a terminal illness and had a choice between a few months of quality living and a few extra months filled with doctors’ visits, surgeries, lab tests and drug treatments, I would choose quality of life.

Many friends, some of them doctors, have told me, “Oh, you think that now, but when the times comes the will to live is just too strong. You’ll do anything for that extra time.”

Would I? I guess I won’t know for sure until my time comes.

That’s exactly what a hospice physician thought—Will I 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

Heads up about Medicare changes

This post if for any of my readers who are Medicare age or about to be Medicare age.

I think it’s important to understand what changes are in the pipeline that will affect your doctors and their ability to be able to treat you.

Some doctors already refuse to see Medicare patients because of government red tape and poor reimbursement.

But starting in 2017 it’s going to get worse, and many physicians are wondering if they should follow their colleagues and drop out of the Medicare game altogether.

I recently read two posts by physicians on the health care blog … 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

Preventing hospital readmissions

I’ve said it many times in this blog: Don’t go to the hospital alone! And don’t let your friends or family members go alone, either.

Having or being a patient advocate during a hospitalization can really improve communication among the patient, the patient’s family and the myriad of health care providers in modern hospitals.

Related story from KevinMD: There are too many cooks in the health care kitchen

Better communication is especially important at discharge time, when the doctor and nurses give you lots of instructions about your follow-up plan: Do you have new medications? Did you stop old medications? … Continue reading

Patients need “Choosing Wisely”

I’ve written several posts about Choosing Wisely, an initiative launched in 2012 by the American Board of Internal Medicine (ABIM) with the mission of decreasing the use of unnecessary health care.

Overuse of diagnostic tests, screening tests, surgeries and drugs is rampant in our health care culture, and it’s costing billions of dollars every year, not to mention that some patients are actually harmed by overtreatment.

It’s a noble goal, but the burden is on the consumer—the patient—to read and use Choosing Wisely’s lists of  inappropriate treatments because a recent analysis shows that physicians are not paying enough attention … Continue reading