PSAPs and the OTC Hearing Aid Act

psapsWhat are PSAPs?

PSAP stands for Personal Sound Amplification Product.

They are available at Target or Walmart or Amazon for a fraction of the price of a traditional physician-prescribed hearing aid.

BUT…they can’t actually be called hearing aids and they can’t be marketed as a treatment for hearing loss. That’s because they are currently not regulated as medical devices by the Food and Drug Administration (FDA).

The FDA will only allow them to be sold as sound “amplifiers” to help with recreational activities, such as hunting, bird watching or eavesdropping  😉

Not being hard of hearing … Continue reading

ZDoggMD and Healthcare 3.0

“Trying to make medicine great again”

I’ve been a fan of Zubin Damania, MD—aka ZDoggMD—for several years. A hospitalist physician based in Las Vegas, he began by making entertaining parody videos on a variety of healthcare topics: end-of-life, the opioid epidemic, electronic health records (EHR), sepsis, sleep apnea, and more.

Now he has expanded his social media footprint in an attempt to rally healthcare professionals behind Healthcare 3.0.

As he explains in the video, Healthcare 1.0 was the old doctor-patient relationship—”Doctor knows best” and all that (I still know doctors and nurses who … Continue reading

Tips to save money at the hospital

save money at the hospital“An American Sickness”

I love Elisabeth Rosenthal’s work.

She’s a medical journalist (an MD, but no longer practicing) who wrote a brilliant series of articles on the high cost of healthcare for the New York Times a few years ago.

Now she has a book on the same topic. Because, of course, our healthcare system with its punishing costs for services, drugs and insurance has not improved. If anything, it’s worse.

As a physician, Dr. Rosenthal has experienced first hand the perverse incentives—illness being more profitable than health, after all—and lack of price transparency in our healthcare system. Her book … Continue reading

We’re doing too many screening and diagnostic tests

More tests = more money

Anyone who has read my blog over the years knows this is a subject I come back to again and again: the overuse of screening and diagnostic tests.

It’s a problem in our healthcare system for a couple of reasons.

First, the majority of healthcare providers are paid based on volume. In other words, the more patients they see, the more tests they run, the more surgeries they perform, then the more they get paid. It doesn’t matter if the outcome is poor, because they still get paid. In fact, they make even more money … Continue reading

Budget-busting prescription drugs

Taxpayers footing the bill

I watched this on my local news the other night: Runaway drug price hikes squeeze Washington’s budget.

Our state is one that expanded Medicaid under the Affordable Care Act (ACA), so I knew we were spending a lot. But I had no idea now much. Through the first 9 months of 2016, my state has spent $1.1 billion on prescription drugs.

Not total medical care. Just prescription drugs.

And Washington is not the only state facing a fiscal nightmare because of skyrocketing drug costs.

Almost half of that spending is for the really high-priced specialty … Continue reading

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

Election day and healthcare 2016

american-flagI started this blog four years ago, the day after President Obama won the general election. I needed an instrument to give voice to my frustrations and fears about the direction of our country’s health and healthcare policy.

I just re-read what I wrote back then:

So, the Affordable Care Act (ACA or Obamacare, as it’s commonly known), having survived its precipitous birth and a few close-calls with death, is poised to enter a prolonged and awkward adolescence.

I am not a huge fan of Obamacare because it seems to be more health insurance reform than health care reform.

Continue reading

Outrageous cost of EpiPens finally getting some attention

Wow. Talk about timing.

I just posted a few weeks ago about my dread of renewing my EpiPen prescription because of its cost—over $700 without insurance, and still over $600 with my insurance!

It seems other healthcare advocates, the media, Congress and even the presidential nominees are at last realizing how insane it is to charge that much for literally a few cents worth of epinephrine.

EpiPens are not even new to the market, like so many other high-priced drugs. It’s been around for a long time, so Mylan pharmaceuticals can’t claim it’s trying to recoup R&D costs. In fact, … Continue reading

View Prevnar 13 ads with caution

prevnar 13Prevnar 13: As seen on TV

I was watching TV the other evening and, as usual, was forced to sit through multiple back-to-back prescription drug commercials.

One that caught my attention was for Prevnar 13, which is one of the pneumonia vaccines. (13 because it protects against 13 strains of streptococcus pneumonia.)

The commercial stated Prevnar 13 was for adults aged 50 and older.

That statement’s true, but needs some clarification.

Yes, Pfizer did get FDA approval a few years ago to market Prevnar 13 to adults over the age of 50. Previously, the vaccine was only used for … Continue reading

EHR – Electronic Hell Records

Healthcare Not Fair is a satirical YouTube video series created by a real-life physician, Dr. Waqas Khan, to highlight problems within our broken healthcare system.

Their latest video takes a stab at electronic health records, EHR—or, as they call it, Electronic Hell Records!

Other videos by Healthcare Not Fair:

I just saw my primary care physician a few weeks ago, and I can relate to the fictional patient’s experience in the video. Receptionists really do keep their eyes glued to their computer screens!

My physician isn’t that bad, … Continue reading

Skin cancer screening guidelines

skin cancer“Insufficient evidence”

Many years ago I had a primary care doctor who used to perform a total body skin examination (TBSE) on me every year as part of my annual exam.

Of course, those all-inclusive physicals are a thing of the past. I haven’t had a physician perform a TBSE for a long time.

I often wondered about that. A TBSE seems like a relatively easy and harmless way to quickly screen for skin cancer. The goal, of course, is to find a melanoma, the deadly skin cancer, when it’s small and possibly curable.

But the go-to source for screening … Continue reading

The high cost of healthcare in America

They say a picture is worth a thousand words, and the online news site Vox recently sought to open Americans’ eyes as to how much more we pay for healthcare compared to other countries.

America’s healthcare prices are out of control. These 11 charts prove it.

I can’t copy their charts, but basically they are bar graphs. The bar that shows how much patients in the US pay for similar drugs and services towers over the others like a skyscraper over a neighborhood of single-family homes. Like this:

healthcare costs graph

Vox got its information from the International Federation of Health Plans (IFHP)Continue reading

Obamacare premium increases for 2017

Up, up and away!

Does anyone’s income go up as fast as their health insurance premium? I wish.

11.6%. That’s how much more my current health insurance provider wants to charge for my bronze high-deductible health plan in 2017.

And although 11.6% seems like a lot to me, another company in my state is requesting a 19.9% average increase on all its plans, with a 28% increase on its gold plan!

So far, the rate increases that have been made public in other states are all pretty high, averaging well into the double digits. So at least I’m not … Continue reading

“End of the Line” for medical guidelines

Knowledge is king

That’s the take home message from Professor (of pharmacy) James McCormack’s latest parody video, End of the Line, which takes a whack at healthcare’s increasingly pervasive and rigid medical guidelines.

 

If followed to the letter, these guidelines (often based on research funded by drug companies) would have everyone diagnosed with a disease and taking one or more medications. Medical guidelines may be great for the drug business, but not so much for individualized, patient-centric care and shared decision-making.

Chronic disease state guidelines (blood pressure/lipids/glucose/bone density) do not provide clinicians with

Continue reading

Screening eye exams in older adults

Just yesterday I posted about the United States Preventive Services Task Force (USPSTF) and the fine line they walk between providing evidence-based recommendations for screening tests and making medical specialist groups happy.

Sometimes it just doesn’t happen.

The task force recently gave an “I” grade to vision screening in patients over 65. An I grade, or Insufficient evidence, means that the task force can’t definitively say that the benefits of vision screening in older adults outweigh the possible harms.

The American Academy of Ophthalmology (AAO) doesn’t agree.

Specifically, the task force reviewed the evidence for primary care doctors screening for … Continue reading