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
October is Breast Cancer Awareness month
October has become the month to pressure women to Buy Pink! and schedule their annual mammograms.
But I’d rather see more women informed about the effectiveness of annual mammograms (not as much as you might think).
And I’d like to see more care providers drop the paternal attitudes and really have a conversation with women about the pros and cons of screening mammograms, and how (or if) this diagnostic tool should be used to meet their health care goals.
I’ve written many posts on this topic, so please check them out!
… 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
Too much testing = too much medicine
I just ran across an old doctor joke: What is a well person? Someone who hasn’t yet been thoroughly examined.
It’s not funny, of course, if you’re the patient and have suffered the harms—and the expense—of too much medical care.
In 2010, my husband was the victim of too much medical care. Because of complications and a string of medical errors he almost died. His care cost our insurance company over $100,000 and we were out of pocket for our $10,000 deductible.
Now he has no thyroid and has to take medication every … 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
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
Newer drugs are not necessarily better drugs
A few days ago at the gym, I was leafing through an issue of Health magazine.
What caught my eye was not the article about preventing stress injuries, or the recipe for a zingy, low-fat curry, but rather the pages devoted to ads for prescription drugs. Drugs to treat psoriasis, hepatitis C, dry eyes, depression, Alzheimer’s, diabetes, arthritis, and overactive bladder, to name but a few.
Each ad took three pages. After doing a little mental math, I discovered the ads for these new prescription drugs made up more than 30% of the … 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
… Continue reading
Don’t get health advice from commercials!
While nursing my cold last weekend, I was watching TV and one prescription drug commercial caught my eye. (One of oh so many. FTC—please make these go away!)
Actually, the ad didn’t mention any drug by name, but it was sponsored by Gilead Sciences, the makers of the new hepatitis C drug, Harvoni.
The commercial was aimed at baby boomers, who were advised to get tested for the hepatitis C virus (HCV).
One in 30 baby boomers could have HCV and not know it, the voice over said, “…because Hep C can hide … Continue reading