Saturday, December 30, 2006

Medical Bankruptcy: Myth vs Fact

Recently, medical bloggers like NHS Doctor have referenced Himmelstein's classic study which claims 54.5% of all bankruptcies filed in 2001 were medically related. However, as happens all to often, people fail to critically analyze published articles that support a particular preconceived viewpoint. Researchers David Dranove and Michael Millenson have published an excellent analysis of Himmelstein's data to outline the disappointingly poor quality of this study and its conclusions.

Abstract:
David Himmelstein and colleagues recently contended that medical problems contribute to 54.5 percent of personal bankruptcies and threaten the solvency of solidly middle-class Americans. They propose comprehensive national health insurance as a solution. A reexamination of their data suggests that medical bills are a contributing factor in just 17 percent of personal bankruptcies and that those affected tend to have incomes closer to poverty level than to middle class. Moreover, for national health insurance to have an impact, it would have to define “medical” expenses in a much broader way than is now typical of either private or government-funded plans.

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Documentary: The Man with the 7 Second Memory

Clive Wearing has the most severe case of amnesia ever and this clip from his documentary is both amazing and bizarre . . .

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On April 1st, Canadaian Pharmcists will be Allowed to Prescribe

I love and respect pharmacists, but they are not diagnosticians and their desire to be able to "prescribe medications independently" puts the patient at a significant risk. Even more alarming is that the new law will allow pharmacists to fill "emergency supplies" of narcotics which is a disaster waiting to happen when drug-seekers skip the ER and harass pharmacies. The risks of this law vastly outweigh the benefits, if any.

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What Makes a Good Doctor?

DB is asking patients and doctors to submit what they feel are the three most important traits for a great physician to have . . .

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Classic WOO: Teachers Produce 'Pharmaceuticals'

Respectful Insolence has a classic post on the pseudoscience that is Airborne. I can't help but think that if teachers are so good at curing the common cold, why don't they try their hand at cancer?

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Consultant Check-ups After Surgery to be Scrapped to Cut Costs

The NHS would prefer patients to see their GP for post-operative care rather than waste the "precious time and expertise" of the surgeons.

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Friday, December 29, 2006

Doctoring The Truth About The Uninsured

This article from the Pacific Research Institute is a few years old now, but since we continue to talk about the '46 million uninsured,' I'd like to share some statistics . . .
. . . a fourth of the 35 million uninsured adults are under 24, and half are under 35.
And the uninsured aren't the same people from year to year or even month to month. Three-quarters of the uninsured remain so for less than a year.

. . . the percentage of uninsured Americans remains at 15.6%, the same as in 1996, and lower than in 1997 and 1998 . . .

One of every three uninsured live in households with incomes of more than $50,000 a year. One in seven live in households with annual incomes that top $75,000.

. . . the Census Bureau counts as "uninsured" individuals who are eligible for Medicaid and the State Children's Health Insurance Program but are not enrolled. Deven Herrick of the National Center for Policy Analysis estimates that as many as 14 million children and adults fall into this category.
If we are going to debate this issue and attempt legislative solutions based on the number of 'uninsured,' we should at least have a greater understanding of who encompasses this population.

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Three-year-old blogger's inspiring chemotherapy diary

Samantha Hughes has been diagnosed with neuroblastoma and her blog documents her struggle.
The youngster's diary - called simply "Samantha's Story" - is written in the style her parents think she would use if she could pen it herself.

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Health Care is a Right, unless . . .

You're obese, or smoke, or drink . . .Then the NHS will deny you 'priority treatment.'

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The Impact of Killing & How to Prepare the Soldier

PBS has a series of excellent interviews with mental health professionals and soldiers about the psychological consequences of war.
I think it is a very important thing to understand that when your friends are wounded or dead, it's a real loss. It's a loss of your friend that you trusted and you loved in a very intense way. When you personally take another life and you go up to that lifeless body with a hole in it and you look down on it, and you say, "I did that," I think it is a loss of yourself at the same time. And I think that [once] they understand that, they can't go back again. They can't say that it didn't happen, or [that] maybe somebody else did it.

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Want to get out of hospital fast? Then don't go in on a Thursday

Wait, we spent money studying this? Could this have anything to do with the fact that most doctors don't work over the weekend . . .

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New York Dialysis Care Named 'Worst'

This is a result of New York state's ban on national dialysis chain centers even though they have been shown to provide superior care when compared to independent providers.

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Most Americans Want Public Policies to Prevent Obesity

Lets start with government mandated exercise . . .

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The Worst Comic Book Medicine of 2006

Scott over at Polite Dissent as compiled a list of the worst medical mistakes in the comics this year. My favorite was "the worst OR scene" from Friendly Neighborhood Spider-Man #3, complete with an "arterial bleed of the 'vena cava.'

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Thursday, December 28, 2006

Pseduo-Journalism: Health Care Olympics

Its as sad as it is scary if this is accepted as 'legitimate journalism' . . .


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Computer Characters Tortured for Science

Professor Mel Slater has recreated the classic Milgram Experiment and found that shocking fake people is still stressful.
The computer program would correspondingly complain and beg as the 'shocks' were ramped up, falling apparently unconscious before the last shock. The skin conductance and electrocardiograms of the subjects were monitored. Even though the subjects knew they were only 'shocking' a computer program, their bodies reacted with increased stress responses. Several of the ones who could see and hear the woman stopped before reaching the 'lethal' voltage, and about half considered stopping the study.

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Wednesday, December 27, 2006

News Media Misreport Health Survey

ABC News manipulates polling data to prove suggest that Americans are for Universal Health Care and against HSAs. I guess the truth didn't fit into their preconceived agendas . . .
Support for universal government-provided coverage fell further when the survey suggested the possibility of higher costs or taxes (35 percent), waiting lists (33 percent), limited choice of doctors (28 percent), or loss of coverage for some treatments (18 percent). ABC News' coverage did not call any of these a "significant hurdle" for supporters of universal coverage to overcome.

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[Another] Popular Supplement Fails to Lower Cholesterol

What?!? Another 'all natural' product doesn't live up to the hype . . .

Flashback . . .

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Universal Studios Parks Ban Trans Fats

Who wants health food while they are on vacation? Besides, doesn't the 12 hours spent standing in line help burn off the extra calories?

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Adopt a Doctor: Support Their Income

A new charity based in England is hoping to provide financial aid to physicians in impoverished countries to encourage them to stay.

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Montanans Support Gov’t-subsidized Health Insurance

I wonder if they realize that "government-subsidized" is the same as 'taxpayer-subsidized'?

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Why Video Games are so Hard to Give Up

Motivational Psychologist Richard M. Ryan theorizes that "games can provide opportunities for achievement, freedom, and even a connection to other players. Those benefits trumped a shallow sense of fun, which doesn't keep players as interested."

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The Most-Avoided Conversation in Medicine is . . .

. . . the one that includes the words "you're dying and we've run out of ways to slow it or stop it."

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Why do intelligent people use alternative medicine?

In summary, "because they are desperate to believe anything that might give them hope."

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Congressional Budget Office's Report on Consumer Directed Health Plans

It seems that their 100 page report has a favorable opinion of CDHD . . .
The central idea behind such designs is that policyholders will remain insured against catastrophic expenses— but will also be more careful about using health care services because they will have to pay a much larger share of their initial costs. Depending on how enrollees in consumerdirected plans responded to those incentives, the end result could be a lower level of spending to achieve the same improvements in health or possibly better health at the same level of spending. Either outcome would represent an increase in the efficiency of the health care sector.

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Courts Rule that No One Owns A Donated Organ

And apparently the organ donor networks doesn't have to give it to who the donor wishes. As if we needed another impediment to organ donation . . .

(hat tip: Kidney Notes)

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In 2007, Germany will Pay 33K for Making Babies

Thats why German mothers-to-be are trying to hold off until January 1st . . .

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Tuesday, December 26, 2006

Physicians in Opera: Reflection of Medical History & Public Perception

Medpundit has found an interesting article in the BMJ about the "representation of medicine in music" . . .

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Prompting Men to Have Syphilis Tests

Ahh yes, nothing like comic strips and cartoons to spread the word about STDs . . .

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Heart Transplant Patient Scales Mountain

Dale Shippam, a 54 year-old heart transplant recipient, raised $1 million for the Toronto General and Western Hospital Foundation when he became the first patient to reach the summit of Antarctica's tallest peak.

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The Man on the Table Devised the Surgery

More amazing than the fact that Dr. DeBakey invented the surgery that saved his life, is the fact that he was almost denied the operation . . .
But beyond the medical advances, Dr. DeBakey’s story is emblematic of the difficulties that often accompany care at the end of life. It is a story of debates over how far to go in treating someone so old, late-night disputes among specialists about what the patient would want, and risky decisions that, while still being argued over, clearly saved Dr. DeBakey’s life.

But Dr. DeBakey’s rescue almost never happened.

He refused to be admitted to a hospital until late January. As his health deteriorated and he became unresponsive in the hospital in early February, his surgical partner of 40 years, Dr. George P. Noon, decided an operation was the only way to save his life. But the hospital’s anesthesiologists refused to put Dr. DeBakey to sleep because such an operation had never been performed on someone his age and in his condition. Also, they said Dr. DeBakey had signed a directive that forbade surgery.

As the hospital’s ethics committee debated in a late-night emergency meeting on the 12th floor of Methodist Hospital, Dr. DeBakey’s wife, Katrin, barged in to demand that the operation begin immediately.

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Nobel Laureate Attacks Medical Patents

Breaking medical patents seems to me like we are robbing Peter to pay Paul . . .

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Monday, December 25, 2006

A healthy sex life: 10 reasons to make love

As if you needed 10 more reasons, but maybe the guys should brush up on their 40 biggest mistakes first . . .

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Blogger Turned Author

Dr. Centor over at DB's Medical Rants has started writing a short story entitled "A Lady with Spells" and the first chapter is quite good . . .

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New Tool to Aid Consumers of Health Care

One of my favorite medical bloggers, Dr. Malpani, has found a new service to help patients manage their health care in a fiscally responsible manner.
Today, it's usually the employer who decides what health plan the employee gets. Once patients start spending their own money on getting health insurance cover for themselves, the smarter health insurance companies which offer value for money and "put patients first" will do very well for themselves!

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In Health Profession, College Is Bottleneck

Training new professionals isn't the problem, keeping them however has proved to be more difficult . . .

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Let the Persecution Begin . . .

The potential for abuse and retaliation is nerve-racking . . .
Most of the nation’s hospitals and nursing homes will have to teach their employees how to ferret out fraud and report it to the government under a federal law that takes effect next month.

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Sunday, December 24, 2006

Medical Merry Christmas Sing-A-Long

Award winning Respectful Insolence has a list of Christmas Carols from the DSM-IV . . .

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You Might Be A Drug Seeker If . . .

A hilarious must read for anyone who has been frustrated by drug seekers . . .
3. If you've ever paused the show Trauma: Life in the ER at the exact moment that a doctor is writing a prescription for vicodin to see if you can decipher his DEA number, then you might be a drug seeker.

15. If you are asked to rate your pain on a scale of 1 to 10 and you answer 23, then not only are you incapable of following simple directions, but you also may be a drug seeker.

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Diabetic Sues Over Nightclub's Syringe Ban

I can understand the nightclub's concerns . . .

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Clowns Help Children Who Need Holiday Cheer

Stephen Ringold works for Clown Care which is "the first residential professional clowning program in a hospital."

I wonder if his clown friends ever work in the Operating Room . . .

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Don't Distract Sword Swallowers!

Can you believe there are no only two published case reports of sword swallowing injuries . . .
Sword swallowers are more likely to sustain an injury -- such as a perforation of the oesophagus -- if they are distracted or are using multiple or unusual swords, finds a study in this week's Christmas issue of the British Medical Journal.

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Saturday, December 23, 2006

Boy's Body Turning to Bone

A brief story about 6 year old Hayden who is one of only 500 people in the world known to have Fibrodysplasia Ossificans Progressiva.

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Senator Clinton Supports Universal Health Care

After Clinton's recent support of socialized medicine, I think a few excerpts of her original plan is in order:
"HHS will control the allocation of residency slots and (p. 129) assure preferential treatment of certain groups of persons."

"Wise allocation of resources: The nation should balance prudently what it spends on health care against other important national priorities.''

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Geographical Differences in Health Insurance Costs

Uncle Sam just released a new tool to help compare insurance costs between different places on the map . . .

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Do You Believe in Miracles?

The Cheerful Oncologist discovers the miracle of life while contemplating the sadness of death.

The miracle of life is not that like the lucky patient we can sometimes avoid death for as long as possible - it is that we were given life in the first place.

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2007: The Year of the Food Police

Dr. Wes has a great piece on the insanity of banning 'unhealthy foods' that is spreading across the country.

Isn’t it reassuring to know that if you cannot control yourself, or are victimized by making politically incorrect choices, others will be there to save you from your own behavior?

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Where Do Claims Go & How Do I Get Paid?

Dr. Schoor sums up our reimbursement model as "Complicated, convoluted, redundant, expensive . . ."

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Private Firm Allowed to Run New NHS Hopsital

Is this an admission that the 'private sector' is superior to bureaucratic red-tape?

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Einstein's Riddle . . .

Do you think you are smarter than 98% of the people in the world? Prove it by solving Einstein's Riddle . . .

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