Month: September 2018

A conversation with Dr. Nicole Saphier

Sep 8, 2018

By, SAURABH JHA

I have a wide ranging conversation with Dr. Nicole Saphier for JACR’s Firing Line Podcast. Dr. Saphier is a radiologist specializing in women’s imaging. We discuss screening mammograms and the breast density law. Dr. Saphier, a frequent contributor to multiple major media outlets, tells us what it means for a radiologist to opine on health policy in the national media.

About the author:

Saurabh Jha is a contributing editor to THCB. He’s the host of JACR’s Firing Line Podcast. He can be reached on Twitter @RogueRad

Physician Well-Being: Lessons From Positive Psychology

Sep 7, 2018• 2

By SANJ KATYAL

The absence of burnout does not equal wellness. While the focus on physician burnout as an epidemic is finally gaining more attention, we may be missing a larger issue. Most physicians are not burned out. We are able to function. We get through our days, make it to some of our kids’ activities and even manage to go out to dinner on the weekends. We survive the work week as we look forward to our next vacation. We do this because that is what we have always done. We put our heads down and do our work. We often project ourselves past the next exam or to the next stage of our lives to help us get through the stress. We become masters of delayed gratification. We develop the mindset of “I’ll be happy when…” I get into medical school or match into a good residency spot or make partner or have enough money to retire etc…Along the way, we may have some bright spots – falling in love, having kids, taking great vacations. We may even reward ourselves for our hard work with a new car or nicer house. We deserve it. But deep inside, “something is missing”. We have achieved most, if not all of the goals we have set for ourselves. Yet despite our hard work, many of us remain unfulfilled with our careers and often with our lives. What is it that we need? A better job with more money? A different car? A different title? Better vacations?

I have struggled with these questions and many more. How do I stop wanting what I don’t have and start wanting what I do have? How can I fully enjoy the present while also preparing for a better future? How can I spend quality time with my kids while they are still around? How can I have a career that uses all of my potentials? Of all the questions that I’ve asked myself, the most important one was this – How can I learn to flourish and not just function?

Fortunately, I found answers in the relatively new field of Positive Psychology which is the scientific study of human flourishing. Unlike traditional psychology which alleviates distress and moves a patient from a -8 to a 0 or +1 (if they are lucky), positive psychology focuses on a patient that is functioning at a +1 and tries to move them to a +8 on the flourishing scale. We need both areas of focus. There are many people that are functioning well by most standards but are nowhere near their potential level of fulfillment.

Disrupting the Cholesterol Test: Finnish Startup Nightingale Health

Sep 6, 2018• 1

By JESSICA DA MASSA, WTF Health

Today’s cholesterol test is about to be disrupted. Nightingale Health, a five-year-old startup based out of Finland, has built a better blood test that – among other things – is about to disrupt the cholesterol test of today.

Their blood test collects 50 times more biomarker data than the standard test – boasting a 20% better prediction rate for diabetes and cardiovascular disease – and they’re offering it at the same price point as the existing industry standard. Why does this matter? Well, for clinicians, researchers, or those working on new drug development, the Nightingale test is not only offering an unprecedented amount of metabolic data, but it’s an unprecedented amount of AFFORDABLE metabolic data that can impact the health care cost curve as far as the eye can see.

What’s more – and this has gotten investors’ blood pumping – they haven’t even fully realized the full potential of their panel. Listen in as Kristiina Tolvanen talks with me about the company’s priorities to build their evidence base and find out what else their biomarker analysis platform can potentially displace. Freshly funded with a $30M round – and a very prestigious partnership with the UK Biobank to analyze 500,000 blood samples – this is one to watch.

Filmed at Upgraded Life Festival in Helsinki, Finland, June 2018. Find more interviews on health and technology here or check out www.wtf.health.

Health in 2 Point 00, Episode 48

Sep 6, 2018

Jessica DaMassa asks me about Cricket Health’s $24m raise for kidney disease services, Rx.Health from Mount Sinai and a whole bunch of big money in little China. All in 2 minutes–Matthew Holt

Is Universal Health Care Socialism?

Sep 5, 2018• 7

By ETIENNE DEFFARGES

The November midterms elections are approaching, and one of the major topics is health care. Democrats are campaigning on retaining Obamacare, in many cases advocating that we move towards universal health care.

That would be pure socialism, retort Republicans, who would rather repeal the Affordable Care Act as they attempted in 2017, even if this leads to 20 million Americans losing coverage.

Is Universal Health Care Socialism?

Only if we believe that every other developed market-based economy in the world is socialist since the U.S. is the only one without universal coverage. We spend almost $10,000 per year per capita on health care, about twice as much as most developed countries. However, in terms of major health outcomes, such as infant mortality or life expectancy, we are laggards. In a recent OECD survey, we ranked 27th out of 35 countries in life expectancy. Japan spends about $4,000 per year per capita in health care, yet the average Japanese has a life expectancy of 84 years, versus 79 for the average American. Why?

Every developed country other than the U.S. has had universal care for decades. While Prussia’s “Iron Chancellor” Otto Von Bismarck implemented the first universal care system…in 1883, our health care history is a patchwork of partial reforms, an inefficient collage of private and public institutions. We first tied health insurance to employment in 1946, because business and conservative opposition would not allow universal coverage; then added Medicare in 1965 so that our seniors would have coverage after they retired; then Medicaid, a different one for each one of our fifty states; Continue reading…

Health in 2 Point 00, Episode 47

Sep 5, 2018

Jessica DaMassa asks me about Patrick Soon-Shiong and his Verity hospital chain going bankrupt, whether Peerfit can justify its $8m raise, and who I’m going to see at TechCrunch Disrupt this week–Matthew Holt

Can CMS’ Proposed ACO Changes Really Help Medicare Beneficiaries?

Sep 4, 2018• 3

By REBECCA FOGG

Earlier this month, the Centers for Medicare and Medicaid Services Administrator Seema Verma proposed bold changes to Medicare’s Accountable Care Organizations (ACOs), with the goal of accelerating America’s progress toward a value-based healthcare system—that is, one in which providers are paid for the quality and cost-effectiveness of care delivered, rather than volume delivered.

CMS has created a number of ACO programs over the last six years in an effort to improve care quality and reduce care costs across its Fee-for-Service Medicare population. In a Medicare ACO, hospital systems, physician practices and other voluntarily band together and assume responsibility for the quality and cost of care for beneficiaries assigned to them by Medicare. All ACOs meeting quality targets at the end of a given year receive a share of any savings generated relative to a predetermined cost benchmark; and depending on the type of ACO, some incur a financial penalty if they exceed the benchmark.

According to CMS’ recent analyses, ACOs that take on higher financial risk are more successful in improving quality and reducing costs over time. So one important objective of CMS’ proposed changes is to increase the rate at which ACOs assume financial risk for their beneficiaries’ care.

How My iPhone Prevented an ER Visit

Sep 1, 2018

By DR. WES

It’s one of those calls you never want to get as an electrophysiologist:

“Doc, I got four shocks from my device yesterday.”

“What were you doing at the time?”

“Working outside.”

“Wasn’t it about a 100 degrees and humid then?”

“Yes.”

“Were you lightheaded before the event?”

“Not too bad… I stopped what I was doing and got better. Should I come in to the ER?”

“This happened yesterday?”

“Yes.”

“Why didn’t you come in then?”

“Well I started to feel better…”

“Do you know how to upload the information from your device at home?”

“You mean using that thing next to my bed?”

“Yes.”

“I think so.”

“Okay, why don’t you go do this and we’ll call you right back after we have a chance to view the information you send us.”

“Okay. Thanks, doctor.”

So I waited about 15-20 minutes, then checked the Medtronic Carelink app on my iPhone.

Grassley Criticizes Removal of Doctor Discipline Data

Sep 1, 2018

By PIA CHRISTENSEN

U.S. Sen. Charles Grassley (R-Iowa) sent a letter today to the Health Resources and Services Administration, criticizing its decision to remove a public version of the National Practitioner Data Bank, which has helped reporters and researchers to expose serious gaps in the oversight of physicians.

“Shutting down public access to the data bank undermines the critical mission of identifying inefficiencies within our health care system – particularly at the expense of Medicare and Medicaid beneficiaries,” Grassley wrote to HRSA Administrator Mary Wakefield. “More transparency serves the public interest.”

Grassley, ranking Republican on the Senate Judiciary Committee, continued: “Generally speaking, except in cases of national security, the public’s business ought to be public. Providers receive billions of dollars in state and federal tax dollars to serve Medicare and Medicaid beneficiaries. Accountability requires tracking how the money is spent.”

Price Tags and Haggling in an Exotic Market

Sep 1, 2018

By DANIELA CARUSI, MD

A friend of mine recently took an exotic trip. While shopping in a market, she picked up an appealing item and asked the seller what it cost. She was given a price that seemed high, and paused to consider whether the impulse seemed justified. The shopkeeper grew confused in the silence. Finally he asked my friend, “Don’t you want to know if I can do better?”

Clearly this person was outside of her bargaining comfort zone. Many – perhaps most – Americans are accustomed to paying the price as written on a tag. If you have to ask, you can’t afford it, or so I was told growing up in suburban shopping malls.

American consumers make the same assumptions as they search for transparency in health care costs. Obviously there are charges for these services – they are clearly written on the bills after the services are delivered. So why is it so hard to find out the cost of a service before it is performed? Here it is essential for the customer to understand that the charge and the price paid may be quite different; in fact, they are expected to be different. The health care consumer is not shopping in a chain store whose clerks forgot to stamp the items with their prices. On the contrary, the confused shopper has stumbled into an exotic market without a clue on how to haggle.