To this dayTo this eveTo the fulfillment of your dreamTo the content of your characterTo hopeTo changeTo visionTo audacityTo equalityTo selflessnessTo unity
Health 2.0 Group Chicago, meets Thurs 15th
Calling all Chicagoans – Some attendees of the Health 2.0 Conference would like to create a regional Health 2.0 group in your area—FIRST MEETING IS TOMORROW!
The Purpose: To form a group within the greater Chicagoland area to connect, to discuss, and to inform on all things health and technology.
Disruptive Physician Behavior: Fact vs. Frenzy
The Joint Commission has recently proposed in its 2009 Accreditation Standards that hospitals develop and implement a Code of Conduct policy and provide appropriate education and processes that address disruptive behaviors.
Many think the decision is long overdue, while others have expressed concern that it was just another way for administration to weed out physicians who are openly vocal in expressing contrary views to administrative policies and decisions.
Disruptive behaviors include any inappropriate behavior, confrontation or conflict ranging from verbal abuse to physical or sexual harassment. Unfortunately, they’re all too common in the health care arena, and they affect staff morale as well as patient safety.
Tone deaf git of the month award
I’m always amused to see Ivy league professors with tenured appointments and gold-plated group health insurance explaining how the individual market for health insurance works pretty well for, well, quite a few of the well people in it. But this award is not for Mark Pauly.
Today there’s a long piece in the Wash. Post (essentially paid for and scripted by Kaiser Family Foundation—which may be the future model of health care journalism). In it, we see this paragraph:
Experts define the underinsured as those forced to spend at least 10 percent of their income on health care, excluding premiums. But the nonprofit Center for Studying Health System Change found recently that financial pressures on families increase sharply when out-of-pocket spending on medical bills exceeds 2.5 percent of family income. New York’s Commonwealth Fund has reported that 72 million adults under age 65 had problems paying medical bills or were paying off medical debt in 2007, up from 58 million in 2005. Many had insurance, and 39 percent said they had exhausted their savings paying for health care.
Yup, even people with insurance are in real trouble. Two days ago I met a woman in her early 20s who faces 3 more years paying off extra bills from emergency ankle surgery 2 years ago. And yes she had insurance–just not very good insurance.
And so we have around 25% of adults having problems paying medical debts. And of course that’s a 2007 number—in other words pre-recession. So in order to be “balanced,” they get a quote from a resident member of the loony right. And for our tone deaf git of the month award we select this wonderful piece of empathy.
Economist Thomas P. Miller of the American Enterprise Institute, a conservative Washington think tank, said he believes the problem of medical debt has been exaggerated and is a symptom of the broader economic crisis. The solution, he said, should not be "to kill people with kindness" by requiring an overly expansive and expensive benefits package that could "preempt the use of resources for other purposes."
In other words, screw you poor people, you’re on your own and the system works fine.
Free Trade and Free Antibiotics
The next time you visit your doctor with a case of the sniffles, he may want to inquire about your position on the North American Free Trade Agreement before deciding whether to reach for his prescription pad.
A recent article by the Charlemagne columnist of The Economist points out a strong correlation among those European nations whose populations believe that globalization offers an opportunity for economic growth and the data on consumption of antibiotics. The article notes:
Rather like trade protection, the popping of an antibiotic offers false comfort to individuals. In an anonymous 2008 survey, Greek pediatricians said that 85 percent of patients demanded antibiotics for children with the common cold virus. As with political debates over free trade, some people appear to suffer from a corrosive lack of trust when the authorities tell them that they are demanding the wrong thing. Even when told that antibiotics cannot fight viruses, 65 percent of Greek parents in the survey insisted they did until their doctors gave in.
Meet the New (Acting) Boss, Same as the Old Boss
It didn’t make a Wall Street Journal story on changes at the Department of Health and Human Services , and a brief mention in a pharmaceutical industry blog was a bit vague , but THCB has confirmed that the Agency for Healthcare Research and Quality now has an acting director who will be in charge after Jan. 20: it’s Carolyn Clancy, the current full-time director.
As the Journal reported, the outgoing Bush administration has named acting heads to lead a number of HHS agencies until the Obama administration can pick permanent new leaders. As part of that process, replacements have been named for some current chiefs who clearly won’t be staying on (e.g., Julie Gerberding, head of the Centers for Disease Control and Prevention). At the Centers for Medicare & Medicaid Services, it will be a case of a new Acting Administrator replacing an old Acting Administrator, since Kerry Weems, the Acting Administrator since September, 2007, was never given a permanent appointment subject to Senate approval.
The Year in Research according to RWJF
A while back we suggested that people went to look at RWJF’s Pioneering blog to rate its posts for the year and see what they liked. Well it appears that RWJF fans like articles about obesity and Massachusetts (and not much else). It’s all in the new post 2008: The Year in Research.
Welcome To Health Wonk Review – 1/09/09
Well, here we are at the beginning of 2009. On TV we’ve learned that the unlimited spending and brilliant, if socially pathological, heroics of Dr. Gregory House, unfailingly saves his patients from unknowable complexity and the abyss of death.
Meanwhile, the rest of health care, aided largely by really excellent lobbying, continues to be buoyed, defying the relentlessly corrosive gravitational pull of waste, corruption, and a tanking economy.
Still, health care’s troops are beginning to feel, in Tom Lehrer’s words, like a Christian Scientist with an appendicitis. Things definitely are not going well, and this longstanding run of great good fortune could be on the downswing. Is it possible that exorbitant pricing and massive waste are NOT entitlements!
Which brings us to the far-ranging insights, jabs, diatribes, rants and enthusiasms of this edition of Health Wonk Review, which features analysis and exegesis as entertainment.
Should the FDA relax in the search for new cures?
Over at DiabetesMine #1 health blogger Amy Tenderich has very important post. She and several fellow travelers are appealing to the FDA to strike a balance between safety and progress in allowing new diabetes treatments.
The FDA of course has been beaten to a pulp these last few years because it’s played footsie with the drug industry and ignored several potentially damning studies, with the result that the number of drugs withdrawn from the market has been much higher than in previous years.(Vioxx, Phen-Fen, Baycol, et al).
I’ve always felt that the FDA’s role should not to be a black/white (dangerous/safe) stamp of approval, but instead it should be the honest broker of getting all the data out there. As Amy and her crew point out, some diabetics may be prepared to take a risk of higher long-term cardiac complications in return for a medium term gain from a new medication. Something similar is certainly true in terms of hormone replacement therapy.
Persistent Nondiagnosis
Brad Kittredge is an MBA/MPH student at the Haas Business School at UC, Berkeley. He is working to build an online tool to assist with complex and difficult diagnoses, which, as you’ll see, he considers among the biggest problems in medical care. He blogs more about these issues at Hyoumanity.
Every day, thousands of Americans are desperately seeking answers to complex medical conditions that doctors are unable to diagnose. Consider one example: Jenny T. is a 14 year old girl with a progressively debilitating neuro-degenerative condition that has taken her from healthy and active to nearly paralyzed in less than one year. Her parents have taken her to some of the best academic medical centers in the US, including Stanford, UCSF, and the University of Pennsylvania, but doctors have been unable to diagnose her condition, leaving Jenny and her parents desperate for answers and short on options.
