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Apr 01 2012

“There are no guarantees in medicine.”

By admin e-patients, healthcare industry

“There are no guarantees in medicine, other than that there are no guarantees in medicine.” That’s actually my own quote. Today in the WEGO Health #hawmc challenge – 30 days of posts on health activism, one each day in April – the prompt sheet says “Quotation Inspiration”. I’m sharing one of my central tenets, something I say constantly to both clinician and patient audiences. Because there are no guarantees in medicine. There are only great attempts at discovering answers, followed – in most cases – by satisfactory outcomes. It’s not rocket science, but sometimes it *is* brain surgery. Ask yourself how much you expect your healthcare team to do for you. Take a long hard look at what you are willing/able to do for yourself. Both sides of the healthcare equation need to take responsibility for the outcome, and admit when there’s nothing they can or will do to advance the cause.

Mar 27 2012

Is it warm in here?

By admin cancer, e-patients

I’ve been quiet for a while. Been doing my one-armed paper-hanger imitation – in a good way – which has taken up too much of my time and attention. She’s baaaaaaaaack! And she’s almost 4 months overdue for her annual mammogram. Yep, a breast cancer survivor is late for her mammo – but it isn’t due to lack of effort on her part. Here’s the challenge: I have the money in hand for a diagnostic mammogram. However, there is *not* enough money in hand for a specialist visit to order said mammogram. And since your (not so) faithful correspondent here has no health insurance – thank you, cancer, you rat bastard – that’s a wrap. My frustration is magnified by my certain knowledge that the reason the mammogram has to be *ordered* is that said order means that the insurance company will pay for it when it’s billed. Of course, since I have no insurance, that’s why *I’m* paying for the mammogram. But I can’t get a mammogram, since there’s no order for said mammogram to ensure insurance payment for same. Crazy yet? Yep, me too. I’m also totally steamed … which is why it’s warm in here. We have created a healthcare payment system in the US that flies in the face of logic. I’m not the only one who thinks so, either. My buddy e-Patient Dave is banging away at some of the same issues as he tries to be a responsible healthcare customer. I’m on record with what I think are some valid health payment reform suggestions over on Disruptive Women in Health Care. And then there’s the ever-epic Jonathan Rauch article in National Journal that became an also-epic YouTube video exploring the issue “If Air Travel Worked Like Health Care”. All I have to say is … GAH! On both the get-a-mammogram issue,…

Mar 27 2012

Did Warren Buffett really say THAT?

By admin healthcare industry, healthcare price transparency, politics

Well, it turns out he did. What did he say? Hang on. I’ll get there in a sec. First, I’ve been silent here for a while (holy crap, I haven’t posted since Jan. 31!) – my only excuse is that I’ve started blogging for clients, and ran out of words. Not really, but that’s my story, and I’m stickin’ to it. Back to our programming already in progress: Did Warren Buffett really say THAT? WHAT DID HE SAY? Well, he said this (on CNBC in July last year), kids: “I could end the deficit in 5 minutes. You just pass a law that says that anytime there is a deficit of more than 3% of GDP, all sitting members of Congress are ineligible for re-election.” Boo-yah! This is essentially what my buddies at No Labels have been saying since they released their 12-point plan to make Congress work back in December. #1-with-a-bullet of those 12 points is No Budget, No Pay. Which, by the way, had a subcommittee hearing earlier this month. Progress. It’s a game of inches, but we’re racking up those inches. Speaking of fighting for inches, the healthcare reform act – or Obamacare, whatever your radio tells you that you should call the Patient Protection and Affordable Care Act – is in oral-arguments phase in front of the Supremes this week. I’m on record as thinking that this iteration of healthcare reform isn’t anything but an attempt at healthcare *payment* reform, but that’s not why I brought this up. If you care about controlling healthcare costs – your own or anyone else’s – you must read e-Patient Dave deBronkart’s latest epic opus on what happens when a healthcare consumer tries to find out what something costs. The insurers don’t know, the hospitals sure as **** don’t know, so what’s a…

Jan 31 2012

FDA paranoia – who knew?

By admin politics, PR, technology

In its rigorous search for food & drug safety, the FDA added searching through the personal emails of agency employees who questioned FDA decisions. That would be an oops – for both sides of that story. Here’s the lowdown: on Sunday (Jan. 29, 2012) the Washington Post reported that the FDA was being sued by staffers – scientists and doctors charged with testing medical devices – for harassment and wrongful dismissal as a result of the agency’s surveillance of their personal email accounts. That email surveillance revealed that the FDA staffers were contacting Congressional staff with whistle-blower complaints about FDA approval of devices that the scientists and docs thought were a risk to patients. Hue and cry! Bad FDA! Actually, I agree that the snoopy surveilling of personal email accounts is creepy, even wrong. However, here’s the rub: the FDA staffers were accessing their personal email using computers at work. At the FDA. Within the Federal government IT infrastructure. You know, the people that oversee other stuff like Echelon. And the Pentagon. Gee, FDA guys plotting whistle-blower campaigns on work computers – stupid much? On the FDA side of the story, we have creepy fascist tactics deployed by an agency that should be all about making sure that no pharmaceutical, no medical device, no food product makes anyone sick. Or worse, dead. The record there? Not so stellar. Can you say Vioxx? On the outraged-former-employee side of the story, we have some folks who thought they were veryvery smart (scientists and MDs always think that, trust me), but who played veryvery stupid on the interwebz. Accessing personal email on a computer that belongs to your employer is pretty dumb if you’re doing or saying anything that casts a shadow on the hand that feeds you. Yes, that means you become…

Jan 24 2012

It’s the education, stupid …

By admin media commentary, politics

The headline on this post is inspired by both the 1992 Clinton campaign meme, and by my personal belief – shared by many – that education in the U.S. is in trouble, and will sink us if we don’t act decisively and quickly to change a broken system. The infographic tells the story. You can click it to open up the source in a new tab, and get the full weight of the problem broken down pretty darn well. Some high(low?)lights: only 30% of U.S. students in K-12 are grade-proficient in math and reading 70% (that’s SEVENTY PERCENT, my friends) of 8th graders can’t read at grade level Every 26 seconds, an American kid drops out of school (can you say “brain drain”?) There are only 50 million skilled workers in the U.S. – there are 123 million skilled job openings (still wonder why jobs get outsourced?) In Finland, South Korea, and Singapore, teachers are drawn from the top 1/3 of college graduates. In the U.S. they’re typically from the bottom 1/3 of college graduates. Looks like the old cliché “those that can’t, teach” might be true? Newly-minted lawyers in the U.S. make, on average, $115,000 per year more than a newly-minted teacher here. Newly-minted engineers and lawyers earn less than teachers in South Korea and Singapore. Is that math you can understand? The U.S. comes in at 30th in math, 23rd in science, and 17th in reading when stacked up against global competition. Is the picture starting to become clear to you? We’re in trouble, not just right now, but our future’s looking pretty dim, too. If we can’t educate our children at a level that makes them – and our society – competitive globally, we’re looking like Rome after the lead poisoning set in: bleedin’ dim, and getting…

Jan 20 2012

Paula Deen + Diabetes = Missed Opportunity

By admin healthcare industry, media commentary

Paula Deen did what every middle-aged woman who’s just been diagnosed with diabetes does: she went on the Today Show to announce that she’d still be cooking with plenty of butter, salt, and sugar. She’d just be practicing moderation. Yeah, I’m kidding. About the Everywoman part, but not about the rest of it. To top it off, the Butter/Salt/Sugar Queen is also going to shill for Novo Nordisk, the maker of diabetes treatment medications. There are so many things wrong with this picture, and this message, I honestly don’t know where to begin … but here goes. After spending almost 30 years making and pushing foods that are literally gateway drugs to the insulin-dependency rehab zone, the Butter/Salt/Sugar Queen is now in the club herself. What a great chance for her to make a difference in the lives of the women she influences, and the families they prepare meals for. But no. It’s ever so much more fun to push even more high fat/salt/sugar recipes … and the insulin to go with ‘em! The diabetes epidemic in the US – and elsewhere in the developed world – started in the Wretched Excess ’80s, when restaurants took a page from the drive-thru playbook and started to super-size their portions. I remember the first time I noticed this, in a restaurant in the Washington DC suburbs that, among other things, served a heaping platter of cinnamon-butter rolls – huge things – as the bread basket. The portions for the entire menu were lucullan (look it up) taken to an extreme. I fell for the con myself over the years, and have the GAS (Giant Ass Syndrome) to prove it. Luckily I’ve escaped the diabetes dx, and I work hard to make sure I keep it that way. Humans are hard-wired to survive, like any other animal. The problem…

Jan 19 2012

Does voting still matter in the wake of Citizens United?

By admin politics

It’s [still] the silly season – which seems like it’s been going on forever, even though it’s only been a little over a YEAR now – and the field of Republicans jockeying for the chance to run against Barack Obama in November is shrinking by the day. Off the list are Tim Pawlenty, Gary Johnson, and Herman Cain, who all bailed before there was an actual voting opportunity. Michele Bachmann dropped out after coming in dead last in her home state’s caucuses, and Jon Huntsman drop-kicked himself today (Jan. 16, 2012) after a down-in-the-pack finish in Iowa and New Hampshire. Still in the hunt are Mitt Romney, Rick Santorum, Ron Paul, Newt Gingrich, and Rick Perry. My question, driven by what seems to be a very short selection process: Does voting still matter? I worry that the answer has drifted no-ward, particularly since the Bloviating Herd (so effectively tagged by Calvin Trillin as the Sabbath Gasbags) shove endless streams of drivel at us 24/7 about projected winners in the days, weeks, and months leading up to a primary or election. The fact that they then, day-of, become so very Caesar’s Wife about not calling anything until all the polls close is … laughable. The actual citizens I hear talking about voting and candidates often say they vote their wallet. That’s a human reaction. My human reaction is to vote my humanity, not my pocketbook. I’m sure that puts me in the Crazy as a Shithouse Rat column for many people, but here’s my reasoning: I’d rather vote with an eye on human history – past, present, future, all of the above – instead of for someone who solely promises to put more money in my hands. Or at least take less out of them. Because the sad truth is they’ll…

Jan 09 2012

Got succession planning?

By admin Uncategorized

If you’re over 55, you’ve been getting junk mail for at least a few years advising you to think ahead about what will happen when you’re gone. Plain-speaking version: after you’re dead. That’s a topic that every business owner, and business leader, needs to examine closely, too. What will happen when you’re gone? When you retire, when you cash out, when you deploy whatever your exit strategy turns out to be? A key part of that exit strategy is making sure your exit doesn’t flatten all the tires on the bus of the business. Or worse, knock the wheels right off that bus. If you’re running a successful business, you have to think of it as part of your legacy. However, you can’t just write a will saying “everything goes to [insert heir here]” without helping that heir understand all the ins and outs of the enterprise. Who will take care of your clients? Who will keep production running? How will business development continue? What’s the plan, Stan? I’m prompted to think about this topic after losing a friend too young recently. Well, he wasn’t years-young, but he was dreams-young, and that made me think that everyone – doesn’t matter if you’re 25, 35, or 75 – who is responsible for the continuing health of an organization must make a fully-fleshed succession plan to guarantee the organization doesn’t die when s/he does. Who can you groom to take the reins? Have you drawn up the “what if?” map of how your team will move forward if you’re not there to lead them? Have you consulted with an expert who can draw you the full map of a succession plan? Talk to other CEOs that you trust. Ask them how they built their legacy plan. If they look at you like…

Jan 05 2012

I have … great news!

By admin cancer, e-patients, media commentary, technology

My good friend Andrew Spong posted something today on his blog that I took one look at and said, “STEALING THIS!” It’s not really theft if you give 100% credit, though, is it? Andrew talks about his “I have” project, and uses this image to drive the point home: What is the “I have” project, exactly? It’s crowd-sourcing health information in a way that makes it accessible and understandable to someone who’s just heard their name and [insert diagnosis here] in the same sentence. Patients, clinicians, experts of all stripes. That he’s kicking this off with “I have breast cancer” has high impact for me, because I just marked my 4-year breast-cancer-versary yesterday. That original diagnosis day – and before, and since – have been in turn marked by more Google searches than a human could count about breast cancer, oncology, radiation, lymphedema, lymphoma, lumpectomy, hormone suppression therapy, and a partridge in a pear tree. This is incredibly important. I’m not a PhD (Andrew is), so I trust him to kick this off and make it fly. Really. Here are the goals for the project, as he states them: What are the ‘I have’ project’s goals? To offer definitive answers to the question ‘I have [disease state]. What should I do?’ To produce 1 page signpost summaries of the most reliable, relevant, patient-focused, outcomes-oriented, evidence-informed health information available for a wide range of diseases. To publish outputs compiled with SEO best practice in mind to be promoted through social networks and communities in an effective way with the intention that they should appear above the fold on the first page of Google results for the disease they address. Even the best health information is useless if it isn’t discoverable. To harness the expertise of healthcare professionals, patients and curators in co-creating and sharing the…

Dec 31 2011

Mighty Mouth 5-Point Manifesto for 2012

By admin Uncategorized

OK, I’ll admit that it’s highly hackneyed of me to publish a manifesto on New Year’s Eve. I’m not a fan of New Year’s resolutions – who even keeps the things into February? – and this is not a set of resolutions. My inspiration(s) for this post are vast and varied. Some are between my ears, and will remain there. External inspiration includes Danielle LaPorte’s White Hot Truth (all of it) Marc and Angel Hack Life‘s post 30 Things to Stop Doing to Yourself (which should be read every day by everyone) My new friend and wordsmith-crush Erika Napoletano, a/k/a Redhead Writing (my sister in knowing exactly how to deploy the f-word. Repeatedly. And well.) who is smarter than any other fucker in the room. Even if I’m in it. This list is a line in the sand. A statement, in public, of what I will and will not allow to exist in my self, in my work, or in my proximity. Some of these have taken decades to learn. Some are very recent epiphanies. I’m not going to indicate which are which … you figure it out for yourself, on your own behalf. #1: Be yourself. Everyone else is taken. One of the greatest skills anyone can learn is adaptability. I learned this at my mother’s knee as a 2nd-generation Navy daughter who was the New Kid almost every year K-12. I learned how to manage rampaging nuns determined to punish children because of their own sexual frustrations, how to handle playground bullies, how to show up even when the very idea of doing so scares the shit out of you. Adaptability is a terrific tool. Taken to excess, though, it turns into approval-seeking. Since I’ve moved from one of the biggest cities on Earth to a small city that…