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healthcare industry

The Checklist

By cancer, e-patients, healthcare industry

This document has its own page on the site as of yesterday, so I thought I’d take advantage of #HAWMC to pimp it toward the e-patient and health activist community. It was debuted during my talk “Dating Tips for Doctors & Patients” for internal medicine grand rounds at Walter Reed/Bethesda Naval Hospital on March 29. I put the Checklist together because (a) I know how much clinicians love a checklist and (b) because, printed front-and-back on one sheet of paper, this document could kick off some great relationships, or repair broken ones, between doctors and patients. Share it, share your thoughts about it. Checklist-for-Clinicians-+-Patients

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Haiku. You?

By cancer, e-patients, healthcare industry

The brain creates thoughts Yet rarely thinks of itself Un-self-seeing sentience – Cancer cells creep in No light cat’s feet involved here Only crawling death’s hands – Some say health is wealth Yet wealth can be penury If health is absent – Breasts are beautiful Yet can become pure terror At a small cell’s whim – Haiku does not come naturally to me – I tend more to prosaic bursts of thought with much syllabic activity. I do enjoy a challenge, though …

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Lighten up. Take flight.

By cancer, e-patients, healthcare industry, storytelling

I was almost 11 years old when my brother was born. I’m the one of the three of us (me, middle sis, little bro) who has had the biggest health adventure (cancer) … at least until early March of 2012. One of my favorite memories of my brother as a little boy centers on a few-week stretch of time in the spring of ’69 when he was almost six, and I was about to turn 17. We were living in Coronado, the island village in San Diego Bay, on Alameda Avenue. The kitchen breakfast nook had a window that looked out on the driveway, and mom had put up a hummingbird feeder on the eave next to the window looking to attract some of the flock of hummingbirds that make the island home. We hit the daily double that year. The window sill was about five inches wide. There was an ample source of food – the feeder. A hummingbird pair seeking a perfect nest placement couldn’t do any better than that. We saw the nest at breakfast one morning – a small, perfect bowl for tiny hummingbird eggs – and my brother was riveted. Every morning, he would literally leap out of bed, race to the kitchen, drag a chair toward the window, and look to see if the eggs had hatched. One morning they had. We watched the hummingbird mom feed her chicks, we watched her give them flying lessons – a nail-biter series, trust me – and then we watched them all fly off to start the cycle themselves. Fly, mate, hatch, fly. I had always liked watching hummingbirds. Since that spring, I’ve been in love with watching hummingbirds, because it brought back the memory of a little boy’s joy at watching a story unfold outside his…

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Life is 100% fatal. Let’s have fun while we’re here.

By e-patients, healthcare industry

Day 4 of #hawmc. Prompt is “I write about my health because … ” I don’t write about just my health because … well, how boring would *that* be? Very. I write about health and healthcare for all of us: me, you, ever’body. Health is our life, it’s what we do, it’s how we behave, it’s how we care for ourselves, it’s how we live life to the fullest. Many of us don’t get a chance to dance, at least not on our own two feet. Many of us don’t get to sing, because we have no voice to raise. Many of us don’t get to laugh, because our ability to see and react/interact is not present for one reason or another. If you can sing, if you can dance, if you can laugh, if you can enjoy a great time over a meal with friends and family … rejoice. Help someone who can’t do any/all of that find some joy if you want to know what “stupendous” feels like. There is one guarantee in life: it’s 100% fatal. None of us gets out of here alive. Be as good to yourself as possible. Help others be as good to themselves as possible. Eat good food, drink clean water, enjoy your body to the extent you can – surfing the North Shore of Oahu or just making it across the room. Whatever your limits are, test them. Stretch. Reach. I write about health because health is life. Healthcare starts within our own heads and hearts. It’s not something that happens “over there” in a healthcare facility. It happens to you every day in how you think about and treat yourself. I write about our health because I want to make a difference, to help drive some positive change within myself…

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“There are no guarantees in medicine.”

By 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.

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Did Warren Buffett really say THAT?

By 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…

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Paula Deen + Diabetes = Missed Opportunity

By 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…

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From the “Who knew?” desk here at C4C Enterprises

By healthcare industry, technology

I read a lot. I read a lot of healthcare-tech stories, since what will save healthcare in the US (and everywhere else) is technology that eases and facilitates communication between clinicians and patients, clinicians and clinicians, and patients and patients. A virtuous cycle of open communication, where individual patient data is secure from viewing by anyone who isn’t the patient or a clinician directly involved in the care of that patient. Where payers have to get permission to see patient health and treatment data that they’re not actually paying for. One of the outlets I read pretty consistently is Fierce Healthcare and Fierce Health IT. The FierceMarkets  media network has a pretty deep bench on a variety of topics, and I personally trust media outlets who are transparent about what they do, why they do it, and who’s doing it for them. As opposed to, say, anything that Rupert Murdoch has a hand in. But I digress (I am REALLY good at digressing). On to the “who knew?” portion of our program: Who knew that patient satisfaction was linked to a smooth billing process? Actually, I’m betting that most patients know this. The people who still don’t really understand this are payers and many hospitals. There’s hope, though, as long as they actually pay attention to survey results like this. Who knew that working long hours led to a greater incidence of medical errors? Talk about breaking news! Not. Anyone who’s ever pulled an all-nighter knows that your IQ falls in direct proportion to the number of hours you’ve been awake. Most of us stopped pulling all-nighters once we were out of college. For doctors and other medical professionals, not recognizing that they become dumber than a bag of hair once they’ve been on the clock for more than 12 hours is the…

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Mobile medicine: movable feast or meaningless motion?

By e-patients, healthcare industry, media commentary, politics, technology

The concept of mobile health and mobile medicine is enticing. “There’s an app for that” when applied to managing a chronic condition like diabetes, or navigating cancer treatment, sounds like real 21st century healthcare, doesn’t it? Tomorrow (Dec. 1, 2011) I’m on a panel that’s part of mHealthCon at Rutgers University, a conference where a plethora of mobile app developers and thought leaders will be talking both the idea and the practical app of mobile in healthcare. Our panel is self-described as the American Idol judges – I’m Simon, including the scowl potential – and we’re expected to give meaningful and frank feedback to the app developers that are in the session preceding us. Leading the conversation will be my buddy Bob Brooks of WEGO Health, and sitting with me in judgement will be Amy Gurowitz (who’s gonna channel either J-Lo or Ellen, she hasn’t decided yet) of MS-OL and MS SoftServe, as well as the founder of Divabetic, Max Szadek (he’s Paula). The challenges that mobile health development face were summed up brilliantly by Dr. Kenny Linn in a post on the US News health blog: Apps have … advantages over traditional medical texts. The information is always current, whereas many textbooks are already dated by the time they hit shelves. If I have a question, I can look up the answer on my smartphone without leaving my patient’s side.  But smartphone apps also have downsides—despite their enormous potential to improve the quality and convenience of healthcare. While textbooks undergo rigorous review by experts, apps vary in quality and don’t have to be vetted for accuracy or safety. That point was driven home to me recently when a colleague shared a nifty app she’d downloaded that acted as a mobile electrocardiogram (ECG) monitor: Just place your finger tip on the smartphone’s camera, and your heart rate and electrical rhythm appear on screen. Visions of chucking…

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DNA: it’s not just for cop shows any more

By e-patients, healthcare industry, media commentary, politics

“It’s in my DNA.”  You hear people say that all the time about something they love to do, a passion, an attitude. There are things that actually are in your DNA that could save you money, and even save your life. Those things are the P-450 enzymes CYP-2C19, CYP-2C6, CYP-2D9  – pay attention, there’ll be a test later – which can predict your response to a wide array of drugs. Statins, blood thinners, anti-anxiety meds, anti-fungals, anti-depressants, antihistamines, beta blockers, and more – in all, about 50% of the pharmaceutical menu. So why isn’t this being offered at every doctor’s office and pharmacy throughout the land? I’ve asked this question in arenas as diverse as women’s health events and healthcare industry conferences, and have gotten a combination of responses: Really? Physicians don’t know enough about it. Patients don’t know about it. Does insurance cover it? The answers to those, in order: Yes. Here’s a link. Here’s another link. Yes. On the insurance question: even if you don’t have insurance, the test itself only costs about $400. And you only have to have it done once. Unless you wind up in a Fukushima-level radiation accident or have massive radiation treatment for cancer. A question: why isn’t pharma, which is so good at saying “ask your doctor about [insert name-brand drug here],” trumpeting DNA drug-response testing? That approach wouldn’t impact their bottom line negatively, even if it works out that some patients need less of the standard dosage of a drug. Because there will be plenty of cases where the standard dose of that same drug won’t be enough for someone else. Another question: why aren’t health insurers pushing this? They can save money with wider use of DNA drug-response testing, because over- and under-medicating leads to poor outcomes. If you get more of a blood thinning drug than you…

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