May
11
2012
Unintentional drug overdose deaths per 100,000 — U.S., 1970–2007 (CDC 2011)
More Americans are addicted to prescription drugs than every before. Aggressive marketing by drug companies of prescription narcotics, ADHD drugs, depression and anxiety drugs, and sleep aids has contributed to the problem. More than 27,000 people died in the U.S. in 2007 from unintentional drug overdoses. More than die from car accidents. Most of these deaths were caused by prescription drugs.
So, what you should do to protect yourself and your family? Keep any narcotic or sedative medications you may have in a secure location. Don’t ever mix sedatives (including alcohol), painkillers, stimulants, anxiety medicines, or depression medicines without your doctor’s permission. If you take narcotics, sedatives, or stimulants on a regular basis ask your doctor if you can wean yourself off of dangerous medications by finding safer alternative treatments. Research shows that for most people with chronic pain from conditions like arthritis and fibromyalgia daily exercise and stretching are the best treatments to reduce pain. Warm baths, yoga, and massage also help with chronic pain and are much safer than prescription painkillers. Likewise, for most people with sleep problems the best treatment is good sleep habits, daily exercise, stretching, and relaxation techniques. Discuss with your doctor or nurse practitioner natural ways that you can improve your sleep. Even for most people with anxiety and depression, counseling is just as effective as drugs and is safer. Daily exercise also helps treat anxiety and depression. If you struggle with anxiety or depression, talk to your physician, psychiatrist, or counselor and discuss whether counseling is right for you.
For more information: Visit www.cdc.gov/homeandrecreationalsafety/rxbrief/
Apr
17
2012
The Harvard surgeon and writer Atul Gawande explains that the routine mistakes and extensive waste in modern medicine result from a longstanding “cowboy” mentality in medical practice. Because medicine has become so complex he suggests that healing medicine will require fewer cowboys and more pit crews.
Dr. Gawande describes how physicians and surgeons can markedly improve care by working together in teams, using simple tools like checklists, and standardizing care. He says: Making systems work is the great task of my generation of physicians and scientists. But I would go further and say that making systems work — whether in healthcare, education, climate change, making a pathway out of poverty — is the great task of our generation as a whole.
Apr
4
2012
The American Board of Internal Medicine and 9 other major medical specialty groups have identified 45 common tests and procedures that are overused (see WSJ blog). Most diagnosis (80% or more) comes from careful history taking or physical exam (10 – 15%), not from expensive tests and imaging studies. These medical societies are counseling physicians to stop ordering tests indiscriminately. These frequently unnecessary tests and procedures are often costly, wasteful, and may unnecessarily place consumers in danger from side effects, radiation exposure, or complications.
Here are a few of the 45 common tests, procedures, and treatments that the physician organizations are urging physicians to perform less frequently:
MRI rarely needed for back pain
- Routine EKGs during physicals
- X-rays and MRIs for back pain
- Antibiotics for mild sinusitis
- Routine stress cardiac imaging in asymptomatic patients
- Imaging scans for simple headaches
- Bone density scans before age 65 without risk factors
- Pap smears < age 21 or after hysterectomy without cancer
Go to the Choosing Wisely website to learn more about the 45 common tests and procedures that you should think twice before undergoing. If your doctor recommends one of these tests, ask your doctor about potential benefits and harms and if the test is really needed.
Feb
20
2012
When Peter Orzag, the director of the White House Office of Management and Budget suggested that $700 billion in waste could be trimmed from the U.S. healthcare budget, many people thought he was nuts. But a report from Thomson-Reuters identifies specific opportunities to do just that: cut $700B from the U.S. system while improving care.
How $700B in Waste Can be Cut from U.S. Healthcare (Thomson-Reuters 2009)
Americans are beginning to realize what healthcare analysts have realized for years. The amount of waste in U.S. healthcare is staggering. Waste accounts for almost one-third of American healthcare spending. And we know how to cut out the waste. Here are a few of the simple steps America must take to cut out the healthcare spending that does nothing to improve health:
1) Improve administrative efficiency –We can start by standardizing insurance benefits, formularies, billing procedures & authorization procedures. Because of the complexity of our insurance system Americans pay nearly one-third of their healthcare dollars for bureaucracy: more than any nation in the world.
2) Improve care coordination, reduce provider inefficiency, reduce preventable hospitalizations & emergency department use –We can improve care and make it more efficient through improving our primary care systems, making sure everyone has a medical home, that all clinics and hospitals have electronic health records, and that clinics and hospitals share health information so that they can better coordinate care.
3) Reduce unwarranted use –Accountable Care Organization (ACOs) that encourage physicians and hospitals to work together to improve health and align their incentives by paying them a blended physician-hospital payment will go a long way to improve care.
4) Eliminate fraud and abuse –Medicare and other insurers can use claims data to identify crooks and can continue to increase enforcement efforts. The Justice Department and Health and Human Services recovered $4.1 billion in 2011, nearly 50% more than in 2009. No one should get away with bilking the insurance companies that pay our bills.
Tags: ACO, budget, electronic, fraud, health, healthcare, hospitalization, insurance, Medicare, reform, waste | 
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23
2011
The prestigious Institute of Medicine (IOM) has issued a new report, Early Childhood Obesity Prevention Policies, that outlines the key steps needed to prevent obesity in children from birth to age 5.
- The physical effects of obesity from “Methods of Healing” website (www.methodsofhealing.com)
The IOM report shows how communities can promote physical activity and healthy eating by giving young children healthier food, play, and learning environments. Changing the environments and choices that we make available to children is central. The business book Nudge suggests that governments, industries, communities, and families should work to make the healthiest choices the easiest ones. A recent press release by the Robert Wood Johnson Foundation (RWJF) outlines the main recommendations from the obesity prevention report, including:
- ensuring that recreation areas encourage all children to be active;
- allowing community residents to use school playgrounds and recreation areas when schools are closed; and
- establishing voluntary nutrition and marketing standards for the food and beverage industry.
- establishing dietary guidelines for children from birth to age 2
Jul
11
2011
According to a recent article in BBC News (http://www.bbc.co.uk/news/world-us-canada-14070090) Americans are falling behind other countries in life expectancy. In this article the BBC reports on recent research by Dr. Ali Mokdad at the University of Washington. The differences are stunning.
Source: Washington University, UN Population Division as reproduced in BBC News
Americans die about 1.5 years earlier than Brits and 3 years earlier than Australians.
Why is this happening? Dr. Mokdad and his colleagues point to good evidence that the main culprits are higher rates of tobacco use, obesity, and salt consumption, and less daily exercise, less emphasis on primary care, and less prevention. They note that the U.S. has not been nearly as tough as Australia in restricting tobacco advertising and public smoking.
So what is the cure? Invest in primary care and prevention and quit looking for a quick (and expensive) fix. Dr. Mokdad and his colleagues suggest that we should use proven approaches. Adopt stricter policies to discourage smoking, discontinue tobacco subsidies, and devote a higher percentage of transportation and education resources to support healthy eating and active forms of transportation like walking and biking. That is the path to a longer and more abundant life.
Jun
7
2011
In this amazing video 11-year-old Birke Baehr talks about what industrial farms are really like. He presents a fresh point of view about why we need green and sustainable food production.
Jun
7
2011
The new national health care quality strategy is designed to promote better health and higher quality care for Americans. This is the first time the federal government has put forward a national strategy to guide local, state and national efforts to improve quality of care. Get the details from the U.S. Department of Health and Human Services. Will this this strategy help lead us to a higher quality and more affordable health care system?
Jun
7
2011
What are the fattest countries in the World? Check out the Peter Smith’s recent post about the country-by-country report on obesity from the Imperial College London, Harvard University, and the World Health Organization. For even more information try the health risk factor visualization tool from the Imperial College London School of Public Health.
Chart: Wilson Andrews and Todd Lindeman of The Washington Post, created with data from Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group.
Feb
2
2011
Metlife Tower in New York (Photo © www.aviewoncities.com)
New AMA study shows that most health insurance markets are dominated by one or two health insurers
Health insurance is expensive in the U.S. Most American families who get insurance through their job pay around one in five (15-25%) of their healthcare dollars to an insurance company. One reason for the high cost of health insurance may be lack of competition. The study found that ”the vast majority of commercial health insurance markets in the United States are dominated by one or two health insurers” and these insurance companies do not have to compete with low cost government-sponsored insurance plans. The study authors found that “99% of health insurance markets in the U.S. are highly concentrated…In 48% of metropolitan statistical areas, at least one insurer had a market share of 50 percent or more”.
What does this mean for you? For the foreseeable future Americans can expect to pay a lot for the privilege of having health insurance, and insurance company towers will continue to grow taller. To reduce insurance overhead and bureaucracy in America experts suggest that competition can help, but there must be a level playing field. Efforts to standardize and simplify health plan options through state insurance exchanges may be a good first step in that direction. But experts suggest that further efforts will be needed to reduce insurance bureaucracy and overhead. Payment reform efforts that encourage responsible spending by the providers themselves may be more effective in reducing costs. Besides, most people care more about having choice of good doctors and treatments than they do about being able to choose amongst dozens of high cost insurance companies.
