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Showing posts from April, 2010

When Doctors are Owners, Surgery Goes Up

More and more physicians are owners in surgi-centers, imaging facilities and GI labs.  Some have labeled these ownerships as the "triple dip" because the doctor collects a professional fee as well as the facility profits and the investment value.  A study by John Hollingsworth, MD, a Robert Wood Johnson Clinical Scholar,  shows this creates a potential conflict of interest.  The study showed doctors that invested in outpatient surgery centers performed on average twice as many surgeries as doctors with no such financial stake.

The study looked at all patients in Florida who underwent 5 common procedures including cataract excision, colonoscopy, knee arthroscopy, myringotomy (placing tubes in the ear), and carpal tunnel release.  They compared surgery use among the owners and looked at before and after they acquired the ownership.  They also compared with physicians who didn't own a facility.

They found the physician investors operated on twice as many patients as the non…

Gene that Regulates Pain

I've often wondered about people's pain threshold and why some people seem to experience more pain than others.  New research reported in the Proc Natl Acad Sci USA, shows that a rare mutation in a gene (SNC9A) that encodes a protein in a type of sodium channel is associated with disorders of either excessive pain or insensitivity to pain.  Those with a rare allele that is found in about 10% of patients had a single nucleotide polymorphism that caused the patients to report higher pain than those without the allele.

(A single nucleotide polymorphism is a DNA sequence variation that can create a copying error for proteins that change how a gene works and can be the site of certain disease processes)

Researchers found that pain scores from patients with sciatica and phantom limb pain were higher if they had the rare allele and even healthy women were more likely to have lower pain thresholds if they had the mutation.  Additional experiments showed that inactivation of sodium chan…

Healthy Senior Inspiration

Thanks to KM for turning me on to this inspirational 73 year old grandmother who runs marathons, trains with weights and has a passion for helping other women reach their peak conditioning also. She started at age 56 when she realized she didn't like the way she was looking in a bathing suit. She adamantly denies using performance enhancing drugs or special supplements. She does take Vitamin D and runs about 80 miles a week.

Hats off to this amazing woman. I am inspired for sure.

Primary Care shortage Predicted to Worsen

The new reform law which is called the Patient Protection and Affordable Care Act (PPACA) will be a huge disappointment to the millions of previously uninsured people who finally purchase insurance policies when they try to find a doctor. Primary care physicians are already in short supply and the most popular ones have closed practices or long waits for new patients. Imagine when 2014 hits and all of those patients come calling. Who is going to be available to treat them?

It takes 8-10 years for an under supply of physicians to be corrected because physicians have to go through medical school and residency. There has been no up swing in physicians choosing primary care specialties for years and, in fact, the shortage is predicted to be 46,000 full time physicians by 2025 (Association of American Medical Colleges). Now add millions of new patients, baby boomers reaching Medicare and you have a disaster in the making.

I have been sounding this alarm for at least 10 years as I saw w…

Preterm Childbirth Caused by Physicians

Babies born between the 34th and 36th week have more complications and the cost in the U.S. is $26 billion annually. These children have more risk of death, cerebral palsy, cognitive impairment or respiratory problems. In the United States, nearly 13% of infants are born before they reach 37 weeks gestation. According the the Society for Maternal-Fetal Medicine (SMFM), that rate is much higher than other developed nations and physicians may be partially to blame for the early deliveries.

Some of the reasons may be older moms or the increased use of artificial productive technology and multiple births. But they are finding that some physicians are choosing to deliver between 34 and 37 weeks even when there is no clear medical indication. SMFM analyzed data of 250 late preterm births and found that the indication for these early deliveries did not meet accepted medical indication in 20% of the cases. Another study from Columbia University Medical Center showed similar results that…

The Uvula

That thing that hangs down in the back of your throat is called the Uvula. Like any tissue, it can get inflamed or infected and swell. This photo shows uvula edema. (or if you are a Brit it is called uvular oedma)

This patient was hospitalized for acute pancreatitis and developed difficulty swallowing and a sore throat. He had been vomiting repeatedly and that may have been the cause of the swelling. Other causes are infection, inhalation injury, an adverse medication effect or allergy.

The treatment is antibiotics if infection is suspected and corticosteroids to reduce the swelling. This patient's symptoms resolved without treatment.

(Case from Consultantlive)

New York Senator Steals from Community Health Clinics

Citizens are outraged at the New York State Senate majority leader, Pedro Espada, Jr (Democrat), who has been charged with stealing more than $14 million from nonprofit health care clinics and using that money for apartments, Mercedes-Benz, meals, vacations and campaign expenses. Mr. Espada founded the organization and stacked its board with relatives and Senate employees. The foundation board includes two uncles, his sister's boyfriend and two daughters-in-law along with 5 past or current members of his staff.

According to the New York Times, it appears the looting has been going on for years and an outside accounting firm noted in 2007 that they were directed to ensure that Mr. Espada and his family were paid before any other financial obligations were met, including the clinics rent and utilities. The clinics failed to pay hundreds of thousands of dollars in payroll taxes, even as it handed out millions of dollars to Mr. Espada. The non-profit clinics received their financing…

Aspirin for Migraine Headache

There are many expensive and complicated treatments for people who suffer from migraine headaches but a new literature review shows that a single dose of 1000mg aspirin is effective for more than half of all patients. Compared with placebo, aspirin reduced associated symptoms of nausea, vomiting, photophobia (lights) and phonophobia (sounds) and made severe or moderate pain into no pain after two hours in 24% of patients. Fifty two percent of patients reduced severe pain to no worse than mild pain by 2 hours after taking the aspirin and headache relieve was sustained for 24 hours more often with aspirin than placebo.

For patients who have migraine associated nausea, adding metoclopramide aka Reglan (an old fashioned medicine that can even be used in pregnancy) to aspirin significantly reduced nausea.

This study, published in the Cochrane Database of Systematic Reviews, is good news because it shows that inexpensive over- the -counter medication can help a large group of migraine suffe…

Surgeon Removes His Own Appendix

You gotta love the British Medical Journal for their report of a surgeon in a remote area of the Antarctic who did emergency surgery on himself. Russian Leonid Ivanovich Rogozov was the only doctor on an expedition ship whose mission was to build a new Antarctic polar base island in 1961. The sea had frozen over and the 12 explorers were alone at the base when the 27 year old team doctor developed fever, chills and symptoms of acute appendicitis. Transportation was impossible and there was no way to get any help.

As his condition worsened and he grew weaker, he knew he would need to operate on himself. The other guys on his team helped by sterilizing the bedding and getting instruments ready. In the event Rogozov lost consciousness, he instructed his team how to inject him with drugs using syringes he had prepared and how to provide artificial ventilation.

Rogozov chose a semi-reclining position and elevated the lower half of his body at a 30 degree angle. He disinfected his skin…

Good Aspects of Heath Care Reform Bill

The large health care bill has some very good elements in it that should help the average American. One is a provision that will kick in in 2011 that says all health insurers will need to spend 85% of the premium dollar on actually providing care. This means people may actually receive benefits they pay for. What a concept! Before you worry too much about WellPoint and United Health Care, remember that insurance companies make most of their billions in profit by investing your premium dollars. Spending 85% on actual health benefits still leaves them with massive profits.

Reuters reports that the insurance industry is already beginning to game the system and WellPoint has already reclassified more than half a billion dollars of administrative expenses as medical expenses. By shifting accounting practices, these corporations think they can get around the new rules.

Senator John Rockefeller says, "This new data makes clear that too many health insurance companies are still putt…

Insurance Companies Invested in Fast Food Stocks

A new article published today in the American Journal of Public Health shows that U.S., Canadian and European insurance firms hold $1.88 billion of investments in fast food companies like Jack in the Box, McDonald's, Burger King and Wendy's/Arby's Groups. Both Health Insurers and Life Insurers have substantial holdings in these companies.

One just needs to read "Fast Food Nation" or watch the documentary "Food, Inc." to understand the negative impact of processed foods on the health of our country. The evidence is so compelling that the new Health Reform legislation is requiring fast food and chain restaurants to disclose calorie counts on their menus. Ironically, the new legislation will also add millions of customers to the health insurers.

The authors of the study write, "The health bill just enacted in the Washington will likely expand the reach of the insurance industry. Canada and Britain are also considering further privatization of health …

Head Lice

It's the phone call every grade school parent dreads..."Come and pick Johnny up from school. He has lice". Before you scream "Ewwww" and hang your head in shame, you should know that head lice are a very common problem. In fact, only the cold is a more common communicable disease that affects school age children. The medical term for head lice is Pediculosis capitis.

This tiny insect is smaller than a sesame seed and feeds on the blood from your scalp. It is not a sign of bad personal hygiene and lice are spread through personal contact or sharing pillows, hats or other personal belongings. They are human parasites and do not live on pets. They don't have wings so they cannot fly and they don't have hind legs to jump.

The first photo above shows a scalp with an infection from scratching and tiny nits that are clinging to the hair shaft. Nits are the eggs of lice and they take 7-10 days to hatch. It takes another 7 days for the louse to mature and…

Announcing The Winner

The Winner of the EverythingHealthMade From Earth giveaway contest is...drumroll....
Country Midwife. She had an advantage because I am partial to women who work all night bringing life into the world and she has a painful spider bite.

The other entries were also good and there will be more healthy contests in the future.

Congratulations, Country Midwife. Please contact me with your name and mailing address and you will receive a full size Rosehips Face Serum to make you beautiful after a hard night's work.

(Lisa, it would be nepotism for you to win...I'll buy you one)

Surprises About Emergency Room Use

If you think the overcrowding in Emergency Rooms across the country is because of uninsured, think again. A new study in the Annals of Emergency Medicine reports that of patients who are frequent users (over 4 times a year) of Emergency Departments, the uninsured represent only 15% of those frequent users. Also the frequent ED users were more likely than occasional users to have visited a primary care physician in the previous year.

They also found that most patients who frequently use the ED have health insurance and the majority of users (60%) were white. These findings contradict the widely held assumption that frequent users are minorities or illegal immigrants without insurance.

It is no surprise that frequent ED users tended to be sicker than occasional users and were more likely to be transported by ambulance. Chronic conditions like renal failure, COPD, asthma and sickle cell disease where common along with "pain". In urban areas like Boston and San Francisco, al…

EverythingHealth Give Away Contest

There may be "no free lunch" but there is a skin serum that is all natural and good for your skin and I'm offering a free give away! I wouldn't offer this to readers if I didn't try it first and love the products. The folks over at "Made from Earth" will send the lucky winner a Rosehip Face Serum and a citrus fresh organic lip balm for free!

Made from Earth is an organic, holistic and healthy supplier of organic body lotions, organic face creams, and, organic lip balms to meet your healthy skin care needs. The selections of healthy lotion and organic creams is extensive and priced right and I tried several of the products myself. They are designed to be absorbed by the skin and do not contain parabens or petrochemicals, which are a group of chemicals that are used as preservatives in other cosmetics and have been linked to cancer.

And the best attribute..they are cruelty free.

So go ahead and tell me why you should win the free Rosehip Fa…

Report On The State of U.S. Health

The Centers for Disease Control and Prevention (CDC) issue an annual report on the state of health in the United States. The 33rd edition just came out and has some surprising findings, especially about the use of procedures, tests and medical technology. The life expectancy in the United States is now 77.9 years. Are you over that age? Congratulations, you beat the odds.

Mortality from heart disease, stroke and cancer continue to decline but the leading cause of death for people age 65 and older is still heart disease. The leading cause of death for people age 1-44 is unintentional injuries. I think that includes war, which always takes the young men.

Here are some findings that show how hard it will be to rein in health care costs:
The use of MRI, CT and PET imaging soared, especially in physician offices and outpatient departments.Knee replacement surgery for people age 45 and older rose 70% in the last decade. Partial hip replacements increased by 60%Drug-eluting stents were u…

Corporate Hall of Shame Award

With the United States undergoing the worst recession since the Great Depression and people everywhere worried about the cost of health care and how health care reform will affect them...isn't it great to know that some special corporate execs got a 51% raise in 2009? Angela Braly, the president and CEO of health insurer WellPoint, Inc, got a nice bonus that raised her salary to $13.1 million from $8.7 million the year before.

Now we know where that 25% rate hike by Anthem Blue Cross (a WellPoint subsidiary) went. I guess she deserves the raise since the stock prices gained ground steadily during the year, closing 38% higher. Braly probably deserves the raise for her testimony before Congress about the rate hikes when she claimed the rate hike was because of the soaring cost of medical care and the weak economy. The $2.7 billion dollar profit that WellPoint posted in the final quarter of 2009 certainly justifies her salary.

And it is great to know that Ms. Braly won't need …

Is Sexual Addiction Real?

Tiger Woods, Jessie James, Michael Douglas,Wilt Chamberlain (remember him?) are just a few of the celebs who admit to being plagued with "sexual addiction". With rehab centers springing up all over, it would appear this condition is on the rise. But is there really a disorder called "sexual addiction" or is it just bad behavior that finally gets caught? Is sexual addiction equivalent to alcohol dependency or is it just an excuse to be unfaithful?

Experts who treat sexual addiction say it is a compulsive need to seek out and follow a certain type of sexual behavior. Acting out sexually is something the person does to avoid dealing with something else...a coping mechanism that is out of control. It is not really about sex; it is driven by shame.

OK, stop right there. Is it really an addiction? Does the person experience physical withdrawal symptoms if he isn't watching porn or bedding new women? I can understand that some may have an unhealthy obsession wit…

Ten Things You Didn't Know Are In the Health Care Bill

The health reform bill is 1,017 pages long but it contains a lot that will have an impact on Americans. I am one who believes we had to come into the 21st century and join with the rest of the civilized nations in beginning to provide health care to all citizens. You be the judge. Here are 10 things I bet you didn't know know are in the new Health Care Bill:
Menu labeling. Restaurants with over 20 employees must include calorie counts and other nutrition information on the menu.SWAG reporting. Doctors must report valuable goodies they receive from health vendors.Right to Pump. New moms must be given space and time to pump. (for large employers over 50)Research. The bill includes research for post partum depressionTan tax. There is a 10% tax on tanning boothsAdoption Credit. Adoptive parents receive tax credits to encourage adoption.Research. The bill includes research for Indian health studies.Safety. The bill includes required background checks for long term care worke…