An Open Letter to a Surgeon From His Patient

Here is the introduction by Jesse Gruman, host of the Prepared Patient Forum:

Andrew Robinson

Posted on the Prepared Patient Forum

Andrew Robinson was a successful New York trial attorney when he was diagnosed with “an incurable form of Leukemia” and told he had “less than five years to live.” That was more than 15 years ago. Despite severe complications, including over 50 hospitalizations, Andrew was the founder and CEO of Patient2Patient, a mission based company that developed disease specific WebGuides to help patients learn how to locate and use the medical information, resources and tools available on the Internet.

Andy is a friend, a playwright, a humorist, a blogger and a veteran of many cancer diagnoses and treatments. Andy embodies the ideal participator in Participatory Medicine. He is an informed, active and curious person who has found ways of working with a wide variety of specialist physicians over the years to devise strategies that allow him to remain as healthy and functional as he can.

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TedMed 2012: Day 1

Patricia Salber

Posted 4/10/12 on The Doctor Weighs In

TedMed 2012 has begun.  And how!  The opening event was “Traces-Urban Acrobats.”  Urban Acrobats?  It was mouth-droppingly over-the-top athleticism.  One long sequence consisted of the members of the troup jumping, gliding, and soaring through hoops at varying heights–always landing on their feet and making it look easy.  This was not circus stuff, this was, as our program book described it, “the human body…pushed to its limits.”  Great way to start an long anticipated event.  Take a look:

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Is My Cancer in the Wrong Body Part?

Elaine Waples

Recently, our city hosted the fifth annual national marathon to fight breast cancer.  This is not part of the Komen “race for the cure” but rather a grassroots effort that mushroomed from its inception five years ago into the impressive event it is today. Thousands of people participate as runners,  volunteers, and cheerleaders clad in the signature color.  I must admit, seeing some grown men run twenty six miles wearing pink tu-tus is both awe inspiring and a testament to dedication over self-image.

It’s supporters include corporate sponsors, vendors, and exhibitors, and (no surprise) pharmaceutical companies. Its originators are a local TV celebrity breast cancer survivor and a cancer physician at Mayo clinic. It promises to donate 100% of the money to breast cancer research or care. To date, the event has raised millions of dollars and has met its contribution promise. It’s all very worthy, noble and heartwarming.

Continue reading “Is My Cancer in the Wrong Body Part?”

Fewer Than 10% of People Manage Health via Mobile: a HIMSS Reality Check on Remote Health Monitoring

Jane Sarasohn-Kahn

Posted 2/28/12 on Health Populi

With mobile health consumer market projections for ranging from $7 billion to $43 billion, according to PricewaterhouseCoopers, a casual reader might think that a plethora of health citizens are tracking their health, weight, food intake, exercise, and other observations of daily living by smartphones and tablets.

Continue reading “Fewer Than 10% of People Manage Health via Mobile: a HIMSS Reality Check on Remote Health Monitoring”

How Many Referrals Is Too Many?

Kenneth Lin

Posted 2/1/12 on The American Family Physician Community Blog

Most AFP review articles about conditions that may require co-management of specialists contain a short section or Table titled “Indications for Referral.” For example, the January 1st article on prevention and care of outpatient burns includes a list of criteria from the American Burn Association for considering the transfer of a patient to a burn center. This and other lists generally represent expert consensus on appropriate reasons to refer a patient in a typical primary care setting; obviously, availability and accessibility of specialists has a large influence on a family physician’s practice with regard to management of “referable” conditions. Clinicians’ training and expertise also affect their comfort levels in caring for patients with complex problems and, as previous studies have shown, these factors lead to variations in referral rates.

Despite variations in referral rates among individual physicians, there is a clear trend in the U.S. toward more referrals. An analysis of ambulatory care survey data from 1999 to 2009 recently published in the Archives of Internal Medicine found that the probability that an office visit resulted in a referral nearly doubled during this time period, from 4.8% to 9.3%. It isn’t clear why this is happening, or what percentage of those referrals are appropriate. Medicine may be becoming more complex, or patients may be presenting with more problems that cannot be effectively dealt with in an office visit that is the same length as it was 10 years ago. What is clear is that at a time when a coalition of national primary and specialty care organizations is leading a campaign to reduce overuse of health care resources, the impact of this dramatic increase in referrals cannot be ignored. But in the absence of evidence-based standards for when to refer, how many referrals is too many? Is this even an answerable question? And if it is, what can be done about it?

Presenting Care & Cost Data

Brian Klepper

Over the weekend, Dan Munro – see his recent provocative post on medical management and cost – dropped me most of the chart below – he had cut off everything above the main part of the graphic – which is chock full of interesting comparative information about cost and life expectancy in developed nations around the world. It was first published in the January 2010 National Geographic, but then discussed on their blog as one of many ways to present complex data.

When I first saw it, I couldn’t help but think of Edward Tufte’s classic book The Visual Display of Quantitative Information, which I discovered in my 30’s – I was developing a lot of newsletters on health industry trends at the time – and which Amazon refers to as among the “Best books of the 20th century.” An astonishingly interesting and enlightening book about how to present data.

Note that the clear winners in this chart, in terms of bang for the buck (or yen, as the case may be here), are the Japanese, who spend the least on health care to get the longest lifespan, though having an ethnically homogeneous population and a supportive social structure are two of probably many more variables that help this along.

I apologize for the size of this. It may be helpful to blow this up a bit using Control-+.

The National Nurse Act of 2011

Brian Klepper

On December 15, Rep. Eddie Bernice Johnson (TX-30) introduced HR 3679, The National Nurse Act of 2011.

The legislation, co-led by Rep. Peter King (NY-3), would elevate the existing Chief Nurse Officer of the US Public Health Service to the National Nurse for Public Health, a new full time leadership position that can focus nationally on health promotion and disease prevention priorities.

Teri Mills, MS, RN, CNE

Teri Mills, a Certified Nurse Educator at Portland Community College in Oregon and President of the National Nursing Network Organization (NNNO), introduced the idea of a National Nurse in a 2005 NY Times op/ed. Here is an excerpt from that article.

…Nurses are considered the most honest and ethical professionals, according to a recent Gallup poll. It’s the nurse whom the patient trusts to explain the treatment ordered by a doctor. It is the nurse who teaches new parents how to care for their newborn. It is the nurse who explains to the family how to comfort a dying loved one.

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