Carmen Bracamonte and The Patient Squad Blog

What's the medical industry trying to sell you?

2011-02-17T12:23:00.000-08:00

Google Images

So, what is the medical industry trying to sell you? Medical care of course — procedures, tests, devices, drugs and treatments.

But be aware that it may be medical care you may not need or want. It’s even medical care that may be harmful to you. It’s been estimated in studies that about 30% of all care is harmful or unnecessary.

Although I didn't believe the stats at first, the intense debates and media coverage of the health care reform last year totally convinced me of what medicine means to all of us today.

The medical industry has also largely sold us on the idea that health and wellness comes from them. It works like this — sell the idea that care is necessary for health and wellness, then sell as much care as possible. Let's face it. Our health care system promotes the new normal in our health care system in which productivity (selling) takes center stage.

It shouldn't be BUT that's reality.

Take a quick look at health and wellness. There is such as exaggerated focus on this trend with the objective to influence your decisions, change your behavior and induce communities to take deliberate action to targeted, pre-selected medical products and services. One thing should be clear. Your are the only one who knows what's best for you. How you live is likely to be the most important determinate of your own personal health and wellness.

That's a decision you need to make on your own.

So what are patients supposed to do? First, let's realize that patients are consumers. We’ve got to deal with this reality. Let’s be educated consumers of care. Let’s take charge of our health care and our bodies. Care for your self physically, emotionally and spiritually.

Take a skeptical attitude towards more testing and more treatment. Always ask for a second and third opinion. Don’t be an “easy sale” for the medical industry that today over-promises and under delivers.

What Value Do You Get From Your Annual Routine VIsit To Your Doctor?

2011-02-11T07:36:00.000-08:00

Image from Google.com

I've been having my routine visits to my primary care doctor during the holiday season in the last three years because I found people to be more relax, patient and in great spirits. It was a win-win situation for all ... and at the end of the day... I would have a bit extra doses of quality health care by my provider and his/her staff. At least that was exactly my experience in the past.

Unfortunately last holiday season broke down the cycle of good experiences. We all know that typically, sales people stops by the doctor's office all the time with food, which made me wonder ... would the doctor's staff actually get in the Christmas mood from consuming so much sugar and saturated fat rather than the sincere desire to provide a good service to patients?

Last year, the doctor I visited ordered a total of 6 routine tests. Her nurse dropped the necessary blood from me. Two days later, her nurse practitioner calls me asking for more blood. Through a number of phone calls with their staff (by the way the doctor never had the courtesy to return any of my calls), I learned that the nurse who took my blood was new and failed to enter all the codes ordered by the doctor in their computer system. When the doctor's office realized the overlook. My insurance provider was already billed in less than 12 hours. Imagine that. Two issues here: (1) why the doctor did not take responsibility and address the issue directly with the patient? After all, it was just a routine test, I am sure there were always ways to work things out. However, the doctor or her staff never offered any alternatives. (2) why a new staff member is not trained on internal office procedures? Were they too busy eating holiday food? Uhmmmmm....

In KevinMD.com, there is a great patient story today. The blogger talks about a $20 co-pay and the value of an office visit. You can read more here and make your own conclusions about why it is important to differentiate good doctors from bad ones. Did you ever have a bad doctor's visit experience?

LOOK: WHY PATIENTS NEED TO ASK THE RIGHT QUESTIONS?

2011-02-10T10:14:00.000-08:00

Let's don't forget in many cases doctors also need to protect themselves, their medical practices and licenses from potential lawsuits. The key to a civil and rational decision making process impacting health matters is PATIENT EDUCATION!

This video highlights some good pointers we all should start putting in practice. What do you think?
http://www.cbsnews.com/video/watch/?id=3395783n

Source: MedPage Today at http://www.kevinmd.com/blog/about-kevin-md

LIVING IN AN ERA OF OUTPATIENT MEDICINE

2010-06-02T10:40:00.000-07:00

The Role of Family Caregivers —

The Dearest of All Patient Advocates

An interesting study conducted by The National Cancer Institute’s third project recruited informal caregiver(s) for each patient from former two projects to test a palliative care intervention for family caregivers. Not only the study enrolled caregivers to pick up skills and knowledge to better support the patients’ needs, but their own quality of life was measured. Data on caregiver effectiveness was evaluated according to disease stage and socio-demographic characteristics and compared with data from family caregivers who did not get the supportive intervention.

“It is families, not just people, who get cancer,” Dr. Ferrell explained, Primary Investigator (PI) in the study. “We are living in an era of outpatient medicine,” shed adds. “When I was starting out, people with symptoms or problems would call the hospital, routinely be invited in, and often stay for weeks as the system provided more care. But in the current economic model family caregivers have become ‘professionals’ who are caring for the patients. This is an urgent social issue in public health,” Dr. Ferrell explained.

The study is a testimony on family caregivers as truly the dearest of all patient advocates. Impacted by long and devastating treatments, they feel helpless seeing their love-ones in pain, but when they are actively involved, family caregivers can significantly reduce the suffering of a family member who has cancer, through the use of simple touch and massage techniques, as the book on “Caring for a Loved One with Illness” explains.

Ninety-seven multi-ethnic cancer patients were chosen. They represented 21 types of cancer (nearly half with breast cancer) and all stages of disease. The caregivers included spouses, adult children, parents, siblings and friends. Researchers evaluated the outcomes of a 78-minute DVD instructional program and illustrated manual shown to the patients and their caregivers.

Caregivers in the experimental group were asked to apply the instruction for at least 20 minutes, three or more times per week for a month. Caregivers in the control group were assigned to read to the patient for the same amounts of time. Patients completed report cards before and after sessions rating their levels of pain, fatigue, stress/anxiety, nausea, depression, and other symptoms.

Companionship alone had a positive effect as the results showed significant reductions for all symptoms after both activities. But, even though symptoms were reduced from 12-28 percent after reading, massage from a caregiver led to reductions of 29-44 percent. The greatest impact was on stress/anxiety with a 44 reduction. This was followed by a 34% decrease in pain, a 32 percent decrease in fatigue, a 31 percent reduction in depression, and a 29 percent reduction in nausea. In addition, caregivers in the massage group showed gains in confidence and comfort with using touch and massage as forms of caregiving.

“Touch and massage are among the most effective forms of supportive care in cancer, but most patients cannot access professional practitioners of these methods on a regular basis,” said William Collinge, PhD, president of Collinge and Associates. “It appears that family members who receive simple instruction in safety and techniques can achieve some of the same results as professional practitioners. This has important implications not just for patient well-being, but for caregivers as well. Caregivers are at risk of distress themselves. They can feel helpless and frustrated when seeing a loved one suffer. This gives a way to make a difference for the patient, and at the same time increase their own satisfaction and effectiveness as a caregiver. It also appears to strengthen the relationship bond, which is important to both.”

The DVD program is now released to the public, titled “Touch, Caring and Cancer: Simple Instruction for Family and Friends,” in English, Spanish and Chinese. More information about the research study and video trailers are available at http://www.partnersinhealing.net.

Bullying in America. Antisocial Behavior, Criminal Behavior or a Case for Mental Health?

2010-04-10T14:41:00.000-07:00

We all heard about the tragic story of Phoebe Prince and her suicide a couple of weeks ago. As news across the board reported, Phoebe Prince took her life after experiencing the tormenting teen culture of bullying at South Hadley High School in a quiet part of Western Massachusetts.

With the case, my community in a recent HOA meeting, ignited conversation about bullying in the digital age. We know it always existed but with the free access to social media and cell phones, some teens and adults (obviously) frequently cross the line in their interactions with others. We wonder "what if" bullying could happen to our kids and not even know about it.

Surely, you'd agree that as adults we have a responsibility to pay attention and take action when we see that something isn't right. The "STOP BULLYING NOW" Association has some good tips and their website says that adults can intervene effectively to reduce bullying. The first step is to identify unacceptable peer actions such as:

Physical aggression: hitting, kicking, pushing, choking, punching;
Verbal aggression: threatening, taunting, teasing, starting rumors, hate speech;
Exclusion from activities: This does not mean that a student should have to be friends with every other student; it does mean that children should not be allowed to systematically exclude others: "No one play with Mary;" "No one wants to play with him;" "Don't be her friend."

In addition, recent research in the United States and abroad has documented that bullying is a common and potentially damaging form of violence among children. "Not only does bullying harm both its intended victims and the perpetrators, it also may affect the climate of schools and, indirectly, the ability of all students to learn to the best of their abilities. Moreover, the link between bullying and later delinquent and criminal behavior cannot be ignored," stated Dr. Susan Limber, Assistant Director, Institute for Families in Society, in the University of South Carolina.

Parents be aware, bullying by children and adults in the digital age is a crime. The U.S. Communication Decency Act is a landmark piece of Internet Legislation and stipulates that internet content providers (including bloggers like me) are immune from liability for providers and users of an "interactive computer service" that publishes information provided by others. This law should encourage us to be alert and have not hesitation to act on the welfare of our children and vulnerable adults victimized by abusive individuals that may be a case for mental health or at least psychological therapy of some kind.

By all means any allegedly defamatory, false, untrue, offensive or harassing content with the intent to harm the reputation of an individual can be suit in any civil court for any form of defamation-- libel (a written form of defamation-- Yes! Think before you comment on blogs and social media forums, and don't forget text-messaging!), and slander (a verbal form of defamation).

Now that we know a bit more about the law, what are your constructive thoughts in the issue now?

SPRING CLEANING YOUR SOUL AND DETOX FROM NEGATIVE EMOTIONS

2010-04-02T18:57:00.000-07:00

Written by: Carmen Bracamonte

Spring cleaning your soul and mind from the inside out can payoff your conscious efforts to detoxify from negative emotions. But it's not that simple.

Jane Smith spends her days in Springfield, Illinois igniting stress in her life. Traumatized by an abusive alcoholic father and a drug-addict mother, Jane lived on the streets for most part of her childhood. A leap of luck helped Jane to strike temporary success at age 18. She got a job. Got married. Had a beautiful child too. She couldn’t explain why but her vivid memories of a traumatic childhood – daily overpowered her present for years. She stressed out over fear, suppressed anger and hurt. Divorced at age 25. Her unresolved emotional issues hindered her life taking a toll on her husband and child. Unfortunately, Jane is not alone. Our brain registers negative emotions faster and deeper than negative emotions, a psychological study shows.

Why Do We Stick To Negative Emotions?

Negative events may edge out positive ones in our memories, according to research by Rose Kensinger and others in the Current Directions in Psychological Science Journal (August 2009). "It really does matter whether [an event is] positive or negative in that most of the time, if not all of the time, negative events tend to be remembered in a more accurate fashion than positive events," Kensinger said.

While we might not remember more total details about a bad event we experience, "the details you remember about a negative event are more likely to be accurate," Kensinger explained. The details we are most likely to remember accurately are the things that directly cause our negative emotional reaction. So, for example, if you are mugged, you may remember the gun pointed at you with a high level of detail because it is what caused your fear, but you may completely forget details that are peripheral, such as the things around you on the street or what your assailant was wearing.

Our Brain Holds A Memory Network

Our brains have a specific memory network that kicks into gear whenever we are trying to remember something, Kensinger said. "But it seems like when we're having an emotional reaction, the emotional circuitry in the brain kind of turns on and enhances the processing in that typical memory network such that it works even more efficiently and even more effectively to allow us to learn and encode those aspects that are really relevant to the emotions that we're experiencing," Kensinger explains.

So by narrowly focusing the memory network on the thing triggering the emotion, such as the gun from the previous example, your brain remembers details of the gun very accurately, but "at the expense of devoting any resources toward processing anything else that's going on," Kensinger said.

Conversely, events that we experience as emotionally positive, such as a wedding, or as neutral, such as an average day at work, don't trigger the brain to focus on any one specific detail, so "you're just going to kind of remember everything going on in an equally good fashion," Kensinger stated.

Our Brain and Life-Changing Events

Those who had life-changing events like the death of a spouse, divorce, personal injury, child abuse, lost of a job, etc. are more susceptible to emotional toxins. Every thought has a corresponding emotion and every emotion affects the body. How we deal with a situation depends a lot on how we view it. It is common knowledge that our breath pattern changes with every emotion. With the millions of thoughts we have, all the corresponding emotions are stored in our body. Often they remain unreleased and unhealed, eventually resulting in extreme physical illnesses like acidity, ulcers, blood pressure, migraines and heart problems. Each cell in our body has a memory of every experience we have ever had. Emotional detoxification is a process of healing and cleansing the mind and body. All you need to do is to use that situation (especially if painful) as a stepping-stone to emotional balance.

AN UNHEALTHY DEBATE ON THE HEALTH CARE REFORM

2010-03-25T16:29:00.001-07:00

Carmen Bracamonte's Point Of View

If you have been following the health care debate, you'd agree on the unhealthy process surrounding the debate which turned into law this week.

Of course, everyone across the country wants all Americans to have insurance. Of course, we all want insurance companies to stop uncontrollable profits from premiums they charge the same way banks profited in the housing and credit card industries for years. And of course, we want children and adults to be covered despite medical conditions by any insurance company. All this is good. Who would deny it? Unfortunately, even when we hear that some of these policies go into effect immediately, by the time, government will support them -- administratively speaking -- may take long. . . maybe longer than we all wish.

The healthcare bill the way it is right now-- tremendously far from what Senator Obama offered in his 2008 campaign-- reminds me of his famous quote: "When I become President of the United States, I will signed a bill that provides Universal Insurance to all Americans that includes a public option." None of those promises, included in today's bill are not surprise . . . after all, campaign politicians always say what's needed to get the votes.

And, if by any chance, you decide to look at the fiscal portion of this bill, you will easily see that this bill will eventually bankrupt the country for youngest generations, if not before, when unemployment continues to rise (we simply will not be able to pay higher taxes and/or penalties to Uncle Sam as the Obama's administration intends to fund the bill). As an American citizen, I was always proud of the democratic system we enjoy in this wonderful land of opportunity, but seeing the arm twisting, the multiple threats to congress men and women, and the many deals taking place close doors to secure votes in the House of Representatives-- simply portraits a government that distant itself from the essential principles of this country's funding parents.

No matter what your position is on Healthcare reform, now that it is law; there's not point for debate anymore. Why waste our energy? We'll live for Republicans to take keep on the battle this November. So, all we can do for now it's "hope" that policy-makers improve the bill on behalf of all Americans. Until then, what are the options for millions of Americans who still struggle?

If you are uninsured or have an inadequate plan, reach out to your town's community health centers. They are federal funded and can assist with general and preventive health issues including vaccinations, dental work, ear infections, and even diabetes management. If you are unemployed, given your financial status, services are free or at least will charge you a modest fee based on your income.

Every hospital's emergency room has a foundation. Again given your financial situation, they will consider your case and provide financial assistance.

Federal money has also been dedicated to a number of FREE CLINICS across your state. If you contact your local county's health care department, they will give you a list of free clinics available in your municipality.

Are medications too expensive? Don't hesitate to work with your primary care physician and ask for free samples. Also, ask your doctor to replace brand medications by generic medications. If you have insurance, a 3-month mail ordering supply can mean significant savings.

Most pharmaceutical companies have Patient Assistance Programs in place that are funded by their own foundations. Simply search for the company that manufactures your medication and learn about their program's eligibility process. Most likely, they will ask you to fill an application --generally in conjunction with your physician -- because they will need your doctor to issue a prescription. Given your financial status, your medication supply will last as long as you need it and as long as your doctor can validate it.

Call your manufacturer's patient assistance program and ensure your medication is on their patient assistance program. If not, ask for the Partnership Patient Assistance Program. They will tell you what other patient assistance programs carry your medication; if they are (some branded medications never make it to these kind of programs).

If still you cannot get in a Patient Assistance Program, ask for a pharmacy partnership discount program such as PS Card, and ESUN Patient Card. If your pharmacy is in this program, they can help you with substantial discounts.

Finally, don't hesitate to take advantage of the numerous discount programs available at pharmacies like CVS, Walgreens and Walmart. They have discount programs up to $25. You just need to pay attention to their websites and stores' newsletters to keep up with their discount programs
.

DISCLAIMER: The content provided in this article is not warranted or guaranteed by the author of this blog. The content provided is intended for entertainment and/or educational purposes in order to introduce to the reader key ideas, concepts, and/or product reviews. As such it is incumbent upon the reader to employ real-world tactics for security and implementation of best practices. Author is not liable for any negative consequences that may result from implementing any information covered in our articles or tutorials. As the Internet is a public forum, our intend at The Patient Squad Blog is to spread out information that the public may find helpful. The content of our posts are Search Engine Optimized (SEO) oriented and constructed in such as fashion to enhance original pieces from established and reliable sources to generate traffic among our readers and boost original sources exposure. Neither the author of The Patient Squad Blog nor the original sources of information quoted in this article, for which all these individuals work and/or represent accept any liability and/or financial responsibility for any potential similarities found in the Internet in the form of studies, articles, social media forums posts and/or journalism.

Part 7- Killing You Softly. . . Seven Feelings That Quickly Take You to a "Dead Road"

2010-03-19T15:54:00.000-07:00

Cynicism

Okay. I can understand why we can easily become cynics. Betrayal from family, friends or coworkers; disappointments; unbelievable set backs; malicious and deliverable intent to hurt us; things that are or aren’t under our control — whatever the reason is, you should know that cynics who tend to be suspicious and mistrustful of others, a character trait that scientists refer to as hostility, may have an increased likelihood of developing heart disease. "These aren't necessarily hot-headed people, but people who are more likely to read into people's behavior as some hostile motive," Stephen Boyle said at the Behavioral Research Center of Duke University Medical Center.

In a study of more than 300 Vietnam veterans who were healthy at the study start, Boyle found that those who scored high on measures of hostility were about 25 percent more likely to develop heart disease.

Boyle and his colleagues think that hostile individuals might experience more stress, which can cause spikes in an immune-system protein called C3 that has been linked with various diseases, including diabetes. In fact, the participants with higher scores on hostility showed an increase in these proteins while the non-hostile men showed no such increase.

After all, when Victor Frankl once said “A human being is a deciding being,” I’m sure that he implied that any sparkle of change should start with us and nobody else.

Disclaimer

As the Internet is a public forum, our intend at The Patient Squad Blog is to spread out information that the public may find helpful. The content of our posts are Search Engine Optimized (SEO) oriented and constructed in such as fashion to enhance original pieces from established and reliable sources to generate traffic among our readers and boost original sources exposure. Neither the author of The Patient Squad Blog nor the original sources of information quoted in this article, for which all these individuals work and/or represent accept any liability and/or financial responsibility for any potential similarities found in the Internet in the form of studies, articles, social media forums posts and/or journalism.

Part 6- Killing You Softly. . . Seven Feelings That Quickly Take You to a "Dead Road"

2010-03-19T15:51:00.000-07:00

Lack of Meaning

Holocaust survivor and world-class author and psychotherapist in his lifetime, wrote the book, “Man’s Search For Meaning.” Again my good brother— the doctor in the family — recently familiarized me with Frankl’s remarkable life. I was so impressed that I couldn’t wait to jump into my own investigation of his human behavioral theories. Frankl originated the term “logotheraphy” and believed that our primary motivational force is to find the meaning of our lives.

If you lack a sense of purpose, rest assured that your stay on Earth could be truncated. A study involving more than 1,200 elderly participants who didn't have dementia at the study's start found that those who indicated having a high purpose in life were about half as likely to die over the study period, which lasted up to five years. The results, published in the June 15 issue of the Journal Psychosomatic Medicine, held regardless of a person's age, sex, education and race, along with level of depression and neuroticism.

"Persons with high purpose readily derive meaning from and make sense of the events of their lives, and likely engage in behaviors and activities that they deem important," said study researcher Patricia Boyle of the Rush Alzheimer's Disease Center in Chicago.

“Some other research has suggested that people with a higher sense of purpose may have different levels of stress hormones, better heart health or improved immune systems, though more research is needed to firm up any of these biological mechanisms,” Boyle said.

The opposite also holds: "The findings from our study suggested that people who no longer set and work actively toward goals or enjoy their day-to-day activities (how they spend their time) are those with greater mortality risk," Boyle stated.

Article continues on Part 7 of 7

Part 5- Killing You Softly. . . Seven Feelings That Quickly Take You to a "Dead Road"

2010-03-19T15:47:00.001-07:00

Fretting

People who are highly neurotic — constantly worried and anxious, and prone to depression — die sooner on average than their chill counterparts. And a recently reported study of nearly 1,800 men followed over a 30-year period suggests that's partly because neurotics are also more likely to smoke and/or drink excessively. “Perhaps having a cigarette eases anxiety,” said study researcher Daniel Mroczek of Purdue University in Indiana, adding that such a short-term payoff might not be worth it if it kills you down the line.

Article continues on Part 6 of 7.

Part 4- Killing You Softly. . . Seven Feelings That Quickly Take You to a "Dead Road"

2010-03-19T15:43:00.000-07:00

Lack of Self-control

Do you have the tendency to jump into conclusions without checking the facts? Are the demons of insecurity imagine you as a victim? Are you often late for appointments? Can't keep your work-desk organized? Is it hard for you to exercise self-control? These seemingly benign qualities could take a toll on your health.

As part of my own town’s Institutional Review Board (IRB) at University of South Florida (USF), you have not idea how much you can learn from all these dedicated clinical researchers. A review of more than 20 studies and nearly 9,000 participants revealed people who are conscientious — organized and self-disciplined, as opposed to impulsive — live two to four years longer than others. Study researcher Howard S. Friedman of the University of California, Riverside, suspects the boost in lifetime can be attributed partly to the fact that highly conscientious individuals are less likely to smoke or drink to excess, and live more stable and less stressful lives. The study is detailed in a 2008 issue of the Journal Health Psychology.

Article continues on Part 5 of 7

Part 3- Killing You Softly. . . Seven Feelings That Quickly Take You to a "Dead Road"

2010-03-19T15:41:00.000-07:00

Anxiety

Sometimes we need to authority on the subject to spell it out for us. Other times, we need to see tragedy in our lives or the life of others to really get the message that jitters can put a strain on our noggin. In this area, research also suggests that compared with the highly frazzled, individuals with a mellow demeanor who are outgoing may be less likely to develop dementia, which can be caused by Alzheimer's disease and other illnesses. The claim is based on a University of South Florida’s study that followed more than 500 elderly individuals for five years. Among the outgoing extroverts, dementia risk was 50 percent lower for participants who were calm compared with those who were prone to distress.

Article continues on Part 4 of 7.

Part 2- Killing You Softly. . . Seven Feelings That Quickly Take You to a "Dead Road"

2010-03-19T15:37:00.000-07:00

Part 2 of 7

Gloom and Doom

The gloomy, inhibited person is not just at a disadvantage socially, but also physically.

Although I hate to cut it dry for you, a preliminary study of more than 180 patients suffering from peripheral arterial disease (plaque buildup in the arteries) showed participants with so-called type D, or distressed personality, had an increased odds of dying sooner than other people. Type-D people are more likely to experience negative emotions while at the same time hold in their feelings.

The researchers, who detail their work in the August issue of the Journal Archives of Surgery, suggest that humans’ personality type is linked with the body's immune system as well as stress response system.

Article continues on Part 3 of 7

Killing You Softly . . . Seven Feelings That Quickly Lead You To A "Dead Road"

2010-03-19T15:26:00.000-07:00

Part 1 of 7

Dr. Stephen H. Boyle at Behavioral Research Center of Duke University Medical Center in North Carolina talks about the impact of bad temper in a healthy live. "The idea that behavior or personality traits can influence health is one that's been around for a long time. We're just now getting a handle on to what extent they do," Dr. Boyle stated in a recent conference at Duke University Medical Center. More and more research studies nowadays concur that the way we think and react is a determinant factor on the development of illness, mental deterioration and a closer path to self-destruction. If you find yourself experiencing highly neurotic habits, you may find this compilation of findings resourceful.

Stress

Recently, I’ve learned by heart about the devastating consequences of letting stress win over my will. After several sleepless nights and the intervention of my good brother — a successful physician who believes in proactive change — I realized that whatever you do, nothing is more important that your piece of mind! Research is showing that prolonged stress can be deadly. Stress can increase your chances of heart disease, flu virus, metabolic syndrome and having high blood pressure.

A Mayo Clinic study of nearly 700 workers across Canada and United States found that those who experienced job burnout (when work stress becomes unmanageable) were nearly twice as likely as others to develop type 2 diabetes — the ability of a person's body becomes resistant to the sugar-regulating hormone called insulin.

And while a job promotion might boost your income, it also stresses you out. British researchers recently found that when people get promoted, they suffer on average about 10 percent more mental strain and are less likely to find time to go to the doctor.

Article continues on Part 2 of 7

Salmonella

2010-03-10T17:57:00.001-08:00

Senior Citizen speaks about Healthcare

2010-03-10T17:54:00.001-08:00

Anger Management

2010-03-10T17:44:00.001-08:00

Women and Heart Disease

2010-03-10T17:41:00.000-08:00

Women and Domestic Violence

2010-03-10T17:38:00.000-08:00

Macro-Trend: HEALTH MONITOR

2009-11-24T14:19:00.001-08:00

OBSERVATION
Rite Aid's reward program gives the gift of health

WHAT'S HAPPENING
At Rite Aid, shopping has healthy benefits. The retailer is testing a rewards program that compensates consumers with free health screenings in addition to traditional discounts (BuffaloNews.com 11.3.09).

The "Wellness+" program lets shoppers earn points for their purchases to redeem for glucose or cholesterol readings. The screenings take place in local labs that send the results to the shopper's Rite Aid store. Wellness+ members also get gratis access to a 24/7 Rite Aid pharmacist phone number.

WHAT THIS MEANS TO BUSINESS
Loyalty points can offer more than discounts and freebies. Points that provide practical and innovative benefits can make real impacts that improve shoppers' lives. As consumers search for savvy ways to stay healthy, retailers have an opportunity to step in and become health partners for their customers.

Being multi-racial makes you happier? You'll be surprised what studies show

2009-11-24T12:55:00.000-08:00

OBSERVATION
The more, the merrier: Multiracial youth claiming two or more ethnicities are happier

WHAT'S HAPPENING
Multiracial youth that identify with two or more of their ethnicities are happier than those who only identify with one, according to a study published by the Stanford Graduate School of Business.

In the study, “The Interpretation of Multiracial Status and Its Relation to Social Engagement and Psychological Well-Being," multiracial high school students were asked which groups they primarily identified with. Those who identified with multiple groups reported either equal or higher psychological wellbeing and social engagement than those who identified primarily with a single group (BusinessWire.com 5.13.09).

The ability to claim different ethnicities indicates resiliency; youth who identify with multiple groups can also adapt to different racial environments more easily.

WHAT THIS MEANS TO BUSINESS
Educational and governmental organizations, including the U.S. Census, are increasing the racial and ethnic options that individuals can identify with in order to get a more accurate picture of this demographic.

As the multiracial population in the U.S. continues to grow, learning the ways they are similar or different from other groups will be important to policy-makers and marketers.

Are Latino teens more happier than non-Latino teens?

2009-11-21T12:54:00.000-08:00

OBSERVATION
Latino teens who retain home-country tendencies are happiest.

WHAT'S HAPPENING
If you’re happy and you know it, say "¡Orale!," "¡Vale!," "¡Aja!," (Hooray). A study shows that bicultural teens who actively embrace their Latino culture, and whose parents become more involved in U.S. culture, are happier and healthier.

The findings of a study by the University of North Carolina’s Latino Acculturation and Health Project showed that teens who maintain strong ties to their Latino culture perform better academically and adjust more easily socially (UNC.edu 6.23.09).

Conversely, as parents become more involved in U.S. culture, their teen children's social problems, aggression and anxiety decreased while peer relations, forming friendships and staying engaged in school improved.

WHAT THIS MEANS TO BUSINESS
The large and growing Latino youth population is playing an increasingly important role in American culture. Actively maintaining ties to home-country culture and traditions serves as a welcome balance from the stress of acculturation.
Brands aiming their products and services at Latino teens in either language should balance their messaging to extol positive attributes of both U.S. and home-country culture.

Our mobile phones, our new laptops?

2009-11-15T09:36:00.000-08:00

With over 83% of the U.S. population or roughly 250 million people connected via mobile devices, mobile Web services are being touted as the next big thing of the near future. Indeed, over 10 % of U.S. citizens and 5% of Canadian citizens do not even have landline telephones.

Recently the organization Rareplay conducted its Mobile Web Presence Survey 2008 which found that 14 % (141) of the "Top 1000 U.S. Brands" have mobile Web sites. To calculate the percentage, Rareplay randomly selected 1000 brands from Brandweek's 2007 list of Superbrands. This statistic represents a 75 % increase over similar research conducted last year which found only 8 percent of the brands had a mobile presence.

The Rareplay survey revealed that industries with the highest mobile web adoption include: travel (36%), entertainment (28%) and ISP & Telecommunications (28%), a significant increase from last year’s findings. On the other end of the spectrum, medicine & pharmaceuticals and consumer packaged goods have mobile web site adoption rates of only 4% - 5%. However, these still represent an increase from last year’s findings of 1% or less.

Of late, several consumer brand marketers (McDonalds, Starbucks and P&G) are testing ways to reach out to consumers by offering discounts/promotions at local fast-food chains and retail stores. Others like PepsiCo, Capital One and Amazon are employing the use of widgets.

With improved usability and navigation of smartphones, higher bandwidth capacities, a move towards open standards as well as innovative ways of delivering mobile content, we can expect to see more brands creating engaging content that’s highly localized and targeted at mobile-savvy consumers.

Obesity -- Excess Body Fat may be leading cause of most cancers.

2009-11-07T14:34:00.000-08:00

More than 100,000 cases of cancer each year are caused by excess body fat, according to a report released Thursday in Washington.

Researchers with the American Institute for Cancer Research looked at seven cancers with known links to obesity and calculated actual case counts that were likely to have been caused by obesity.

Specifically, the report says that 49 percent of endometrial cancers are caused by excess body fat. That number is followed by 35 percent of esophageal cancer cases; 28 percent of pancreatic cancer cases; 24 percent of kidney cancer cases; 21 percent of gallbladder cancer cases; 17 percent of breast cancer cases; and 9 percent of colorectal cancer cases.

"This is the first time that we've put real, quantifiable case numbers on obesity-related cancers," said Glen Weldon, the American Institute for Cancer Research educational director. In addition, he said, it's not just causing cancer that's an issue.

"Obesity not only raises the risk for getting cancer," Weldon said. "It also has a negative effect on survival and can make treatment more difficult."

Although there is no concrete science on why obesity increases a person's risk for cancer, scientists hypothesize that excess estrogen released by body fat could be the culprit in cancers such as estrogen-receptor positive breast cancers.

Studies have also shown that increased body fat can lead to increased levels of oxidative stress and inflammatory compounds in the blood, which are linked to DNA mutation and diseased cell growth, as is seen in many cancers.

The American Cancer Society applauded the new research, but said the report is only the first step.

"This helps to communicate the magnitude of the problem," said Dr. Michael Thun, vice president emeritus at the American Cancer Society.

"While the study addresses the magnitude of the problem, it does not propose potential solutions. The bottom line for people concerned about this issue is to try to balance the calories you take in with those your body expends every day."

In addition to cancer, obesity is a known cause of heart disease, diabetes, high blood pressure and strokes.

This Holiday Season- Give the gift of Healthcare

2009-11-03T17:06:00.000-08:00

WHAT'S HAPPENING: For BlueCross BlueShield of Florida, the line between healthcare and retail continues to get fuzzier; this fall, the company has rolled out healthcare gift cards (MyFoxOrlando.com 10.07.09).

Two different types of gift cards are available and can be picked up in Winn Dixie or CVS pharmacy stores. The $59 Blue Health Care card covers up to ten weeks of limited health insurance and can be used towards the purchase of plans (like GoBlue) for routine and preventive medical care (including doctor, dentist, pharmacy or lab work).

The Family Blue Discount card ($19) gives users significant discounts on dental (10-50%), prescription (20%) and vision services (10-60%) for up to three months (BCBSFL.com 10.09).

WHAT THIS MEANS TO BUSINESS
These days even those who have insurance could use more help in the health department. Innovative signs that affordability and healthcare can co-exist provides peace of mind when times are tough.

A company that seemingly makes healthcare as easy, accessible and affordable to pick up as laundry detergent is a health hero for consumers.

BREAST CANCER AWARENESS MONTH

2009-10-08T14:35:00.000-07:00

AMAZING BREAKTHROUGH
Scientists in British Columbia have decoded the entire DNA sequence of a metastatic lobular breast cancer tumor. This type of breast cancer accounts for about 10 percent of all breast cancers. There are three billion letters in the DNA sequence, and scientists at the British Columbia Cancer Agency have found all of the mutations, or “spelling” mistakes, that cause the cancer to spread.

The study will be released in the October 8 issue of Nature, an international science journal. The information sheds light on how cancer develops and spreads. It is believed that it will enable scientists to come closer to a cure as they use this information to develop treatments and therapies.

Metastastis is the spread of cancer cells throughout the body. To learn more about metastasis, watch this video.

The group at the BC Cancer Agency discovered 32 mutations in the metastatic tumor. They then compared that with the mutations in the original tumor, and found that only five of the 32 could have been present in the all of cells of the original tumor. This was a clear indicator that those five cells were present at the origin of the disease.

Breast cancer affects one in eight American women. This announcement gives them—and survivors like Olivia Newton-John—hope that a cure will be found.

For more info: Read the press release regarding this historic event.

OCTOBER-BREAST CANCER AWARENESS MONTH

2009-09-27T09:19:00.000-07:00

Public support for breast cancer awareness and research funding has helped improve the diagnosis and treatment of breast cancer. Breast cancer survival rates have increased and the number of deaths has been declining, thanks to earlier detection, new treatments and a better understanding of the disease. Often, there are no symptoms of breast cancer, but signs of breast cancer can include a breast lump or an abnormal mammogram. Breast cancer stages range from early, curable breast cancer to metastatic breast cancer, with a variety of breast cancer treatments. There are different types of breast cancer. In addition, breast cancer in men is not uncommon and male breast cancer must be taken seriously. For more information visit The American Cancer Association, Moffitt Cancer Center, WEBMED, Mayo Clinic.

Dr. Rapper

2009-09-22T17:49:00.000-07:00

Why We Eat So Much Under Stress?

2009-09-19T17:03:00.001-07:00

Constant stress causes our body to pump out high doses of hormones, like cortisol, that over time can boost the appetite and lead to overeating. "Cortisol and insulin shift our preferences toward comfort foods--high-fat, high-sugar, or high-salt foods," says Elissa Epel, Ph.D., an associate professor at the University of California, San Francisco (UCSF), Department of Psychiatry and a leader of the UCSF Center on Obesity Assessment, Study, and Treatment. Health.com: Feeling stressed? Why you may feel it in your gut

Fat cells also produce cortisol, so if you're overweight and stressed, you're getting a double-whammy in terms of exposure. Overweight women gained weight when faced with common stressors such as job demands, having a tough time paying bills, and family-relationship strains, according to a study published in the American Journal of Epidemiology.

Cortisol, together with insulin, also causes your body to store more visceral fat, which is a risk factor for heart attack and stroke, Epel notes. What's more, stress makes it harder to stick with a healthy eating plan. "It's a reason why people go off diets," notes Marci Gluck, Ph.D., a clinical research psychologist at the Obesity and Diabetes Clinical Research Section of the National Institutes of Health in Phoenix, Arizona. Folks who normally restrict their eating, tend to overeat in response to stress.

What To Do:

Sure, real-life pressures can put you in nonstop-nibble mode. But working stress-reduction techniques into your busy days can really help. Yoga, meditation, and deep-breathing exercises are powerful tools that keep tension in check. And spending 20 minutes doing progressive muscle relaxation--alternately tensing and relaxing muscle groups--significantly lessens stress, anxiety, and cortisol, according to a study published in the International Journal of Obesity and Related Metabolic Disorders. Health.com: How to grocery shop on a diet

Exercise will also do the trick. "Try dancing to your favorite tunes, running in place, playing a sport, or taking a simple walk," says Elisa Zied, R.D., an ADA spokeswoman and author of "Nutrition at Your Fingertips." When you're feeling edgy, make a habit of turning to these activities rather than diving into your candy stash. If you're feeling completely overwhelmed by stress, talk to a counselor who specializes in stress management. Or simply do what Latinos do best, enjoy the company of our family and friends at the sound of good Salsa or Merengue Music.

Can Human Behavior Be Collectively Changed?

2009-09-06T11:19:00.000-07:00

It's the age-old question: How do you get your kids to put down the burger and pick up the carrot sticks? How do you get them to transform a bedroom that looks like a tornado recently passed through into a gleaming beacon of cleanliness?
According to parenting experts, one way is to give them a little "nudge" in the right direction.

"A nudge is any small feature of the environment that captures our attention and alters our behavior. A simple, sometimes unknowing suggestion can alter human behavior dramatically.” That's the theory in Richard H. Thaler and Cass R. Sunstein's recent book, "Nudge."

In fact, special interests often go beyond mere nudges into distracting spin, tendentious framing of issues and even bald-faced lies. It's telling, for example, that frightening talk about trillion-dollar health care reform and phony death panels rarely seemed to arise about the trillion-dollar Iraq War and the real deaths to which it did lead.

Despite its appeal, providing nudges and sometimes even tricking people into doing the right thing, even when it's clear what "right" is, can be very uncomfortable to process.

Advertising makes us accept the necessity of this, however, because such tricks have been used for so long by more than a few politicians, advertisers, credit card companies, health insurers, lobbyists and others to tempt people into doing what is, by almost any reasonable standard, the wrong thing, we should start making better decision by understanding how “nudges” work.

Junk Food? Recession's Punishment?

2009-09-02T15:44:00.000-07:00

Carmen Bracamonte & Co. recently published two studies, "A Recession to Remember," and “ Are we all fat?," detailing the continued struggle with obesity as compounded by all the emotions experienced during the recession. Last week, a few fascinating pieces of data added color to the situation.

70% of consumers say healthful foods are more difficult to afford; 53% say they often buy less healthful foods to save money (ProgressiveGrocer.com 8.25.09). And guess what? Prices on dairy products, meat, eggs and other foods are expected to rise 2-3% over the next year (NYTimes.com 8.25.09).

So, the cheap gets more … challenging? KFC confirmed tests of a Double Down sandwich, which dares consumers to eat a sandwich with fried chicken filets in place of bread (NRN.com 8.24.09). The over-the-top "monster" genre of fast food shows no signs of slowing. P.S. This is Why You're Fat, the tumblr site-cum-book, is now available for pre-order!

And speaking of challenge, a study from the University of South Carolina found that consumers are more likely to choose a strange, unknown snack (in this case, Camembert and plum potato crisps from the U.K.) when their lives are in the midst of change (TheDailyBeast.com 8.25.09). Perhaps recession, with its upset and upheaval, is the perfect time to push palate limits.

So whether the junk we eat will be more comforting (as most people assume) or more challenging, it does sound like we'll be eating more junk. Either way, this recession is proving to be an inflection point for stomach share.

A New Fat-Burning Gadget.

2009-08-25T12:20:00.000-07:00

OBSERVATION

My curiosity about keeping track of calories in and calories out-- brought me to calling all calorie counters. Graphic designer Cyrene Quiamco has introduced Stix, a concept phone she claims will help burn calories while charging (Textually.org 7.19.09). The phone — which attaches to the wrist, purse or belt — only recharges when users jog, jump, shake, stroll or perform other modes of physical activity. Meaning that --at least you do some kind of physical activity--the phone will charge. The phone uses GPS technology to track physical activity levels and comes with a built-in pedometer and heart rate monitor to keep track of calls — uh, vitals.

WHAT THIS MEANS TO BUSINESS

When health, fitness and technology meet, the result is a consumer’s concept of a seamless solution: a portable, completely integrated lifestyle enabler.

In an app-abled world, consumers lean on their cellphone as the one-stop answer to just about any life dilemma.
Technology has been blamed for much of today’s sedentary lifestyle; a fitness-focused mobility solution is just what the 2.0 doctor might prescribe. Way to go Cyrene!

Online Cognitive Behavioral Therapy For Depression

2009-08-23T08:50:00.000-07:00

If you're feeling depressed but can't see a shrink in person, the next best thing may be instant messaging, according to a new British study.

With patients and therapists communicating in real time via instant messaging, or IM -- was not only effective, but could broaden access to treatment, researchers reported in the Aug. 22 issue of The Lancet.

After four months, 38 percent of patients who had participated in the Internet-based therapy program had recovered from depression, compared with 24 percent of those in a control group, according to Dr. David Kessler of the University of Bristol.

After eight months' follow-up, 42 percent of the treatment group -- but only 26 percent of controls -- had recovered.

Researchers said they undertook the study because of a "growing unease" about the increasing use of antidepressant medications and the lack of availability of psychological treatments such as cognitive behavior therapy (CBT), particularly in remote areas.

Should you wish to read about the most common signs and symptoms of depression, here is an article by Harold Koenig, M.D., Professor of Psychiatry and Behavioral Sciences, Duke University Medical Center

Beyond The Weight Loss War. . . There is a computer.

2009-08-23T07:45:00.000-07:00

Traditional weapons in the weight loss war are a gym membership, sneakers and an often wavering will. But if you are like me, someone who is always looking to make my life easier, consider adding a computer. Recently, I have been playing with the WebMed Diet Assessment. I like it. Although not all online calorie-counters are created equal, a great doses of honesty is necessary to benefit from their use.

Documenting your diet is known to aid weight loss. Studies have shown that food diaries help people lose twice as much weight as they would have had they not kept track of what they ate. And, online calorie trackers, many of which are free to use immediately or following free registration on the website, can be powerful additions to the weight loss arsenal.

"How people choose to keep track will vary depending on lifestyle and personality," said Connie Diekman, director of University Nutrition at Washington University in St. Louis. "Having websites as an option is very helpful."

The benefits of sites that track your food, compared to a simple, pen-and-paper food diary, are that they categorize and display what you are eating every day. By offering caloric and nutritional information about specific foods, an online calorie counter aids the weight loss battle by pinpointing areas of nutritional improvement.

The U.S. Department of Health and Human Services estimates that the average American adult should eat 2,000 to 2,600 calories each day to maintain their weight. Most people must slash their daily intake to 1,500 calories if they want to lose weight.

Here are some other online calorie-trackers in case you would like to give it a try:

SparkPeople.com, The Pyramide Tracker, and My-Calorie-Counter

If you decide to go for it, please let me know what you think and how it worked for you. THE FORCE BE WITH YOU!!!

Media Advisory: THE PATIENT SQAUD CONTEST

2009-08-21T12:29:00.000-07:00

THE PATIENT SQUAD CONTEST
“Lift Up Your Resident's Voice And Create Change”
1st Prize: $1,000 2nd Prize: $500
Open to the Tampa Bay Community

WHO: THE PATIENT SQUAD empowers patients to become their own best advocates.

WHAT: THE PATIENT SQUAD CONTEST

WHERE: THE PATIENT SQUAD FACEBOOK FUN PAGE
http://www.facebook.com/thepatientsquad

WHEN: From August 20, 2009 to September 30, 2009. Prizes will be awarded on October 1, 2009.
Winners will be contacted via e-mail and by telephone.

CONTEST: Use your camera to document the barriers to healthy eating and active living in your home, church, work or your own communities. Then, post it in The Patient Squad Facebook Page. A visual record of the environmental conditions in our neighborhoods will help us identify opportunities for community change, set priorities, and act as advocates for change with city officials, policy makers, and legislators. Simply post your video or photo on The Patient Squad Facebook Page and add a brief description of the issue and a wish list to solve the problem.

Contest Rules:
* Must be 18 years old to participate. Children can make a submission with an adult sponsor.
* Our staff reserves the right to block and delete any inappropriate content that does not meet the mission of this contest.
* Entries or postings can be made in English and/or Spanish.

CONTACT: Carmen Bracamonte, Carmen Bracamonte & Co. http://www.carmenbracamonte.com

Media Communications —(813) 482-2552 or clb@carmenbracamonte.com

THE CDC and Their YouTube Contest- Check it out.

2009-08-18T15:13:00.000-07:00

http://blogs.cdc.gov/healthmarketingmusings/2009/07/24/21st-century-outbreak/

Do you think a doctor/nurse judge based on your color?

2009-08-18T12:56:00.000-07:00

Studies have shown that race plays a role in quality of care a patient gets. Race, poor education, poverty and lack of insurance can affect a doctor's view. Study: 46 percent of the doctors surveyed had a negative reaction to obese patients.

While it's extremely difficult to tell in any given situation how much race -- consciously or subconsciously -- plays a role in a doctor's decision making, multiple studies over several decades have found doctors make different decisions for black patients and white patients even when they have the same medical problems and the same insurance. It's absolutely proven through studies that a black man and a white man going to the hospital with the same complaint will be treated differently.

The lesson learned here is that you need to be your best advocate and seek a doctor who will care about you. If you feel like you have a doctor who isn't genuinely concerned about you, just get another doctor/nurse. What do you think? I would like to know your opinion.

So Do You Think You Don't Have Any HealthCare Options?

2009-08-18T12:17:00.000-07:00

There is too much discussion about a public healthcare option for Americans these days that makes me wonder what exactly is the fuzz all about. President Obama says that his intention is to insured all Americans and while noble, the plan to do does not seem to make sense among millions of upset americans and the opposition. The fact of the matter is that there are already multiple options available for the non-insured and the under-insured.

First, there are community health centers also known as Federal Qualified Health Centers (FQHC) popping up across the nation, all thanks to your gracious tax dollars. They offer general services including dental and OBG provisions. They however may not offer you assistance if you face a catastrophic situation like cancer or brain injury.

A heated discussion on health reform on nationwide town-halls is taking place this month. We hear people talk about many options but nobody talks about building up from where we are. Why do we have to reinvent the wheel to help Americans? As of today there is not a clear plan of what exactly a public option will entail. If the goal is to insure all americans, these FQHC are doing the job already. Only problem is that they are only federally funded through 2011 and have not profit model developed yet.

Second, all non-for profit organizations as they relate to healthcare services conduct numerous fundraising events to raise money and help the under-served or individuals struggling financially due a heath issue. Next time, you open your wallet to benefit your favorite charity, just make sure your donation is used in the best fashion possible and ask your fundraiser to direct your donation to the organization's emergency funds.

Everyone knows that adversity faces us when we list expect it. Pride is a great quality in you and me but at the moment of truth it does not help us at all. Exercise your rights as a patient and as a member of your community. There are always ways to manure the storm when it comes to healthcare options.

Enabling the Disabled Consumers-Part II

2009-08-18T11:03:00.000-07:00

OBSERVATION: PURCHASING POWER AMONG AMERICANS WITH DISABILITIES IS A MULTI-CHANNEL OPPORTUNITY

Internet retailers are in a particularly unique position to take advantage of the market for people with disabilities. On average, 40% of people with disabilities conduct business and personal activities online, spending an average of 20 hours per week logged on to the Internet, Solutions Marketing Group says. That’s more time on average than people without disabilities spend online.

What's Happening? Accessibility is often associated with physical accommodations at bricks-and-mortar buildings, such as adding ramps or widening aisles to accommodate wheelchairs. While those are important and necessary steps, accessibility is actually a much bigger concept, particularly for today’s multi-channel retailers. In the online world, accessibility is the development and integration of systems, tools, structures and processes that facilitate the inclusion of more people—irrespective of their age, abilities, preferences or personal challenges—as valuable customers and members of the world community.

In a legal case currently before the U.S. District Court for the Northern District of California, the National Federation of the Blind charges that Target Corp. “failed and refused” to make Target.com accessible to blind people, putting it in violation of the Americans with Disabilities Act and two California civil rights statutes. Target contends it is committed to serving all of its guests, abides by all applicable laws and has improved its site to accommodate users of assistive technologies.

What This Means For Business? An integrated accessibility strategy that takes all delivery channels into account can help multi-channel retailers reach out to 76 million U.S. baby boomers (two-thirds of whom will acquire some type of disability after the age of 65), novice technology users and non-native language speakers. Ultimately, accessibility is about opening up all aspects of one’s business and making it possible for the greatest number of people to locate the business and learn about and buy products.

An accessible solution in the online world involves two parts. The first is the development of information technology—including systems and web sites—that follow recognized accessibility programming standards such as those outlined in the World Wide Web Consortium’s Web Accessibility Content Guidelines; or Section 508 of the U.S. Rehabilitation Act; or Section III of the United Kingdom’s Disability Discrimination Act.

The second part is the use of assistive technologies by individuals, who are in turn able to take advantage of the properly programmed system. For example, a screen reader used by a blind person is not functional if a web site storefront she is visiting cannot provide the proper accessibility programming “hooks” to communicate with the screen reader. Both pieces must exist to have a successful, accessible solution.

2009-08-11T12:34:00.000-07:00

OBSERVATION
From bad to worse: Economy affects Mexican immigration

WHAT'S HAPPENING
Mexican immigration to the U.S. is decreasing, down from 653,000 in 2005 to 175,000 in 2008, according to a Pew Hispanic Center study (WSJ.com 7.23.09).
The current economic downturn was cited as the number one deterrent for new immigrants, though it has done little to compel Mexicans already living in the U.S. to go back home. Why? The Mexican economy isn’t faring much better; the risk and cost of crossing the border has gotten higher; and drug violence back home is at an all-time high (WashingtonPost.com 7.22.09).

WHAT THIS MEANS TO BUSINESS
As the global economic downturn slows migration around the world, Mexicans on both sides of the border are staying put, too, hoping to wait out the recession.

Brands that depend on a consistently growing pool of Hispanic-dominant Latinos need to keep their eyes on constantly shifting migration patterns and consider becoming part of the debate on immigration reform. Migration patters for the Hispanic-dominant follows:

32% Mexicans
28% Others (Latinos from South & Central Americans, Caribbean, and Europe)
27% Puerto Ricans
13% Cubans

IS PREVENTION THE BEST MEDICINE?

2009-08-11T12:21:00.000-07:00

More consumers are becoming forward-thinkers by embracing healthier lifestyle choices that promote wellness from head to toe.

From gaming to fitness, active means proactive; niche ways to seamlessly integrate health into leisure abound.

Enabling the Disabled Consumers-Part I

2009-08-09T09:06:00.000-07:00

Three top misconceptions about the disability market generally revolve around money, mobility and technology usage. In reality, the facts paint a much different picture. Not only do people with disabilities have money to spend, they are in stores and online in record numbers. Of the estimated 55 million people in the United States with disabilities, 73% are heads of households, 58% own homes and 48% are principal shoppers controlling over $220 billion in discretionary income, reports the Census Bureau and Solutions Marketing Group, a firm that provides research and consulting services for marketing to consumers with disabilities.

In a global retail economy where customers can research, compare and shop for the best deals on products and services anytime and from anyplace, should a retailer ignore a market of more than 50 million people in the U.S. alone, according to the U.S. Census Bureau, with aggregate annual income of more than $1 trillion and $220 billion in discretionary spending power?

How companies can provide accessibility to this powerful niche market of consumers? To be continued . . .

TODAY SHOW: WE THE PEOPLE: Hispanic Women and Breast Cancer

2009-06-17T08:59:00.001-07:00

Visit msnbc.com for Breaking News, World News, and News about the Economy

FIT FOR RECESSION

2009-06-02T14:15:00.001-07:00

The mere thought of another recession-focused article may be depressing enough, but the daily reminders of economic struggle are unavoidable: Collectively, consumers are getting less sleep, smoking more, feeling out of control and appearing sadder. While a state of mass uncertainty takes its toll on mental, emotional and physical health, forward-thinking consumers with more time and less money on their hands are investing again — in themselves.

Combine a little soul searching with a craving for some control and here's the result: Gym promos abound, offering low-cost incentives and even lose-your-income guarantees. Alternatively, anytime and anywhere home and social workouts are enjoying new members. Sales of exercise DVDs jumped 16% in early 2009, and yoga-mat maker Manduka claims that sales have risen 45% over the past 12 months (WSJ.com 4.16.09). From personal experience, I can attest that Jillian Michaels of The Biggest Loser fame will be happy to push every muscle you've got to the physical extreme for free and OnDemand.

As a new benchmark for wellness, prevention (through DIY monitoring, fitness regimens or better lifestyle choices) is seen as a risk-free investment that guarantees ROI. Consumers cite health-insurance coverage as one of their top three financial concerns (McKinsey Quarterly Healthcare Consumer Study 5.09). So it's no surprise that getting healthy today is the new savings strategy for tomorrow.

Bilingual Beginnings- A story that speaks by itself

2009-05-26T18:35:00.000-07:00

There's a baby laughing. In a minute, she may be crying, squealing, grunting or whining. Nine-month-old Jewel, along with her mom (my friend, Ana) is staying with us for a while, and her unpredictability is, well, predictable.

One sure thing: Every morning, she quiets to the familiar voices of Big Bird, Grover and Oscar the Grouch as mother and daughter sit in front of the TV to watch and interact with Sesame Street.

Not much has changed. A number and letter are featured each episode. Hooper's Store is still a center of activity. Short animated and live-action segments feature humans, monsters and animals.

Una diferencia: There's a lot more Español since Ana was Jewel's age. Bilingual muppet Rosita helps to translate for Elmo and Telly. "Murray Has a Little Lamb" is a recurring segment with Murray Monster and a pink lamb named Ovejita (little lamb) who speaks only Spanish. Ovejita provides clues to help Murray guess — ¡adivina! — what kind of school they will visit that day.

Jewel might just be responding to the colors, music and movement, but Ana's got a plan: to raise her baby to be fully bilingual, even though neither she nor her husband is. And if it begins with repeating words offered up by a TV series that's older than she is, Ana's willing to play along.

WHY LATINOS DO NOT PARTICIPATE IN CLINICAL TRIALS?

2009-05-21T09:20:00.000-07:00

In the tenements of Spanish Harlem, a 28-year-old PuertoRican single mom feels pressured into making an important decision: either undergo La Operación, a surgery which was supposed to keep her from unplanned pregnancies, or risk losing her Welfare benefits. Rosa was alone in this country, with limited reading and marketable skills and only an 8th grade education. She was raising a little girl with no child support from her ex-husband. She had no choice but to accept her doctor’s recommendation; which in the doctor's words: "it was just the tying of the tubes." This statement did not mean anything to Rosa who wondered if and when she remarry, she would simply go back and untie them and have more children. Rosa died at 56 having failed to detect her liver disease in time. Resentful over being duped by her doctor, Rosa made sure that her daughter learned to never trust doctors in this country.

Stories like Rosa's reflect an unequal burden of cancer and other chronic diseases, and how it unfairly burdened other communities of color. Lack of consistent data, linguistically-proficient cancer and chronic disease education, as well as more accurate research on Latinos should improve to mirror those in the population, especially women and older people. This is an important national discussion that was held at Moffitt Cancer Center in Tampa Bay on May 19, 2009.

As an advocate, we provide proven market intelligence to determine the gravity of these appalling diseases on the rapidly growing Latino population in the USA. We feel it is essential to obtain data through outreach efforts, education, preventive medicine and early detection screening. Yet, gathering information can be challenging because of the fear and distrust that exists with this vulnerable community. Furthermore, there are major gaps in the collection of data as well as how it is analyzed.

For example, Latinos represent a mix of racial and ethnic lines from 22 different countries of origin. This specific population-at-risk has unique demographic characteristics and degrees of acculturation in addition to differences in language, history and cultural background. For this reason, it is essential to understand the difference between the two terms of “Hispanic” and “Latino” when developing outreach programs in each particular community. With no data, there’s no funding for research or preventive programs, which results in more terminal cancers discovered — just to mention one disadvantage. Our investigation shows that simple translation of one language to another, fancy marketing brochures, complex, inaccurate educational classes are rejected or ignored by first and second generations of Latinos.

As an advocate in the elimination of health disparities for Hispanics, PATIENTSQUAD™ brings specialized market (consumer) intelligence in products and services needed by patients, their families, patients, researchers and other healthcare professionals.

Multiple Factors influencing healthy eating

2009-04-23T07:59:00.000-07:00

Diabetes Diet takes Planning

2009-04-23T07:53:00.000-07:00

CNN Article: Man twitters using brain waves

2009-04-23T07:19:00.000-07:00

By Richard Allen Greene
CNN

Adam Wilson posted two messages on Twitter on April 15. The first one, "Go Badgers," might have been sent by any University of Wisconsin-Madison student cheering for the school team.

The brain-computer interface allows people to compose a tweet by focusing on the desired letter.

His second post, 20 minutes later, was a little more unusual: "Spelling with my brain."

Wilson, a doctoral student in biomedical engineering, was confirming an announcement he had made two weeks earlier -- his lab had developed a way to post messages on Twitter using electrical impulses generated by thought.

That's right, no keyboards, just a red cap fitted with electrodes that monitor brain activity, hooked up to a computer flashing letters on a screen. Wilson sent the messages by concentrating on the letters he wanted to "type," then focusing on the word "twit" at the bottom of the screen to post the message.

The development could be a lifeline for people with "locked-in syndrome" -- whose brains function normally but who cannot speak or move because of injury or disease.

Wilson and his supervisor, Justin Williams, made the breakthrough last month after hearing a question posed on the radio. Watch how the new technology works »

"Wouldn't it be great if you could Twitter just by thinking about it?"

That query sparked what Williams called the "a-ha moment."

"We can do that," said Williams, an assistant professor and the principal investigator at the lab in Madison, Wisconsin. "We can do that tomorrow."

In the end, it wasn't quite "tomorrow," Williams said, but Wilson had written the software to link existing technology with Twitter "within a couple of days" of starting on the project in March.

He sent Williams his first "tweet" -- or message -- from the brain-computer interface on March 31.

"I had set up my phone to get Twitter updates, and I walked in my door and got this message, and I knew it was really possible," he told CNN by phone. "My wife was sitting there, and I showed her the message and she immediately got excited about it -- and it's rare that I come home from work and she gets excited about what I have been doing."

That's because using the brain to post Twitter messages is potentially much more than an academic exercise or a party trick -- it could help paralyzed people communicate.

"These are people who have ALS, like Stephen Hawking, or they have a brainstem stroke, or a high spinal-cord injury," Williams explained. "There is nothing wrong with these people's brains. It's a normal person, locked into a lifeless, useless body." (The British physicist Hawking has ALS, amyotrophic lateral sclerosis, which is also known as Lou Gehrig's disease.)

Hundreds of thousands of people suffer from locked-in syndrome, Williams estimated.

Many of them want just the kind of ability the brain-Twitter project seems to offer, said Kevin Otto, an assistant professor of biomedical engineering at Purdue University in Indiana.

"The interesting thing about this project is they are directly addressing some of the patient desires," he said. "A lot of people think [locked-in patients] want to walk and want fancy prosthetics, but a lot of times what they want are bladder control and basic communication skills."

Otto, who was not involved in the University of Wisconsin project, called it "a very important incremental step to take two existing technologies and marry them together like this."

Williams had been working on brain-computer interface technology "for many years," he told CNN, before the idea to use Twitter.

"The technology we were developing was 10 or more years down the line, so we started wondering, 'Is there something we can do now?' "

His lab at the University of Wisconsin -- like those at Brown University, Purdue and the Wadsworth Center in Albany, New York, among others -- is developing ways for locked-in people to communicate. Projects range from manipulating a cursor on a computer screen to operating a robotic arm, and they can include devices physically implanted into a brain.

But the Twitter project has a lot of advantages, Williams said.

"Twitter fits so many of our needs and patients' capabilities," he said. "Their first interest is in being able to communicate in a normal fashion, and at a distance."

Twitter is simpler than e-mail, he said.

"If I am locked in and I want to e-mail someone, the format is all wrong. You have to be able to select recipients and group them, copy, paste, send. ... We don't think about that much as normal people, but it can become unmanageable.

"Twitter takes care of all those things. They just have to get [the message] to a location where people can come and find it," he said.

Locked-in people communicating by tweet might have followers who don't even realize they are disabled, Williams said.

"Nobody's going to notice that the person at the other end is disabled. They might not have any idea. And that might be very empowering for people," he said.

The interface is not unlike the method the French journalist Jean-Dominique Bauby used to dictate his novel "The Diving Bell and the Butterfly" -- later turned into a movie -- after a massive stroke left him paralyzed except for his left eyelid. Bauby's caregivers recited letters of the alphabet; he blinked when he heard the one he wanted and they wrote them down.

The brain-Twitter application flashes letters on a screen while the user, wearing a cap fitted with electrodes, concentrates on a letter.

"When the letter that you are concentrating on flashes, we can pick that up," Williams said.

Williams declined to say how soon the interface could be available commercially, noting it has not yet been used by anyone with locked-in syndrome.

"I'd hate to speculate about things being on the market," he said. "Adam [Wilson] is going to graduate in May, and his next role is to start preclinical trials with subjects in New York and Germany."

But Williams said he is excited about the development.

"We were interested in seeing what we could do right now to help people," he said. "The field has come far enough that we need to start getting to people in their homes."

Patients like me believe that. . .

2009-04-21T12:47:00.000-07:00

“The doctor of the future will give no medicine, but will interest his patients in the care of the human frame, in diet, and in the cause and prevention of disease.”

Latino youth and their parents get healthy 10,000 steps at time

2009-04-14T12:27:00.001-07:00

OBSERVATION Latino youth and their parents get healthy 10,000 steps at time

WHAT'S HAPPENING
Latino youth and parents in Carpenteria, CA, are losing weight and making lifestyle changes as participants of a fitness and nutrition program.

The eight-week class, called Salud y Bienestar (“Health and Well-Being”) for kids with BMIs higher than the 85th percentile, was created by the Diabetes Resource Center of Santa Barbara County.

Each participant gets a pedometer, with the goal of taking 10,000 steps daily. Lessons include how to read food labels, the importance of eating fruits and vegetables, and how to cook low-fat versions of traditional meals.

Results: 90% of participants increased their physical activity and 100% made at least three changes in their family’s nutrition and fitness practices (The Santa Barbara Independent 4.2.09).

WHAT THIS MEANS TO BUSINESS

Efforts to reduce the increase in Type 2 diabetes and other obesity-related diseases in kids and families are becoming a priority in school districts with sizable Latino populations.

Brands that actively partner with organizations and schools empowering Latinos to fit health and good nutrition into their daily lives may benefit from those relationships.

St. Pete Times Article: Doctors weight in to Electronic Medical Records

2009-04-09T11:48:00.000-07:00

Medical care charts moving from filing cabinets to computers
Written By Letitia Stein of St. Petersburg Times

In the next five years, the government wants to outfit every person in the United States with an “electronic health record,” a plan backed with $19-billion in economic stimulus money.

Moving medical records from paper charts to computer screens marks an opening shot in the new administration’s ambitious agenda to reform health care. President Barack Obama says the new technology will help “reduce errors, bring down costs, ensure privacy, and save lives.”

Some doctors in the Tampa Bay area already are making the switch to electronic records. Their view from the front lines helps explain the controversy over a digital transformation that holds great promise, but also great concern about how Americans’ most private information is safeguarded.

Security, cost, reliability of the software — doctors and patients can find many reasons to be wary. Dr. Rick Wilde, a Lutz pediatrician who has been carrying a laptop into examining rooms for more than two years, once shared those worries. But now he’s a convert.

“You have the ah-ha moment. The first time you’re not sending staff all over the building looking for a paper chart is priceless,” he said. “We can’t lose anything any more.”

From the front lines

A little over a month after going digital, paper charts are piled high on the chairs, floors and desk in Dr. Emily Perkins’ office in North Tampa. Nothing about this transition has been clean.

These days, she lugs both paper charts and a heavy, new laptop into her patient exams. Everything takes longer. Between the “stick out your tongue and say aah’s,” she searches for boxes to click on a screen. She dislikes having to turn her back to patients to type into the computer.

“I’m actually seeing fewer patients right now, because I’m learning the system. So we’re having to turn patients away, which is bad,” she says. “I feel like I’m back like a new pediatrician, starting over, which is very frustrating.”

During the transition, her patients can visit one of the Pediatric Health Care Alliance’s other 12 locations in Hillsborough, Pinellas and Pasco. Perkins’ site is among the last to go digital, a conversion that has taken the alliance nearly four years to implement and cost in the $1 million range.

While the learning curve can be steep, many doctors who made the switch say they would never go back.

Dr. Wilde works in the alliance’s office in Lutz in Pasco County, one of the first to go online. He says patients are thrilled when he electronically transmits prescriptions to their closest pharmacy.

Wilde also likes how the computer automatically checks his dosages against a child’s weight. And it’s easier to keep track of after-hours visits, when other physicians treat his patients.

When the 9-month-old Aaron triplets came in for a regular checkup recently, he knew about their emergency visit last weekend to the pediatric group’s Brandon location. They all had come down with pink eye.

“I saw the note. So they all had the crud?” he said, greeting their mother, Cristie, with a smile.

She really likes the convenience of knowing that she can visit any of the alliance’s offices, and her children’s health information pops right up.

“They also give me really good printouts of the measurements and everything so I can keep track, because I wouldn’t remember,” said Aaron, who has to keep the triplets and her 3-year-old calm during the doctor’s visit.

With a click, Wilde can also update the triplets’ growth charts to reflect how their weight and height compares to other premature babies. Before electronic records, such graphing was done by hand.

“It allows me to monitor the growth more precisely,” he said. “I think we make less errors with the plotting and less errors with immunizations.”

Dollars and sense

One day, the government envisions health information flowing over a vast national network. Have a medical emergency during a vacation in Michigan? No problem. A physician there could access your records.

Just as any electrical appliance works in any wall outlet across the county, there now is a need for technology standards ensuring the electronic health record system at one hospital can talk to another provider across town.

The federal government is working on how to make this happen, a process that is also building up from the local and regional level, said Jane Horowitz, chief operating officer for the National Alliance for Health Information Technology, a nonprofit representing stakeholders from hospitals to health information technology consultants.

For doctors and hospitals, stimulus money amounts to a carrot, to be followed by a stick, intended to bring them online. Today, as few as 1 in 6 physicians have even basic electronic health record systems, according to the New England Journal of Medicine.

Still, technology is only as good as the people using it. Clicking a wrong button can be easier, in some ways, than writing down the wrong prescription.

“The truth about electronic health records is that, even though the president really wants everyone to have one, they are not ready for prime time,” said Dr. Deborah Peel, a psychiatrist and founder and chairwoman of the Texas-based Patient Privacy Rights, a leader in a coalition that lobbied for safeguards on health information in the stimulus bill.

They include allowing patients to request an audit trail of electronic disclosures of their health information. The stimulus bill also requires that patients be informed of any unauthorized use.

Industry supporters point out that people have become comfortable paying bills and managing financial information online. It should be no different to give physicians better access to critical health information.

But concerns linger over how well anyone, from a doctor’s office to the electronic record vendors, can secure our most sensitive and personal data.

“The day when somebody hacks the big mother ship or the big system is going to be an interesting day,” said Michael Igel, an attorney specializing in health care law with Trenam Kemker in St. Petersburg. “You’re talking about medical records here.”

Spending and saving?

The government’s billions are sure to accelerate a feeding frenzy among vendors seeking their cut of stimulus cash. Locally, doctors may not be prepared to navigate it.

“It’s a train wreck getting ready to just crash in the biggest, hardest way because the physicians are not educated,” said Anissa Raiford, executive director of the Pinellas County Medical Association, which last week launched the first of four lectures in a series on the topic. “We still have doctors who don’t want us to e-mail them any information. They just want us to fax.”

And now the University of South Florida is seeking to take a lead in converting physicians to electronic prescribing, considered a first step to a comprehensive electronic health record. Its corporate partner, Allscripts, offers the e-prescription software to doctors for free — but hopes, of course, that doctors will want to buy the bigger package.

“Sometimes you can do well by doing some good,” said Glen Tullman, chairman and CEO of Allscripts, describing e-prescriptions as “the on-ramp to the electronic medical society.”

The Department of Health and Human Services says the adoption of health information technology will reduce health costs for the federal government by $12 billion over 10 years.

How? The technology could lead to fewer medical errors — and less spent to treat them — and care that is both higher quality and more cost-efficient. Advocates also believe it will help patients and doctors manage chronic conditions before they become expensive emergencies.

But others say the potential savings to the system are exaggerated. Certainly, many local doctors getting a jump on the transformation don’t expect to make money from the investment.

St. Petersburg physician Fadi Saba said his seven-doctor practice in internal medicine, Professional Health Care of Pinellas, received quotes between $150,000 and $400,000 to convert to electronic health records.

It drove down the cost to less than $100,000 by teaming up with other doctors in the same position. But for all the research time and effort already invested, the hardest part is coming in the transition in a few weeks.

“It’s a mixed bag. In the long run, we know everybody is going to go with (electronic health records) because it basically gives you easy accessibility to medical records no matter where you’re at — and that’s priceless when you’re taking care of a critically ill patient,” Saba said.

But he noted it will take time to convince every doctor. “Physicians usually are very resistant to change. They are set in their own ways, they want to do things the way they used to 10 or 15 years ago.”

Article by Bay News 9- Tampa Bay Doctors weight in to Electronic Medical Records

2009-04-09T11:45:00.001-07:00

Article by Bay News 9

President Obama is moving forward with the controversial project to make all medical records electronic.

The president tapped Harvard medical school professor David Blumenthal to start a federal health information network. The system would allow doctors to share information over the Internet.

The project is a hot topic with doctors here in the Bay area, partly because more Bay area doctors are actually making the switch to a computerized system.

“Basically access to information becomes an issue,” said Dr. Chris Politis, an urologist in St. Petersburg. “A lot of times patients get x-rays, visit other physicians and unfortunately we may not have access to that information.”

This week in Clearwater the Pinellas County Medical Association held a seminar to discuss the pros and cons of a computerized health network. And while Politis says he understands the reluctance by some, he believes the benefits will help doctors and patients.

But as Letitia Stein, a health reporter with the St. Petersburg Times, discovered, not every Bay area doctor is ready to give up the paper files. They say the switch could create a very complicated situation.

“Things that they’re used to doing very quickly right now, take a long time for them to do. You have to find the right boxes to click. You’re not familiar with the technology,” Stein said. “One physician I talked to even found that it cuts time on her patient interaction because she has to put things in her records.”

There’s also concern about clicking the wrong buttons and the privacy of the electronic records.

“If anything bad happens and somehow people get your information, you’re reacting to a situation no one ever wants to be in,” Stein said.

Another big turnoff for doctors is the cost. The switch is expected to be very expensive. And it could eventually even cost patients more in health costs.

Obama says he wants all medical records digitized within five years.

Kaiser Family Foundation Report on Medical Media Inquiries

2009-04-09T11:40:00.000-07:00

With Health Related News Stories Being 8th Most Prominent Topic on the Nightly News, it’s Good to Know How to Handle Potential Media Inquiries

In a December report, the Kaiser Family Foundation, a non-partisan source of facts, information, and analysis for policymakers, the media, the health care community and the public, and the Pew Center’s Project for Excellence in Journalism, found that health related news stories in newspapers, on TV and radio and online between January 2007 and June 2008, were the 8th most prominent news topic.

With health related stories being so popular on our nightly news, it’s important that physicians be prepared to handle every media inquiry that comes their way.

Following are some important points to consider when preparing for media interviews:

· Prepare and rehearse what you want to say before the interview takes place. Often, you can request the reporter’s questions ahead of time.
· Always return news media phone calls and e-mail inquiries promptly.
· Reporters have tight deadlines, so if you are not able to be interviewed right away, ask what his or her deadline is.
· The reporter will usually ask if you are ready to start the interview — don’t be afraid to say no. You should make sure you feel comfortable and prepared.
· Think about your body language and attitude during the interview — avoid crossing your arms, looking angry or poor posture.
· Avoid wearing busy or loud patterns — neutral colors always look better on camera, but be weary of the color white.
· Keep your answers as concise and simple as possible — the reporter and his or her readers or listeners are not all experts in the medical field.
· Tell the reporter if you are not sure of the answer to a question and offer to refer them to an alternative medical expert or get back to them once you have found the answer.
· Never speak “off the record” as there is no guarantee that what you say in this instance will not be used.
· Never use the phrase “no comment.” This is a comment in itself and often not the one you intended.

At the end of the interview, always check to ensure the reporter has correctly spelled your name, title, medical degree and the name of your medical practice.

“And, it’s okay to ask the reporter if he or she knows when the story will appear. The more physicians help working journalists with their stories, the more receptive they will be when future contacts are made.

Just 9 patients made 2,700 visits to the emergency room in 2008 cost &3 M of taxpayers money.

2009-04-02T08:12:00.000-07:00

THE ASSOCIATED PRESS reported that just nine people accounted for nearly 2,700 of the emergency room visits in the Austin area during the past six years at a cost of $3 million to taxpayers and others, according to a report. The patients went to hospital emergency rooms 2,678 times from 2003 through 2008, said the report from the nonprofit Integrated Care Collaboration, a group of health care providers who care for low-income and uninsured patients.

"What we're really trying to do is find out who's using our emergency rooms ... and find solutions," said Ann Kitchen, executive director of the group, which presented the report last week to the Travis County Healthcare District board.
The average emergency room visit costs $1,000. Hospitals and taxpayers paid the bill through government programs such as Medicare and Medicaid, Kitchen said.

Eight of the nine patients have drug abuse problems, seven were diagnosed with mental health issues and three were homeless. Five are women whose average age is 40, and four are men whose average age is 50, the report said, the Austin American-Statesman reported Wednesday.

"It's a pretty significant issue," said Dr. Christopher Ziebell, chief of the emergency department at University Medical Center at Brackenridge, which has the busiest ERs in the area.

Solutions include referring some frequent users to mental health programs or primary care doctors for future care, Ziebell said.
"They have a variety of complaints," he said. With mental illness, "a lot of anxiety manifests as chest pain."

Genetic Testing uncovers illness in your future

2009-03-25T20:47:00.000-07:00

The Wise Man Knows His Genetic Destiny A simple new DNA test uncovers illness in your future--and gives you time to do something about it.

By Kimberly Wong
(Business 2.0)

You can't help feeling uncertain. As sure as the sun rises, alarmist morning headlines report illness and disease. Then you breathe that hazy metro air, work to exhaustion, and hear that a friend just had a heart attack. Could you be next? If you are, you can at least now be forewarned--and take steps to prevent such a catastrophe--thanks to the first true consumer application to arise from the completed Human Genome Project. While plenty of research remains for gene scientists, there is already a way to find signs of danger in your DNA.

Learning your genetic secrets is easy: Swish some mouthwash around your gums, spit it into a test tube, and ship the sample overnight to the Great Smokies Diagnostic Lab in Asheville, N.C. The lab's year-old predictive genomics test, called Genovations (www.genovations. com), analyzes the DNA taken from your mouth to reveal risk for several diseases. More specifically, the test looks for certain single nucleotide polymorphisms (SNPs)--small, unique deviations in your DNA. "Think of SNPs as typos--pieces of the genetic code that have been changed," says Patrick Hanaway, chief medical officer at GSDL. "Such variations lead to changes in the way your body works."

Three weeks after you send in the test, the company mails back a 40-page report that details your predispositions to heart disease, osteoporosis, or immune-system maladies (such as asthma). Not that you'll be the one doing the reading. Predictive genomics tests have received bad press, but accuracy hasn't been the problem. The issue has been participants freaking out after interpreting their own data or receiving poorly communicated advice. Some people thought they were getting death sentences. So GSDL only sends its patients to physicians trained to explain the information.

"We're still figuring out how best to translate genetic testing. The results are complicated to interpret," admits Joann Boughman, the executive vice president of the American Society of Human Geneticists. "But with proper counseling, those results often help people."

A physician takes the Genovations report and recommends changes to a patient's diet, lifestyle, or environment. Prescriptions get specific: For instance, estrogen therapy might be advised for one woman, herbs for a second, and eliminating caffeine for a third, all in the name of preserving calcium. In some cases, a subject showing predisposition to high blood pressure will be cleared to season his food with impunity, while another will be told to go on a low-salt diet. The difference maker is a SNP that, when present, indicates the subject's kidneys absorb too much sodium.

Genovations is a leader in the field of predictive genomics--several smaller competitors provide less information--and indeed, the $2,000 tests have provided epiphanies for subjects who thought they were healthy. One 37-year-old male, deficient in vitamin B, discovered that he was on a potential collision course with a heart attack. A 42-year-old woman found that she hosted SNPs in four of five genes screened for osteoporosis. In both cases, and in hundreds of others, the test helped patients address diseases that might not have fully manifested themselves for a decade.

Of course, Genovations is hardly medicine's holy grail. Testing negative for predisposition to a certain disease doesn't mean you won't ever come down with it--it just means you have better odds.

Nonetheless, you can't know too much about your health. An individualized Genovations test, many doctors say, can move someone to take action in a way that mass-market Dean Ornish tomes can't. "It says, this is your personal risk," explains Richard Delany, a Massachusetts internist who's put more than 50 subjects through Genovations tests. "And all of a sudden, the patient goes out and does the recommended stuff. At that point, wouldn't you?

Health care meets social networking

2009-03-24T15:58:00.000-07:00

Jacksonville Business Journal - by Kimberly Morrison

The Mayo Clinic wasn’t sure what to expect from social media when it gave it a test run four years ago.

Things like iPods, MySpace and blogs had exploded onto the social scene, and businesses were looking to cash in. But the health care industry had other considerations, and more rules to play by.

The interest was not exclusively marketing and advertising, but rather how to use the technology to transform the access, delivery and dissemination of health information. And then there were other issues like patient confidentiality and related privacy issues.

Mayo started with a podcast, largely unsure of what it was doing. There was no staff dedicated to new media, so a few of the public affairs employees hastily podcasted a 60-second broadcast radio feed normally provided to radio stations.

Then they waited. Then they watched as a few listeners grew to some 76,000 in one month. They knew they were on to something.

“It was us dipping our toe in to see if this is something people actually do and can we do it,” said Lee Aase, Mayo’s manager of syndication and social media based in Rochester, Minn. “We were somewhat surprised to see our podcast featured on the front of the iTunes store, so that was kind of a ‘Wow’ moment.”

Mayo Clinic, which has a campus in Jacksonville, has come a long way in just a few years, since adding a Facebook page with more than 3,000 friends, a YouTube channel with videos of doctors talking about illness, treatments and research, a health blog for consumers and another for media to improve the process of medical reporting. It’s also creating “secret groups” on Facebook to connect patients to others with similar illnesses, an area it hopes to expand in the future.

But that’s just the tip of the iceberg in the brave new world of Health 2.0.

The Internet in its infancy, or 1.0, was all about accessing information. Think WebMD. But where Web 2.0 describes the onslaught of user-generated content like Wikipedia or Yahoo Answers, Health 2.0 is defined by the use of social software and its ability to promote collaboration between patients and the rest of the medical industry.

Having a company Web site is so five years ago. Social media — the umbrella term for blogs, social networks, photo video and podcasts, and other user-generated mediums — is the new era. And the possibilities are seemingly endless.

Try a virtual existence in Second Life. The Centers for Disease Control, Partners HealthCare System and CIGNA Corp. all have active pilots to test scenarios and study behavior in the virtual world.

Then there’s Medscape, a social network for doctors that has a format similar to MySpace or Facebook and includes 100,000 physicians. It’s similar to its predecessor, Sermo, and both are exclusive to verified physicians.

Recent forum discussions on Medscape range from gossip about a colleague dating a patient and complaining about the frequency of patients who request a note to be excused from jury duty to more serious topics such as concern over a baby mix-up and how to avoid malpractice lawsuits.

Mood diary

But over at Realmentalhealth.com, patients come together to chat and blog about their illness, support each other with recommendations, like to check out an article on celebrities with bipolar disorder or use a mood diary to track symptoms, and post local events like 12-step meetings and invite others to attend.

Martin Ogawa started Real Mental Health Inc., based in Miami, after working in the information technology industry. Ogawa said when the site went live in 2006, it was the first of its kind, but by 2008, social media in health care had exploded.

“More health care companies adopted some sort of social media in 2008, and that’s a good step,” Ogawa said. “It’s good for the industry and it’s good for patients, but most importantly, it’s focused on treatment and wellness, and makes it easier for everyone to accomplish that goal.”

Just like the Internet itself, there are potential downsides when there are few controls. One of the early social networks on health topics was a pro-anorexia site where users worship scary-skinny celebrities, exchange tips and tricks that enable their diseases and hide it from others. It became a cult phenomenon with its own name — “Ana,” as in anorexic — and has spawned other copycat sites.

There are also sites where those contemplating suicide can solicit tips from others in the network, and get blood-curdling advice. The British Medical Journal reported in 2008 that people researching suicide are more likely to find sites that promote it than sites that provide help and support, and many of those sites are forums or other user-created content.

Health officials entering the dialogue could change that. Aase said Mayo-led discussions of diseases are popping up earlier in searches.

“I was just looking at a blog post that we had on Potts Syndrome. It’s a 20-minute discussion that has 45 comments and has been viewed thousands of times for a relatively obscure condition,” Aase said. “The great thing about social media is you can produce content for people who have that condition and want to be better-informed patients or family members who want to educate themselves.”

But it’s not all just about talking about disease.

Nemours, the Jacksonville-based children’s health system, has used social media in the process of creating its upcoming hospital in Orlando. It established a blog for its family user group to make recommendations on the design of the hospital, which breaks ground next month. Nemours also has a two-year-old viral media campaign featuring parent testimonials and podcast speeches by Chief Executive David Bailey.

“For now, our focus is the Central Florida market, but we will expand this into other areas in the future,” said Odette Struys, spokeswoman for Nemours.

And the American Red Cross is big on Twitter, sometimes referred to as micro-blogging. It used Twitter in 2007 to send minute-by-minute updates on California wildfires, deliver aid and raise money. It now regularly uses Twitter to post updates on storms and natural disasters.

Setting up most social media accounts is free, but depending on their use, they may require part- or full-time management. Mayo Clinic implemented all of its social media for less than $1,500, Aase said.

EXPONENTIAL EATING IN EL PASO

2009-03-24T15:39:00.000-07:00

After years of visiting El Paso, TX, I've come away with one conclusion: There's some Texas-size people 'round those parts. I've seen a rotund family barely squeezing into a Ford F-350 after a movie matinee; a group of businessmen bursting out of their chairs at an all-you-can-eat restaurant; and empty doughnut cases at two Albertsons stores less than a mile apart.

And now, it's official. According to "How Healthy Are We? Selected Measures for El Paso, Texas, 2008," published by the city's Health Department, El Paso has a higher percentage of obese adults (27.2%) than the state and the nation (ElPasoTimes.com 3.1.09).

I can see why. Seemingly every major intersection features fast food franchises. Highway billboards advertise cheap Tex-Mex and BBQ joints. Drive-through kiosks sell border-hopping delicacies like elotes (corn on the cob slathered with mayonnaise, cheese, lime and chile). Even meteorological factors are at play. It's too damn hot for outdoor physical activity!

Since Latinos make up 81.6% of El Paso County's population, the obesity epidemic is hitting that community pretty hard (Census.gov 2.20.09). But help is on its way. The city's Healthy People 2010 program brings health professionals and the parks association together to reduce the obesity rate through workshops and health screenings — in English and Spanish.

Online diabetes management may result in better care, study concludes

2009-03-24T15:27:00.000-07:00

Healthcare IT Reports/Bernie Monegain, Editor

Online diabetes management programs may lead to improved patient knowledge, engagement and accountability, as well as better communication between patient and doctor, according to a new study by the Center for Connected Health, a division of Partners HealthCare.

The study is published in the March issue of the Journal of Diabetes Science and Technology.

About 23.6 million children and adults in the United States, or 7.8 percent of the population, have diabetes, according to the American Diabetes Association.

Based on the results of the pilot study, which examined a program called Diabetes Connected Health, the Center for Connected Health has initiated a randomized clinical trial involving 200 patients from six primary care practices affiliated with either Massachusetts General Hospital or Brigham and Women's Hospital.

Joseph Kvedar, MD
"This study provided valuable feedback from diabetes patients and providers on the utility, benefits and limitations of a Web-based diabetes management program," said Joseph C. Kvedar, MD, director of the Center for Connected Health. "Although the mean number of readings sent per month decreased over time, the number of comments posted per month increased, indicating ongoing engagement."

The pilot study included seven patients with type 2 diabetes at Massachusetts General Hospital. Study participants received access to a secure Web site that stored and graphed glucose readings uploaded remotely by the patients using a standard glucometer. Both patients and providers had access to the Web site, where the data could be viewed, analyzed and discussed.

Mean glucose levels declined over the three-month pilot period, as did self-reported HbA1c levels, which indicate the level of blood glucose over time.

Providers participating in the study reported that the Diabetes Connected Health program increased their confidence in adjusting medication based on remote glucose readings submitted by their patients. Patients also rated the Web site and provided feedback on the program, which will be used to enhance the platform.

"Diabetes Connected Health has the potential to truly impact the way diabetes care is delivered and to improve both clinical and economic outcomes," said Alice Watson, MD, corporate manager of the Center for Connected Health and a co-author of the paper. "Self-monitoring of blood glucose may have a greater impact when patient data can be shared with a provider in a timely manner, leading to treatment changes and enhanced patient education and motivation."

HEALTHY PEOPLE 2010

2009-03-24T04:16:00.001-07:00

Healthy People 2010, the US Department of Health and Human Services set of health goals for the nation for the first decade of this century, has two primary objectives:
• Increase quality and years of healthy life.
• Eliminate health disparities among different segments of the population.

Healthy People 2010’s challenges all of us—professionals, communities, and individuals, to take specific steps to ensure, that good health and long life are enjoyed by all.

MEDICINE 2.0 BY JMIR

2009-03-23T00:23:00.000-07:00

In a very significant development for eHealth, a broad adoption of Web 2.0 technologies and approaches coincides with the more recent emergence of Personal Health Application Platforms and Personally Controlled Health Records such as Google Health, Microsoft HealthVault, and Dossia. “Medicine 2.0” applications, services, and tools are defined as Web-based services for health care consumers, caregivers, patients, health professionals, and biomedical researchers, that use Web 2.0 technologies and/or semantic web and virtual reality approaches to enable and facilitate specifically 1) social networking, 2) participation, 3) apomediation, 4) openness, and 5) collaboration, within and between these user groups. The Journal of Medical Internet Research (JMIR) publishes a Medicine 2.0 theme issue and sponsors a conference on “How Social Networking and Web 2.0 changes Health, Health Care, Medicine, and Biomedical Research”, to stimulate and encourage research and education in these five areas.

Ahead of the Curve: Patient Advocate

2009-03-22T23:38:00.000-07:00

Patient Advocate By Marty Nemko, US NEWS.

Even Christopher Columbus would have had a tough time navigating the waters of the complicated U.S. healthcare system, and most people, especially when ill, aren't the best navigators. Enter patient advocates. They help ensure that the patient gets to see the desired specialist. They do Internet research so the patient is more informed when talking to the doctor. They educate family members on how to support the patient during a hospital stay, for example, ensuring that the pills really are meant for her. And they sort through the mountains of bills and, if necessary, negotiate fees with the healthcare provider, insurance company, or other payer. ("Medicare, how dare you refuse to pay for that surgery!")

The confluence of aging baby boomers with an ever more complex, cost-conscious healthcare system means unlimited demand for a persuasive, persistent person willing to do the vital work of patient advocacy. Some hospitals and HMOs hire nurses and social workers as patient advocates, but there remains a huge unmet need, which may be filled by self-employed advocates.

ABC Report: Surgeons 'Tweet' From Operating Room During Brain Surgery

2009-03-22T10:15:00.000-07:00

Using Twitter to Teach

By BARBARA PINTO

http://abcnews.go.com/video/playerIndex?id=7143331

As doctors Steven Kalkanis and Kost Elisevich performed brain surgery at Henry Ford Hospital in Detroit, a watchful medical team looked on. So did more than 1,900 others, who subscribe to the microblogging social network site Twitter and had decided to "follow" Henry Ford Hospital.

Holli Charbonneau is one of them. She was watching the surgery not from the operating room but from her kitchen, 15 miles away. Holli, or "Holli81" as she is known on Twitter, is a third-year medical student at Wayne State University. From behind the screen of her computer, she checks the updates or "tweets" streaming in. "They're making good progress." she says.

In Massachusetts, Harvard medical resident Phil Williams is watching, too. He plans to specialize in orthopedics, and has never seen this type of brain surgery, an awake craniotomy, before.

He types in a question for the surgeons. "I asked about the brain. It doesn't feel pain, but does it feel pressure?" he explained. Moments later, one of the doctors in the operating room "tweets" back an answer.

Henry Ford Hospital has launched an unusual marriage of medicine and new media. The hospital began "twittering" some of its more groundbreaking surgical cases.

Doctors will post real-time "tweets" from the operating room, while a technician uploads video of the surgery to YouTube.

A technician installs a computer in a corner of the operating room. As surgeons scrub out of the surgery, they spend time answering questions "tweeted" in from around the country.

Shouldn't You Be Operating?

Dr. Kalkanis reads from the twitter page, "I have a question: shouldn't these surgeons be operating rather than tweeting?"

He then reads his reply, "I said that patient safety comes first. Whoever is not attending to the patient jumps on the feed& but at any given point there is a very senior team with the patient."

This patient is a 47-year-old man with a tumor in the part of his brain that controls his speech. He consented to the twitter feed, and to have video of his surgery uploaded to YouTube.

At home, Holli is watching the first YouTube feed, as surgeons expose the patient's brain.

"I felt like I was right there...in there," she said, " I felt like they were going to ask me to hold the retractor for them, because that's the medical student's job."

Doctors say that immediacy and the real-time nature of the feeds give students a window into the surgeon's decision-making process.

"That is the real power of this technology," explains Dr Kalkanis.

The give and take nature of this technology provides a sort of surgical play-by-play.

Phil Williams kept the questions coming. "I asked what kind of anesthesia is used for this ... basically trying to figure out how they can have the patient go to sleep and then wake them up, and have it be a smooth transition between the two," he explains.

In this surgery, doctors put the patient under to expose his brain, and then wake him up and keep him talking so that surgeons can map his speech center, and navigate around it to remove the tumor.

As doctors send tiny electrical impulses into various parts of the brain, a speech therapist holds up flashcards.

"What is this one" the therapist asks.

"A cow," the patient answers.

At one point, the patient tells the doctors that he has a headache. Not surprising, since they are staring at the right side of his brain.

"Some other people asked is he nervous right now," explained Phil Williams, tracking the twitter exchange, "but he's talking up a storm, apparently."

The patient is put back under, and surgeons successfully removed the entire tumor. The pathology report comes back, and his prognosis is good.

As surgeons close the incision, the questions keep coming.

At her computer, Holli chuckles as she reads this one out loud, "The questions is asking if brain surgery is really as hard as brain surgery." The surgeon's reply:

"Umm..yes."

So, then why have so many people follow along on such a potentially risky operation?

Dr. Kalkanis explained, "It's always better and best if we can err on the side of furthering the field, advancing the frontier, and educating as many people as we can."

"The public comes to know, I think, what our limits are, what our fallibilities are," says Dr. Elisevich, "and can judge essentially where technology can take them at this stage."

Dr. Kalkanis also believes it is important for educators to now communicate in the language this generation of students understands.

"It's a generation skilled in instant, interactive, interpersonal communication and feedback, and I think that if medical education is going to be as relevant and effective as possible, it needs to keep pace with this new standard."

Copyright © 2009 ABC News Internet Ventures

Integrating prevention into health care

2009-03-19T08:38:00.000-07:00

Due to public health successes, populations are ageing and increasingly, people are living with one or more chronic conditions for decades. This places new, long-term demands on health care systems. Not only are chronic conditions projected to be the leading cause of disability throughout the world by the year 2020; if not successfully prevented and managed, they will become the most expensive problems faced by our health care systems. People with diabetes, for example, generate health care costs that are two to three times those without the condition, and in Latin America the costs of lost production due to diabetes are estimated to be five times the direct health care costs. In this respect, chronic conditions pose a threat to all countries from a health and economic standpoint.

Many costly and disabling conditions - cardiovascular diseases, cancer, diabetes and chronic respiratory diseases - are linked by common preventable risk factors. Tobacco use, prolonged, unhealthy nutrition, physical inactivity, and excessive alcohol use are major causes and risk factors for these conditions. Trends in tobacco use will increase in the foreseeable future especially in developing countries. The ongoing nutritional transition expressed through increased consumption of high fat and high salt food products will contribute to the rising burden of heart disease, stroke, obesity and diabetes. Changes in activity patterns as a consequence of the rise of motorised transport, sedentary leisure time activities such as television watching will lead to physical inactivity in all but the poorest populations. Many diseases can be prevented, yet health care systems do not make the best use of their available resources to support this process. All too often, health care workers fail to seize patient interactions as opportunities to inform patients about health promotion and disease prevention strategies.

CURRENT SYSTEMS OF HEALTH CARE

Many diseases can be prevented, yet health care systems do not make the best use of their available resources to support this process. All too often, health care workers fail to seize patient interactions as opportunities to inform patients about health promotion and disease prevention strategies.

Most current health care systems are based on responding to acute problems, urgent needs of patients, and pressing concerns. Testing, diagnosing, relieving symptoms, and expecting a cure are hallmarks of contemporary health care. While these functions are appropriate for acute and episodic health problems, a notable disparity occurs when applying this model of care to the prevention and management of chronic conditions. Preventive health care is inherently different from health care for acute problems, and in this regard, current health care systems worldwide fall remarkably short.

HOW CAN HEALTH SYSTEMS RESPOND TO THIS CHALLENGE?

Given that many conditions are preventable, every health care interaction should include prevention support. When patients are systematically provided with information and skills to reduce health risks, they are more likely to reduce substance use, to stop using tobacco products, to practice safe sex, to eat healthy foods, and to engage in physical activity. These risk reducing behaviours can dramatically reduce the long-term burden and health care demands of chronic conditions. To promote prevention in health care, awareness raising is crucial to promote a change in thinking and to stimulate the commitment and action of patients and families, health care teams, communities, and policy-makers.

A collaborative management approach at the primary health care level with patients, their families and other health care actors is a must to effectively prevent many major contributors to the burden of disease.

Essential elements for action

Support a paradigm shift towards integrated, preventive health care
Promote financing systems and policies that support prevention in health care
Equip patients with needed information, motivation, and skills in prevention and self-management
Make prevention an element of every health care interaction

WHO'S RESPONSE

WHO's Non-communicable Diseases and Mental Health cluster has created a new framework for assisting countries to reorganize their health care for more effective and efficient prevention and management of chronic conditions. The Innovative Care for Chronic Conditions Framework is centred on the idea that optimal outcomes occur when a health care triad is formed. This triad is a partnership among patients and families, health care teams, and community supporters that functions at its best when each member is informed, motivated, and prepared to manage their health, and communicates and collaborates with the other members of the triad. The triad is influenced and supported by the larger health care organization, the broader community, and the policy environment. When the integration of the components is optimal, the patient and family become active participants in their care, supported by the community and the health care team.

EXAMPLES OF INNOVATION FROM AROUND THE WORLD

The following three case studies demonstrate successful implementation of one or more components of prevention in health care.

Brazil: Establishing preventive health services in low resource communities

Cearà, a poor state in Brazil presents a model of care that may be achievable for other countries in which resources, income, and education levels are limited. In 1987, auxiliary health workers, supervised by trained nurses (one nurse to 30 health workers) and living in local communities, initiated once-monthly home visits to families to provide several essential health services. The programme was successful in improving child health status and vaccinations, prenatal care, and cancer screening in women. It was low cost, too. Salaries for the heath workers were normal wage, few medications were used and no physicians were included. Overall, the programme used a very small portion of the state’s health care budget.

In 1994, the health worker programme integrated into the Family Health Programme that includes physicians and nurses on the team with the health workers. For the first time in Brazil, large scale integrated, preventive health services were in place.

Svitone, EC, Garfield, R, Vasconcelos, MI, & Craveiro, VA Primary health care lessons for the Northeast of Brazil: the Agentes de Saude Program, Pan Am J Public Health 2000;7(5):293-301.

USA: Incorporating prevention into primary care

Kaiser Permanente, a large managed care organization in California, recently reoriented its primary care clinics to better meet the needs of patients, emphasizing the needs of those with chronic conditions. Multidisciplinary teams were created that include physicians, nurses, health educators, psychologists, and physical therapists. These primary care teams link with pharmacy, the telephone advice and appointment centre, chronic conditions management programmes, and specialist clinics creating a totally integrated system of care from outpatient clinics to inpatient hospital care.

Patients are enrolled in the chronic conditions management programs via outreach strategies that identify those with chronic conditions who have not sought primary care, and through physician identification during primary care office visits. Patients receive services from multiple disciplines, based on the intensity of their needs. The diagram depicts the three levels of care. There is an emphasis on prevention, patient education, and self-management. Non-physician team members facilitate group appointments. Biological indices have improved across conditions such as heart disease, asthma, and diabetes. Screening and prevention services have increased and hospital admission rates have declined.

A recent comparison of Kaiser’s integrated care system with the UK’s National Health System found that although costs per capita in each system were similar, Kaiser’s performance was considerably better in terms of access, treatment, and waiting times. Explanations for Kaiser’s better performance included real integration across all components of health care, treating patients at the most cost-effective level of care, market competition, and advanced information systems.

Feachem GA, Sekhri NK, & White KL. Getting more for their dollar: a comparison of the NHS with California’s Kaiser Permanente. British Medical Journal 2002;324:135-143

India: Integrating non-communicable disease prevention and management

Cardiovascular and cerebrovascular diseases, diabetes, and cancer are emerging as major public health problems in India. Apart from a rising proportion of older adults, population exposure to risks associated with certain chronic conditions is increasing. Obesity is increasing, physical activity is declining, and tobacco use is a substantial problem in the country.

Although it is commonly believed that non-communicable diseases (NCDs) are more prevalent in higher income groups, data from India’s 1995-1996 national survey showed that tobacco intake and alcohol misuse are higher in the poorest 20% of the income quintile. As a result, the government of India is anticipating that the prevalence of tobacco-related conditions will increase in lower socio-economic groups in the coming years.

The government has adopted an integrated NCD prevention and management programme. The main components of this programme are:

Health education for primary and secondary prevention of NCDs through mobilizing community action;
Development of treatment protocols for education and training of physicians in the prevention and management of NCDs;
Strengthening/creation of facilities for the diagnosis and treatment of CVD and stroke, and the establishment of referral linkages;
Promotion of the production of affordable drugs to combat diabetes, hypertension, and myocardial infarction;
Development and support of institutions for the rehabilitation of people with disabilities;
Research support for: Multisectoral population-based interventions to reduce risk factors;
The role of nutrition and lifestyle-related factors;
The development of cost effective interventions at each level of care.
Planning Commission, India, 2002.

CONCLUSION

Many of the costly and disabling conditions facing health systems today can be prevented. Additionally, with proper support many of their complications can be averted or delayed.

Strategies for reducing onset and complications include early detection, increasing physical activity, reducing tobacco use, and limiting prolonged, unhealthy nutrition.

Through innovation, health care systems can maximize their returns from scarce and seemingly non-existent resources by shifting towards activities that emphasize prevention and delay in complications.

Small steps are as important as system overhaul. Those who initiate change, large or small, are experiencing benefits today and creating the foundation for success in the future.

A MEDICAL EXECUTIVE WHO USES HIS HEAD AND HEART

2009-03-12T15:40:00.001-07:00

As I read this story, my admiration and respect goes to Mr. Levy in recognition for his excellent judgement. Would you agree?

A head with a heart
Courtesy of Kevin Cullen, Globe Columnist

It was the kind of meeting that is taking place in restaurant kitchens, small offices, retail storerooms, and large auditoriums all over this city, all over this state, all over this country.

Paul Levy, the guy who runs Beth Israel Deaconess Medical Center, was standing in Sherman Auditorium the other day, before some of the very people to whom he might soon be sending pink slips.

In the days before the meeting, Levy had been walking around the hospital, noticing little things.

He stood at the nurses' stations, watching the transporters, the people who push the patients around in wheelchairs. He saw them talk to the patients, put them at ease, make them laugh. He saw that the people who push the wheelchairs were practicing medicine.

He noticed the same when he poked his head into the rooms and watched as the people who deliver the food chatted up the patients and their families.

He watched the people who polish the corridors, who strip the sheets, who empty the trash cans, and he realized that a lot of them are immigrants, many of them had second jobs, most of them were just scraping by.

And so Paul Levy had all this bouncing around his brain the other day when he stood in Sherman Auditorium.

He looked out into a sea of people and recognized faces: technicians, secretaries, administrators, therapists, nurses, the people who are the heart and soul of any hospital. People who knew that Beth Israel had hired about a quarter of its 8,000 staff over the last six years and that the chances that they could all keep their jobs and benefits in an economy in freefall ranged between slim and none.

"I want to run an idea by you that I think is important, and I'd like to get your reaction to it," Levy began. "I'd like to do what we can to protect the lower-wage earners - the transporters, the housekeepers, the food service people. A lot of these people work really hard, and I don't want to put an additional burden on them.

"Now, if we protect these workers, it means the rest of us will have to make a bigger sacrifice," he continued. "It means that others will have to give up more of their salary or benefits."

He had barely gotten the words out of his mouth when Sherman Auditorium erupted in applause. Thunderous, heartfelt, sustained applause.

Paul Levy stood there and felt the sheer power of it all rush over him, like a wave. His eyes welled and his throat tightened so much that he didn't think he could go on.

When the applause subsided, he did go on, telling the workers at Beth Israel, the people who make a hospital go, that he wanted their ideas.

The lump had barely left his throat when Paul Levy started getting e-mails.

The consensus was that the workers don't want anyone to get laid off and are willing to give up pay and benefits to make sure no one does. A nurse said her floor voted unanimously to forgo a 3 percent raise. A guy in finance who got laid off from his last job at a hospital in Rhode Island suggested working one less day a week. Another nurse said she was willing to give up some vacation and sick time. A respiratory therapist suggested eliminating bonuses.

"I'm getting about a hundred messages per hour," Levy said yesterday, shaking his head.

Paul Levy is onto something. People are worried about the next paycheck, because they're only a few paychecks away from not being able to pay the mortgage or the rent.

But a lot of them realize that everybody's in the same boat and that their boat doesn't rise because someone else's sinks.

Paul Levy is trying something revolutionary, radical, maybe even impossible: He is trying to convince the people who work for him that the E in CEO can sometimes stand for empathy.

Kevin Cullen is a Globe columnist. He can be reached at cullen@globe.com.

Free Health Care from a Recession Angel

2009-03-11T08:04:00.001-07:00

CNN Health Report

Cottrell isn't alone in thinking that small acts of kindness can make a big difference in peoples' lives.

In the Minneapolis suburbs, a six-physician gynecological practice has started giving free preventive care to any of its existing patients who lost their medical insurance because of layoffs.

Dr. K. Anthony Shibley has been offering free check-ups for uninsured patients.
"It's not going to kill us to do a little extra work," Dr. K. Anthony Shibley said. "They probably already have enough bill collectors calling them."

The patients can get one free preventive-care visit and a free Pap smear. If they also want tests for sexually transmitted diseases or cholesterol screening, the doctors are offering those services at a reduced rate. The plan resulted from the worries of a few longtime patients who no longer had insurance.

"We have a doctor-patient relationship," Shibley said. "It's not exactly a business-client relationship."

Survey shows Physicians using technology but they don't like it.

2009-03-10T08:19:00.000-07:00

The percentage of physicians using electronic medical records has nearly doubled in five years, according to a survey by the American College of Physician Executives.

The Tampa organization, which provides medical management education for physicians, also found that most physicians consider EMRs “clunky” and unresponsive to their needs, it said in a release.

The survey findings were released a few weeks after approval of a federal $787 billion economic stimulus that includes $19 billion for health information technology, including $17 billion for incentives and penalties to encourage doctors and hospitals to abandon paper record-keeping and go high-tech beginning in 2011.

About 1,000 members of the ACPE responded to the 2009 survey, which was a repeat of a survey conducted in 2004, the release said.

Some of the findings were:

• More than 64 percent of respondents in the 2009 survey said they used electronic medical records, up from 33 percent in 2004.

• About 44 percent said their organization uses computerized order entry, while only about 33 percent used the systems five years ago. Computerized physician order entry systems are electronic prescribing systems that intercept errors when medications are ordered.

• More than 38 percent said they use pharmaceutical bar coding, up from 20 percent in 2004.

Some physicians embrace the new technology, but a larger number view it as frustrating and difficult to use,

President’s Budget Sets Aside $634 Billion to Reform Health Care

2009-03-04T09:45:00.000-08:00

President Obama has made health care a top priority in his first budget proposal by setting aside $634 billion over the next decade to begin reforming the health care system and expanding health care coverage to all Americans.

The proposed “reserve fund” for health care would get half of its funding from new revenue and half from savings proposals. For example, the Obama administration wants to introduce a competitive bidding process to the Medicare Advantage program, a move estimated to save more than $175 billion over 10 years.

However, in its budget proposal, the administration acknowledged that even $634 billion would not be enough to fully fund a comprehensive reform of the health care system and that administration officials would need to work with Congress to find even more money.

President Obama delivered the 140-page outline of his fiscal year 2010 budget proposal to Congress on Feb. 26; complete documents will be submitted to Congress in April.

“With this budget we are making an historic commitment to comprehensive health care reform,” President Obama said. “It’s a step that will not only make families healthier and companies more competitive, but over the long term, it will also help us bring down our deficit.”

The budget proposal contains a set of eight principles the president plans to use to guide his health reform efforts: reducing premiums and other costs for American families and businesses; reducing costs from unnecessary tests and services; putting the nation on a path to universal health care coverage; providing portability to health care insurance; providing individuals with a choice of health plans and physicians; investing in prevention and wellness; improving patient safety and quality of care; and ensuring the long-term fiscal sustainability of the system.

Key among the reforms identified by the Obama administration is the need to change the Medicare physician payment formula. The President supports “comprehensive, but fiscally responsible” changes to the current payment system, according to the budget proposal. “The Administration believes Medicare and the country need to move toward a system in which doctors face better incentives for high-quality care rather than simply more care.”

The budget proposal also contains good news for physicians who have been bracing for a deep Medicare pay cut next January. In what the administration calls a “return to honest budgeting,” the FY 2010 budget proposal will account for the fact that payments to physicians under Medicare will not be significantly cut as called for under current law.

The American Medical Association applauded the administration’s willingness to address Medicare physician payment issues.

“President Obama’s budget proposal takes a huge step forward to ensure that physicians can care for seniors by rejecting planned Medicare physician payment cuts of 40% over the next decade,” AMA President Dr. Nancy H. Nielsen said in a statement. “Looming widespread physician shortages coupled with aging baby boomers highlight the urgent need for permanent Medicare physician payment system reform to preserve seniors’ access to health care.”

The investment in health reform was praised by health care advocates. Ron Pollack, executive director of Families USA, a national organization for health care consumers, said the FY 2010 budget proposal bodes well for achieving health care reform this year. “The fiscal investment proposed by the President is a critical first step towards two related and important objectives--bending the health care cost growth curve and ensuring that everyone has access to high-quality, affordable health coverage and care,” he said in a statement.

America’s Health Insurance Plans also praised the President’s commitment to health reform. However, the group criticized the proposal to make Medicare Advantage plans engage in a competitive bidding process, saying that significant cuts to Medicare Advantage would “jeopardize the health security of more than 10 million seniors” enrolled in the program and reverse payment incentives designed to improve quality of care.

The FY 2010 budget proposal also includes $76.8 billion in discretionary funding for the Health and Human Services department. At press time, Congress was still finishing up work on the FY 2009 budget for HHS.

The FY 2010 budget proposal for HHS includes more than $6 billion in cancer research funding at the National Institutes of Health, on top of the $10 billion in NIH funding that was included as part of the American Recovery and Reinvestment Act, enacted Feb. 17.

The administration’s budget proposal also aims to address physician shortages by spending $330 million to expand loan repayment programs for physicians, nurses, and dentists who agree to practice in medically underserved areas.

Finally, the proposal aims to reduce drug prices by accelerating access to generic versions of biologic drugs. The administration said it would establish a regulatory, scientific and legal pathway for the creation of generic versions of biologic drugs.

The Life and Death of an Empowered Patient

2009-02-26T14:57:00.000-08:00

Gilles Frydman wasn't ready to see his friend Dr. Doreen Kossove in her condition: tethered to an oxygen tank, hardly able to speak, living with only one lung, her tiny, frail body ravaged by cancer and barely visible under her blankets.

Empowered Patient extraordinaire: Doreen Kossove with her daughter Natasha de Lange.

But as he approached the hospital bed in her tiny Berkeley, California, apartment, he saw that she was typing furiously on a laptop computer.

Kossove, he learned, didn't let cancer -- in her lungs, chest and brain, and on her spinal cord and her vocal cord nerves -- get in the way of helping others.

"[I have] about 2,000 rare-cancer patients under my gimlet stare," Kossove wrote about the patients she communicated with on the Association of Cancer Online Resources, a Web site Frydman founded. "I have had three deaths and another person dying in the last month among the people whom I advise. The last two current ones are breaking my heart."

Many of these patients say Kossove is the reason they're alive today. A Brooklyn, New York-born pediatrician who practiced in the United States and South Africa, she was found to have leiomyosarcoma, a rare and aggressive cancer, in 2001. She corresponded online with her fellow patients nearly every day -- sometimes all day -- until she died February 6. She was 65.

"I owe her my life," cancer patient Erica Gero wrote in tribute to Kossove on the ACOR Web site. Gero explained that Kossove convinced her to see a doctor who specialized in sarcomas, a move Gero said got her the treatment she needed. "Doreen gritted her teeth and would not let go of me until I went to the right kind of doctor. She was polite, but snarky at the same time. And of course, she was right."

"She was the most powerful patient advocate I've ever known," Frydman added.

"The world is missing a hero," wrote Chaim Kurz, whose wife, Adina, for eight years has been battling synovial sarcoma, a rare type of soft tissue cancer. Kurz writes under the alias 'Bruce Katz.'

"I remember at one time there was a question as to whether the tumors had spread into my wife's spinal cord or brain. We had nowhere to turn. Doreen was herself starting a new chemotherapy treatment and was extremely tired, but sent me a three-page e-mail explaining in detail what options we had," Kurz wrote on the ACOR site. "She never candy-coated anything, but we knew that she loved everybody who ever asked her a question."

With a mother-hen style, Kossove pushed the cancer patients under her "gimlet stare" to hire the right doctor, fire the wrong doctor and find the latest treatments, which can be very difficult for rare cancers. She urged them to question doctors who told them there were no options left; she'd been told the same thing when her cancer was first diagnosed. "When she joined the ACOR list in 2001, she was told she had one month to live," Frydman remembers.

"Her ability to be up on the latest research and to impart the knowledge was uncanny," wrote Susan Lowenbraun, nursing director of the Sarcoma Center at Cedars-Sinai Cancer Center in Los Angeles, California, who worked with Kossove to help patients on the ACOR site. "Even when she felt ill herself, she did research and communicated tirelessly with other patients."

Sometimes Kossove showed impatience for others in her leiomyosarcoma group. If she felt someone wasn't moving quickly enough to fight LMS, which can spread at lightning speed, she let them know in very blunt terms. "I get very exasperated, very bitter and very worried about the people on this list," she wrote to one woman. "[Some of them] put their heads in the sand. ... If one has high-grade LMS, one has to hit the road running."

Kurz paid tribute to her forcefulness on the ACOR site. "If she was in the U.S. Army or Navy, there would be peace in the world now -- that is how strong she was," he wrote.

But she also showed great compassion, inspiring others on ACOR to keep searching for the newest treatment. "Together we are more, and more effective, than we are separately," she often told her fellow cancer patients. Signing off on one message, she wrote, "Celebrate being alive. Warmly, Doreen."

Health Coverage for All -- Is It on the Way?

2009-02-22T08:26:00.000-08:00

On Friday, the New York Times revealed that major players in the nation’s health care debate -- including big insurance companies, lobbyists representing consumers, physicians, hospitals and the pharmaceutical industry -- may soon unveil a consensus plan advocating comprehensive legislation that requires every American to carry health insurance.

At the center of this collection of lions and lambs -- termed the “workhorse group” in a memorandum obtained by the Times -- is Sen. Edward Kennedy, D-Mass., a prominent advocate of health care reform. Here is what ABC News Medical Editor Dr. Timothy Johnson had to say about the developments:

“Today’s report in the New York Times confirms earlier reports (and many rumors) that key meetings about health care reform are being orchestrated by Sen. Kennedy and his staff. The idea of ‘insurance for all’ would certainly please insurance companies -- 45-50 million new customers!

“However, unless such an expansion/requirement is also accompanied by true reform -- cost and quality control -- it will be a bailout rather than true reform. Almost all experts agree that about a third of the 2.6 trillion we spent on health care last year (and rising every year) is ultimately wasted -- fraud, unnecessary testing and treatment, etc. So if we simply expand coverage and don't get control of costs and quality we will miss a golden opportunity for reform.”

Surgeons use natural orifices for weight-loss procedures to reduce stomach size

2009-02-19T07:31:00.000-08:00

In the fight against obesity, doctors have deployed stern warnings, dieting tips, liposuction and open-incision bariatric surgery. But some surgeons have found another avenue for weight loss.

A handful of surgeons are using natural orifices -- such as the mouth or the vagina -- to perform bariatric surgery, which reduces stomach size.

Surgical instruments and a tiny camera travel through the patients' natural body openings to reach the desired organ in the procedure, known as natural orifice translumenal endoscopic surgery. In the bariatric procedure, the surgeon trims the stomach to a smaller size or stitches a slight pouch in it to make the patient feel full after a modest meal.

"Perhaps to some people, physicians and patients alike, it looks strange and unusual," said Dr. John Morton, director of bariatric surgery and surgical quality at Stanford University School of Medicine in Stanford, California. "I think from a female perspective, there's a natural apprehension in terms of having surgery done through [the vagina]."

Because no incisions are made through the external skin, the surgery reduces risks of infection, is less painful and leaves no scars, proponents say.

"We're trying to make a surgery that can minimize trauma," said Dr. Santiago Horgan, director of the University of California at San Diego Center for the Future of Surgery and Center for the Treatment of Obesity.

So far, American doctors have removed gallbladders, a kidney and appendixes through vaginas, pulled appendixes through mouths and repaired a hernia transvaginally. These surgeries are part of clinical trials and not used in general practice.

Horgan and doctors at UCSD have done about 50 natural orifice procedures-- 34 of them have been transvaginal gallbladder removals. Two of the procedures were gastrectomies, where 70 percent of patients' stomachs were removed through the vagina.

"We have three patients who got pregnant [after a transvaginal surgery], so pregnancy isn't an issue," Horgan said.

Female patients who've gone through a transvaginal surgery usually complain of pain they normally feel during their period. Others who've had a procedure through their mouth complain of a sore throat.

"The pain level's lower and, of course, the cosmetic result is incomparable," Horgan said.

For men, there have been ideas about using the penis as a natural orifice, but that's been dismissed because the point of entry is too small.

"If you're male, you're going to have to go through the rectum," said Dr. Sayeed Ikramuddin, director of gastrointestinal surgery at the University of Minnesota Medical School. That procedure hasn't been done on humans because, it's "dangerous because there's a lot of bacteria that could be spilled. If you leak, it's a disaster."

The concept of using natural orifices is not new, said Dr. Mark Talamini, professor and chairman of the Department of Surgery at UCSD.

"In many ways, neurosurgeons have been viewing the brain between the mouth and the nose for quite a long time," he said. "That's already common practice. We just never called it that."

The movement got started with an appendix was removed through a patient's mouth in India in 2004. Weight-loss procedures using natural orifices are under way in clinical trials. It could minimize risks encountered in standard bariatric surgery.

"When you cut a patient that is overweight, you're much more prone to infections of the abdominal wall," Horgan said. "So if you can minimize the number of incisions you do, you minimize hernias, abdominal wall infections and skin infections."

Doctors are researching whether the less-invasive surgery could reduce risks and eliminate scars while delivering similar results. But it's too early to tell whether these surgeries carry more risk than standard operations.

Dr. Scott Shikora, president of the American Society for Metabolic and Bariatric Surgery, said he hasn't been impressed with the results.

"They're unproven," he said. "There's no long-term data. In some cases, there were human experimentation without proper studies and consent and Internal Review Board approval. They are potentially relying on mechanisms of action that didn't demonstrate themselves to be successful than when the surgery was done conventionally."

While natural orifice surgery "isn't ready for prime time, maybe it's a steppingstone to something else," Shikora said."The crazy ideas of today might be the standard treatments tomorrow."

Similar doubts came about when the laparoscopic surgeries first surfaced in the 1980s, he said. Now, laparoscopy has largely replaced open surgery.

After a laparoscopy, patients often complain of soreness, swelling and gas-related irritation.

Paul Martin felt bloated from the gas and tenderness in the four incisions after his standard gastric bypass. Although Martin said he didn't feel much pain, it took him a week before he could return to work.

Three years after the bypass, he started regaining weight. "I could eat more and was not as active as I had been," said the resident of San Jose, California. "I started putting a little bit of weight back on."

Instead of cutting through the skin, his surgeon, Stanford's Morton lowered a surgical tool down his throat. Using that device, Morton stitched pleats to narrow the patient's stoma. There were neither incisions nor gas injected into his abdomen.

When Martin woke up, he returned to work that day with just a sore throat.

Despite the emphatic thumbs-up from patients like Martin, his surgeon said more research and better tools are needed before natural orifice surgery goes mainstream.

"At the end of the day, science has to win out," Morton said. "We have to make sure that this procedure is going to be at least as effective and safe as the original procedure. If it's not, we shouldn't be doing it just because we can."

Two groups, the American Society for Gastrointestinal Endoscopy and Society of American Gastrointestinal and Endoscopic Surgeons, formed a research group to consider issues and exchange information about natural orifice surgeries. The group is called the Natural Orifice Surgery Consortium for Assessment and Research, also known as NOSCAR.

Despite efforts to make surgery easier and more comfortable for patients, natural orifice surgery isn't a cure-all for obesity.

"Surgery is just a tool," Ikramuddin said. "You need to have given up the Doritos, given up the apple juice... If you eat like that, no bariatric procedure is going to help you, period."

An Incredible and Unusual Story Of Organ Donation

2009-02-19T07:10:00.000-08:00

One morning a couple of months ago at Westchester Medical Center, Dawn Verdick gave Daniel Flood one of her kidneys.

Daniel Flood received a kidney from Dawn Verdick. They were brought together through Craigslist.

Verdick and Flood were not friends or family. In fact, they were total strangers from the East and West coasts. But that's not the most unusual aspect of this case.

The patient and donor were brought together after Flood's three daughters placed an ad on Craigslist, the online classifieds site that offers everything from autos to real estate and guitar lessons to massage.

"Please help us, my dad needs a kidney!" began their posting in the site's volunteer section. Watch more on the Craigslist-kidney connection »

"It was a shot in the dark, but it had worked for everything else," Jennifer Flood said.

After years of untreated high blood pressure, Flood's levels of creatinine had risen, indicating damage to the kidney. The bean-shaped, fist-sized organs process blood to sift out waste products and extra water. More than 15 million Americans have some degree of kidney disease, according to estimates.

Flood's doctor told him he needed a transplant or dialysis. Both options have pros and cons. Dialysis can be hard on the heart and takes up time several days a week.

Making Flood's situation more difficult was the fact that the retired 68-year-old life insurance salesman was born with only one kidney. In addition, Flood's rare O-negative blood type made the odds even tougher. None of Flood's daughters, or his immediate family, was a match.

Jennifer and sisters Cynthia and Heather, all in their early 30s, vowed to find their father a living donor.

"We knew that the waiting list was two to six years. And we knew how dialysis takes a toll on your body, and we knew we had to save Dad.''

About three-quarters of kidney transplants are between family members, and the rest are among friends and acquaintances, according to the United Network for Organ Sharing, a not-for-profit organization that manages the nation's transplant system.

Nearly 75,000 Americans were waiting for a kidney by the end of 2007, according to the organization. Just over 16,000 on the wait list received one, about 6,000 of them from living donors.

Although the number of kidney donors has grown since 1998, the wait list has doubled as the incidence of diabetes, a leading cause of kidney disease, rises to crisis levels.

A kidney from a deceased donor is far more likely to be rejected than one from a living donor and may not hold up for the recipient's lifetime.

"Kidneys from living donors last, on average, 25 years while kidneys from cadavers last an average of 10 years, because kidneys from living donors are usually in better shape,'' said Dr. Jonathan Lazare, a urologist with the Mount Sinai Medical Center in New York.

The Floods received more than 100 responses to the Craigslist ad. Many sounded genuinely interested in helping, but others sought to sell a kidney, which is illegal in the United States.

One encounter with a young man from the Washington area was especially disheartening. The man traveled to the Floods' home in Pleasantville, New York, just outside New York City, and even stayed with them a few days. Soon after, he e-mailed Jennifer Flood to say he had only wanted to see the city.

Internet appeals for organ donations raise a number of questions of fairness, one medical ethicist said.

"Ideally, organs should be fairly allocated on basis of medical need and time on the waiting list," said Dr. Kenneth Prager, director of clinical ethics and chairman of the Medical Ethics Committee at New York Presbyterian Hospital.

"Solicitations undermine the concept of a level playing field."

But, he added, "we are a country with free speech. There is nothing illegal in advertising or in using the Web for personal or health reasons. Altruistic organ donors have the legal right to designate recipients."

And he sees a potential benefit from the Internet.

"An important argument supporting the solicitation of donors through advertising is that many such altruistic unrelated donors would never have given their organs without being moved by the personal stories of the patients on the Web," Prager said. "As such, patients who solicit such donors do not do so at the expense of others on the list. By expanding the population of organ donors, Web sites such as matchingdonors.com or Craigslist can benefit the population of those in need of organs as a whole."

For the Flood family, the breakthrough came when Verdick, who lives in Monterey, California, went on Craigslist for the first time to look for a volunteer project when a close friend died.

"I didn't set out to donate a kidney,'' said Verdick, 48, the founder of a not-for-profit educational organization.

The ad initially caught her attention because it mentioned her blood type.

"I turned it over to the universe early on. And I just said, 'If it's meant to be, then I will qualify, and if it's not, I won't.' ''

Verdick was such a strong match that doctors said it was as if she and Flood were close relatives.

As part of the screening process, Verdick underwent two psychological evaluations. One question asked how she would react if she were to donate and later have kidney failure.

'"What if I'm hit by a bus tomorrow?" she responded. "There's a lot of 'what ifs.' I don't live in 'what if.' I live in the 'what is.' "

The experience has brought profound renewal to Daniel Flood.

After feeling tired and having a symptomatic gray skin tone for so many years, he says, his complexion has turned ruddy again, and he feels more energetic.

He takes 14 medications every day, including three anti-rejection drugs. For a while he won't be allowed to shake hands or hug anyone because of the risk of infection, or to lift more than 10 pounds.

But for now, the numbers are on his side. The five-year survival rate for kidney recipients from a living donor is about 90 percent, versus an 80 percent chance for people who receive from a cadaver, according to the organ-sharing organization.

"Every day is a fresh start for me. It's a whole new awakening, a whole new beginning,'' said Flood, who looks forward to playing golf again and spending more time with his wife, children and 3-year-old granddaughter.

Flood's daughters are now making it their mission to give back.

They launched the Flood Sisters Kidney Foundation of America at www.floodsisters.org, which has about 20 members, to bring potential living kidney donors together with people who need them.

And come December, Verdick and the Flood family are marking their calendars for dinner, to celebrate their special "anniversary.'' Courtesy of CNN Health New York.

Prescription Drugs Discount Program

2009-02-16T07:05:00.000-08:00

If you can't afford health insurance -- or if your insurance doesn't include good prescription drug benefits -- look for $4 generic drugs at many major supermarkets and drug stores. Also, your state may offer a discount drug program (after you click, scroll down to see Table 2). You can also check these private groups that offer prescription assistance.

HealthWell Foundation

FamilyWize discount drug card

Needy Meds

Rx Assist

Rx Hope

Chronic Disease Fund

Partnership for Prescription Assistance

The Access Project

What makes a successful story in Medical Practice?

2009-02-15T11:36:00.000-08:00

What makes a successful story? The short answer - a new procedure using new technology. But, you’ve got to have a willing patient too, and that can be a deal killer if you don’t have one. We’ve had women show their face on TV who’ve had breast augmentation, laser eye surgery and liposuction. But THE MOST difficult: VAGINA TIGHTENING Surgery! How’d we do that? We just asked that the patients be interviewed in “shadow” or under a blurred lens to protect their privacy.

Medical Marketing and Medical Practice PR Are Critical To Doctors Success

2009-02-15T11:29:00.000-08:00

Medical Public Relations is important because often the first time a patient hears about a new procedure or drug it's from the media. As you know people trust the media because they are a disinterested third party talking about it, therefore it’s credible. Most importantly, the media must trust the publicist and that perhaps is why we’ve been so successful. Members of the media trust the stories given to them because are backed up by clinical research and can be objective when presenting ideas to them.

The stories placed on the news have resulted in THOUSANDS of medical procedures and consultations provided by doctors and hospitals. Medical Public Relations works and works beyond most expectations.

The risky business of PR Healthcare and Social Media

2009-02-14T21:44:00.000-08:00

Healthcare is different from other practices in PR. You have the whole direct-to-consumer guidelines from the FDA, and then you have a ton of other issues in dealing with the press and social media.

But, it's beyond that. When you are working in social media, you are entering a community. Too many PR people don't get that - they view social media - or just blogs - as another media venue, that can be pitched. Just today, I was sent a press release from a firm in Los Angeles - no pitch letter, no garnering my interest on the subject, just the press release. And, that does not work.

When explaining social media, I use a Town Hall analogy. From a conversation with a friend, she wrote it out like this: Imagine a small town in Ohio with a highly civically-active community. On a regular basis this tightly-knit community hosts Town Hall meetings to discuss current events, areas of concern, etc. Now imagine someone wholly unconnected to community coming in, raising a topic of concern and just leaving. Town Hall meeting members have every reason to be annoyed, incensed and even hostile.

Now take that Town Hall scenario, multiply it exponentially, and stick it online - where anyone and everyone can see it. The quaint little Town Hall is now a blog. And the outside, rude intruders are PR people - those that neither seem to care or understand the community, but are just following orders to get "ink" no matter what.

For healthcare, take that Town Hall scenario, and put it in the hospital ward. With some health blogs, you are either talking to the patient, or the patient's relative. Now, unless you have ever been sick, you cannot truly empathize with that scenario. However, it does help to get information at our fingertips and discern about our choices. Whether you like or not, Social Media is here to stay and you will rather be death before the notion of transparency goes away making both doctors and patients accountable for making the best decisions concerning our health.

2009-02-14T10:05:00.000-08:00

THE NEW BUZZ IN MEDICAL CARE FOR 2009

2009-02-14T10:01:00.000-08:00

OBSERVATION
The buzzword for medical care in 2009?

WHAT'S HAPPENING
More primary-care physicians are taking a shot at a “boutique” model that downsizes their patient load and eliminates their dependency on insurance and Medicare coverage (Baltimore Sun 10.26.08).
Patients will be charged a flat annual fee, which promises less hurried visits and 24-hour access to doctors, including home visits. For example, Charter Internal Medicine in Columbia, Maryland, will charge $2,000 a year plus $500 per child. Only those who can pay can stay.

Patients are encouraged to keep their insurance for procedures such as hospital stays, ambulance rides and blood work.
Advocates hope it means better patient care overall, while opponents fear a physician shortage and lack of accessibility for many people.

WHAT THIS MEANS TO BUSINESS
For the haves, a concierge model that guarantees better healthcare services and more attention will be money spent well. For the have-nots, it means more disappointment (trusted doctors turning them away), fewer options and less accessibility to the kind of care they need.