No Shows

"No Shows" are a thorn in our sides.

A recent article suggests taking the approach that the airlines take...to overbook.

Is the ideal of immediate access, no wait time, plenty of time with your physician, and quality care reasonable?

Paging Dr. Gupta: The Anti-Vaccine Crowd is Calling

Should Dr. Gupta stimulate conversation around a controversial topic (vaccinations), or should he share what he knows (or should know) about the data?

The heated commentary sure increases hits.

More Expensive Pills Work Better, Right?

This MIT study suggests that a placebo at $2.50 per pill relieves pain better than one priced at $0.10 per pill.

Incidentally, it looks like the same is true for wine--the same wine priced more expensively tastes better.

My ass hurts just thinking about the larger macroeconomic consequences of this conclusion.

Good luck explaining cost effectiveness to these folks.

Who Needs Evidence? There's Money to be Made!

Look at this irresponsible campaign recommending that people demand a CT scan.

Bullshit, bullshit, bullshit.

It's enough that this racks up waste and cost in the system. In fact this does actually does harm!

Shame on the oncologists that support this...but then again, since when is oncology evidence-based? There's money to be made!

Flu Shots and Autism? Dumb Asses.

People are so frickin' stupid sometimes.

The CDC recommends flu shots for all kids now.

This story says that parents disagree.

The reasons are bullshit, by the way. Let me clear this up:

• Vaccination does not cause autism (and "Dr. Bryan Jepsen" can't be a real physician--nor an autism expert--base on his suggestion--quackery in mainstream media).
• The vaccination isn't just about protecting kids (the pediatrician interviewed doesn't seem to get this fact either)--it's about preventing it from spreading to the high-risk groups (the elderly, those with chronic diseases, the immunocompromised, etc.) for whom it really is deadly on a wide-scale basis. A great example of selfishness ("it's all about me") in our society.

10 Out of 10 Pain?

10 out of 10 pain apparently means different things to different people.

Suckered by the "Popes of Cardiology"--LDL is Bullshit?

Have we been suckered by the "Popes of Cardiology" (who have also made a bundle of cash in the process)?

Could it really be true that LDL cholesterol is bullshit? That LDL values should be ignored?

I just read two kick-ass posts from Maggie Mahar at Health Beat.

Check out The Cholesterol Con Part I and Part II.

Skin Color is Often the Most Important Predictor of Survival

RWJF on Thursday released a report that looked at how education, income, race and ethnicity play a role in health. Findings include:

• Blacks are more likely than whites to die from many health conditions, such as diabetes, heart disease and cancer (Hille, Washington Examiner, 2/29);
• Residents who have not graduated from high school are more than four times as likely to have poor or fair health than college graduates;
• College graduates on average live five years longer than residents who do not graduate from high school;
• Higher-income residents on average live two years longer than middle-income individuals; and
• About one in three lower-income residents has a chronic disease, compared with about one in 10 higher-income residents.

Google Health and Cleveland Clinic--Hell Yeah!

Google and Cleveland Clinic are teaming up to create a personal health record (PHR) quicker than anyone else could hope.

PHR's from our perspective are very important.  The fact they are patient-centric is huge.  The fact that they are portable and can be viewed outside of the walls of just one clinic is extremely valuable, and ultimately saves lives by reducing the likelihood for medical error.

(If you live in Cleveland and, by chance, are somehow rendered unconscious and taken to an ER in Lincoln, Nebraska, the fact that the physician can access your information completely dramatically increases the likelihood that you'll survive.)

We've had the technology to do this for a long time, but so many people haven't had the balls to move forward.  These companies have been fearful of the potential problems associated with HIPAA, and have either chosen to rack up legal fees in the process of creating a watered-down version of their initial idea, or have abandoned the idea completely.

Google has balls.  And although I didn't realize it, Cleveland Clinic seems to have balls too.

I like it.  

HIPAA hasn't been tested in this fashion.  When a law is created, it's also important to test the legislation based on real-world scenarios.

Do something remarkable, and worry about the impact later.  This is an idea that kicks ass, that is revolutionary, and that is in the best interest of all of us.

Privacy is important, but not to the degree that people get hurt.

More commentary on The Health Care Blog...

Tying Pharma Rep Income to Outcomes?

Could it actually happen that pharmaceutical rep income will one day be tied to patient outcomes or health status within a territory?

More Cardiac Arrest Deaths at Night & Weekends

You are 18% less likely to survive a cardiac arrest in a hospital if it occurs on a night or a weekend. Huh.

I'll make sure I don't.

Health Care Competiton in The Simpsons

So, I started this post just looking for a picture of my hero, Dr. Nick Riviera.

But in the process, I found and learned so much more.

In an insightful piece published in the Canadian Medical Association Journal in 1998, two physicians analyze the medical care received by Homer J. Simpson and his family.

Which is the better physician, in terms of balancing cost and quality, Nick Riviera, or Dr. Julius Hibbert?

Oh, who the fuck am I kidding?! I don't care. Dr. Nick kicks ass.

Read the CMAJ article comparing these two physicians for the Simpson family here.

Happy Ending to OHRP Checklist Story

The "....ragtag band of committed clinicians and other quality improvers..." has made a difference in changing policy in the OHRP regarding the use of checklists....says Bob Wachter.


Blog on.

Raise hell.

Do something.