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Standardizing claims can save billions of dollars

MedPage Today

Health Policy

May 25, 2010

by Joyce Frieden

A standardized claim form and a single set of submission and payment rules for all health plans could save the U.S. healthcare system $7 billion annually, a study has found.

“Although not all costs of excessive administrative complexity have been captured in our study, both real costs in billing operations and opportunity costs in physicians’ practices are significant,” Bonnie B. Blanchfield, ScD, of Massachusetts General Hospital in Boston, and …

Rental housing can worsen your health

Erin Marcus, MD

Conditions and Diseases

May 25, 2010

Whenever I diagnose a person with asthma or allergies, I usually ask a few questions about his or her living environment. Is there shag carpeting in the bedroom? Is the air conditioning filter changed every month? Is there evidence of roaches and other vermin? I ask these questions because mold, dust mites, animal saliva and insect droppings can worsen the symptoms of asthma and other illnesses.

But some of my patients …

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Rental housing can worsen your health

When will cost effectiveness ever be acceptable in US healthcare?

David Williams

Health Policy

May 24, 2010

Cancer. The Big C. No one wants money to stand in the way of curing a patient.

But real life is messier. Many new treatments for cancer are pricey yet provide only marginal gains over existing therapies in life expectancy and/or quality of life. Forty thousand dollars for a cure is not a real dilemma for policymakers — the same spend for an extra six weeks of life is another story.

In …

Voluntary simplicity can ease the stress of American life

Aldebra Schroll, MD

Patient

May 24, 2010

Who hasn’t heard the story of a friend or acquaintance who retires only to become seriously ill or die soon after?

Are we working ourselves to death? For anyone who has ever wondered “is this worth it?” a move is afoot to question the concept of the American work ethic. We are currently the most overworked society on the globe. The United States has surpassed Japan as the nation with the …

Definition of health includes social well-being

Emily P. Walker

Physician

May 24, 2010

by Emily P. Walker

I was covering an FDA tobacco meeting a while back when I heard a Howard Koh, MD, assistant secretary of health at the Department of Health and Human Services (HHS) start his speech with the World Health Organization’s definition of health.

“Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or …

Failing to prevent disease in patients costs lives

Shantanu Nundy, MD

Physician

May 24, 2010

An excerpt from Stay Healthy At Every Age: What Your Doctor Wants You to Know.

When you were growing up, somebody probably told you that “an ounce of prevention is worth a pound of cure.”

Many of us have learned from experience how much better it is to prevent a bad thing from happening than to try to fix the consequences once it has happened. Most people can agree that prevention …

Legalizing marijuana, an opinion from a former JAMA editor

George Lundberg, MD

Medications

May 23, 2010

While I was still the editor of JAMA, I was in Boston in January, 1997, to do my regular teaching at Harvard. I dropped in to see my friend Jerry Kassirer, the editor of the New England Journal of Medicine. Little did I know that Jerry was in the midst of a firestorm of protest for his just-published editorial called “Federal Foolishness and Marijuana.” Jerry told me that he received …

Evidence based medicine at the expense of the art of medicine

Hans Duvefelt, MD

Physician

May 23, 2010

Health care in the United States is struggling to redefine itself. We have been spending twice what other countries spend on health care, yet our citizens are less healthy. We now have legislation to create more or less universal insurance coverage, and we are about to embark on a technology-driven quest for quality and uniformity. At the same time, Americans are increasingly turning to alternative health care practitioners, mostly at …

Radiation and whether cell phone towers are dangerous

Roy Benaroch, MD

Conditions and Diseases

May 22, 2010

Radiation. Powerful enough to turn Dr. Bruce Banner (Bill Bixby) into The Incredible Hulk (Lou Ferrigno), or meek Peter Parker (Tobey Maguire) into The Amazing Spider-Man (still Tobey Maguire, but more buff and spandexed). It also obliterated two cities in Japan, and continues to contribute to cancers near Chernobyl. It’s sciency, strong, and scary. No wonder it creates so much apprehension.

We’re all living every day surrounded by radiation sources, and …

Medical imaging is increasing in cancer patients

Kristina Fiore

Conditions and Diseases

May 22, 2010

by Kristina Fiore

Medical imaging for cancer patients and resulting costs have increased over the last decade, particularly in positron emission tomography (PET), researchers have found.

Annually, use of the diagnostic screen rose significantly between 1999 and 2006 — ranging from 36% in lung cancer to 54% in breast cancer, Kevin A. Schulman, MD, of Duke University, and colleagues reported in the April 29 Journal of the American Medical Association.

Imaging costs also …

Joint Commission hospital inspections have improved

Robert Wachter, MD

Physician

May 22, 2010

Until about 8 years ago, inspections by the Joint Commission (TJC) were predictable and fairly silly.

Hospitals were given a couple of years’ notice of the week that “The Joint” would be visiting. Everybody scurried around preparing – waxing the floors, locking up all the medications, that sort of thing. (It always struck me as the most dangerous day to be in the hospital, since nobody could find any of the …

Chronic migraines changed this patient’s life

Diana E. Lee

Patient

May 21, 2010

by Diana E. Lee

When I start to think about all the things I want to do, I end up feeling like my life is on hold, waiting for some miracle to come along and make me better. There was a time when I believed I would get better. Now I’m not so sure.

I was just getting started in my career in 2003 when my migraines exploded from periodic to chronic. …

Allergy drug recommendations for patients on a budget

Leslie Ramirez, MD

Conditions and Diseases

May 21, 2010

Ahhh spring.

The lovely blooms unfurling. The trees budding.

It’s enough to make a girl get tears in her eyes.

And sneezes in her nose.

And itching on her face.

Yes, it’s allergy season again — but what can you do to make yourself more comfortable without emptying your wallet?

1. Avoidance. Close the windows. Make someone else cut the grass. Stay inside. (Yes, I hate this one too- let’s move on.)

2. Neti pot or other nasal saline rinsing. LOVE …

Ethics of futile care

Jeffrey Hall Dobken, MD, MPH

Physician

May 21, 2010

The bioethics community has been working on defining the concept of medically futile care for more than a quarter of a century, yet the debate continues. The way in which the current notion of medical futility becomes folded into the proposed healthcare reform bills is at a critical point.

Sophisticated medical technology that is at once life-saving, life-prolonging as well as death-prolonging has created populations which, in the past, would have …

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Ethics of futile care

Patients with dementia and when they should stop driving

William R. Yates, MD

Conditions and Diseases

May 20, 2010

A common clinical problem in aging is when should driving a motor vehicle be discontinued. When does driving become a significant safety hazard as cognition and motor skills decline?

The American Academy of Neurology recently published a Practice Parameter update: Evaluation and management of driving risk in dementia. This important review provides clinicians and family members with assistance in making an accurate and timely decision.

The authors of the guideline review research …

Father of a patient with a sudden brain hemorrhage

StorytellERdoc, MD

Conditions and Diseases

May 20, 2010

She was 50. Prior to being transported to our ER, her only complaint had been for non-traumatic elbow pain over the past two weeks. She was on no medications and had no significant medical history.

She was at home, preparing to visit her doctor for a scheduled visit, when she collapsed. Because she didn’t drive, her elderly father had planned on swinging by to pick her up. He had just called …

Diabetes prevention can be led by health insurance companies

David B. Nash, MD, MBA

Conditions and Diseases

May 20, 2010

Whether I’m wearing my health policy hat or seeing patients in the office, one condition continues to surface as a source of concern and frustration.

Diabetes, one of the nation’s most serious and costly health burdens, now affects almost 25 million people in this country — a conservative estimate. Another million new cases are diagnosed each year.

Three years ago, the American Diabetes Association estimated the total diabetes cost in the U.S. …

Ritalin and Adderall to improve college grades

Edward Pullen, MD

Medications

May 19, 2010

I watched 60 Minutes on CBS recently, and was surprised to hear how many college students are using stimulants like methylphenidate (Ritalin) and amphetamine/dextroamphetamine (Adderall) to get better grades.

These drugs are amphetamines, and Schedule 2 drugs that require a written prescription, cannot be faxed or called into pharmacies, and are considered to have high abuse and addiction potential by the FDA. They have the same type of effect on the …

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