In today’s Dose:
Health care reform
(Gawande radio interview; Public option)
Health news
(Bayer and prostate cancer)
Obesity politics
(Michelle Obama)
Social networking technology
(Doctors on Twitter and email)
Health care reform
- National Public Radio has an interview with Atul Gawande about his recent New Yorker article. It’s 30 minutes and covers much the same material as the article. At the end, the interviewer asks Gawande what it was like to learn that Obama and his staff were reading and discussing the article. His reply:
Completely shocking. This is the dream you have, that anything you write is absorbed by the people who affect your life. And right now the folks in Washington are deeply important to us as patients and as clinicians, and so it felt like a victory. At the same time I also knew that the brickbats would come and I had better suit up.
(Thanks, Joanne, for the heads up.)
- More on the fate of the public option: Marie Cocco on AlterNet, “Warning: Health Care Lobbyists Are Winning the Battle to Screw All of Us,” and Digby on Hullabaloo, “But I Thought Tom Daschle Was So Crucial To Real Health Care Reform.”
From Cocco:
Advocates of a single, national insurance system that would involve explicit cost controls and guidelines for care — that might put an end to such wasteful practices as over-testing — have been shunted aside. This is in part because Democrats quiver when Republicans call them “socialists.” But Republicans cry “socialist” even when Democrats promote weak reforms that barely nick the vested interests. That’s what’s happening now. No one has seriously proposed an overhaul that would achieve what a single-payer system has been shown to accomplish in most other countries: universal coverage with lower costs that delivers better results than we now get in the United States.
From Digby:
Financing was always going to be a problem. … [W]atching Baucus run for cover, watching Daschle do the old el foldo, I’m seriously pessimistic that anything out of Washington will meet the expectations of anyone in the country.
Health news
- The Center for Science in the Public Interest (CSPI) has threatened to sue Bayer over its vitamin product One A Day Men’s 50+ Advantage, which contains selenium, zinc, vitamin E, and lycopene. The product is promoted as preventing prostate cancer. According to CSPI, “Bayer is exploiting men’s fear of prostate cancer just to sell more pills.” Here’s a blog post from Tom Barlow at WalletPop, and here’s the CSPI letter to Bayer (PDF). It includes the following:
The attached FTC complaint discusses the research in detail, but, in summary, the research does not substantiate Bayer’s cancer claims – and in fact shows that the amount of selenium in the Men’s Multis may be harmful. …
More importantly, analysis of the NPC [Nutritional Prevention of Cancer] data found nearly a three-fold increased risk of diabetes in the men who were assigned to take selenium and who had the highest levels of blood selenium at the start of the trial.
Obesity politics
- Video of Michelle Obama’s
talk to the fifth-graders who helped work in her garden (12.5 minutes). She repeats the clichés that support the idea of an obesity epidemic, but, to her credit, she never mentions losing weight. She emphasizes nutritious food and exercise and access to healthy food in poor neighborhoods. She’s also good at talking to kids, which is sweet.
Social networking technology
- A New York Times piece by Dr. Pauline Chen on whether doctors and patients should twitter.
“On the one hand it is really good to see the human side of your doctor on a site like Facebook,” observed Dr. Daniel Sands …. “On the other hand, … maybe letting your patient get too close isn’t always good for the therapeutic relationship.” …
Taking on the responsibilities of yet another form of communication can also be onerous for physicians, many of whom already feel overburdened by multiple demands on their time. “Physicians are really busy,” Dr. Sands said. “In our current health care environment, the only commodity they have is time. Doctors don’t want to introduce new technologies of unknown value, which is why many were hesitant about e-mail. Something like Twitter is going to take longer to accept because the value proposition is even hazier.” …
“With social media,” Dr. Sands observed, “we can aggregate across space and across the world and create a safe environment for support. Although there may be only 10 people in greater New York with a certain disease, there may be 250 people across the world.” Dr. Sands recalled guiding a patient to the Association of Cancer Online Resources, a social network of online communities for patients and families. “That was the most important advice I ever gave him. It was an information prescription.”
There are many pages of comments on this article at Tara Parker-Pope’s blog, Well.
- Here’s an excerpt
from a 1998 article in The Journal of the American Medical Informatics Association on guidelines for doctors using email with patients.
Providers should use discretion in their outgoing message titles. Patients may have fewer safeguards on their desktops than they need for their own privacy. “About Your HIV Test” is not an acceptable subject header. …
Irony, sarcasm, and harsh criticism should not be attempted in e-mail messages. The impersonal nature and ambiguity of e-mail often results in real or imagined exaggeration of animosity toward the recipient. Providers must realize that sick, anxious, or angry patients might indeed express stronger sentiments with e-mail than they would face-to-face or over the phone. Clinicians should make an effort to restrain their language despite their own stress and fatigue.
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