Health Medicine comes with a smile

Laboratory Outreach Solution

laboratoryGrow your laboratory outreach business by giving easy and accurate purchase entry and result shipping portal at client sites and remote industry offices. Live life eligibility and medical requirement checking to decrease payment denials. Nearby label and barcode publishing for automation. Local ensure that you ICD-9 / ICD-10 program code listing to adhere to government regulations. Lookup of entered orders and individual demographics and billing information previously, and also direct population of the data into fresh orders to increase data entry. Allows customers to order proper and billable tests.
Features and Benefits
·    Easily accessible from anyplace on any computer
·    Integrated with Documen Imaging module permitting customers to scan or see documents remotely
·    Live Eligibility Checking
·    Custom Customer Panels Acknowledgement and Maintenance
·    Local test program code & ICD-9 / ICD-10 Integration
·    Insurance & Patient Information Lookup (Population)
·    Admit Discharge Move (ADT) Support
·    Customizable Ask at Purchase Entry fields
·    Shipping Manifest / Log Publishing / Courier Tracking
·    One group of physician tables, individual lists, and test requirements
·    Real-time test status keep track of and result delivery
·    Screen requisitions could be created to mimic the papers requisitions in the client's office
·    Ability to customize search for each client's workplace or by physician specialty (e.g. OB/GYN, Oncology)
·    Uniquely determine specimens by publishing barcoded labels during (remote) order entry
·    Automatic check routing for multisite laboratories
·    Integrated faxing allowing customers to utilize centralized faxing appliance to distrube reports
·    Medical Requirement Checking (with automated ABN type determination and printing)
·    Front-finish compliance looking at with instantaneous ABN generation
·    Robust validation, logic and rules motor to streamline order access process
Advantages to Clinics and Physicians
·    Low-cost, easy-to-use answer for the physician's office
·    Easy new patient set up, quick and efficient purchase entry
·    Customizable displays to mimic requisitions presently in place
·    ABN forms could be printed to nearby printers or created within an electronic format for electronic storage
·    HIPAA enabled with several security controls

Divorce Tips: Stay Healthy During Divorce

Copy Your Records
Before your divorce concerns, make sure to create copies of all of one's financial records.  Maintain them in a safe location away from your partner.  These information include, but aren't limited by, personal and business tax returns (last 3 years), business records, accounts statements from investment companies, banks, and pension workplaces, spend stubs, life insurance coverage information, annuities, charge card statements, share certificates, and receipts for sale of larger items.  Duplicate anything to which you may need to refer.  Obtaining copies of information via the discovery procedure within the midst of a divorce is a lot more difficult and may be expensive.
Obtain Copies of Credit score Applications
Obtain copies of any mortgage or credit applications from your own bank or creditors, particularly people with been completed 12 months to your separation prior.  If the application form was joint, it'll list assets then, liabilities, and earnings for both spouses.  Those trying to get loans or credit have a tendency to list all feasible assets and income to be able to qualify for the credit score.  As a total result, this may be an excellent way to obtain asset discovery when one partner believes that another is withholding home elevators marital property.
Identity Check
Verifying accurate personal, monetary, and company information is crucial to keeping your identity.  It is critical to check information reporting solutions, such as for example credit agencies, and also investment/insurance and banks companies, to make sure that your name, tackle, along with other private information are correct.  Search engines yourself!  Discover what info, if any, about you will be on the Web.  The Webmaster can be contacted by you for sites where you discover inaccurate information.  Contact your local postoffice and utilities once you or your (ex) partner intend to move to give a forwarding address also to make sure that you continue steadily to receive your mail.
Marital Debt
Debts which were obtained inside the title of both spouses before a new divorce (meaning both couple signed a document or even application saying they were responsible for your debt) remain the obligations of both events after a divorce, regardless of what a separation and divorce decree says.  Creditors aren't celebration to your separation or house settlement agreement.  Consequently, if your ex-spouse will not pay a personal debt that he / she was accountable for in accordance with your divorce decree, you then are responsible for your debt.
Cancel "Joint" Credit lines
If your divorce settlement helps make your ex-spouse in charge of the transaction of a debt that has been jointly incurred, continue steadily to keep track of the account to make sure that obligations are made regularly. If your ex-spouse will be past due or defaults on a transaction, it could adversely affect your credit score.
Understand Your Social Protection Advantages (U.S. Rule)
When you have been married a decade or more, you may be eligible for 1 / 2 of your spouse’s benefit or 100% of one's accrued benefit, whichever is greater. This will not impact your partner’s benefit at all, therefore it is not just a negotiation stage in a divorce.
Adhere to the 5 Ds for Alimony Deductibility (U.S. Rule)
If you prefer a deduction for the alimony you pay out (it'll be taxed to your ex partner), it should be paid in bucks, under a decree or written agreement, and cease on your own ex's death. Following the separation and divorce you must sustain your range (you can't live together with your ex), and the obligations can not be designated as nontaxable or child support.
MAKE SURE YOUR Income shall Continue
In case you are receiving kid or spousal support, be certain there is disability insurance coverage and you also own a life insurance coverage on your own soon-to-be-ex spouse.  These policies would make sure that the income you will need proceeds if your ex will be disabled or dies.  You need to own the life span insurance and pay out the premiums.  You might be in a position to negotiate a rise in support to cover the premiums.  Don’t rely on your ex partner or their company to safeguard your interests.  Be certain your ex partner applies for and will be issued coverage prior to the divorce is final.

Overview of Environmental Allergies

In case you have environmental allergies, you might find yourself sniffling, sneezing, coughing, or itching - and it’s your environment which are causing the issue. Thankfully, you’re not really doomed to times of misery. The key would be to avoid or get rid of airborne allergens, which can only help you obtain back again to feeling your very best. Here are usually six of the very most common environmental allergies.
Pollen
allergyPollen, the airborne allergen right behind hay fever, is among the most typical allergy triggers, in fact it is very hard to avoid. Many pollen allergy symptoms could be handled with avoidance steps. But it’s difficult in order to avoid outside allergy triggers like tree pollen or weed pollen, - if you don't want to reside in a bubble or on the moon!
Most people will get relief with over-the-counter or even prescription medication. You may use a nasal steroid for sneezing and itching or an antihistamine for occasional post-nasal drainage or itchy eye. Ultimately, if your asthma and allergies are poor enough, it is possible to explore the choice of traditional allergy photos, that may rid you of nagging symptoms for good allergy.
Dust Mites
Though pollen allergy will probably attack when you’re outside, being allergic to dust mites puts you vulnerable to experiencing environmental allergies indoors, including in your house. Dust mites are usually microscopic creatures which are within everyone’s mattresses, pillows, upholstered couches, and carpets. They're not bed bugs plus they do not bite. Nevertheless, in case you are allergic to them, they are able to cause significant problems with nasal congestion, sinus attacks, headaches, and problems sleeping. Dust mites feed off dead human skin really, so they are located in high volumes we have a tendency to shed dead skin anywhere, such as for example pillows and mattresses.
Pets and Animals
You don’t necessarily need to part with your dog in order to decrease your contact with this environmental allergen. If animals could be made outdoor animals, then this can diminish your contact with pet dander. Bathing pets weekly will certainly reduce shedding and lower your contact with pollens, like grass, embedded in the animal’s fur. Allergens may also be found in your dog’s saliva and urine, so be sure to minimize your contact with the cat kitty litter box.

Health Tips: Treatment for Ants, Centipedes, Millipedes

bed_bugCentipedes, millipedes, sowbugs, and pillbugs are usually arthropods (not bugs), although they do benefit from the same living problems as bugs. These creatures aren't harmful. They're unattractive and regarded as a nuisance merely, when found indoors especially.
Sowbugs and pillbugs
Sowbugs and pillbugs are usually significantly less than 2 cm long and so are usually black to slate gray. They're armadillo-like and participate in the same course of creatures as lobsters and shrimps. These tiny property crustaceans need moist problems to survive, and prefer to live under particles or rocks where they prey on decaying organic matter. They often die quickly as soon as inside homes because dampness levels aren't high sufficient for them.
Millipedes and centipedes
Wormlike centipedes and millipedes both have many entire body sections and several legs. However, the centipede includes a more flattened entire body and only one couple of legs per area, while the millipede's entire body is rounded at the top with two pairs of hip and legs per section. Also, the centipede 's hip and legs are longer, and can quickly move more. When disturbed, millipedes have a tendency to coil up, but centipedes run for the closest dark hiding place swiftly.
Centipedes are a competent method of controlling other bugs in your house.They prefer to eat spiders, bed bugs, cockroaches, silverfish, carpeting beetles, or ants. Millipedes, however, do not survive as soon as in the home since it is too dried out for them.
Should I get worried?
Although all centipedes have poison glands that open up through their jaws, almost all house centipedes cannot penetrate human skin with a bite. Nevertheless, the few that may will give an impact similar to a moderate bee sting, with signs and symptoms disappearing inside a few hours generally. The home centipede's bite won't cause any serious injury to pets like cats and dogs.
Sowbugs and pillbugs can enter damp regions of your house in good sized quantities sometimes. However, they don't bite, sting, or transmit illnesses, plus they don't infest food, clothes, or wood.
Sowbugs, pillbugs, and millipedes breakdown organic matter, releasing nutrition to garden vegetation. Centipedes help control some other bugs. For these reasons, this combined group can be viewed as beneficial and really should be tolerated whenever you can.
A new persistent infestation of sowbugs, pillbugs, or millipedes indoors might indicate a significant moisture problem inside your home, and the current presence of a food source such as rotting wood.
How can I eliminate them?
·Make sure the bottom slopes aside from your house in order to avoid drinking water and moisture retention close to the building foundation.
·Get rid of leaf litter and decaying vegetation round the foundation of your house. Other items providing hiding locations on the floor (like stones, boards, or boxes) ought to be moved away as well.
·Use coarse (rather than good) mulches that allow drinking water to drain.
·Foundation plantings ought to be pruned and cleaned to boost ventilation around your house.
·Allow the soil to dried out between waterings.
·Repair cracks in basis walls or about windows prior to the fall.
·Indoors, work with a dehumidifier or perhaps a small electric lover to dry damp areas inside the basement.
Chemical products
Changing the particular habitat of the creatures outside your house should reduce their figures. If these efforts usually do not handle them sufficiently, you may opt for a registered domestic-course pesticide product (that you can use yourself). Note that utilizing a pesticide indoors to regulate millipedes, sowbugs, or pillbugs isn't recommended because they will quickly die from dehydration as soon as indoors.
·Diatomaceous earth, a dynamic ingredient within many domestic pesticides, can be an ecological method of control. It is a good powder created from crushed microscopic marine fossils. As insects crawl on the powder, their external "pores and skin" is scratched, leading to them to dehydrate and die. Diatomaceous earth shall remain active so long as it really is kept dry. It is nontoxic to humans and animals, but take care not to inhale the dirt when applying the product. This powder may be used in crevices and cracks being an ongoing control measure.

Institute for Health Technology Transformation Announces Health IT Summit in Denver July 24-25

The iHT2 Health IT Summit in Denver, will bring together C-level, physician, practice management, and IT decision-makers from North America’s leading provider organizations and physician practices. For two full days, executives interact with a national audience of peers, national leaders and solutions providers featuring the latest solutions for practice management, mobility, telemedicine, outsourcing, IT infrastructure, next-generation electronic medical records, disease management, and more.

The Summit will feature keynote presentations from Peter Fine, FACHE, President & CEO, Banner Health, and Bernard Harris, Jr., MD, MBA, President & CEO, Vesalius Ventures, and President, American Telemedicine Association.

Featured Speakers include: Dana Moore, SVP & CIO, Centura Health; Gregory Veltri, CIO, Denver Health; Russell Leftwich, MD, CMIO, Tennessee Office of eHealth Initiatives; Neal Ganguly, VP & CIO, CentraState Healthcare System; Andrew Steele, MD, MPH, Director, Medical Informatics, Denver Health; Jonathan Gold, MD, MHA, MSc, Regional CMIO, Catholic Health Initiatives; Charles Doarn, MBA, Research Professor and Director, Telemedicine & e-Health Program, University of Cincinnati; Mark Caron, SVP & CIO, Capital BlueCross, and many more.

Panel Discussions for the Health IT Summit in Denver include: Accountable Care Organizations: Taking on Risk & Identifying Critical Tools, Leveraging Data to Improve Outcomes & Safety, Preparing for 2013: Organizational Strategies for the Transition to ICD-10, Breach Avoidance: Strategies to Protect Patient Data, HIE Performance: Defining Your Objectives & Measuring Progress, Meaningful Use Stage 2: Reaching the Next Stages of Quality & Care, and Mobile Health: Leveraging Data at the Point of Care.

The full agenda can be viewed by visiting: http://ihealthtran.com/2012denveragenda.html

Sponsors and Partners include: ICA, Quantix, Extract Systems, SLI Global Solutions, Nuance, Comcast, Altus, Rubbermaid Healthcare, VMware, Healthcare IT News, CMIO, FierceHealthIT, ADVANCE, NASCIO, AMDIS, eHealth SmartBrief, Frost & Sullivan, IDC Health Insights, Mobile Healthcare Today, SearchHealthIT.com, and more.

Institute for Health Technology Transformation Appoints New Health IT Leaders to Advisory Board

The Institute for Health Technology Transformation (iHT²) announced ten new members to their Advisory Board this week. These members represent some of the brightest minds in healthcare information technology, and they will work to provide thought leadership and valuable industry connections to expand and improve the quality of the Institute’s initiatives throughout the year.

The Institute’s Advisory Board is a group of health care thought leaders representing the diverse stakeholders involved in the integration of health information technology. This esteemed group provides iHT² with insight and guidance throughout the year on how it can better serve the health care industry in their goal of fostering the adoption and implementation of health IT.

“Members of the iHT² Advisory Board greatly enhance our ability to offer health IT leaders superior educational and collaborative opportunities,” said Barry P. Chaiken, MD, MPH, Senior Fellow & Health IT Chair, Institute for Health Technology Transformation, CMO, DocsNetwork & former HIMSS Chair. “The insight provided by these distinguished professionals allows iHT² to keep pace with developing trends in healthcare, and offer conferences, webinars and publications that satisfy the needs of a wide range of industry professionals.”

The new members join a board of over twenty health IT leaders representing organizations throughout the country including: Kaiser Permanente, Catholic Health Initiatives, Capital BlueCross, Visiting Nurse Service of New York, Delaware Health Information Network, and more.

The newly appointed members are:

  •     Samantha Burch, VP, Quality & Health IT, Federation of American Hospitals
  •     Mary Carroll Ford, MBA, VP & CIO, Lakeland Regional Medical Center
  •     Dick Gibson, MD, Chief Health Intelligence Officer, Providence Health & Services
  •     Fred Galusha. CIO & COO, Inland Northwest Health Services
  •     Chris Jaeger, MD, VP, Medical Informatics, Sutter Health
  •     Elizabeth Johnson, SVP, Applied Clinical Informatics, Tenet Healthcare
  •     Bill Phillips, CIO, University Healthcare System
  •     Justin Graham, CMIO, NorthBay Healthcare
  •     Andy Steele, MD, Medical Director, Informatics, Denver Health
  •     Doris Crain, CIO, Broward Health
  •     John Santangelo, Director of IT, Cleveland Clinic Florida

“The Advisory Board contributes invaluable industry insight that results in some of the most comprehensive, intimate, and informative programs taking place year after year,” said Waco Hoover, CEO, Institute for Health Technology Transformation. “The accomplishments and dedication of the Advisory Board is what truly separates the Institute apart from other organizations.”

Intermountain Healthcare, Partners Healthcare System, and Kaiser Permanente to Deliver Keynote Presentations at the Health IT Summit in San Francisco

The Institute for Health Technology Transformation announced the keynote presenters for the Health IT Summit in San Francisco, which will take place March 27-28th at the Hyatt Regency San Francisco Airport. The keynote presenters at the annual program will be Mark Probst, CIO, Intermountain Healthcare, Blackford Middleton, MD, Corporate Director of Clinical Informatics Research & Development, Partners Healthcare System, and Hal Wolf, SVP & COO, The Permanente Federation, Kaiser Permanente.

The iHT2 Health IT Summit, will bring together C-level, physician, practice management, and IT decision-makers from North America’s leading provider organizations and physician practices. For two full days, executives interact with a national audience of peers, national leaders and solutions providers featuring the latest solutions for practice management, mobility, telemedicine, outsourcing, IT infrastructure, next-generation electronic medical records, disease management, and more.

“We are dedicated to continuous improvement that enhances patient care. I look forward to learning from health care leaders and sharing our experience in improving outcomes by putting advanced health IT in the hands of clinicians, care teams, and patients,” said Hal Wolf, Senior Vice President and Chief Operating Officer of The Permanente Federation, Kaiser Permanente.

Panel discussions for the Health IT Summit in San Francisco include: Accounting for Assumptions: Taking a deeper look at reforming our healthcare delivery system, HIE & HIX: The convergence of healthcare information, Securing Electronic Personal Health Information (ePHI): From the Data Warehouse to the Point of Care, Analytics in Healthcare: Improving Outcomes Through Data Management, The Cloud in Healthcare, Stage 2 Meaningful Use: Leveraging Technology to Improve Outcomes & Efficiency, Patient Management Without Walls: Enabling mHealth and Telemedicine, and more.

“Healthcare I.S. leadership is consumed with the demands of ARRA HITECH (meaningful use), ICD-10 (maybe we are going to get some relief) and a barrage of requests to meet the demands of a changing healthcare landscape,” said Mark Probst. “I believe that even though the demands are great – as I.S. leaders, we must not simply follow and adopt aging solutions, rather we have the responsibility to innovate.”

Sponsors and Partners include: ICA, InnerWireless, CloudPrime, Accellion, ICW, SLI Global Solutions, VMware, athenahealth, Comcast, InterSystems, LANDesk Software, Pano Logic, Aventura, Key Info, AUXILIO, Somansa Technologies, Inc., Salesforce.com, EMC2, AMDIS, The California Association of Healthcare Leaders (CAHL), California Association of Public Hospitals and Health Systems (CAPH), CMIO, DOTmed, eHealth SmartBrief, Executive Insight, Frost & Sullivan, Healthcare IT News, IDC Health Insights, MarketsandMarkets, NASCIO, ReportsandReports, SearchHealthIT.com, and more.

Health Care Thought Leaders Release Research Report Finding Automation Is Key to Population Health Management

The Institute for Health Technology Transformationtoday released findings from an Automating Population Health Research Project, which seeks to educate the healthcare industry on how best to apply technology in meeting the challenges of population health management.

Prepared in consultation with a broad range of industry experts, the Population Health Management: A Roadmap for Provider-Based Automation in a New Era of Healthcare report finds that population health management requires healthcare providers to develop new skill sets and new infrastructures for delivering care. To make the transition from fee-for-service reimbursement to accountable care, which depends on the ability to improve population health, providers will need to automate many routine tasks, ranging from identification of care gaps and risk stratification to patient engagement, care management, and outcomes measurement.

“In the era of healthcare reform, provider organizations must change their traditional approach and embrace new ways of thinking about their mission,” said Waco Hoover, CEO of the Institute for Health Technology Transformation. “They must not only care for the sick, but also strive to keep their patient populations healthy. Information technology is the key to doing this cost efficiently, and automation can enable care teams to identify and work with the patients who truly need their help.”

Report coauthor Paul Grundy, MD, Global Director of Healthcare Transformation for IBM, and President of Patient-Centered Primary Care Collaborative, commented, “Patient-centered medical homes based on primary care are the building blocks of accountable care, and information technology is the key to successful medical homes. With the help of registries, electronic health records, health information exchanges, and other tools for care coordination and automation, healthcare providers can manage their populations effectively and keep their patients as healthy as possible.”

Andy Steele, MD, MPH, Director of Medical Informatics at Denver Health, and another of the report’s contributing authors, said, “Given potential health care reform and efforts to increase quality and efficiency of care in the setting of persistent fiscal limitations, the importance of leveraging information technology and focusing on population health management has become a top priority for many health care institutions. Our goal for the project is to provide resources that health care providers can utilize as they are considering and implementing population health management initiatives.”

Richard Hodach, MD, MPH, PhD, Chief Medical Officer of Phytel and chair of the report’s research committee, commented, “This important new report underscores the message that Phytel has been spreading among physician groups for the past several years. By using technology to identify subpopulations and patients who are at risk, to reach out to those patients, and to automate care management, healthcare providers can provide optimal preventive and chronic care to their patient populations. Providers can also use technology to engage patients in their own care, which is the real key to lowering costs and improving population health. We are proud of our participation in this project, and we hope that the report will be helpful to providers who plan to move in this direction.”

Among the healthcare thought leaders who contributed to the Automating Population Health Research Project are Alide Chase, MS, Senior Vice President for Quality and Service, Kaiser Permanente; Robert Fortini, Vice President and Chief Clinical Officer, Bon Secours Health System; Connie White Delaney, PhD, RN, School of Nursing Professor & Dean, Academic Health Center Director, Associate Director of Biomedical Health Informatics, and Acting Director of the Institute for Health Informatics, University of Minnesota; Richard Hodach, MD, MPH, PhD, Chief Medical Officer, Phytel; Paul Grundy, MD, MPH, Global Director of Healthcare Transformation, IBM; Margaret O’Kane, President, National Committee for Quality Assurance; Andy Steele, MD, MPH, Director of Medical Informatics, Denver Health; and Dan Fetterolf, Principal, Fetterolf Healthcare Consulting.

Institute for Health Technology Transformation Appoints Jay Srini Senior Fellow & Innovation Chair

The Institute for Health Technology Transformation announced today that Jay Srini, Chief Strategist at SCS Ventures has been appointed Senior Fellow & Innovation Chair for the Institute’s 2012 series of educational programs and meetings.

Jay Srini is an internationally recognized thought leader on national and international trends that are changing the face of healthcare. In her current role at SCS Ventures, Jay works with startup companies internationally to help them with their business development, technology strategy, and expansion. She also advises established companies on their strategies to enter and grow their healthcare vertical.

“We’re thrilled to work with Jay in a concerted effort to move our health system forward with programs that foster the more innovative use of information technology,” said Waco Hoover, the Institute’s CEO. “Jay has a wealth of industry expertise that will make a meaningful and lasting impact on programs and initiatives developed at the Institute.”

In Jay Srini’s role as Senior Fellow and Innovation Chair she will work with the Institute’s Advisory Board and other industry leaders to program and develop leading educational programs and collaboration opportunities for health care leaders. In tandem with the Institute’s mission to promote the effective use of technology across the U.S. health system, Mrs. Srini will engage leaders from the community to ensure the Institute continually provides timely and relevant resources.

“We are in the midst of tectonic shifts in healthcare on all fronts ranging from new discoveries to new payment models and new stakeholders entering the healthcare sector,” said Jay Srini. “Finding innovative ways to deliver cost effective patient centered health care has never been as important as now. Innovation is virtually impossible without collaboration! I am honored and excited to take on this new role at iHT2 to develop new programs and platforms to drive innovation in healthcare through collaboration knowledge acquisition and knowledge dissemination.”

Jay’s prior experience includes her role as Chief Innovation Officer for UPMC (University of Pittsburgh Medical Center) Insurance Services Division as well as her role as Vice President of Emerging Technologies for UPMC. Jay was Managing Director for e-Health Initiatives at Internet Venture Works where she led technology and industry assessments of opportunities presented by strategic partners, investors and external sources and served in executive management roles for its’ portfolio companies. She has served on several healthcare boards including HIMSS (himss.org), PRHI (prhi.org) and is a frequent speaker on International Healthcare forums. She serves on several HHS (Health and Human Services –hhs.gov) related advisory panels and serves in an advisory capacity to International healthcare Institutions and Venture capitalists.

Jay has a Master’s Degree in Computer Science from New York University and a Master’s Degree in Business Administration from Bucknell University and her executive education from the Kellogg School of Management at Northwestern University. She also serves as one of the commissioners at CCHIT (Certification Commission of HealthCare Information Technology) in addition to her role as adjunct faculty Assistant Professor at the University of Pittsburgh and advisory board of the School of Computer Science at Carnegie Mellon University.

 

About iHT2

The Institute for Health Technology Transformation is the leading organization committed to bringing together private and public sector leaders fostering the growth and effective use of technology across the healthcare industry. Through collaborative efforts the Institute provides programs that drive innovation, educate, and provide a critical understanding of how technology applications, solutions and devices can improve the quality, safety and efficiency of healthcare.

The Institute engages multiple stakeholders:

• Hospitals and other healthcare providers
• Clinical groups
• Academic and research institutions
• Healthcare information technology organizations
• Healthcare technology investors
• Health plans
• Consumer and patient groups
• Employers and purchasers
• Device manufacturers
• Private sector stakeholders
• Public sector stakeholders

Islands of Common Stewardship – TLC/Dartmouth/ReThink Health UCRV/Schweitzer Fellowship/RCP

VIDEO Mike Magee A little over a year ago, I made a quick trip to Washington – one day, back and forth, from Hartford, CT. I was there to seek advice from an old friend, Fitzhugh Mullins, as we completed planning for the second decade of the Rocking Chair Project. This early childhood intervention program […]

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Lessons from Ebola in the Age of Zika

Mike Magee In the run up to the Olympics, and now as they have drawn to a close, Zika has been top medical news when it comes to exotic infectious diseases. It’s story has been so compelling that the mosquito borne disease has pushed Ebola to the sidelines – an epidemic which infected  28,616 Africans […]

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Precision Medicine vs. Public Health $$$ – NIH Funding Priorities Not A New Debate.

Paul Starr, Princeton Paul Starr’s observations (The Social Transformation of American Medicine, p.370) in 1982: “In 1964 a Presidential Commission on Heart Disease, Cancer, and Stroke (the DeBakey Commission) which had been appointed at the behest of the Lasker lobby, recommended a massive commitment of federal funds to establish ‘a national network of regional centers, […]

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“Medicaid-for-all” vs. “Medicare-for-all”.

Families USA/Medicaid Expansion Mike Magee The verdict is pretty much in – increasing health coverage through whatever means possible, improves health outcomes. This is especially true for the large numbers of formerly uninsured who are now covered through Medicaid expansion plans offered through the Affordable Care Act. Healthy citizens are not only less sick (which […]

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The Medicalization of Public Health: “Precision Medicine” vs. “Precision Health”?

NIH Director Francis Collins Mike Magee Last week I was at a small, invitation only dinner in New York City, and left dejected and feeling “odd man out”. I saw the failure as mine alone – an inability to articulate succinctly, and in few enough words, my concerns about the evening’s topic: Precision Health (that’s […]

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Why Do Health Professionals and Their Schools Ignore The Planetary Patient?

Mike Magee If health is defined today as the capacity to reach one’s full human potential, our environment – including the quality and availability of water, air, soil, and plant and animal life – are critical determinants of human health. For too long health professionals have considered the planetary patient as beyond their domain. In reality, […]

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New Study Suggests Gender, Race, And Age Gap In Responsible Use Of OTC Medications

Millions of Americans use over-the-counter medicines; in fact, about 35% of Americans use OTC medications on a regular basis. A recent national survey of 2,038 U.S. adults suggests that many Americans are not in touch with the risks associated with OTC medications, and don't feel compelled to review OTC drug facts labels carefully. As I have discussed on this blog previously, excessive medication use (regardless of whether they are prescription or OTC) can be dangerous.

Some of the survey’s key findings include:

  • 2 in 5 respondents believe that OTC dosing instructions are suggestions, not directions
  • While all age groups find it important to read the label on OTCs they are taking for the first time, significantly more millennials say it is still important to read the label on OTCs they have taken before (82%), whereas only 54% of older Americans over age 70 agree
    • 75% of those over age 50 believe that it's not possible to overdose on an OTC medication
    • 25% of respondents feel it's ok to not read the drug facts label if they've taken the medicine before

On the brighter side, some consumers are doing a little better than others at taking OTC medicines as directed and these...

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Living Your Best Life, Even In The Hospital

My patient was an elderly farmer with severe vascular disease. He had advanced leg artery narrowing, had survived multiple heart attacks, and was admitted to the hospital after a large stroke. He was incredibly cheerful, vibrant, and optimistic. He had a very large, loving family who took turns attending to him, and encouraging him with each small improvement in his leg and arm strength. They knew his neurological exam better than his doctors.

I was amazed at his recovery, given the size and location of his stroke (and his advanced age), I had suspected that he would end up wheelchair bound. But he was determined to walk again and get back to his gardening as soon as possible. His children told me that he was very stubborn and was a true "fighter." As their patriarch, he carefully questioned each of them about their goings on, making sure that they were each on track with grain harvesting plans, animal feedings, and various farm-related projects. His life had meaning and purpose, and the hospitalization was merely a change of venue for his daily instructions.

Because my patient was so motivated, I offered to bring him to his physical therapy session early one day. To my...

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Pain Management And Why It’s So Personal

Most of my patients think about pain medicines in terms of the symptoms they treat. “This is my headache medicine, and this is my arthritis medicine,” they often say. Healthcare providers are more likely to categorize pain medicines by the way they work: some are anti-inflammatory, some affect nerve endings, and others influence how the brain perceives pain. But the truth is that no matter how you classify pain medicines, there is no way to know if they'll help until you try them for yourself.

Most people don't realize that pain management is personal. Research is beginning to help us understand why people respond to medicines so differently, and one day we will probably be able to personalize treatment plans more successfully. For now, there are several known genetic reasons why pain medicines are more or less effective for one individual over another. Genes affect:

  1. The number of enzymes that break down medicines and remove them from the body. Some people have larger numbers of these enzymes and therefore require more drug to feel its pain-relieving effects. Others may be strongly affected by even small doses of drug.

  2. Pain medicine receptor variations can make one medicine...

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Doctors: It’s Not What You Say, But How You Say It

Most physicians will be thrust into the role of patient or caregiver at some point during their careers. Unfortunately, it's not until this occurs that many become fully aware of the finer points of excellent care and communication. Take for example, the simple act of reporting test results to a patient. We do this every day, but may not realize that how we frame the information is as important as the data themselves.

I came to realize this on a recent hospital visit when I was in the role of healthcare proxy for a loved one with heart disease. Not only did various physicians present information with different degrees of optimism, but individual doctors presented things differently on different days... depending on (I guess) how tired/hurried they were. Consider these different messages with the same ejection fraction (EF - a measure of heart pump strength) and angiogram (heart vessel imaging) test results:

Doctor 1: "I wish I had better news. The EF is lower than we thought. It is low because of your previous massive heart attack."

Doctor 2: "Although your EF is impaired, there's a lot that can be done to improve pump function with medications."

Doctor 1 (different day): "On...

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When Elderly Parents Suck The Life Out Of Their Kids

My patient's son stood vigil outside her hospital room day and night. His eyebrows were frozen at an anxious angle. Although his mom was healing well from her injury, I could see that he was worried about next steps. He asked staff repeatedly about his mom's pain management, and reviewed every therapy session she attended.

His mom, on the other hand, was deceptively charming. She was a thin, well-groomed elderly woman who knew how to exact empathy from others. When I looked into her room from a distance she appeared comfortable, lying in her hospital bed covered in a quilt that her son had brought her from home. When I entered the room to check on her, she would grab my hand and wince, telling me that the pain was severe but that she didn't want any medication. She was quite invested in convincing me that she was unable to go home and care for herself, and that she needed to be discharged to her son's home. She would not accept others help at home, nor would she go to a skilled nursing facility.

She was doing well in therapy, limited mostly by her macular degeneration (poor eyesight). Again, I watched her from outside her field of vision. I saw her stand without assistance,...

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Why Young Physicians Should Consider Locum Tenens: Try Before You Buy!

*This blog post was initially published on the Barton Blog.

When doctors complete their residency training, they are under a lot of pressure to land their first “real job” quickly. Student loan deferments end shortly after training, and whopping debt faces many of them. But choosing a job that is a good long-term fit can be difficult, and gaining a broader exposure to the wide variety of options is key to success. That’s why “try before you buy” can be an excellent strategy for young physicians.

Locum tenens agencies such as Barton Associates work with healthcare organizations and practice locations across the country to offer a variety of temporary assignments for physicians.

These agencies negotiate your salary and call schedule. They also arrange the logistics, covering the costs of travel and accommodations. Once the doctor and the facility agree to terms, the physician simply arrives on the required date(s) and takes on the responsibilities requested. It’s a hassle-free, minimal-commitment arrangement that pays an hourly or daily rate for work.

Locum providers are given the convenient option to receive direct deposits to their bank accounts at regular intervals. Physicians...

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Healthcare And The Importance Of Hope

Hope is a tricky thing. On the one hand, false hope can lead patients to opt for painful, futile treatments at the end of life. On the other, unnecessarily bleak outlooks can lead to depression and inaction. When health is at stake, presenting information with the right amount of hope can guide patients away from both suffering needlessly and/or succumbing to treatable disease.

I was reading a sad story about a patient whose physician had made her feel hopeless. She was an elderly widow with some real, but not immediately life-threatening, medical conditions. His attitude led her to believe that she was sick and useless - with little to look forward to but ongoing testing, disease progression and eventual death. His professional opinion held special weight for her, coloring her entire outlook. It wasn't until a friend reminded her of the doctor's fallibility that she began to question her diagnoses, treatment options, and even prognosis.

When faced with concerning new medical diagnoses, even the most educated among us tend to imagine the worst case scenario. Knowing this, physicians should take care to offer reassurance and optimism whenever it is warranted. Hope provides the...

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The Three Pillars of the Medical-Industrial Complex – and the Physician. Part 5. Decoupling Research.

VIEW ENTIRE SERIES Mike Magee Historically, for a century since the Flexner report, some 40 premier academic health systems have been the masters and the model for American health delivery, constantly reinforcing the three-prong definition of the ideal senior level “thought leader” and successful academic physician – researcher, teacher, clinician. But in 2009, AHA president, […]

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The Three Pillars of the Medical-Industrial Complex – and the Physician. Part 4. Inside the White House – Cost vs. Coverage.

VIEW ENTIRE SERIES Mike Magee When President Obama entered office in 2008, and made the political assessment that it was now or never for health care reform, he saw waste and excess everywhere he looked. As New York Times columnist, Steven Brill, explained in 2015, he found: an $86 billion expenditure annually for ineffective treatments […]

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The Three Pillars of the Medical-Industrial Complex and the Physician. Part 3. Rapid Cost Escalation.

VIEW ENTIRE SERIES Mike Magee As we have seen, by the time the 1990’s arrived, prospects for the premier academic health systems were looking questionable. The educational enterprise was increasingly underfunded. Inpatient reimbursement continued to decline alongside admissions and length of stay. The massive faculty hirings of the 70’s and 80’s now left the institutions […]

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The 3 Pillars of the Medical-Industrial Complex and the Physician. Part 2. Evolution of The Hospitals and Insurers.

VIEW ENTIRE SERIES Mike Magee In Part 1 of this 5 part series, I described the financial power and stakes of the pharmaceutical, health insurance and hospital industries, as revealed in the “givebacks” they granted to the Affordable Care Act in return for policy concessions to the Obama White House. In Part 2, I explore […]

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