What happens when consumers are able to compare the performance of primary care physicians in their state using Consumer Reports, the magazine that’s so highly regarded for its ratings of thousands of products and services we all use every day?
Your new post is loading...
Your new post is loading...
To be effective in relieving suffering, doctors must strike a balance between paucity and excess of empathy.
As a young doctor working in the E.R. my capacity for compassion, and that of my colleagues, was often stretched; this was particularly the case when my patients could be said to have brought misfortune on themselves. I saw drug addicts suffering overdose, teenagers retching after self-poisoning, thieves injured through being arrested, all treated more brusquely than other theoretically more blameless patients.
I tried hard to maintain empathy, reflecting that the overdosed, self-poisoned and criminal may no more have brought their problems on themselves than those with skiing or horse-riding injuries or heart palpitations through overwork.
But it’s complicated: I’ve stitched up many slashed wrists cut not through willfulness but as a release from intense anguish; I’ve attended alcoholics for whom alcohol was clearly a substitute for love.
I may not have always succeeded, but I always hoped that my humanity, or my professional duty to provide a high standard of care, would step in when my compassion was running low.
By GAVIN FRANCIS
Via Edwin Rutsch
Over the past 20 years, over 700 new active substances (NASs) have successfully been discovered, developed and authorized by regulatory bodies for use with patients globally. This report profiles the NASs launched in the U.S. over the past 20 years and measures the length of a molecule’s lifetime from patent filing to launch and eventual patent expiry. It also explores the significant variations in this lifetime when viewed by molecule characteristics such as therapy area, orphan drug status, and the type of companies involved in the development and marketing. These issues and trends highlight important implications for investors and manufacturers.
Regulation makes economic sense, argue Douglas Sipp, Christopher McCabe and John E. J. Rasko.
Under US President Donald Trump, defunct economic arguments about prescription drugs are coming to the fore. His advisers contend that today's system is a bad deal. They want to undo regulations that require companies to show that a medical product actually works before it is sold. The advisers argue that removing the burden of large, lengthy clinical trials will cut costs and reduce delays, and that the marketplace can be trusted to sort good drugs from bad ones.
Le Ministère de la Santé et le Centre national des soins palliatifs et de la fin de vie lancent une campagne nationale , un an après l'adoption d'une loi portée par le député PS Alain Claeys et Jean Leonetti, député-maire d'Antibes.
Via Centre national des soins palliatifs et de la fin de vie, catherine cerisey
Visiting the doctor can sometimes feel like being slammed down on an assembly line: Make co-pay. Check vitals. Diagnose the problem. Get a prescription. Next!
The fee-for-service model of American medicine doesn’t put much value on long doctor’s visits, which aren’t as profitable for providers as performing costly medical procedures. And that’s a problem, argues Senior Fellow Robert S. Kaplan, the Marvin Bower Professor of Leadership Development, Emeritus, at Harvard Business School.
“If doctors can’t charge for doing certain things, they tend not to do them even when they can make the patient better off,” he says. “On the other hand, sometimes doctors do things they shouldn’t, just because they can charge for them. It’s a very dysfunctional system.”
Via Richard Meyer, Lionel Reichardt / le Pharmageek
Following a brief pause after the economic crisis, health expenditure is rising again in most OECD countries. Yet, a considerable part of this health expenditure makes little or no contribution to improving people's health. In some cases, it even results in worse health outcomes. Countries could potentially spend significantly less on health care with no impact on health system performance, or on health outcomes. This report systematically reviews strategies put in place by countries to limit ineffective spending and waste. On the clinical front, preventable errors and low-value care are discussed. The operational waste discussion reviews strategies to obtain lower prices for medical goods and to better target the use of expensive inputs. Finally, the report reviews countries experiences in containing administrative costs and integrity violations in health.
The introverts who are the subject of Susan Cain’s new book, “Quiet,” don’t experience their inwardness in quite so self-congratulatory a way.
They and others view their tendency toward solitary activity, quiet reflection and reserve as “a second-class personality trait, somewhere between a disappointment and a pathology,” Cain writes. Too often denigrated and frequently overlooked in a society that’s held in thrall to an “Extrovert Ideal — the omnipresent belief that the ideal self is gregarious, alpha and comfortable in the spotlight,” Cain’s introverts are overwhelmed by the social demands thrust upon them. They’re also underwhelmed by the example set by the voluble, socially successful go-getters in their midst who “speak without thinking,” in the words of a Chinese software engineer whom Cain encounters in Cupertino, Calif., the majority Asian-American enclave that she suggests is the introversion capital of the United States.
You can’t be sick, you’re fat. You don’t look like your dying. You still have hair. Oh come on, you’ve been dying for years. It can’t be that bad, it’s not like you’re dying tomorrow. At least you have a few years. Stop complaining. Others have it worse. At least you’ve lived your life.”
Abstract: Patient education (PE) is expected to help patients with a chronic disease to manage their lives and give them the possibility of adopting, in an appropriate manner, beneficial changes in health behaviors that are prescribed by their physicians. It is aimed at delineating, agreeing on, and implementing a patient’s personal action plan and is therefore an essential constituent of the person-centered model of care. The aim of this article is to examine the idea that PE may sometimes be a manipulation that is organized for the good of patients in a paternalistic framework. Theoretically, PE differs from manipulation by addressing the reflective intelligence of patients in full light and helping them make autonomous choices. In this article, we examined some analogies between PE and nudge (ie, techniques used to push people to make good choices by organizing their environment). This analysis suggests that PE is not always as transparent and reflective as it is supposed to be and that unmasking these issues may be useful for improving the ethical quality of educational practice that must be performed in a framework of a trusting patient–doctor relationship. Under this condition, PE may sometimes represent a form of persuasion without being accused of patient deception and manipulation: trust is therefore the core of the person-centered model of care.
Via VAB Traductions
Health care guidelines are produced in ever-increasing numbers. The National Guideline Clearinghouse, a U.S.-based public website compiling summaries of “clinical practice” (health care) guidelines, has over 1,000 entries and is updated weekly. The National Institute for Health and Care Excellence in the U.K. has over 180 clinical guidelines.
Health care guidelines cover all aspects of medicine, from using aspirin to prevent heart attacks and colon cancer to managing earwax and caring for athletes with concussions.
Health care guidelines impact policy decisions and care for individuals. Recent research, though, suggests that the public has only a vague understanding of what guidelines are and how they are developed.
This is consistent with my own experience as a physician studying best practices for patient engagement in guideline development. Most of my patients and focus group participants are unfamiliar with how guidelines are developed. This can lead to uncertainty for patients and contributes to controversy, such as debates about mammography guidelines.
As part of efforts to better capture patients' perspectives, the US Food and Drug Administration (FDA) on Monday said it is considering establishing an "Office of Patient Affairs," to be tasked with supporting and coordinating patient engagement across the agency.
The move to create the office would be part of the agency’s efforts to offer “a single, central entry point to the Agency for the patient community,” as well as “triage and navigation services for inbound inquiries from patient stakeholders.”
The office would likely host and maintain data management systems to incorporate and formalize knowledge shared with FDA by patient stakeholders and FDA's relationships with patient communities, and the office would be part of efforts to develop a scalable and forward-looking platform for communicating with patient stakeholders, particularly online.
Via Pharma Guy
Elles font partie de ces personnes très réactives dès qu'on les enferme dans une définition, et qui pourtant ne peuvent s'empêcher de se reconnaître à la lecture des articles et témoignages sur la multipotentialité.
Parfois surdouées et hyperactives, souvent très orientées "cerveau droit", elles aiment créer, explorer, expérimenter dans des contextes toujours nouveaux, et surtout garder toujours ouvert l'espace infini des possibles.
Toujours conscient de ma subjectivité, et avec les schématisations auxquelles m'obligent l'écriture d'un article lisible, j'aborderai quelques défis et talents de ces personnes touchantes, étranges, passionnées et passionnantes que sont les multipotentialistes.
Via Lionel Reichardt / le Pharmageek, Pharmacomptoir / Corinne Thuderoz
Utilizing research data from Bing, researchers found that careful analysis of a patient’s search history could be used as a pre-screening tool for lung cancer.
Anonymous searches on Bing were scanned for indicators of a recent lung cancer diagnosis: searches for symptoms, first-person phrases, and more. For example: Their example is “I was just diagnosed with lung cancer,” and follow-up searches for treatment. They also reviewed demographics, location, and red flags like searches for smoking cessation products. The researchers then looked at what that individual searched for over the previous year, specifically looking for queries of symptoms like chest pain, cough, bronchitis and found that these queries correlated with an increased chance of lung cancer diagnosis.
En santé, il ne s’agit pas simplement de reconstituer de façon réaliste La leçon d’anatomie du Dr Tulp, mais de concevoir un corps en 3D virtuel, ce qui pourrait un jour remplacer la dissection traditionnelle en universités de médecine. La réalité virtuelle en 3 D, avec le Hololens de Microsoft, sert à apprendre l’anatomie aux étudiants et à rendre plus précis le geste du chirurgien, pouvant planifier à l’avance sa stratégie opératoire.
Via Philippe Marchal
At a Harvard Business School panel discussion on health care management, experts looked to the retail industry as a possible model for delivering medical services more effectively.
In order to get its financial and management woes under control, the health care industry might want to peek at the playbooks of retail giants like Walmart, Google, and Amazon.com.
This was a key conversation point at "Perspectives on Health Care as a Management Challenge," a March 31 panel discussion held at Harvard Business School, where several experts talked about how to treat the troubled industry at a time when the year-old Health Care and Education Reconciliation Act of 2010 is still in its relative infancy.
Administrative tasks are essential at all levels of the health care system, from
ministries and insurers to health providers. Many tasks are vital to ensure access,
equity and quality of health care provision. Other activities may be of limited use,
adding no value for patients.
This chapter looks into differences in administrative costs at the level of the health
care system, for both health care facilities and individual health workers. Some
differences are related to the way health care is financed. Many countries see the
need to tackle inefficiencies in health care administration. The most promising
strategies to increase efficiency are centred on simplifying procedures – partly by
making better use of ICT – and optimising the size of administrative bodies to
generate economies of scale. Additionally, regulatory changes can have an
enormous and immediate effect on administrative costs and the administrative
workload of health providers.
The nation’s largest patient advocacy groups are on the front lines of some of the biggest health care debates, from the soaring costs of prescription drugs to whether new medicines are being approved quickly enough.
But while their voices carry weight because they represent the interests of sick patients, a new study has found that more than 80 percent of them accept funding from drug and medical-device companies. For some groups, the donations from industry accounted for more than half of their annual income, and in nearly 40 percent of cases, industry executives sit on governing boards, according to the study, which is published in The New England Journal of Medicine.
Drinking high-concentration hydrogen peroxide is a tactic sometimes promoted in alternative medicine circles as a so-called "natural cure," but nearly 300 people have been poisoned and five have died after trying it, according to a new paperpublished this week in the Annals of Emergency Medicine.
Dr. Benjamin Hatten, assistant professor of emergency medicine at the University of Colorado School of Medicine, used data from the National Poison Data System collected between 2001 and 2011 and looked specifically at poisonings from hydrogen peroxide solutions of 10% or more, with most cases involving concentrations of 30% to 40%. These formulas aren’t usually sold in drug stores, and are generally marketed for industrial or commercial purposes. But they’re also sold by some alternative health retailers and promoted as an ingredient in what’s sometimes referred to as “super water.”
“For people who follow these regimens, the instructions involve placing a dropper-full of high-concentration peroxide into a large quantity of water or another liquid, so it’s fairly diluted,” says Dr. Hatten. “People believe that it’s hyper-oxygenating, putting extra oxygen into your beverage, and that it somehow improves your health.”
Lo scorso 31 gennaio il Senato ha approvato il disegno di legge in materia di cyberbullismo.
Il testo segna, nella sostanza, un ritorno alle origini ovvero al disegno di legge originariamente proposto proprio in Senato – prima firmataria la Senatrice Elena Ferrara (PD) - esattamente due anni fa, il 27 gennaio 2014.
Si ritorna, opportunamente, ad un disegno di legge che mira a introdurre nell’Ordinamento un corpus di regole speciali che hanno l’ambizione di garantire – a prescindere da ogni valutazione sulla loro efficacia – una tutela rafforzata per i minori nella loro vita in digitale e ciò in particolare davanti ad un ventaglio, che per la verità resta amplissimo, di condotte suscettibili di ledere la loro identità e dignità personale.
Una scelta coraggiosa che impone il ritorno del disegno di legge alla Camera dei Deputati e che, dunque, considerata la fragilità della legislatura in corso, potrebbe condannare l’iniziativa al naufragio.
Ma si tratta di una scelta saggia, opportuna e doverosa che consente di fare tabula rasa dell’interminabile serie di emendamenti, ritocchi e correzione che, nel suo primo passaggio alla Camera dei Deputati, avevano snaturato profondamente il disegno di legge sino a trasformarlo in una sorta di legge marziale per i crimini online, uno zibaldone di idee e strumenti confusi, ambigui e poco efficaci.
Il Senato ha rimesso ordine nelle originarie buone intenzioni, ha rimesso in fila le vere priorità e segnato una via.
Non è il miglior disegno di legge possibile – benché scriverne uno in una materia tanto delicata e complessa è operazione estremamente complessa – ma è un’iniziativa legislativa che torna ad essere coerente, ferma, puntuale.
E onestà intellettuale impone di darne atto con la stessa convinzione e determinazione con la quale, in agosto, si è attaccato e criticato duramente il disegno di legge uscito dalla Camera dei Deputati.
I dubbi, almeno alcuni, restano.
Prevenzione e cure non farmacologiche