Thinking around pharmaceutical-oriented medicine
posted 6-19-2014 9:50 p.m.

 
(Note: this post is addressed mainly to health care professionals and to the wonderful nurses on 7West at Advocate Christ Medical Center, but it’s also of interest to patients and consumers. It’s longer, too, because a typical blog post a few paragraphs long wouldn’t adequately describe either the problem or the solution. So bear with me, and all will be revealed. Thanks.)


You never know how good your hospital really is until you need it. Mine’s very good, based on objective criteria. But even an excellent hospital that does all the right things 99.9 percent of the time can still have blinders on about certain ways in which it practices medicine. It’s a question of medical mindset.

It turns out continuing education is failing our health care professionals – and, thereby, patients – when it comes to knowing about nutraceuticals and how the foods and beverages we consume can help or hurt our medical care. Instead, physicians and nurses rely too much on marketing material from Big Pharma. That’s a mistake.

Gay marriage: just do it, and move on
posted 3-26-2013 5:40 p.m.

 
I said my bit on this subject seven years ago, on this very blog, figuring I'd said all I had to say: just allow gays legal unions with all rights attendant for marriage, promote social stability that way, then move on to bigger issues — like fixing the economy and getting our troops out of the Middle East. I'd be perfectly fine with letting homosexuals and lesbians marry; it doesn't affect me in the least, and I don't see a good reason to deny them that right. Now that the first of the gay marriage cases have reached the U.S. Supreme Court, perhaps it's time to revisit the subject. Besides, I'm deeply tired of all the hyperbolic conservative blathering on the subject. Time for a definitive smackdown.

If public opinion polls are to be believed, the balance has shifted ever so slightly towards sanity: more Americans would approve of gay marriage than disapprove, and most would like the subject settled. I'm all for that. The shrill minority keeps insisting that recognizing marriages between consenting adults of the same gender is somehow grossly, intrinsically destructive to all marriages everywhere; that's just stupid. They rant as if their own marriages were somehow damaged by the marriages of others. That's silly. And this conversation has been coming for a long time.

A medical district for Roseland??   Not so fast
posted 12-16-2011 1:45 p.m.

 
Let's get one thing straight at the start: I want Roseland to recover from its economic black hole and be able to offer good jobs to its residents. I'd love for it not to be the armpit of poverty that it's been for a few decades on the South Side of Chicago. It would be good for the people and good for the city. That said, I have to wonder what toxic waste filtered down into the drinking water there to make the local activists think that starting a medical district down there was the answer.

Gov. Quinn gave the community false hope, if you ask me, by making the designation official. But nobody's come up with the resources and commitments to make it real, and the likelihood that they will is poor. We'll see a functioning airport in Peotone before that happens.

The uninformed public, led by the misinformed 'experts'
posted 7-29-2010 2:51 p.m. Central

 
Sometimes, disinformation is spread by perfectly well-meaning people who are less informed than they think they are. And they don’t even realize they’re doing it. Trouble is, if their credentials look good at first glance, the rest of us may not realize it, either. This is one of the frustrations of covering health care reform.

Case in point: a New York cardiologist volunteers to provide aid for several months in Haiti after the earthquake. He’s part of a team helping to reinstate cardiac care at a city hospital in Port-au-Prince. A noble deed, well and good. While he’s there, he notices that the “sudden availability in Haiti of free high-quality care from foreign doctors put enormous competitive pressure on the private local doctors, who had already been working under difficult conditions.” This influx of foreign aid causes local clinics to lose business. The cardiologist wonders “if the same would happen to private medical services back in the United States were our government to suddenly provide high-quality, low-cost health care.” So he writes an op-ed piece for the New York Times with suggestions for our health care reform efforts, based on his experience in Haiti.

I begin to see where this guy's argument is going and shake my head, but I keep reading, giving him the benefit of the doubt for the moment. Yet already the misunderstandings are piling up.

Also missing: better ways to pay doctors and hospitals
posted 6-23-2009 7:50 p.m.; updated 7-13-2009 4:41 p.m.

 
In my last post, I began a list of what’s missing so far from health care reform efforts:

• enough primary care doctors, primary care nurse practitioners and hospital nurses
• more practitioners and resources in the right places
• better funding mechanisms for practitioner and hospital malpractice insurance
• a national medical malpractice arbitration system to settle most claims, similar to no-fault workers' compensation
• functional, properly financed metro and regional trauma networks
• better physician practice organization
• needed data collection and analysis on a large scale
• a federal privacy czar at cabinet level to monitor and police the privacy and security of consumers' medical, financial and other data and punish offending database owners and other violators

The last entry addressed the first four points. Since then, I’ve come up with two more missing pieces:

• better ways of paying health care practitioners
• better ways of paying hospitals

You’ll notice I didn’t include nursing homes or intermediate care facilities; that’s an entirely separate discussion and a mammoth Gordian knot of its own. Let’s leave that for another time.

By ‘better ways’ I mean mechanisms for paying health care providers that provide reasonable compensation for them without bankrupting the rest of us. But there’s more to it than that.

Fixing health care reform: too many missing pieces now, but we can build on parts that work
posted 5-12-2009 2:17 p.m.

 
There are those who liken tinkering around the edges of health care reform (which is all Congress and the president have attempted, so far) to fixing a leaky faucet or unclogging a drain in New Orleans while Hurricane Katrina approaches: there’s a much bigger picture that needs to be addressed. I agree with that last part, but to me the health care system is more of a Rube-Goldberg machine or a potential This Old House project: it began long ago with a very small core and was slowly cobbled together over time to do more and more but performs in a costly, roundabout, less than effective way — yet our attempts to improve it have only resulted in more things cobbled on, without rethinking the entire design.

With the rising clamor for a public health insurance plan as an alternative mechanism for covering everyone, it’s time to think about whether or not we have the pieces of the delivery system in place to make a public health plan effective. I don’t think we do. However, we do have pieces that are useful now and would be good to incorporate into any reformed delivery system. We have to retain those parts while we figure out what our care system needs to look like, which will determine what our reform plan must look like.

Sebelius, DeParle will have their work cut out for them
posted 3-2-2008 7:46 p.m.

&nbspbr>The Obama Administration today announced the nominations of its top two health care officials. In appointing two different people for those positions, the administration wisely reversed itself. Each of the nominees will have more than enough to do, once they are approved.

Earlier today, Kansas Gov. Kathleen Sebelius(D) accepted the nomination for Secretary of Health and Human Services, replacing former senator Thomas A. Daschle, who withdrew from consideration last month after his tax problems and position as a lobbyist complicated matters for the Obama Administration. Also, Nancy-Ann DeParle was named director of the White House Office for Health Reform. DeParle headed the Health Care Financing Administration, which oversaw Medicare and Medicaid, during the Clinton Administration. She was also a Clinton era health care adviser at HHS and at the White House Office of Management and Budget.