Wednesday, October 14, 2009
QD: News Every Day--The disconnect of health reform
ACP Internist's daily digest of internal medicine in the news continues with the disconnect on health care reform, a larger analysis of who was hospitalized for H1N1, and more on the primary care shortage.
Health care reform
Americans want health care reform to change, but they don't want to pay for it.
Meanwhile, the Economic Policy Institute, a think tank focused low- and middle-income Americans, points out that Medicaid and the SCHIP held in check the number of children who would have gone without health between 2000 to 2008. Children without insurance dropped 1.7% between 2000 and 2008, while adults less than 65 without insurance rose 3.1%. By contrast, children with public coverage grew 8.8%, compared to a 3.5% increase for the adult population under 65.
H1N1 influenza
Health officials now say that 46% of 1,400 adults hospitalized with H1N1 influenza did not have a chronic underlying condition, according to the largest analysis to date. The study looked at adults and children hospitalized from April through August in 10 states at medical centers participating in a special disease surveillance network. Anne Schuchat, FACP, who heads the CDC's National Center for Immunization and Respiratory Diseases, said the larger analysis looked at underlying conditions not previously examined. Among adults, 26% had asthma, 10% had diabetes, 8% had some other chronic lung disease, 8% had weakened immune systems and 6% were pregnant.
Primary care shortage
A financial advisor chimes in with his analysis of why primary care doesn't pay, including input from his own internist. The doctor says, "The average income of a primary care doctor in Massachusetts is about $86,000. Why do I do it? Because I love it."
The medical home
Profiles of practices trying the patient-centered medical home include Greenhouse Internists in Mt. Airy, Pa. and the Adirondack Regional Medical Home Pilot, which also an effort to stop the loss of primary care practitioners in the region. And for a lighter note, don't miss ACP Internist's own Stacey Butterfield's report from the MGMA meeting in Denver.
In case you missed it ...
In Minnesota, the Vitality Project prompted one town to build sidewalks and bike trails; restaurants, groceries and schools to push healthier foods; and employers to give workers time to exercise. The experiment added an average 3.1 years to the longevity of about 2,300 residents who calculated their lifespans by answering 36 lifestyle questions.
Labels: diet, exercise, flu, H1N1, health care reform, health insurance, health policy, patient-centered medical home, primary care shortage, QD
posted by Ryan DuBosar at
11:53 AM
0 Comments
Monday, August 10, 2009
Medical news of the obvious
Depressed people were almost three times as likely to have impaired cognition after gloomy weather in one study. Researchers screened by phone 16,800 Americans enrolled in a stroke study for signs of depression and then administered a cognition test. Data were correlated with NASA's daily records of how bright sunlight was at any given location for the two weeks before the test. We're not rocket scientists, but two weeks of cloudy weather is enough to fog anyone's senses, let alone people who are already depressed.
This next video starts off with what exercisers knew intuitively: Working out makes one hungrier. But does exercise really make it harder to lose weight? Let's sit on the couch for a while and mull that over ...
Labels: depression, exercise, medical news of the obvious, weight loss
posted by the staff of ACP News at
9:00 AM
0 Comments
Monday, June 1, 2009
Medical news of the obvious
People choose high-calorie over healthier drinks, especially when they're on sale. Sad but true, it often costs more to buy healthy or organic products than their high-fructose, saturated-fat-bearing cousins. A New Zealand study, published in Nutrition and Dietetics, corroborates this notion, concluding that of 1,500 supermarket discounts on non-alcoholic drinks, only 15% were considered "healthy." Although, researchers noted, the difference may have something to do with there being signficantly more non-healthy drinks on shelves than the alternatives, no doubt a savvy move by companies that are interested in making a profit as opposed to feeling good about their customers' eating habits. It turns out that water, plain reduced-fat milk and plain reduced-fat soy beverages (the "healthy" drinks) aren't as appealing as sodas and flavored sports drinks--sadly, I suspect that price has very little to do with it.
Driving everywhere is making us less healthy. By how much? A Reuters feature reported that driving cuts the average person's 10,000 steps a day to as few as 1,000. Because it cuts into potential time for exercise, each 30 minutes of driving translates into a 3% greater chance of being obese.
Labels: exercise, medical news of the obvious, Nutrition, obesity
posted by Janet Colwell at
9:00 AM
0 Comments
Wednesday, November 12, 2008
Power to the patient! (with your encouragement)
The theme of several late-breaking trials today seems to be, very loosely, patient empowerment. To wit:
One study compared atrial fib/heart valve patients on warfarin who were monitored monthly at a clinic with those who did weekly home INR testing. There was no difference in the primary outcome-- time to death, major bleed or stroke.
This is a case where a negative outcome isn't really bad. It's good to know, the author said, that patients can test at home just as well as in a clinic, especially for those who live in remote areas or have other barriers to getting to a clinic. Plus, patients were happier with the home testing approach, and Medicare covers it for AF, heart valve and VTE patients.
Next comes a sub-study of yesterday's HF-Action study on exercise and heart failure (see earlier post for main study). This one found patients who did exercise training reported significantly better health status (quality of life, symptoms and physical/social limitations) at three months, and the difference lasted for three years.
Quality of life is important in heart failure patients, because HF is a chronic, incurable disease, discussant Anne Taylor, MD said. She noted that in this study, the subjects were receiving optimal medical therapy, and were 59 years old on average-- while in the general population, heart failure patients don't always get OMT, and are older. Study author Ileana Pina, MD, responded that the group did plan to analyze the results in an older cohort, so stay tuned.
Finally, Lori Mosca, MD, reported on her group's creative study in which researchers screened and counseled the relatives of hospitalized patients about their health risk factors. The control group got a handout about reducing risks, while the intervention group got immediate feedback on screening tests, and a year of diet and exercise counseling.
LDL levels declined in both groups after a year-- a testament to how motivating it is to see a loved on get sick, Dr. Mosca said-- but there was no difference between groups. The intervention group had a significantly better diet score and exercised more, and their HDL went up slightly, while the control group's HDL declined. Both groups significantly decreased their saturated and trans fat consumption.
Given that both groups improved their behaviors after some level of intervention, hospitals have a unique opportunity to educate, motivate and help patients' relatives, observers noted. A lot of these relatives were unaware they had CV risks, Dr. Mosca said, and that awareness alone might have spurred them to action.
Labels: AHA Sessions, exercise, heart failure
posted by Jessica Berthold at
1:41 PM
0 Comments
Thursday, October 9, 2008
Government exercise guidelines
There are a lot of competing recommendations out there about how much exercise people need to stay fit. This week, the Dept. of Health and Human Services released what it hopes is the definitive word on the subject with its "Physical Activity Guidelines for Americans."
These are based on "the first thorough review of scientific research about physical activity and health in more than a decade," and crafted by 13 advisory committee members appointed by HHS Secretary Mike Leavitt.
Without further ado, some highlights:
For adults, 2.5 hours a week of moderately intense aerobic activities, like brisk walking or gardening, is enough to yield big benefits. The 2.5 hours can be spread out over the week, but you need at least 10 minutes at a time to get your heart rate up.
Vigorous aerobic activity like jogging or jumping rope buys time: adults need only 75 minutes/week to stay healthy. You know it's vigorous if you can only say a few words before having to catch your breath.
Adults should also do muscle strengthening activities (lifting weights, sit-ups, carrying heavy stuff) 2 days/week.
Older folks should do as much as they can to meet the adult guidelines, and also do balance exercises if they are at risk of falling.
Pregnant women should follow the adult guidelines, though vigorous exercisers should talk to their doctors about whether they need to modify any activities.
Kids and adolescents need an hour or more of moderate or vigorous exercise at least 3x/week. They should do muscle strengthening and bone-strengthening activities (eg: running and jumping rope) 3x/week.
These are minimum guidelines. More exercise than this is, of course, better.
posted by Jessica Berthold at
12:34 PM
0 Comments
ACP Internist hosted Grand Rounds on June 16, wrapping up the best of the medical blogosphere. Click here for the complete wrap-up.
Contact ACP Internist
Send comments to ACP Internist staff at acpinternist@acponline.org.
Previous Posts
- QD: News Every Day--Santa's take on H1N1 influenza...
- Rethink pink: breast cancer screening evidence met...
- QD: News Every Day--Santa's take on H1N1 influenza...
- QD: News Every Day--when evidence and politics col...
- Ghostwriting haunts Congress' hallowed halls
- QD: News Every Day--payment fix inches forward (fo...
- QD: News Every Day--not the intended effect
- Medical news of the obvious
- QD: News Every Day--flu's growing tally
- QD: News Every Day--no holidays for Congress
Archives
Blog log
American Journal of Medicine
Also known as the Green Journal, the American Journal of Medicine publishes original clinical articles of interest to physicians in internal medicine and its subspecialities, both in academia and community-based practice.
Clinical Correlations
A collaborative medical blog started by Neil Shapiro, ACP Member, associate program director at New York University Medical Center's internal medicine residency program. Faculty, residents and students contribute case studies, mystery quizzes, news, commentary and more.
db's Medical Rants
Robert M. Centor, FACP, contributes short essays contemplating medicine and the health care system.
Everything Health
EverythingHealth is designed to address the rapid changes in science, medicine, health and healing in the 21st Century.
Getting Better with Dr. Val
Getting Better is the continuation of Dr. Val Jones' previous blog at Revolution Health. It is devoted to helping people understand health issues from a balanced, scientifically sound perspective.
HealthHombre
A roundup of health policy news drawn from a database of hundreds of Web sites.
Interact MD
Michael Benjamin, ACP member, doesn't accept industry money so he can create an independent, clinician-reviewed space on the Internet for physicians to report and comment on the medical news of the day.
Kevin, MD
The alter ego of Kevin Pho, ACP Member, is the closest thing to royalty in the medical blog world.
LSUHSC-S Medical Library Evidence Alert
Major guidelines, systematic reviews, meta-analyses and/or major reviews by national and international organizations.
PLoS Blog
The Public Library of Science's open access materials include a blog.
White Coat Rants
One of the most popular anonymous blogs written by a doctor.
