Monday, April 21, 2014

How Americans Die

How Americans Die
This is a fantastic visual presentation of data that you can look at in more detail on the Bloomberg Site
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If the embedded page does not work head over there directly here

The main points highlighted
  • The mortality rate fell by about 17 percent from 1968 through 2010, years for which we have detailed data...Almost all of this improvement can be attributed to improved survival prospects for males
  • The surge in for 25- to 44-year-olds was caused by AIDS, which at its peak, killed more than 40,000 Americans a year (more than 30,000 of whom were 25 to 44 years old)
  • AIDS was the single biggest killer of Americans who should otherwise have been in the prime of their lives (Sobering Statistic)
  • 45- to 54-year-olds are less likely to die from disease, they have become much more likely to commit suicide or die from drugs
  • How does suicide and drugs compare to other violent deaths across the population? Far greater than firearm related deaths, and on the rise. (Suicide and has recently become the number one violent cause of death) - (Sad Statistic)
  • The downside of living longer is that it dramatically increases the odds of getting dementia or Alzheimer's
  • The rise of Alzheimer's and other forms of dementia has had a big impact on health-care costs because these diseases kill their victims slowly. About 40 percent of the total increase in Medicare spending since 2011 can be attributed to greater spending on Alzheimer's treatment

They do a great job of slicing the data by cohorts of age groups showing how much we have improved mortality and how our 25 and under age group is benefiting from the health improvements with the lower mortality and higher life expectancy than any other cohrot

Friday, April 18, 2014

Giving Personal Health Advice to Family and Friends

In an interesting post on the medscape site (subscription/registration probably required): The Pitfalls of Giving Free Advice to Family and Friends Shelly Reese described some of the challenges of giving medical advice

to friends and family (even if you are a wannabe Dr Phil).

As she puts it the path can sometimes lead to challenging areas of ethics and professional boundaries.
How do you address or deflect such requests? Unfortunately, there are no easy answers. It depends a lot on you, your boundaries, and the situation.
And she links to the AMA Guidelines
The American Medical Association (AMA) Code of Medical Ethics is clear, however: "Physicians generally should not treat themselves or members of their immediate families."[1] The statement goes on to provide an extensive list of good reasons why, including personal feelings that may unduly influence medical judgment, difficulty discussing sensitive topics during a medical history, and concerns over patient autonomy (Ref: American Medical Association. Code of Medical Ethics Opinion 8.19: Self-treatment or treatment of immediate family members. Issued June 1993.)
Some of the challenges of simple advice include

  • Escalation to more complex or persistent advice 
  • Long distance diagnosis with missing data
  • Lack of Doctor/Patient relationship and documentation
  • Litigation
  • Impaired judgement 
  • Changing and coloring of relationships

In one section she describes the challenges of dealing with family members and says
"I try not to give too much medical advice, even to my parents. I see my role as an advocate: to help them synthesize information when they have questions. When my mother calls and says, 'I'm short of breath and I don't know what to do,' I walk her through all the things her doctor has talked to her about: Have you taken your blood pressure and pulse? Do you know how many times you're breathing per minute?"
Good advice on being the patient advocate and healthcare manager for your family members (which many already are)
In the end it boils down to personal judgement and your own boundaries.
Questions are appropriate and to be expected, Caplan says, but doctors have to wrestle with themselves in determining how to respond if they're to act responsibly and ethically. "When close friends and family ask for medical advice, that's always a matter for introspection, and at the end of the day, it's not resolved by codes of ethics but by considered individual judgments."
It used to be as the trusted source of knowledge where access to information was limited this was a significant responsibility but with the age of

and medical applications like
AskMD, iTriage and HealthTap to mention a few you might find there is fewer and fewer requests. So for those of you that like the opportunity to help others out...enjoy it while you can mHealth and Telemedicine may be changing the landscape and soon!

Monday, April 14, 2014

Social Media in Healthcare

Social Media is here to stay and its impact in Healthcare has been impressive and far reaching.

If you still need convincing - look no further than this piece 24 Outstanding Statistics & Figures on How Social Media has Impacted the Health Care Industry that features a host of examples. As they put it
In a generation that is more likely to go online to answer general health questions then ask a doctor
And that’s the point our population and customers are changing and they are using the internet and social media as a major source and guide to their care.
A few choice data points:
90% of respondents from 18 to 24 years of age said they would trust medical information shared by others on their social media networks
This may be the younger generation but in many instances they are becoming the healthcare support infrastructure for their parents and will use the same methodology to for their parents care as their own
31% of health care professionals use social media for professional networking
I am willing to be this is increasing and I only have to look at my own twitter feed and lists of doctors I am connected with, follow and use as major source and guides
41% of people said social media would affect their choice of a specific doctor, hospital, or medical facility
Ignore this at your peril - 2 in 5 of your patients are looking at social media to guide their healthcare selection.
And the opportunity and impact will increase as we see the penetration of mobile devices increasing
International Telecommunications Union estimates that global penetration of mobile devices has reached 87% as of 2011
So for those of you already online the impact and effect will increase. Those of you not….well that train has left the station. This graphic by Howard Luks (@hjluks) captures the extent of the opportunities