State of Health - Latest Comments

Re: Governor’s New Budget Slices — Again — Into Health Care

anne — Tue, 15 May 2012 13:08:57 -0000

i wish people would agree to paying just a little more in tax. that would mean less cuts...in government benefits and people who work in support of these benefits won't lose their jobs.
It's common sense that you can't balance a budget by just cutting things out. You need a revenue!!!

Re: Federal Court Dismisses Veterans’ Suit over Mental Health Care

Charles — Thu, 10 May 2012 10:17:23 -0000

it's a disgrace and embarrassment that our Vets are not being cared for in this area. It is well known that the largest problem for returning Vets is PTS. The Bush years were the years when they talked the talk, but didn't walk the talk. I'm hoping that the Obama Administration is going to do more, as they seem to have a focus on Vets and what they can do for families and returning Vets, but right now it is still talking the talk.

Re: High-Deductible Health Plans: Health Access or High Risk?

HSAconsumer — Mon, 07 May 2012 18:50:47 -0000

Learn how to be a better HSA Consumer at the same name dot com

Re: Rural California Hospitals Slow to Digitize

harriseve — Sat, 05 May 2012 12:57:32 -0000

Yes, the financial incentives have been a wonderful boon! But unfortunately, barriers to electronic health record implementation in rural areas threaten to perpetuate the already-existing disparities in healthcare delivery.

Re: Rural California Hospitals Slow to Digitize

JEngdahlJ — Fri, 04 May 2012 22:47:32 -0000

Centers for Medicare and Medicaid Services (CMS) has provided $4.5 billion in electronic health record incentives. How might electronic health record (EHR) efforts progress from here? http://www.healthcaretownhall....

Re: Cash-Only Practices: Better for Patients or Just Better for Doctors?

Bobby Gladd — Fri, 04 May 2012 11:51:32 -0000

In his new book "Healthcare Beyond Reform," Sausalito based healthcare futurist Joe Flower brings up this topic as a potentially viable component of an improved health care delivery system. I'm reviewing his book now on my REC blog at http://regionalextensioncenter...

I've thought about going "concierge" myself.

Re: Rural California Hospitals Slow to Digitize

Lori — Thu, 03 May 2012 21:04:40 -0000

Great article. Thougful and thought provoking.

Re: Share and Share Alike — Especially in Medical Decisions

IMDFoundation — Thu, 26 Apr 2012 14:06:36 -0000

Very nicely written! We couldn’t agree more, that informing and involving patients in their health care decisions is truly an ethical imperative. Every patient has the right to fully understand their options and voice their preferences because it is the patient who will live with the repercussions of the decision. Each and every patient is unique and there is no one right decision for everyone.

Informed Medical Decisions Foundation
www.informedmedicaldecisions.o...

Re: Tobacco Brands Target Black Teens, Study Finds

Charles Amico — Mon, 23 Apr 2012 17:58:09 -0000

This is good info. Thanks! It helps us make comments on accountability for these issues. It is my opinion that the easy answer is always taxing cigarettes. I think more drastic measures are required. The majority population is not Black. And we need to consider and take action based upon the fact that the cigarette companies are targeting kids still. IT DOESN'T MATTER IF THEY ARE BLACK OR WHITE. IT IS PLAIN WRONG AND THERE NEEDS TO BE CONSEQUENCES TO THE CIGARETTE COMPANIES.

Re: Technology Enables Collaborative Doctor-Patient Relationships

anonymous — Fri, 20 Apr 2012 22:29:16 -0000

The doctors should not be ordering calcium scans on the patients to begin with. The radiation increases their risk of cancer, and calcium scans can lead to additional tests and run up costs for our health system. Calcium scans are one of the most obvious examples of medical waste and overuse. We have other ways of deciding whether to take a statin, such as calculating Framingham risk score.

Re: Technology Enables Collaborative Doctor-Patient Relationships

Eve Harris — Fri, 20 Apr 2012 20:59:16 -0000

I don't suspect doctors of trying to scare patients, because fear has already been tried and it doesn't work to motivate healthier behaviors. If it worked, we wouldn't be in the public health messes we're in.

When I look at a provider who takes time to show scans to patients and answer their questions I see patients becoming empowered and being respected --fundamentals on the collaborative care continuum.

Re: Technology Enables Collaborative Doctor-Patient Relationships

anonymous — Fri, 20 Apr 2012 18:57:19 -0000

I'm not a big fan of calcium scans. No one has ever shown that screening asymptomatic people with calcium scans results in fewer heart attacks than simply measuring cardiovascular risk factors such as cholesterol and blood pressure.

In addition, calcium scans expose people to radiation, to the possibility of the scan picking up "incidentalomas" that have to be followed up with more tests, and to increased anxiety in the case of people with high scores. So even if there is a benefit for some people in the form of weight loss you have to weigh that against the harms.

Also, I guess I'm missing something but how did you conclude this was collaborative care? Couldn't it just as easily be doctors thinking that they can scare their patients into losing weight (or taking a statin, as in a companion study that was also presented at ACC) by showing them some scary pictures? From the doctor's point of view, what this study shows is that calcium scans improve compliance.

Re: Technology Enables Collaborative Doctor-Patient Relationships

MightyCasey — Fri, 20 Apr 2012 15:01:43 -0000

Why I use dating analogies in my presentations to both clinical and patient audiences, exactly. Technology enables patients to gather information, after which it helps immeasurably if their doctor welcomes that approach and offers the meaning and context for that information. Then a treatment plan has a better shot at a better outcome: everyone is on the same page (literally) and communicating. Nirvana.

Re: Technology Enables Collaborative Doctor-Patient Relationships

Eve Harris — Fri, 20 Apr 2012 15:01:15 -0000

Yes, I believe that's the one

Re: Technology Enables Collaborative Doctor-Patient Relationships

Marilyn Mann — Fri, 20 Apr 2012 14:42:00 -0000

Is this the study you are referring to?

MOTIVATIONAL EFFECT ON WEIGHT LOSS AFTER VISUALIZING CORONARY CALCIUM BY CARDIAC
COMPUTED TOMOGRAPHY
ACC Moderated Poster Contributions
McCormick Place South, Hall A
Saturday, March 24, 2012, 9:30 a.m.-10:30 a.m.
Session Title: Imaging: CT - Coronary Artery Calcification
Abstract Category: 24. Imaging: CT
Presentation Number: 1109-445
Authors: Nove Kalia, Dong Li, Matthew Budoff, Los Angeles BioMed Research Institute at Harbor UCLA, Torrance, CA, USA, University of
Saskatchewan, Saskatoon, Canada
Objectives: The aim of this study was to assess the effect on behavioral lifestyle changes (weight loss) in patients who underwent coronary artery
calcium (CAC) scoring with cardiac computed tomography.
Background: Despite convincing data demonstrating the benefits of weight loss for both primary and secondary prevention of coronary heart
disease, it remains to difficult to motivate behavioral changes resulting in weight loss. In this study, we assess whether higher CAC scores are
associated with beneficial lifestyle behaviors resulting in weight loss.
Methods: We evaluated 518 patients that had undergone baseline CAC testing and returned for a follow-up scan with documented weights. The
primary end point was measurable weight loss between visit one and visit two.
Results: The study population consisted of 518 individuals (68% men, mean age 60 +/- 8 years) who were followed for a mean of 3 +/- 2 years
after an initial CAC scan. Overall, behavioral modification resulting in weight loss was lowest (21.8%) among those with CAC = 0, and gradually
increased with higher CAC scores (1 to 99, 35.7%; 100 to 399, 31.5%; > or =400, 38.2%; (p <0.001 for trend). In multivariable regression analysis,
there is a dose-response relationship between increasing CAC score and weight loss. In the group that had weight loss compared to those without
weight loss there was a 40% increase in mean CAC score (95% CI 0.2-0.6 p<0.001) after being adjusted for age gender and race. In logistical
regression analysis those with CAC score of 1-99, 100-400 and >400 as compared to those with a score of 0 were 2.0 (95% CI 1.1.0-3.9 p<0.001),
3.6 (95% CI 1.7-7.3 p<0.001) and 3.3(95% CI 1.6-6.9 p<0.001) fold respectively more likely to lose weight when adjusted for age gender and race.
Conclusions: In conclusion, in addition to risk stratification of individuals, determination of CAC may also improve behavioral modification
resulting in weight loss.

Re: Technology Enables Collaborative Doctor-Patient Relationships

Carla TN Berg — Fri, 20 Apr 2012 14:02:18 -0000

You are so correct on all these points. Patients are getting more engaged and better equipped all the time (electronic records, good web sites, new apps and devices), and as a result, are feeling more empowered. Doctors are coming to see their role not as the "sage on stage" but as a "guide on the side," a trusted consultant Together these changes this decade will impact our lives as much as the Internet did in the 90s. Thanks for the excellent summary, Eve.

Re: California Advocates For Healthy Food in U.S. Farm Bill

Dapollack — Tue, 17 Apr 2012 19:39:56 -0000

It is ironic that this post came a few days before the new PBS series, America Revealed, aired its first episode, which focuses on the US food system. The program is an appalling jaw-dropping paean to the agricultural-industrial complex masquerading as educational television. I am surprised none of the major food policy experts who support sustainable, sensible, healthy (i.e., good, clean, and fair) food policy have not commented on this surprisingly flawed program.

Re: Tribal Clinic Uses Native Foods to Fight Diabetes

William L. Wilson, M.D. — Sat, 14 Apr 2012 20:13:42 -0000

Native Americans have a high incidence of diabetes and obesity because they are more genetically prone to a disease called Carbohydrate Associate Reversible Brain syndrome or CARB syndrome. This disease is triggered by consumption of excessive fructose from sugar and HFCS and high glycemic carbohydrates, the typical ingredients of food made by the Industrial Food Complex.

The genetic susceptibility of a given race is inversely related to how long that race has been consuming sugar, HFCS and high glycemic carbohydrates. Because native Americans have only been eating this food for a few generations, they are extremely susceptible to CARB syndrome, a disease characterized by up to 21 brain dysfunction symptoms and excessive fat storage at any caloric intake.

The only hope for Native Americans is to return to a pre-agricultural diet. I recommend reading Cordain’s excellent book “The Paleo Answer” for guidance. For more information about CARB syndrome go to: http://carbsyndrome.com.

Re: California Advocates For Healthy Food in U.S. Farm Bill

Lisa Aliferis, Editor — Wed, 11 Apr 2012 19:48:30 -0000

We included several links in the blog which might provide more background for you. As always, anyone with strong opinions on any matter before Congress can certainly write or call your Representative or Senator.

Re: ouRXperience: An “F” in Air Quality; Hmong Shaman Training; Healthy Food Access; Child Abuse Awareness

Tom DeVries — Wed, 11 Apr 2012 15:25:19 -0000

If you heat yr house with natural gas, there're gas wells and a refinery and holding tanks and high pressure pipelines thru all the neighborhoods between all that and you. Just because we keep the mess out of our sight doesn't mean there isn't any.

Re: California Advocates For Healthy Food in U.S. Farm Bill

Pasadena Personal Trainer — Wed, 11 Apr 2012 07:18:06 -0000

I like this article Michael Pollan Just because the Important thing that has been submitted to the Government for approval and that's under process. Wasn't in my knowledge ever before but I got it in this Site. Well I hope that'd Approved because as Michael Pollan Said above there under his own photo that the Farm Bill needs to change Radically to focus on People's health.

Re: California Advocates For Healthy Food in U.S. Farm Bill

biobabbler — Mon, 09 Apr 2012 14:05:14 -0000

Do you have any links to sites where we can show our support for these initiatives?

Re: Can the Government Make You Buy Health Insurance?

pradeep nagar — Mon, 09 Apr 2012 02:46:10 -0000

Thank You

The given information is very effective
i will keep updated with the same

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Re: The Greatest Health Risk to Children? No, It’s Not Drugs

susan256 — Sun, 08 Apr 2012 12:45:43 -0000

Preventive measures are key to better health and less hospital admissions. Less sodium and fat filled food, more time outside playing and less time in front of a computer or TV and a relationship with a primary care doctor will likely lay the foundation for less medical intervention - and more money in your pocket - down the line. http://whatstherealcost.org/vi...

Re: Please, Don’t Call It Rationing

Jane006 — Fri, 06 Apr 2012 10:13:37 -0000

Wow! What a cautionary tale. Great information. As ever, we need to be our own advocates which, as you mention, is difficult when you're feeling awful and lying in a hospital bed.