Anthony Lee's Blog
Posted by Anthony Lee
I have said it before and I will say it again: Prevention is the best way to live a long and healthy life.
Imagine, for example, the consequences of not eating right, not exercising enough, and choosing to smoke and drink. The first thing that may occur is obesity, which can lead to problems like diabetes mellitus, hypertension, hyperlipidemia, osteoarthritis, and obstructive sleep apnea. These problems, in turn, have their own complications, such as heart attacks, strokes, congestive heart failure, and kidney failure. Let's not forget difficulties with sleep, chronic obstructive pulmonary disease, lung cancer, liver cirrhosis, and hepatocellular carcinoma.
Just imagine how any of the above diseases requires at least one type of treatment, whether medical or surgical. Now picture the amount of money that goes into all of it. One thing automatically comes to mind: disability. I'm not just talking about the physical inability to do things in life. I'm also talking about financial burden, regardless of how much health insurance coverage one has. Just being preoccupied with such problems can significant impact one's quality of life.
These physical and financial constraints have a ripple effect on everyone else. Think about how a patient's family can be affected. I won't list examples of this, but I'm sure you can think of at least a few. I will say, however, that treatment of active disease does impact society. It is often cited as a factor associated with rising healthcare costs, shortages of nurses and doctors, and lost work productivity. All of this, of course, can circle back and affect the individual.
This is why prevention of disease is the way to go. It takes some discipline and effort, but if one can accomplish this task, it can do wonders. Trust me. It'll help everyone in the long run.
Posted by Anthony Lee
This week, I am posting two blog entries, both of which are a major departure from my usual musings. Instead of disease or the inner workings of the medical profession, I would like to discuss rising healthcare costs in America.
President Barack Obama is working to provide health coverage for the uninsured, an effort I applaud given how the issue has always been all talk and no action. At the same time, I am reminded of factors that could possibly drive up healthcare costs. After all, a problem is best solved from multiple angles, including the root causes (why costs are rising) and the end consequences (the now increased costs). While generating money to fill health insurance gaps is a start, one might also want to think about the following issues:
Malpractice Jury Awards
- Problem: Award money for pain and suffering in medical malpractice cases can be so excessive that malpractice insurance for doctors spins out of control.
- Suggestion: Legislate a cap on noneconomic damages for medical malpractice cases or, ideally, set up a medical court system.
Fear of Malpractice Litigation
- Problem: Doctors fear litigation and order unnecessary tests to prevent losing a lawsuit, if it occurs.
- Suggestion: While doctors should openly admit mistakes if they do happen, nonmedical people should understand that malpractice means negligence with standard of care, not unsatisfactory results despite the doctor's best efforts.
Pharmaceutical Ads
- Problem: Pharmaceutical companies spend much money on advertising to both consumers and doctors, often more than research and development of the drugs themselves.
- Suggestion: Drug advertising should never be directed to the consumer, and doctors should be free to objectively evaluate new drugs on the market without influence by the drug companies.
For more thoughts on U.S. healthcare costs, see my other blog entry.
Posted by Anthony Lee
This week, I am posting two blog entries, both of which are a major departure from my usual musings. Instead of disease or the inner workings of the medical profession, I would like to discuss rising healthcare costs in America.
President Barack Obama is working to provide health coverage for the uninsured, an effort I applaud given how the issue has always been all talk and no action. At the same time, I am reminded of factors that could possibly drive up healthcare costs. After all, a problem is best solved from multiple angles, including the root causes (why costs are rising) and the end consequences (the now increased costs). While generating money to fill health insurance gaps is a start, one might also want to think about the following issues:
Fee for Service
- Problem: A fee-for-service health plan reimburses the doctor for any office visits, test, and treatment, creating a financial incentive for the doctor to order unnecessary tests.
- Suggestion: Pay the doctor on a fixed salary, leaving services to be decided based on medical necessity.
Emphasis on Sick Care
- Problem: Some health plans pay little to none for preventive health and much more for services related to disease, leading many patients to wait until they get sick before requiring expensive tests and treatments.
- Suggestion: Create a level playing field by reimbursing more on prevention and less on sick care.
Abundance of Specialists
- Problem: Primary care physicians earn much less than specialists, an incentive for doctors to specialize while creating a shortage of generalists to do preventive medicine.
- Suggestion: As with health plan reimbursements, create a level playing field by boosting salaries for generalists and controlling salaries for specialists.
For more thoughts on U.S. healthcare costs, see my other blog entry.
Posted by Anthony Lee
As patients, we like to view our doctors as people who can help us. Naturally, it's easy to assume that, if they want to help us, they will grant our every wish to be healthy and disease-free. It's no wonder that some people feel upset if he or she asks for a specific test or treatment and the doctor says no.
At first, it may seem that the doctor is cruel. However, I know enough about how doctors think to say that there's often a good rationale for such a response. For example, a doctor may say no to a test or treatment because it may be more expensive than the standard without actually being better. This is especially true when a medically-oriented advertisement seems promising. Also, the requested test or treatment may be more dangerous than the standard that has a more acceptable safety profile.
In such cases, you also want to consider how the doctor is acting in the patient's best interest by thinking in the long term. Suppose a patient asks for a test or treatment that the doctor says is neither efficacious nor safe, but the patient really believes it will help. What will happen if the patient finds out the doctor is right? Will the patient regret not listening in the first place?
Basically, thinking of the patient's best interests doesn't just mean making sure the best options are available. It also means advising against bad options if the patient is tempted to pursue them without understanding their risks and benefits. The next time you find yourself not getting what you're asking your doctor for, take a step back and consider the doctor's position. It never hurts, and it's often a good idea, to talk with your doctor in order to come to a consensus.
Posted by Anthony Lee
Some people like to consider snoring to be an annoying but harmless sleep phenomenon. Is it possible, however, that this supposedly normal occurrence during slumber could be a warning sign for something worse?
During sleep, the muscles of the upper airways and throat relax, reducing the diameter of the air passages. A simple law in physics applies here. When the diameter of a tube is smaller, the resistance faced by liquid or gas flow increases. In the upper airways of humans, this resistance causes tissues to vibrate, resulting in the characteristic sound of snoring.
In severe cases, the airway narrows and closes off. This is the phenomenon known as obstructive sleep apnea (OSA). It is a serious condition because sensations of being unable to breathe cause the person to repeatedly wake up. This results in sleep deprivation among other consequences.
Given how loud snoring occurs with narrow airways and OSA occurs when the airways close, it may help to look at snoring, particularly very loud snoring, as a warning sign for OSA. If you have a bed partner who complains that you snore too loudly, consider it more than just a comfort issue for that other person. Consider it a potential health issue for yourself as well.
