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Now that my heart rate has returned to normal and my inner health policy goddess has stopped doing back flips, I can try to put Thursday’s historic vote into perspective.

WHOO-HOO!

Oh, sorry. I guess I haven’t completely calmed down.

But my joy is tempered with fear. Fear that the Republicans will make good on their promise to repeal the law or defund it. Fear that the ruling will tilt November’s election to the Republicans, giving them the votes to throw the law out. Fear that, as I said in my earlier blog, we will return to where we were 10 years ago—which is heading off a cliff in terms of health care.< This is in no way a statement about which party should win. It is a statement about the need to continue on the path that has been set. If a political change can change hard-fought laws previously passed, what does that mean for the country? We have some serious problems to deal with beyond health care; if we can’t find a way to work together, we are doomed. Ok, enough philosophizing for one blog. Let’s get back to the Affordable Care Act (ACA). One thing I’ve read—and … Continue Reading

I fired my doctor few weeks ago. The reason has a lot to do with what’s wrong with our healthcare system today while the new doctor I hired has a lot to do with what could be right with our healthcare system.

I write a lot these days about something called a “patient-centered medical home.” It enables patients to access care when needed; communicate in a variety of ways with their physician, including email; and be treated as a partner in their healthcare rather than a subservient patient—subservient to the doctor, of course. In a patient-centered medical home, your medical records are accessible, typically on line, and all test results are communicated within 24 hours of receipt.

I’d been seeing an internist in a small private practice for the past six years. He practiced with his wife, a family practitioner, who saw our kids. Initially, all was good. I could get appointments as needed; was treated respectfully; and received good care. But gradually I began to notice that it was harder and harder to get in to see this doctor during the week—often because the office was closed. I became frustrated when I couldn’t communicate with him except by playing … Continue Reading

Implementing Electronic Medical Records: Advice from the Trenches

The latest. . .from moi!

The Spirited Atheist: Who decides when medicine prolongs dying, not living? – On Faith at washingtonpost.com: “- Sent using Google Toolbar”

This article perfectly captures my earlier blog on end of life discussions.

I spent last week in Gothenburg, Sweden covering the European Committee for the Treatment of Multiple Sclerosis (ECTRIMS) meeting. Lots of good science, lots of excitement over the new oral and targeted therapies coming on the market to treat this awful disease. But what I want to write about isn’t the science, but about how it will play out in the brave new world of health care in which we all live in today.

For instance, consider the first oral therapy to hit the market: Gilenya (fingolimod), which the FDA approved in September. Last month Novartis announced the price: $48,000 a year.

This is not a rant against the high cost of drugs, however. It is a rant against the inability of our healthcare system to take the long view of the impact of such drugs, a view that is particularly important with a chronic disease like MS that strikes healthy young adults in their early 20s and 30s.

Because what I heard at the meeting was that treating early—as soon as the first clinical signs of MS appear—can slow the progression to disability, and that some of the newer drugs may actually put patients into remission.

This is extremely … Continue Reading

Just a reminder that I need your recommendations for Grand Rounds for GetBetterHealth. On Tuesday, June 22 I’ll be posting on my own blog an overview of the best stuff out there for the week with an emphasis on postings that focuses on customer service in health care. Want to get your blog considered? Email me directly at debra@debragordon.com and put “Grand Rounds” in the subject line.

Remember: DEADLINE is Monday morning at 10 a.m. eastern.

You can read all the details here.

Happy blogging!

So you’re probably wondering what I’m doing blogging about social networking when this is a blog about health and medicine and medical writing. Well, just consider:

Thousands of tweets are sent every hour about health/medical issues. Want a cool way to follow them? Check out Health Tweeder. Thousands of health care professionals, medical organizations and healthcare facilities have Facebook pages. And I’m sure that’s only the beginning; those, together with Linked In, are the only social networking sites I currently use so that’s all you get for now. Anyway, I’m here at the American Society of Journalists and Authors annual meeting in NYC. Our lunch speaker was Peter Shankman, social media guru and PR maven. His advice was not only hysterically funny (explaining to the under-30 crowd in the ballroom that MTV used to have music videos–not reality TV–and that telephones used to have cords) but right on. Among his nuggets of wisdom we would all be wise to listen to: Be transparent. If you screw up, admit it. If someone is paying you to hawk their product, admit … Continue Reading

So I’m sitting in a large ballroom in a hotel in New Orleans listening to a plenary speaker at the Alliance for Continuing Medical Education meeting (ACME). The topic? Hot Topics in CME.

An aside: for those of you who follow me who don’t know, CME is continuing medical education, the ongoing learning that all medical professionals must complete on an annual basis to maintain their certification. It’s a huge, multimillion dollar industry and it has come under withering scrutiny in recent years for its reliance on industry (read: pharmaceutical) support and the potential for bias that introduces into the process.

Full disclosure: a significant part of my work comes from companies applying for grants to put on CME-accredited activities or from companies putting on CME activities. From what I understand, in the “old” days of CME funders did have tremendous influence; a man I talked to last night at the wine-and-cheese gathering recalled the days 15 years ago when CME funding came from the marketing department of pharmaceutical companies.

Today, however, there are thick firewalls between commercial supporters and CME programs. The funding comes out of medical education departments separated from marketing. Once the money changes hands, … Continue Reading

Back in the day when I was a newspaper reporter I completed a biomedical ethics fellowship at the University of Virginia Medical Center in Charlottesville, VA. In addition to sitting in on the hospital’s bioethics committee discussions, I spent much of the week shadowing a nurse in the ICU.

They called her the Death Nurse because her job was to intervene with doctors, nurses, patients and families when the time came for a patient to move from the ICU to hospice. While her title was Supportive Care, she flat out told her me her job was to help people die; not actively, but from behind the scenes by helping patients and those caring for them understand when the time had come to move from curative care to supportive care (email me if you’d like a copy of the article I wrote about her).

When I asked why her job was necessary, she told me it was because it was so hard for doctors, nurses, patients and even families to face the reality of death. Her thoughts were echoed by a doctor there who was … Continue Reading