Hot Dogs and Common Sense

boy eating hot dogSo the American Academy of Pediatrics just came out with a statement that–gasp!–hot dogs (and hard candy, peanuts/nuts, seeds, whole grapes, raw carrots, apples, popcorn, chunks of peanut butter, marshmallows, chewing gum, and sausages)  pose a choking hazard to young children.

Maybe about a dozen children a year die from choking on hot dogs. So the AAP would like hot dog manufacturers to put warning labels on their products and consider changing the wiener’s shape so they pose less of a risk to young children.

I honestly do not know where to start.

My oldest child  just turned 23 and my youngest just turned 14; maybe I’m too old a mother to understand these pronouncements. But you know what. . .I just don’t care. I still have to ask the question that I’m sure will get me flamed:

Are you insane????

When I was a “baby” parent of just 23 myself the rule was. . . common sense. I didn’t feed my 1-year-old a hot dog or individual grapes because — duh! — they were about the same thickness as his … Continue Reading

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Visiting the ER WITH Health Insurance and Without

girl and fence$2600. $544.

Look carefully at those two numbers. The first is the sum of three bills I received for my husband’s day-after-Christmas visit to the emergency room for unusual dizziness. A CT and EKG ruled out a stroke or heart attack. Diagnosis? Vertigo.

(Note: both figures will likely be much higher once all the bills come in, but I needed a blog post so I’m going with what I’ve got now).

Now look at the second figure. That’s what I have to pay after the discounts my insurance company has negotiated with the hospital and radiologists. Note: there are no payments from the insurance company in there because we had not yet met our deductible. These are just the discounts.

Which points out a really critical issue when it comes to those who have health insurance and those who don’t. Merely by having health insurance–even before my insurance company spends a single cent on my medical care–I benefit. I benefit from the administrators who go to the hospitals and doctors and negotiate deep discounts in exchange for funneling more volume (i.e., patients) … Continue Reading

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healthcare reform

Blame the Genes

DNA StrandsJust heard a news story that researchers have identified three genes responsible for about 9 percent of  stuttering. In the story, a woman who stuttered as a child and teenager and who now works with other stutterers was nearly in tears at the news. Her clients, she said, would be so happy to learn that their stuttering “wasn’t their fault.”

I’m happy for the stutterers of the world. But this story made me think about so many other things related to our health that we try to find an “out” for, something that makes it not our “fault.” The more we learn about the contribution of genes to human health, the more stories like the stuttering one we’ll hear. The thing is, our genes do not operate in a vacuum. Just because I have a gene or genes that increase my risk of lung cancer doesn’t mean I’ll get it. But add smoking to the mix–an environmental component–and it’s much more likely I’ll develop lung cancer as the environmental stress combined with the genetic mutations turn on or off the underlying biochemical processes … Continue Reading

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The Care and Feeding of a Freelance Medical Writer

horseMany have asked me: How can I make sure that my freelance medical writer is happy? For, as any freelance medical writer knows, we can be an ornery lot, arguing over the merits of yellow vs green when highlighting PDF references; Endnote vs RefMan; the true meaning of a P value. Yet, like any high-strung, thoroughbred, given the right care and feeding, your medical writer can be your greatest asset.

To that end, here is my advice on the care and feeding of your freelance medical writer.

1. Be specific in your commands. I just met with a new client about writing needs assessments. Rather than verbally explain things to me (and the other freelancers he uses) he handed me a folder. Inside was a sample needs assessment with his comments as to what worked and what didn’t work. He also included a sample letter of agreement and a checklist for identifying potential faculty. It was only my years of training that prevented me from leaping across the table and hugging him.

2. Commit to your training regimen. You know how much … Continue Reading

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Check, Please!

CheckA couple of recent news stories reminded me of the dirty little secret about healthcare that no one wants to talk about, the proverbial elephant in the room. All those pills, surgeries, x-rays, medical care? It costs money! 

Yes, Virginia, quality medical is not a right, not guaranteed in the Constitution, not something good-hearted corporations and companies, whether for-profit or not, are obliged to hand out like candy corn at Halloween. It costs money. Billions of dollars a day.

This appears to be something we all forgot in the warm fuzzy moments of watching military transport planes fly critically ill people out of Haiti to Florida hospitals. Who was going to pay for all this medical care? For the months of hospitalizations and rehabilitation these people were going to require? When the state of Florida, rightly so, asked the same question, prompting the halting of those military convoys, it ended up on the receiving end of a world-wide outpouring of boos and hisses.

Hey guys, back off. How would you feel if we sent thousands of Haitians to your house … Continue Reading

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federal budget Haiti healthcare costs healthcare reform

The Future of CME

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

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Back Away from the Quacks!

breast cancerSo my cousin emailed me the other night. She had a breast cancer recurrence about 6 years ago. Before you feel too sorry for her, however, know this: She’s doing great, moving from one targeted treatment/chemotherapy/laser knife procedure to another. Her doctors are fabulous. Her attitude is amazing. And, as she constantly tells us, she feels great and is loving life. No, this isn’t about her. It’s about her friend, the one she emailed me about.

Her friend was diagnosed with an early stage of an aggressive form of non-small cell lung cancer a year ago. After chemotherapy, a CT scan this summer showed her lungs clear of cancer; but a followup CT scan last week showed some spots. This woman had participated in a clinical trial during her first round of treatment and her doctor wanted her to join another clinical trial. But my cousin’s friend is freaked out; she doesn’t want to feel like a “guinea pig.” So when her daughter suggested she see a doctor who specializes in an unproven and experimental therapy called insulin potentiation therapy, she was ready … Continue Reading

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alternative therapy cancer clinical trials quackery

Focus People!

upset boyOk, yes, the Democrats just lost their filibuster-proof majority. Politics, politics, politics.

Can we please focus on what’s really important here, people, which is not seeing who can pee further. It is providing health insurance for more than 35 million people and taking the first baby steps towards fixing our mess-of-a-healthcare system.

One statistic and then I’ll stop ranting: An estimated 17,000 children in the United States might have died unnecessarily over nearly two decades because they didn’t have health insurance, according to a report from researchers at Johns Hopkins Children’s Center in Baltimore.

Ok, now you Senators can start peeing again.

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healthcare reform

Ode to Death Panels?

deathBack 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

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