One proposal — to increase Medicare payments to general practitioners, at the expense of high-paid specialists — has touched off a lobbying fight.

Family doctors and internists are pressing Congress for an increase in their Medicare payments. But medical specialists are lobbying against any change that would cut their reimbursements.

Shortage of Doctors… - NY Times

Denying economic incentives for primary care physicians is the same as denying the fact that there is a shortage of primary care physicians.

While I don’t agree with directly redistributing dollars from specialists to primary care physicians, I think that changing from the current fee-for-service system to a different reimbursement approach (bundled payments for conditions?) may incidentally cause a pay scale shift.

Medical school takes just as long for specialists and primary care physicians. And they both start practicing medicine with the same amount of debt. Do specialists deserve higher yearly incomes? I’m not sure. But we can’t expect medical students to choose primary care fields solely out of good will when higher salaries beckon elsewhere.

About 1 in 5 children suffer from eczema, the condition causing red flaky, itchy patches of skin. While frustrating and unsightly, children occasionally suffer from skin infections as a result of constant itching. And treatment normally requires expensive topical antibiotics and anti-itch creams. However, adding half a cup of 6% bleach to the bathwater showed significant decreases in eczema and bacterial infections:

Children in the study who took the bleach baths had a reduction in eczema severity that was five times greater than the children who took the placebo baths after three months.

The results were so dramatic that researchers stopped the three-month study early so that all the children could benefit from the bleach baths

-Web MD, “Bleach Baths May Help Kids With Eczema”

The results are promising and tempt emulation at home, but it is important to consult with a physician before trying any experimental home treatments

The study was published in Pediatrics Vol. 123 No. 5 (May 2009)

My father used to say that if I told myself I was smart and liked homework, then my brain would respond accordingly. Apparently, recent research has shown that this might actually be true:

Researchers found that when older volunteers took a series of cognitive tests after being given hints that their age might affect the results, they did less well. The study, which appears in Experimental Aging Research, was led by Thomas M. Hess of North Carolina State University.

-NT Times, “Reminders of Age Undermine Memory”

When thoughts manifest into beliefs, beliefs intertwine with reality.

Photo by Eneas

More swine flu news (I know, it’s been a hot topic these last few days). The number of deaths in Mexico attributable to swine flu are up, but there have still been no deaths or hospitalizations in the US.

Also, the World Health Organization raised its pandemic alert level to 4 in response spreading of swine flu. While “alert level” may sound intimidating, level 4 only signifies that the virus is capable of sustained transmission at the community level. It doesn’t measure the lethality of the strain.

Below is a summary of the relevant WHO alert phases:

Level 2:

• Predominantly animal infections.
• Few reports of animal-to-human infection.
• No human-human transmission.
• Potential pandemic threat.

[Read the rest of this entry...]

For over a decade now, researchers have documented the effects of language barriers on health care. Patients who speak English poorly or not at all face longer hospital stays, an increased risk of misdiagnoses and medical errors, and decreased access to acute and preventive care services, often regardless of socioeconomic or insurance status.

-NY Times, “When the Patient Gets Lost in Translation”

This point really emphasizes the importance of doctor-patient communication. Not present in medicine of yore, new technology, diagnostic tests, and administrative duties have slowly separated the doctor from the bedside.

Instead of waiting for a translator, many doctors see it as an acceptable shortcut to base their decisions on the outward presentation of the patient. And instead of spending time on in-depth conversations with patients, doctors shuffle speedily from patient to patient (which is not entirely the physicians fault — the US system for reimbursement and financial incentives therein perpetuate this practice).

Doctors and policy makers need to take the importance of patient-doctor conversations into account and ensure that any future reform reflects their value.

The news is flooded with headlines like “Mexico City on alert over swine flu outbreak” and “Mexico Swine Flu Epidemic Worries World”. So far, there have been 42 deaths from 1112 confirmed cases of A/H1N1 subtype influenza in Mexico (May 7, 2009, WHO).

Photo by be_khe

H1N1 is endemic to pig and bird populations and has been compared to the Spanish flu pandemic of 1918 (which killed up to 100 million people worldwide). But the spanish flu only exists today in a few isolated lab samples, and the bird and pig H1N1 strains are usually only transmittable through animal to human contact. However, the recent swine flu cases have shown that the new H1N1 strain is capable of human to human transmission.

[Read the rest of this entry...]

The debate over if fructose, glucose, or sucrose have different effects on human health from one another is long and ongoing. However, a recent study has shines new light on the case against fructose:

…consuming too much fructose can actually put you at greater risk of developing heart disease and diabetes than ingesting similar amounts of glucose.

-TIME, “All Sugars Aren’t the Same…”

Although high-fructose corn syrup only has slightly more fructose than table sugar, 55% and 50% respectively, the study still raises concerns about excessive fructose consumption

While the sucrose, glucose, and fructose all weigh in at 4 calories per gram, their effects on human weight gain differ.

…but only the people drinking fructose-sweetened beverages with each meal showed signs of unhealthy changes in their liver function and fat deposits. In this group, the liver churned out more fat, while the subjects consuming similar amounts of glucose-sweetened drinks showed no such change.

-TIME, “All Sugars Aren’t the Same…”

Adding insult to injury, the study also found that fructose consumption gave sudy participants symptoms suggestive of diabetes. The participants in the high-fructose group had decreased sensitivity to insulin. Regardless, sugar packed drinks are a dietary nightmare — they always have been.

“Half the money that we spend in this country on Medicare is spent on patients in the last 6 months of their lives. If we were providing some sort of wonderful existence, then one could make the case. But these last six months are not, they’re often agonizing and very unsatisfying for all concerned.”

-Dr. Robert Martensen, M.D., regarding palliative care.

Photo by Luza return to nature

In observation of earth day, this series of organic foods posts will end. Part 1 explored the effects organic foods have on personal while Part 2 touched on the global health benefits of buying organic. But this question remains to be answered: for how long is organic farming sustainable?

Although organic farms require fewer chemical inputs to grow their crop, reducing toxic runoff and worker exposure, farmers merely trade chemical use for a different input: land. Without the advantage of pesticides, fungicides, and fertilizers, organic farms yield 5% to 50% less crop per acre, and they need significantly larger fields to maintain the same output as a conventional farm.

[Read the rest of this entry...]

I’ve written about vitamins and cesarean sections in the past month, so I found it interesting that a study found a correlation between the two.

Of 253 women who gave birth in a Boston, Massachusetts hospital, those deficient in vitamin D were nearly 4-times more likely to deliver by cesarean section than women with higher levels of vitamin D, report Dr. Michael F. Holick and colleagues.

-Reuters, “Vitamin D deficiency may raise cesarean risk”

However, this doesn’t necessarily mean that low vitamin D actually do increase cesarean rates. More in-depth study will be needed to verify that claim. However, to keep your bases covered just in case, spending about 10 minutes a day in the sun is a safe way to increase vitamin D levels