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As narrower insurance networks begin to limit where we can get our care and contradict the American notion of abundant choices, I thought about the Canadian health care system and rumors of its long waiting lists that grab U.S. headlines. Yet, narrow insurance networks, sky-high deductibles, co-insurance and co-pays are ways of controlling our medical expenditures. Instead of rationing with waiting lists, America rations with price...
Young sexual minority women, including those identifying as lesbian, gay, bisexual and transgender (LGBT), were found to have higher elevated odds of adverse health conditions than heterosexual young women. They also have lower odds of receiving a physical or dental examination, according to a new study in the American Journal of Preventive Medicine
Ninety-one percent of doctors are concerned about giving patients access to their detailed electronic health records, anticipating patients will feel anxious about the results. Only 34 percent of consumers are concerned about anxiety-due-to-EHR-exposure. Welcome to the digital health chasm, the gap between what consumers want out of digital health and what doctors believe patients can handle...
A new study in Health Services Research
reveals that expanding Medicaid to cover more adults boosts health care access and use in rural populations.
The use of social networking sites like Facebook may have implications for accessing online health information, finds a new longitudinal study from the Journal of Health Communication
A new study in the Journal of Adolescent Health finds that the sexual risk behaviors of young Hispanic people living in the U.S. vary considerably with their degree of acculturation.
Not long ago, the only options my patients had for communicating with me were to come in to the office or relay a message through the office staff. But since recently introducing the patient portal in our electronic medical record, my practice has changed substantially for the better...
Poor oral health can have a negative impact on seniors’ overall health and well-being, but for many, there are significant barriers to visiting a dentist, finds a new report in the American Journal of Health Behavior.
Veterans who receive mental health screening during primary care visits are generally getting adequate follow-up treatment, but the process for acquiring care could be improved, finds a new study in General Hospital Psychiatry
Blacks with a family history of untreated mental health disorders are less likely to seek treatment, even when they rate their own mental health as poor, finds a new study in the Journal of Health and Social Behavior
A new study in General Hospital Psychiatry
confirms that Blacks with depression plus another chronic medical condition, such as Type 2 diabetes or high blood pressure, do not receive adequate mental health treatment.
"When I think of patient engagement, I think of a partnership where people work together to figure out what the patient wants and how to support the process. Engagement is the knowledge base, working through the decisions and helping people to become full partners in their health outcomes." – June Simmons, MSW — Founding President and CEO, Partners in Care Foundation, San Fernando, CA
A federal screening program markedly reduced death and illness from cervical cancer in underserved, low-income women but reached just 10 percent of the likely eligible population, finds a new study in the American Journal of Preventive Medicine
Blacks and Whites living in an integrated, low-income urban area had similar rates of treatment and management of hypertension, or high blood pressure, finds a new study in Ethnicity & Disease
The ED is convenient, it's open 24 hours, it does not require an appointment. So when the stomach bug or kitchen accident gets the best of you at 9:00 pm, and your doctor's office is closed, where are you going to go? And, yet, we still chide people – via reporting, casual comments and the communication of health systems – for using the ED for "non-emergent" needs. What I'd like to see is more hospitals flinging open the doors of their EDs and saying, "We'll take you, any time, for any reason, and you won't wait long or pay an arm and a leg"...
Mental distress in people with disabilities is associated with increased prevalence of chronic illness and reduced access to health care and preventive care services, finds a new study in the Journal of Health Care for the Poor and Underserved
Some low-income, uninsured and Medicaid patients report feeling stigma when interacting with health care providers, finds a new report in The Milbank Quarterly
What does it means to be an "engaged" patient in the VA system today? It seems you have to know a senator who will intervene on your behalf, to give your health care a priority higher than his other constituents. This is deeply discomforting, and I hate that I am treated in a health care system where even those who are most accountable for the quality of the care it provides (the institutional leaders) can't trust the institution or the professionals who work there to routinely and uniformly deliver excellent care...
Are insurance companies making more decisions about the health care you receive? I received a letter from Aetna, my Medicare supplement insurance carrier, advertising a pitch for getting "started on a healthier lifestyle." "Because of your health history, we think you might benefit from joining our program," the letter read. Annoyed, I called the insurer...
Minority patients with atrial fibrillation, a heart condition that increases the risk of stroke, were less likely to receive common treatments and more likely to die from the condition than their white counterparts, finds a new study in Ethnicity and Disease
A new study in Health Services Research
reports that patients who get care at federally funded health centers have fewer office visits and hospitalizations, and receive similar or a better quality of preventive care when compared to similar patients of non-health center primary care providers.
Perhaps due to a lack of or inconsistent insurance coverage, young adults age 18 to 25 tend to go to the doctor’s office less often than children or adolescents, yet have higher rates of emergency room use, finds a study in the Journal of Adolescent Health
Black adults who reported feeling more financial strain also rated their health more poorly than those with less financial strain, finds a new study in the American Journal of Health Behavior
As the health care system changes in the coming years, one particular trend that will negatively impact consumers' out-of-pocket costs is the use of co-insurance (instead of a co-pay) for expensive specialty medications. Approximately 57 million Americans rely on these drugs to maintain their health, and it is disheartening to learn that many people are suffering because their medications have become too expensive...
A few days before the recent deadline for Obamacare sign-ups, I visited with one of the exchange navigators in Colorado, a state that expanded its Medicaid program and is working hard to enroll uninsured residents. This visit got me thinking of the millions of other people who live in states where they can't get access to Obamacare because they are too poor and yet are also not eligible for Medicaid...
It is common for those who work in and deliver health care to overestimate our knowledge about our bodies, our illnesses and how the health care system works. Such as: Who is the nurse practitioner? Where is Dr. X's office? When is "soon"? Why are you recommending this test? To help people find good health care and make the most of it, the following video explains two key things to ask when making your appointment and three questions to get answered before you leave your doctor's office...
"I walked in a person, and out a cancer patient," my dad said as we filed home. Crossing this threshold, we found ourselves on the other side of medicine – the side on the exam table or gurney, as opposed to the one standing over it. In time, it became clear we were running out of money...
By now it's hardly a secret that insurance companies have canceled the policies of millions of Americans whose old coverage did not comply with new benefit requirements of the Affordable Care Act. But after hearing all the backlash and requiring people to buy newer and, in the eyes of ACA supporters, better policies, the administration took another U-turn and changed the rules once again...
Despite having access to online ratings, patients can’t distinguish the quality or performance of one hospital from another, finds a new study in Health Services Research
Patients with an existing relationship with a doctor ranked as lower performing were no more likely to switch doctors than patients with higher performing doctors, finds a new study in Health Services Research
Opponents of health care reform, especially those who resist moving to a single payer system like Canada’s, have often used a very powerful argument to sway public opinion. Any significant changes, they warn, to America's private insurance system would mean that the government will come between patients and their doctors by making decisions about the care Americans receive. But what if it's not the government that is inserting itself between you and your doctor?
We have all heard the term patient-centered medicine by now. It's in the PR materials for hospitals, in the Affordable Care Act, in health care model innovations like the "medical home" and the "accountable care organization." But what is it? What would you like to see in a health system that is truly patient-centered?
Expanded smoking cessation benefits offered under the Affordable Care Act (ACA) should give more people the opportunity to quit, finds a new study in the American Journal of Preventive Medicine
Shoppers searching the Internet for health insurance coverage can be forgiven if they are confused.
The Obama administration and Affordable Care Act supporters have not bothered to explain how the law includes cross-subsidization, missing an opportunity to talk about the "we" aspects of the law. As one 58-year-old woman put it: "The chances of me having a child at this age is zero. Why do I have to pay an additional $5,000 a year for coverage that I will never, ever need?" Here's how it works...
A new study in General Hospital Psychiatry
finds patients visiting the hospital for a variety of ailments can be easily screened for depression and anxiety as they wait for care.
It looks like an airport lounge without the rolling suitcases. There are about 20 of us fiddling with our phones or reading the newspaper, waiting to meet with our doctor for follow-up or monitoring visits. All of us are between the ages of 20 and 70 and all of us are dressed for success – or at least for our jobs. What's wrong with this picture? Why are employed adults spending a busy Wednesday morning waiting (and waiting) for our health care appointment when we should be working?
Depression rates are increasing in the U.S. and under-treatment is widespread, especially among certain groups including men, the poor, the elderly and ethnic minorities, finds a new study in General Hospital Psychiatry
During my senior year in college, with medical school acceptance letter in hand, I was diagnosed with metastatic testicular cancer. Early in my treatment I received a letter that my health insurance had been exhausted and I would no longer receive any health benefits. Needless to say, this was a problem...
What exactly is primary care? There have been a number of news stories lately that point to shifts in its traditional definitions and in what patients can (or should) expect to receive from primary care providers...
A new study in the American Journal of Preventive Medicine
finds that rural residents have experienced smaller gains in life expectancy than their urban counterparts and the gap continues to grow.
We know that the U.S. has the most expensive health care in the world. But beyond noting that dubious achievement, we seldom ask why...
What's the key to reducing costly emergency room visits and readmissions? People who lack convenient access to a health care provider, with or without insurance, return to the emergency department or hospital out of need and desperation...
Hospitals that treat more poor seniors who are on both Medicaid and Medicare tend to have higher rates of readmissions, triggering costly penalties, finds a new study in Health Services Research
Increased federal funding for community health centers has helped low-income adults get access to primary and dental care, according to a new study in Health Services Research
In part seven of our series, we offer advice about how to make the most of your doctor's appointment. Here's what you should do before, during and after your visit...
In part six of our series, you'll find out what key pieces of information you need to know about your new doctor's office. Keep it handy with your personal health records or household files...
In part two of our series, we look at the difference between Medicare and Medicaid. Our 'Be a Prepared Patient' resources can help you figure out if you qualify for either of these or other special health care programs...
In part one of our series, we look at the basics of picking a health insurance plan that's right for you, your family or a loved one. Our 'Be a Prepared Patient' resources can help you find the best coverage at the best price for your health needs...
Patients who are placed in observation instead of being admitted to a hospital may face high out-of-pocket costs for treatment, finds a new study in Health Services Research
Last week at a New York City meeting of the Association of Health Care Journalists, Elisabeth Benjamin, a vice president of the Community Service Society, tried to explain the New York health insurance exchange to a group of skeptical journalists who had more than a passing familiarity with the topic...
Residents of Massachusetts saw small gains in health status following the enactment of a state-wide health insurance mandate in 2006, finds a new study in the Milbank Quarterly
Age at immigration and citizenship status may have health implications for immigrants, finds a new study in the Journal of Health and Social Behavior
People who identified their medication by shape, size or color instead of name had poorer adherence and an increased risk of hospitalization, finds a recent study in the Journal of Health Communication: International Perspectives
Electronic health records collect non-clinical information that can be used to measure a medical practice’s patient-centeredness, finds a new study in Health Services Research
A new study in the American Journal of Preventive Medicine
finds that many local health departments aren’t able to meet goals to increase health care access.
At Home/Chez Soi, a Canadian program for the mentally ill, is built on the concept that providing housing is the first order of business. An approach that reinforces the truism that good health is more than swallowing the latest wonder drug.
Blacks, Hispanics and Asians are less likely than non-Hispanic Whites to visit a health care professional, even with health insurance, finds a recent study in the Journal of Health Care for the Poor and Underserved
Outsourcing work to cheaper workers is a common strategy of corporations. It has largely escaped the public’s notice, however, that much of this new labor force isn't located in Southeast Asia, but is rather found here in the U.S. and is virtually free. It is us...
In this week's health news: Patient-doctor relationship affects diabetes care | Women in Appalachia at risk for late stage breast cancer | People with asthma need not fear exercise | Treating depression helps some smokers quit...
Health care providers say that older teens often go to the doctor without a parent who can provide consent for needed vaccinations, finds a new study in the Journal of Adolescent Health
Don’t have health insurance? Here’s advice on how to find the right insurance for your needs.
Don’t know a deductible from a premium? Here’s a helpful guide to health insurance terms.
Learn more about the U.S. government’s health insurance programs for older adults and people with low-incomes and resources.
It can be hard to figure out how much your health care will cost ahead of time. Here are some tips for preparing for the cost of your procedures.
What to do if your health insurance denies you coverage for a procedure.
We want to have choices about the health care we get and who provides it. Many of us think we have that now...
Learn about long-term care and whether you need long-term care insurance.
Older women living in the most deprived areas of the U.S. Appalachia had higher rates of late stage breast cancer than women in more affluent areas, finds a new study in Health Services Research
A new study in the American Journal of Preventive Medicine finds that some cancer survivors do not always have the best access to primary care and that the type of health insurance they have—or don’t have—may be a factor.
Many people rely on the internet to look up health information or find a new doctor. However, navigating through the vast amount of resources and information online can be exhausting. Doctors Kevin Pho and Kenny Lin share some tips.
Fluctuations in the unemployment rate affect people’s health care choices, finds a new study in Health Services Research
Blacks and Latinos receive less adequate mental health care than Whites, finds a new study in Health Services Research
Black and Hispanic children with asthma are less likely than White children to use long-term asthma control medications, finds a new study in Health Services Research
Nursing homes with higher proportions of Black residents do worse financially and deliver lower-quality care than nursing homes with few or no Black residents, finds a new study in Health Services Research
Sometimes it is clear that the only response to a health crisis is to call 911 and head for the emergency department. But so many times the course of action is less obvious while the demand for some action is urgent.
Last week, a friend told me that her mother had been fired as a patient by her primary care physician in a letter she received in the mail. Last week, I fired my oncologist by email. My friend and I both wrestled with accepting that, in fact, this relationship needed to end.
Black women with breast cancer are more likely than Hispanic or white women to experience delays in the initiation of chemotherapy or radiation after surgery, finds a new study in Health Services Research
Victims of trauma are at higher risk of either dying or suffering a major complication if they are treated at a hospital that serves a large population of black patients, finds a large new study in Health Services Research.
People with outstanding credit card or medical debt were more likely to delay or avoid medical or dental care, finds a new study in the Journal of Health and Social Behavior.
Improving people’s knowledge and skills about their medications may be best achieved with multimedia patient education materials, finds a new systematic review in The Cochrane Library.
Low-income women who chose to deliver their baby at a birthing center under the care of a certified nurse-midwife had the same or better birthing experience as women under traditional care with a hospital-based obstetrician, according to a new study in Health Services Research.
I find myself relieved that I don’t have to figure out how to document (or not document?) concerns [in patient records]...Wondering what they are? Ok, I will tell you, but shhh...don’t tell my elderly patients that I may be considering these topics as I care for them.
Should nurse practitioners, RNs, physician assistants, pharmacists, social workers and others including, yes, peer patients, take up much — or even most, of doctors’ tasks?
Primary care providers could help people with warning signs of psychosis get critical early treatment and potentially reduce the current burden on emergency departments and inpatient units, finds a study in the journal Social Psychiatry and Psychiatric Epidemiology.
Low-income patients served by “safety-net” community health centers want to communicate with their doctors via email or text or are already doing so, according to a new study in the Journal of General Internal Medicine.
Have you heard that soon most primary care in the US will be delivered by teams? Yep. Team-based care is one of the characteristics of the patient-centered medical home, a way of organizing the care of patients that allows primary care clinicians to see more patients in a day while at the same time delivering better care.
In addition to dispensing, packaging or compounding medication, pharmacists can help improve patient outcomes in middle-income countries by offering targeted education, according to a new review in The Cochrane Library.
These 10 steps will help you get the information you need for your doctor’s appointment.
You're sick, but your doctor's office says the next open appointment is in two weeks. Or you're traveling, don't have a primary care physician or don't have health insurance. For all these reasons and more, potential patients are turning increasingly to retail clinics to cure their minor ailments.
All patients have their stories of hassles: hustling against traffic to inconvenient doctor appointments, not to mention waiting on hold to schedule a follow-up visit. But what if you couldn't read the road signs on your way or hear the options on your physician's answering service?
Choosing a doctor and building a relationship with him or her is an important first step to getting and staying healthy.
Here's advice on how to locate a new physician to make sure you get care that fits your needs.
Seek insurance and manage the worrisome chores of arranging and paying for care.
Using retail walk-in health clinics, often located inside pharmacies or big-box stores, for simple acute care problems can interfere with establishing and maintaining a relationship with a primary care provider, find a new study in the Journal of General Internal Medicine.
Even with access to health care, male military veterans are in poorer health than both men in the National Guard and Reserves and civilian men, finds a new study in the American Journal of Preventive Medicine.
What does it take for us and our families to find good care and make the most of it? And what can be done to help those who lack the skills, resources or capacities, or who are already ill, compensate for their inability to do so? This collection of essays identifies some of the key challenges posed to most of us by health care as it is currently delivered in many settings.
While the benefits of having (and keeping) a good physician may be evident, how do you find this just-right-for-you clinician?
Physicians have great influence over whether minorities and women participate in cancer clinical trials, according to a new literature review.
New research into "health care deserts" finds that primary-care physicians are especially hard to find in predominantly Black and/or low-income Hispanic metropolitan neighborhoods.
As more and more soldiers return from recent conflicts overseas, new research reveals that female veterans experience poorer health than other women.
Last week, the waiting room of the out-patient cancer clinic looked like an airport lounge without the rolling suitcases. There were about 20 of us cancer survivor-types talking on our smartphones, fiddling with our iPads, reading The New York Times...What's wrong with this picture?
I get a lot of inquiries about how to find a good doctor. I don't have a good answer. I thought it might be useful to throw out some ideas that have occurred to me and hope that readers will have better ideas and will share their experiences about what has or hasn't worked.
A new research review finds that if reproductive health services were more easily accessible, youth would be more likely to use them.
You may have seen the billboards or gotten a message on your smartphone: Come to our emergency room; our waits are short.
Less than one in four college students with symptoms of serious depression receives adequate treatment. Current health care services on campus might not be sufficient for delivering good quality mental health care, according to a new study in the journal General Hospital Psychiatry.
If you could see what your doctor wrote about you in your medical record, would this hurt or enhance your relationship? A new survey found that the majority of patients more than 90 percent are supportive and even enthusiastic about being able to read the doctor's notes. But among physicians, the reaction was mixed.
All kinds of people seek out health care, but studies show that not everyone accesses and receives care in the same way. Here, health care insiders look at how access varies among women, children and those with disabilities.
New health review sites promise to help you make this important decision for yourself or your loved ones. However, patients and physicians alike are finding that these doctor reviews aren’t as transparent or useful as they might seem.
When it came time for Jennifer Stevens, an Omaha, Nebraska resident and mother of two, to find an obstetrician for her first baby, she was faced with a dilemma.
User reviews and ratings on websites can help you locate a reputable handyman, the perfect restaurant for your anniversary dinner or the right TV for your den. So why wouldn't you turn to the Internet to find your next doctor? New health review sites promise to help you make this important decision for yourself or your loved ones. However, patients and physicians alike are finding that these doctor reviews aren't as transparent or useful as they might seem.
Nobody likes to wait. And patients and doctors alike are frustrated by the general waiting that seems to be an inevitable part of delivering and receiving care. Here, Art Markman, Lisa Gualtieri, and anonymous patient blogger WarmSocks share their views.
We patients are always tourists in the world of health care. Whether we are coming to our doctor's office to rule out a strep infection, a clinic for a bi-monthly diabetes check-in, or a hospital for surgery, we don't work here.
The current literature indicates that we in the various health disciplines provide texts that are poorly written and organized, web sites that are hard to navigate, as well as charts and graphs that are difficult for many to interpret and use. I say that we can make information truly accessible and usable by adding needed rigor to our work.
Dr. Jan Adams has had more than her share of painful experiences. A retired general practitioner and mother of two who practiced 'womb-to-tomb' medicine, she conducted humanitarian work around the world, notably with medical clown Patch Adams (no relation).
Whether caused by injury, surgery or a toothache so bad it slams you awake in the middle of the night, acute pain is difficult. Receiving prompt and helpful treatment can make all the difference in the world. But lack of care or inadequate care means that the acute pain may develop into chronic agony.
When safety net hospitals close or switch from not-for-profit to for-profit status, certain vulnerable groups suffer disproportionately, a new study finds.
With almost a decade's worth of the National Healthcare Disparities Reports behind us, it is clear that addressing disparities defies simplistic solutions. As we all believe that the complexity of cancer, cardiovascular diseases and HIV/AIDS will not stop us from one day finding a cure, I firmly believe that this same tenacity of spirit is needed to successfully surmount the challenges of disparities.
Here's is my recent interview for 'Middle-of-the-Night Medicine is Rarely Patient-Centred' by Erin Walkinshaw, a report in the Canadian Medical Association Journal (CMAJ) on the subpar level of health care provided in hospitals on weekends or evenings.
Medical student Katherine Ellington grapples with reconciling her two roles as daughter and doctor-in-training as her mother recovers from a heart procedure.
When her mom is being treated for a newly diagnosed heart condition, medical student Katherine Ellington learns first-hand how her medical training applies to real life. This is the second in a series of three posts.
Just getting to the doctor, making appointments and taking time off from work or other responsibilities are major hindrances for some people to getting the medical care they need.
This June, an Institute of Medicine report estimated that chronic pain affects 116 million Americans. Here, Tara Parker-Pope, Maia Szalavitz, and Elizabeth Cohen offer their perspectives on the findings. Kelly Young, RAWarrior, adds her personal experience, too.
Health centers and birth hospitals serving largely minority populations could do more to promote and encourage recommended breastfeeding, according to a new study of Philadelphia safety-net health clinics.
Each of the four times I have received a cancer-related diagnosis, I felt like I had been drop-kicked into a foreign country: I didn't know the language, I didn't understand the culture, I didn't have a map and I desperately wanted to find my way home.Over the years I have listened to hundreds of people describe the same experience following the diagnosis of a serious illness. As the number of physicians, diagnostic test sites and treatment options have grown and the lack of seamless, coordinated care persists, the majority of patients and their loved ones struggle to find the right care and make good use of it.
Expansion of health care coverage mandated by health reform will push demand for primary care providers sharply upward, and thousands of new physicians are needed to accommodate the increase, a new study finds.
Too often, mental health patients have problems accessing or paying for their prescription drugs under Medicaid. The results — longer hospital stays and more emergency room visits — are hard on patients and costly for the entire health care system, a new study finds.
A large study found that patients in certain large chain facilities are significantly more likely to die than those treated elsewhere. Mortality was also higher in for-profit than non-profit dialysis centers.
A colleague of mine, Cheryl, has been trying to help a solo physician address a thorny issue. Through the use of 'How's Your Health', an amazing Web-based suite of health and practice tools, the physician realized that many of her patients struggled with maintaining an adequate income. Cheryl went looking for some ideas for the physician, and she came across this: Health Providers Against Poverty, an Ontario-based group that has a toolkit to help primary care professionals address poverty issues.
On October 11, 2010, Baltimore Sun reporter Meredith Cohn reported that some U.S. health care providers are experimenting with trying to reach patients through social media and reaping big rewards. Providers are not just using Twitter and Facebook but trying new social media tools like Groupon, Foursquare, Scoutmob and LivingSocial that all blend social media with market forces to bring customers value and create new revenue for entrepreneurs, business owners and now health care providers.
When I first learned of the primary care medical home model it seemed to offer a great solution to medical homelessness a sort of permanent doctor-patient renter status, where both parties are bouncing around without a foundation, without a community and where a certain uncertainty exists and miscommunications and disorganization prevail.