Managing Managed Care

Our inequitable, inefficient, oftentimes uncaring health care "system," revealed. -- Jeffrey G. Kaplan, M.D., M.S.

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Antibiotic Harm - MRSA, the Super Bug

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What's the Relationship Between Using Antibiotics and Then Getting MRSA? RE: Community-acquired methicillin-resistant Staphylococcus aureus (MRSA) such as in an abscess or cellulitis–- the more the antibiotic exposure prior to getting MRSA, the more likely it was you would get MRSA. Setting and Study Design  A population-based case-control study in children, 1 to 19 years of age using a primary care, General Practice Research Database, United Kingdom, 1994-2007.

Obesity/Overweight Prevention/Treatment

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Obesity is a contributor to or a cause of chronic medical and/or surgical conditions including diabetes, hypertension, hyperlipidemia, heart disease, stroke, certain cancers, recurrent trauma and arthritis. Here are a few of the more ponderous facts: The apparent rise in the incidence of hypertension and diabetes worldwide is concerning.  Certain populations, non-Hispanic blacks, for instance are at higher risk, but it is getting scary for all of society!

Delaying Shots ⇔ No Benefit; Much Risk

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In faith there is enough light for those who want to believe\enough shadows for those who don't [modified quote: Blaise Pascal]  I'm so tired of the excuses some parents make for not giving or wanting to delay vaccinations.  So, here's evidence; take or fight it on faith or consider the recommendation to immunize on time to be scientifically validated, 'best medical advice (BMA).

Really Poor Performance, U.S.A.!

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Beyond our obvious quality problems.... Yearly, approximately 100,000 patients die of health care–associated infections, about another 100,000 die from other preventable errors, and "tens of thousands more die of diagnostic errors or failure to receive recommended therapies."1-3 But, That’s Just the Obvious Quality Problems.  Possibly related Is the FACT That Our Mortality Rates Pale In Comparison to Other Industrialized Countries

Vitamin Insufficiency or Expensive Urine

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You want the best health and well-being for yourself and loved ones, but vitamins and supplements, are no panacea.  Furthermore, know that the law does not require proof they work. And, overdoses and conflicts with real medicines do occur (so they cannot be taken with impunity).  Nevertheless, well-designed studies do indicate a modest benefit.  Here's one, for instance, that states:

The Best Diet

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The six (6) fundamentals, the Cardinal Rules, so to speak, in trying to lose weight and reduce your risk of heart disease : You MUST take in (eat) less calories than you burn (exercise and by being active) Portion size must be reasonable; do not eat to satiety; try to eat a fair amount of whole grains, fruits, and vegetables, but consume Fewer carbohydrates, especially refined and high sugar-loaded ones. Enjoy more polyunsaturated fats (e.g., plant oils and fish).

Healthcare Reform/Economic Imperative

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Is health care reform merely cost-minimization, an opaque attempt to force economic responsibility? Simplifed, Here's the essence of health care reform and how to restore equity in access.... 1)    To reform care we must manage the care a)   The fact that delivery models vary or that they are evolving should not distract us from our goal to have effective care that is efficient and thereby cost-effective.  At the end of the day, however, it must be about the patient!

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