Tag Archives: money

Half of “low intensity” CBT clients relapse within 12 months

False economy? Half of “low intensity” CBT clients relapse within 12 months – By Christian Jarrett

Heralded as a revolution in mental health care – a cost-effective way to deliver evidence-based psychological help to large numbers – low-intensity Cognitive Behavioural Therapy (CBT) is recommended by NICE, the independent health advisory body in England and Wales, for mild to moderate depression and anxiety.

Prior studies into its effectiveness have been promising. However, little research has looked at whether the benefits last.

A new study in Behaviour Research and Therapy has done that, following a cohort of people with depression and anxiety over time.   Continue reading

Why the advice to take all your antibiotics may be wrong

Why the advice to take all your antibiotics may be wrong – Stat News By Helen Branswell @HelenBranswell – February 9, 2017

If you’re taking antibiotics, don’t stop taking them until the pill vial is empty, even if you feel better. But the warning, a growing number of experts say, is misguided and may actually be exacerbating antibiotic resistance.

The reasoning is simple:

  • Exposure to antibiotics is what drives bacteria to develop resistance.
  • Taking drugs when you aren’t sick anymore simply gives the hordes of bacteria in and on your body more incentive to evolve to evade the drugs, so the next time you have an infection, they may not work. Continue reading

The Myth of Drug Expiration Dates

The Myth of Drug Expiration Dates – ProPublica

The box of prescription drugs had been forgotten in a back closet of a retail pharmacy for so long that some of the pills predated the 1969 moon landing. Most were 30 to 40 years past their expiration dates

the cache was an opportunity to answer an enduring question about the actual shelf life of drugs: Could these drugs from the bell-bottom era still be potent?

The age of the drugs might have been bizarre, but the question the researchers wanted to answer wasn’t.  Continue reading

NoL Index Measures Patients’ Pain During Surgery

Nociception Level Index Detects Patients’ Pain During Surgery – Pain Medicine News – Mar 14, 2017

Israeli researchers have devised a multivariable index that appears to accurately reflect patients’ experience of pain during surgery.

This kind of objective “pain measurement” is the holy grail of pain management, but I wouldn’t trust it – would you?

I suspect not.

Pain is such a primal sensation with a literally overpowering impact that I cannot bring myself to trust some device, no matter how ingenious, to detect the enormity and full significance of this sensation.   Continue reading

Top US hospitals aggressively promoting alternative medicine

Medicine with a side of mysticism: Top hospitals promote unproven therapies – By CASEY ROSS @byCaseyRoss, MAX BLAU @maxblau, and KATE SHERIDAN @sheridan_kate – Mar 2017

I know that various unusual therapies work for some people some of the time (myself included), but they are truly a hit and miss proposition.

They’re among the nation’s premier medical centers, at the leading edge of scientific research.

Yet hospitals affiliated with Yale, Duke, Johns Hopkins, and other top medical research centers also aggressively promote alternative therapies with little or no scientific backing.

They offer “energy healing” to help treat multiple sclerosis, acupuncture for infertility, and homeopathic bee venom for fibromyalgia. A public forum hosted by the University of Florida’s hospital even promises to explain how herbal therapy can reverse Alzheimer’s. (It can’t.)  Continue reading

How U.S. Health Care Became Big Business

Elisabeth Rosenthal Explains How U.S. Health Care Became Big Business: Shots – Health News : NPR – April 10, 2017 – Heard on Fresh Air

Dr. Elisabeth Rosenthal, a medical journalist who formerly worked as a medical doctor, warns that the existing system too often focuses on financial incentives over health or science.

“We’ve trusted a lot of our health care to for-profit businesses and it’s their job, frankly, to make profit,” Rosenthal says.

Rosenthal’s new book, An American Sickness, examines the deeply rooted problems of the existing health-care system and also offers suggestions for a way forward. She notes that under the current system, it’s far more lucrative to provide a lifetime of treatments than a cure.

On what consolidation of hospitals is doing to the price of care

In the beginning, this was a good idea: Hospitals came together to share efficiencies. You could share records of patients so the patient could go to the medical center that was most appropriate.

Now that consolidation trend has kind of snowballed and skyrocketed to a point … that in many parts of the country, major cities only have one, maybe two, hospital systems. And what you see with that level of consolidation is it’s kind of a mini-monopoly.

What happens, of course, when you have a mini-monopoly is you have an enormous sway over price. And so, what we see in research over and over again is that the cities that have the most hospital consolidation tend to have the highest prices for health care without any benefit for patient results.

On the ways the health-care industry stands to profit more from lifetime treatment than it does from curing disease

It’s far better to have treatments, sometimes really great treatments … [that] go on for life. That’s much better than something that will make the disease go away overnight.

On how prices will rise to whatever the market will bear

Another concept that I think is unique to medicine is what economists call “sticky pricing,”

It basically means … once one drugmaker, one hospital, one doctor says “Hey we could charge $10,000 for that procedure or that medicine.” …everyone sees that someone’s getting away with charging $10,000, the prices all go up to that sticky ceiling.

On initiating conversations early on with doctors about fees and medical bills

You should start every conversation with a doctor’s office by asking “Is there a concierge fee? Are they affiliated with a hospital? Which hospital are they affiliated with? Is the office considered part of a hospital?” In which case you’re going to be facing hospital fees in addition to your doctor’s office fees.

You ask your doctor always … “If I need a lab test, if I need an X-ray, will you send me to an in-network provider so I don’t get hit by out-of-network fees?”

On getting charged for “drive-by doctors” brought in by the hospital or primary doctor

You do have to say “Who are you? Who called you?” and “Am I going to be billed for this?” And it’s tragic that in recovery people have to think in this kind of keep-on-your-guard, somewhat adversarial way

On how to decipher coded medical bills

Don’t be alarmed by the “prompt payment discount.” Go back to the hospital and say, “I want a fully itemized bill. I want to know what I’m paying for.”

I’ve discovered you can Google those codes and find out what you’re being charged for, often, and most importantly, you might find you’re being charged for stuff that obviously you know you didn’t have.

Elizabeth Rosenthal is editor-in-chief of Kaiser Health News, an editorially independent news program of the Henry J. Kaiser Family Foundation and a partner of NPR’s.

Patients not Profits: How Markets Dehumanise Health

Patients not Profits. How Markets dehumanize health. | A Better NHS | Last edited 04.06.2009

This is a long, thoughtful essay about the commercialization of healthcare, exactly what we are struggling with in the US. Financial interest and healthcare do not align, their goals and successes are almost directly opposed.

I’ve written this because I believe that the corporatisation of healthcare is dehumanising.

By this I mean that real, whole people living with their hopes and worries, ideas and expectations, are broken down by the process of corporatisation into biological parts not for diagnosis and treatment but so that they can be measured and converted into profits.   Continue reading

Free market ideology doesn’t work for health care

Free market ideology doesn’t work for health care | Center for Public Integrity – June 8, 2015 – By Wendell Potter

In my column last week I suggested that one of the reasons Americans tolerate paying so much more for health care than citizens of any other country — and getting less to show for it — is our gullibility.

We’ve been far too willing to believe the self-serving propaganda we’ve been fed for decades by health insurers and pharmaceutical companies and every other part of the medical-industrial complex.  Continue reading

Genetic lab pays doctors to push dubious tests

Genetic lab pays doctors up to $144K/yr to push dubious tests By CHARLES PILLER @cpiller  Feb 2017

For doctors, the brochure from a California medical laboratory sounded like easy money: $30 for every person enrolled in a study of genetic tests meant to help select the best pain medication for each patient. A typical physician could make $144,000 a year in “research fees.”

But the clinical trial was largely a ploy to boost Proove Biosciences’s revenues, and many of the doctors who signed up did no actual work, say current and former employees.

Proove has grown rapidly by tapping into the public angst over surging opioid addiction.   Continue reading

Top US hospitals aggressively promoting Alt-Med

Top US hospitals aggressively promoting alternative medicine offerings – Should prestigious hospitals promote unproven alternative medicine? – Stat News – Mar 2017

They’re among the nation’s premier medical centers, at the leading edge of scientific research. Yet hospitals affiliated with Yale, Duke, Johns Hopkins, and other top medical research centers also aggressively promote alternative therapies with little or no scientific backing.

They offer

  • “energy healing” to help treat multiple sclerosis,
  • acupuncture for infertility, and
  • homeopathic bee venom for fibromyalgia.
  • A public forum hosted by the University of Florida’s hospital even promises to explain how herbal therapy can reverse Alzheimer’s. (It can’t.)   Continue reading