We’re Back!

09Jan08

After much deliberation, I have decided to throw some energy back into this blog.

I attribute my absence to me being abroad in England, but with connectivity being abundant these days it isn’t much of an excuse. In any event, the plan for the Spring semester is to track my medical school application process, including my battle with the MCAT on April 19th! The hope behind this is that it will provide something new out there for Pre-Meds to read while they too jump the hurdles of the medical school admissions process.

In addition to new content, I am also going to do some “spring cleaning” and get rid of all the irrelevant stuff that I have put up on here. Any suggestions or ideas as to what you want to see more of (or, less of for that matter) please drop some comments here!

Best of Luck for the Spring Semester!


I should preface this article from Slate.com by saying that no health-care system exists without issues. I reside in Canada and have enough experience with our health-care system (as a patient, shadowing, and some research) to know that while our system may look appealing to our neighbors to the south, it is by no means ideal. We have terrible waiting times for necessary operations, certain cancer treatments, and most non-emergent procedures. While most Canadians have ‘access’ to the health-care system, it is barely keeping up (if at all) with demand. Some would argue that the open-access of our nationalized health-care causes patient care to fall by the way-side. My family and I have always been looked after by the hospitals in Canada, so I haven’t seen this fall in quality of care. I have heard enough horror stories around home, however, to know that maybe there is a quality of care issue emerging with the massive patient load on our nationalized system.

Taking Our MedicineThe bad economics of switching health-care plans.


In the long-simmering argument over what’s wrong with American health care, recent polls show that many people blame our market-based system of private health insurance. Private insurance companies are faulted for, among other things, failing to do enough to prevent disease. They have no incentive to do so, argue advocates for reform, ranging from Michael Moore in Sicko to some of the current presidential candidates. And yet if preventive measures today result in savings on treatment tomorrow, then what’s good medicine should also be good business.

Diabetes management is a case in point. If they get help early on in managing blood-sugar levels, diabetics can stave off later medical complications that may result in expensive hospital stays. Yet many of these preventive measures aren’t covered or encouraged by insurers. Instead, patients are forced to haggle over reimbursement for insulin pumps, and most are rationed only four test strips per day to monitor their blood sugar (sometimes enough, but often not). If better access to insulin pumps and blood-sugar monitoring will save money in the long run, why are insurers so miserly with their diabetes customers?

A recent study (not yet published) by researchers from Case Western Reserve and Carnegie Mellon University explains that the culprit in poor diabetes management—and the lack of preventive care in general—may be the very high rate at which Americans switch among insurance plans. It takes about a decade for insurers to recoup their investment in early diabetes treatment, and by then odds are that their customer has moved on to another health plan. Alas, a lot of this turnover may be built in to the way Americans get health insurance. And it’s the doing not of individual patients so much as their employers, who are always on the lookout to switch plans for lower-cost coverage.

How often do Americans switch plans? Using data from the Community Tracking Study, a national household survey on health-care delivery, the authors estimate that 20 percent of policyholders switch insurers each year. Based on more-detailed data from a large regional insurer, they calculate that annual turnover may run as high as 30 percent, far too high to make back the cost of pre-emptive diabetes care, or subsidized gym memberships, or other front-loaded investments in good health.

High turnover of insurance plans isn’t news to health-care providers. With coverage tied to an employer (or a spouse’s employer), every time someone gets married, divorced, or moves to a new job, odds are he’ll switch to a new insurance plan. But the five economists who conducted the new study show that this accounts for only half of all turnover—a surprisingly small share. The rest comes from entire employer groups switching among insurers.

Continue reading ‘Healthcare: “The Bad Economics of Switching Health-Care Plans”’


Making predictions is difficult for anyone. Qualified meteorologists, stock market statisticians, and sports betting insiders all screw up from time to time. What happens though, when a physician doubles the life expectancy of an ailing patient, and only to have the patient pass on earlier than the prediction? According to this NY Times Opinion article, only 37% of physicians are willing to provide prognoses for their patients, and only when pressured by the patients’ families. The author of this article, Dr. Nicholas A. Christakis, argues that a “realistic assessment” of a patient’s life expectancy can be a significant benefit to the quality of life in the final days/months/years of the patient’s life.

Published: August 24, 2007

Boston

NO surprises” is a basic rule in hospitals. Junior doctors are supposed to notify their superiors promptly about worrisome developments in a patient, and information is supposed to move smoothly up the chain of command. One of the gravest errors a doctor in training can make is to inform the attending physician well after the fact about a patient’s turn for the worse.

Unfortunately, this rule does not extend to seriously ill patients themselves. They and their families are frequently surprised by the sudden imminence — and the raging authority — of death.

Research has revealed doctors’ tendency to contribute to the problem by avoiding making prognoses. In one study of nearly 5,000 hospitalized adults who had roughly six months to live, only 15 percent were given clear prognoses. In a smaller study of 326 cancer patients in Chicago hospices, all of whom had about a month to live, only 37 percent of the doctors interviewed said they would share an accurate prognosis with their patients, and only if patients or their families pushed them to do so.

Continue reading ‘NY Times Opinion: ‘The Bad News First’’


The New York Times reported yesterday on new legislation that prevents Medicare from having to pay hospitals and doctors for the treatment of ‘preventable’ ailments like bed sores, infections acquired while at the hospital, and surgical equipment left in patients.

In a significant policy change, Bush administration officials say that Medicare will no longer pay the extra costs of treating preventable errors, injuries and infections that occur in hospitals, a move they say could save lives and millions of dollars.

Private insurers are considering similar changes, which they said could multiply the savings and benefits for patients.

Under the new rules, to be published next week, Medicare will not pay hospitals for the costs of treating certain “conditions that could reasonably have been prevented.”

Among the conditions that will be affected are bedsores, or pressure ulcers; injuries caused by falls; and infections resulting from the prolonged use of catheters in blood vessels or the bladder.

In addition, Medicare says it will not pay for the treatment of “serious preventable events” like leaving a sponge or other object in a patient during surgery and providing a patient with incompatible blood or blood products.

“If a patient goes into the hospital with pneumonia, we don’t want them to leave with a broken arm,” said Herb B. Kuhn, acting deputy administrator of the Centers for Medicare and Medicaid Services.

The new policy — one of several federal initiatives to improve care purchased by Medicare, at a cost of more than $400 billion a year — is sending ripples through the health industry.

It also raises the possibility of changes in medical practice as doctors hew more closely to clinical guidelines and hospitals perform more tests to assess the condition of patients at the time of admission.

Hospital executives worry that they will have to absorb the costs of these extra tests because Medicare generally pays a flat amount for each case.

The Centers for Disease Control and Prevention estimates that patients develop 1.7 million infections in hospitals each year, and it says those infections cause or contribute to the death of 99,000 people a year — about 270 a day.

Intravenous catheters are widely used to provide hospital patients with medications, nutrition and fluids, but complications are relatively common.

One state, Michigan, has had spectacular success with systematic efforts to reduce infection rates in intensive care units.

Susan M. Pisano, a spokeswoman for America’s Health Insurance Plans, a trade group, said, “Private insurers will take a close look at what Medicare is doing, with an eye to adopting similar policies.”

Consumer groups welcomed the change. And while hospital executives endorsed the goal of patient safety, they said the policy would require them to collect large amounts of data they did not now have.

Lisa A. McGiffert, a health policy analyst at Consumers Union, hailed the rules.

“Hundreds of thousands of people suffer needlessly from preventable hospital infections and medical errors every year,” Ms. McGiffert said. “Medicare is using its clout to improve care and keep patients safe. It’s forcing hospitals to face this problem in a way they never have before.”

Christine K. Cahill, a registered nurse who used to inspect hospitals for the California Department of Public Health, said: “This is a great start. Infection-control specialists have been screaming for 20 years that federal and state officials should pay more attention to this problem because hospital infections hurt patients and cost money.”

The Bush administration estimates the new policy will save Medicare $20 million a year. But other experts say the savings could be substantially greater.

Continue reading ‘NYTimes: ‘Medicare Says It Won’t Cover Hospital Errors’’


Lifehacker.com posted an article from Hampshire College about how to read primary literature more carefully. You many not be reading abstracts or convoluted discussion sections of primary literature on your MCAT, but the tips provided here will assist in building your reading comprehension regardless.

Want to understand more of what you read – even if the material is somewhat above your head? No problem – just follow educator Ann McNeal of Hampshire College’s four-step guide for reading a research paper.

Now, while her tips primarily apply to students trying to slog their way through academia, anyone who wants to read with more comprehension will get something out of this. Basically, the tips boil down to skimming, deciphering vocab, attempting to comprehend, and then criticism/reflection. A good set of reminders for anyone who wants to get more out of their reading.

‘How To Read with More Comprehension’ from Hampshire College, via Lifehacker.com


1,200 Hits!

13Aug07

Last time I checked we had 500 hits…but the popularity of this blog is sky-rocketing and we just hit 1,200 hits. I am glad I am able to be of service to you all!

With that being said, I am going to start shifting the focus of this blog. I I posted some content early on that was relevant to university life in general, but probably wasn’t very interesting for the neurotic pre-med. I am going to try and aim future content more towards the original goal for this blog and have everything relate to medical school as much as possible.

Any feedback would be greatly appreciated! Thanks a ton!


Lifehack.com posted a link to a great writing resource site.  All of the links appear to be quality sources, so when you are typing up your application essays make sure to check, double-check, and triple-check your work with some of the solid style, grammar and spelling guides available out there (if you lack a decent hard copy of such guides).

“Writing Links & Links for Writers” at Internet-resources.com, via Lifehack.com




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