I knew that the Farm Bill favors meat subsidies over vegetable ones, but I didn’t know it was this incredibly ridiculous. I’d imagine changes to what we subsidize would great impact the nation’s health–and probably for the better.
Had a nasty, nasty virus about 4 weeks ago that provided me with nasty throat pain and pretty much constant fevers, chills, and night sweats. (I could practically tell you when 10pm hit, as my cold sweats would start.) I put myself on around the clock Tylenol and ibuprofen x 8 or 9 days (I know, I know) and somehow made it out alive. Rumor is it’s a parainfluenza virus going around the area.
Anyway–I usually weigh around 155 pounds; last week at the gym I stepped on the scale and was 147 . I think that’s the lightest I’ve been since med school began. My pants no longer fit; my belts are too big. I lost 5% of my entire body weight (unfortunately mostly muscle).
Power of the fever and increased metabolism. Amazing, that human body.
If you ever had any interest in knowing what Violet the Vulva looked like from my standardized patient encounter last month , look no further. Tyra Banks and guest doctor provide said puppet, and an educational lesson to boot!
I haven’t really seen much discussion of this really, really important 2007 Commonwealth Foundation Survey of 7 Countries (wait, don’t click!), so I thought I’d give you my take. Without all that pesky reading and analysis. We’ll just summarize the tables. (I know, I know, this is not the recommended way to read an article.)
If you want to read them yourself: Table 1 , Table 2 , Table 3 , Table 4 , Table 5 , Table 6 , Table 7 . But really, here’s the summary:
7 countries, phone interviews conducted: Australia, New Zealand, Germany, the Netherlands, the United Kingdom, and the United States. At least 1000 people surveyed in each country. A wide variety of questions asked. These ranged from questions about primary care access to prescription drug costs to medical errors to going without care because of cost to electronic medical record usage to ER visits to elective surgery wait times to chronic disease to health care quality. (Yes, of course, some of these answers depend on culture and stuff. Hear me out.)
If you do look through all that data, you’ll notice something really striking: country to country, it’s really not all that different . Sure, there’s lots of variation. Germans are the most confident they’ll receive the “best medical technology”; people in the Netherlands are the least likely to wait greater than 6 months for elective surgery; Australians are the most likely to be able to contact their doctor on the weekends; Americans were the most likely to receive reminders for preventative or follow-up care; it’s very easy for New Zealanders to contact their doctor by phone during regular hours; the Brits are the most likely to have financial incentives for quality.
If you look at the numbers, however, again: things are fairly similar. As a general trend, what separates the best from the worst is only 10 or 20 percentage points’ difference. Overall, these 7 countries are fairly similar. Sure, in some areas there are countries that seem to really be doing a better job–but it’s not consistent for every area and for every country. There’s not one health care system that’s the best, and as the authors point out, all these countries (not just ours) are struggling, trying to figure out how to provide care for an aging population with technology that’s advancing faster than we can pay for it. In this way, I do agree with KevinMD –that if we’re going to redesign our health care system, we can’t just copy Canada or France–their systems are struggling just as ours is.
But there is one area where things are markedly different. (You knew where this was going, right?) Cost . In the US, we’re spending 16.0% of GDP on our healthcare system, where the next closest country in this survey, Germany, comes out at 10.2%. Now you say to yourself, “Self, that’s only 5.8% difference!” But that difference ends up being hundreds of billions of dollars (and $3,410 per person). And you look at percent uninsured, and New Zealand is our closest competitor, at less than 2%. We’re up at 16%.
So you look at all this survey data, where the United States is clearly in the middle of the pack (along with everyone else), and don’t you seriously have to wonder, “Then what the hell are we paying so much for?” If we’re not the fastest to get elective surgery (that award goes the Germans), and we’re not the most likely to see 2 or more specialists (again, Germany wins that one), and yet we’re the most likely to have people report forgoing care because of cost, and the most likely to have a problem with coordination of care (getting lab results or medical records sent to another doctor), again, where’s the money going?
For what we’re paying for, our health care system should be winning every single poll, every single year. What a disgrace.
In many ways, yes, I’d say this quote sums up the 21st century pretty well:
“If anything characterizes the 21st century, it’s our inability to restrain ourselves for the benefit of other people,” said James Katz, director of the Center for Mobile Communication Studies at Rutgers University. “The cellphone talker thinks his rights go above that of people around him, and the jammer thinks his are the more important rights.”
And in other ways, it doesn’t sum it up at all. Oh dichotomous world!
(via NYT )
I start interviews next week! Getting very pumped. Wanted to see if any of my blogging colleagues out there (especially you Emergency Medicine folk–I’m looking at you, Panda , Nick , GruntDoc , Dr. Whitecoat , Ten out of Ten , Shadowfax , etc) had suggestions for questions they would’ve asked on their residency interviews that they might not have thought of in my position. I’ve been brainstorming things I’d like to know about the programs (in addition to the obvious stuff) but anything that you don’t realize until you’ve started residency already would be great to know. Thanks!
As I’ve said before, I love McSweeney’s for all its literary humor and fun. And thus I present:
AN OPEN LETTER TO MY ACROSS-THE-STREET NEIGHBOR WHO ALWAYS DOES HIS YARD WORK IN HIS SCRUBS.
I have a friend at another school whose attending specifically wears scrubs for no reason to Starbucks, hoping women will hit on him, and there are plenty of people who have no reason to be wearing scrubs to the campus gym.
My policy is such: if I’m going to/from work and need to quickly do something in public (like pick up a gallon of milk from the store post-call), I’m not going to make an extra trip home or bring extra clothes for something simple. Otherwise, I want to get the nasty hospital-y stuff off me and slip on some jeans or something.
See? Exact opposite. (Click for the full size.)
With a baby, you pull down, THEN up. No, really!
(via a bathroom)
Totally, totally off-topic, but I am harnessing the amazing, gigantic audience of Over My Med Body (audience: 2, hi mom and dad!) to support my cousin, who made this video for Chipotle with seven classmates at KU. View it early, view it often–apparently if they win, they get some money, which college students can always use. Good luck, Patrick!
November 6th, 2007
My own ED is blogging? How did I not know this? Straight Talk from the Stanford ED : go Cardinal. Maybe people will realize we see more than just horse accidents down at the Farm.