Everybody Has Plans ‘Til They Get Punched in the Mouth’

http://www.cfah.org/images/authors/carolyn%20thomas.jpgWhen Edward Davies of the British Medical Journal attended the recent Lown Institute conference in Boston, he was reminded of some unlikely wisdom from boxer Mike Tyson. In the run-up to a big fight, Iron Mike was being bombarded with media questions about how he intended to deal with his latest challenger. Did he have a strategy in place to cope with their plans? The boxer’s response was simple: “Everybody has plans ’til they get punched in the mouth.”

In boxing terms, as Davies wrote in the BMJ, this is completely literal, sound advice, but as a figurative metaphor for life, it’s not bad, either: “Listening to a patient panel here at the Lown Institute conference, I was reminded that this is a worldview that doctors might do well to remember.”

Most patients diagnosed with a life-altering diagnosis can readily identify with what that metaphorical punch in the mouth feels like. And no matter how competent, how smart, how resourceful we may think we are before a catastrophic health crisis strikes, many of us may suddenly feel incompetent, ignorant and helpless when thrust inexplicably into the stress of such formidable reality. This may feel like being momentarily powerless for some or like a sucker-punch that knocks the wind right out of us for others. (more…)

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It’s Time to Think Differently. Have You Prepared a Health Care Budget?

Terri Prof Headshot 0412Have changes in health care hit your pocketbook yet?  In addition to a high deductible insurance plan, are you using a Health Savings Account (HSA) for the first time?

If you’ve gotten new health insurance, a different deductible level due to the monthly premium cost, or if you’ve been taking your chances without any health care coverage at all, you may be in for a big surprise.  Do you know how much your overall health care will cost you and your family this year?  Are deductibles, premiums, maximum out-of-pockets amounts and co-pays clear to you?  If not, you have some planning to do.  You’re going to need to lay out a health care budget so that you know what you can afford.  You may also need to start thinking differently and proactively. (more…)

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How to Make the Most of Your Doctor Visit

jessie-gruman picI recently wrote about how common it is for those who work in and deliver health care – physicians, nurses, clinics and hospitals – to overestimate our knowledge about our bodies, our illnesses and how the health care system works. This overestimation of our familiarity happens with even the most seemingly simple and straightforward aspects of care, 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, CFAH has created a library of Be a Prepared Patient tips and resources including two videos. The two-minute video below shares tips for How to Make the Most of Your Doctor Visit by explaining how to effectively describe your symptoms in four key steps. Being prepared with this information will allow you and your doctor to discuss the best treatment for you, including next steps. (more…)

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What’s Hobby Lobby’s Real Agenda?

Displaying blogphoto.jpgIt has recently come to light that Hobby Lobby, currently embroiled in a legal debate over the federal mandate requiring employers to provide insurance coverage for contraceptives, has significant investments in companies that produce the very contraceptives they’ve objected to in their lawsuit, leading many to claim that the lawsuit is hypocritical.  David Green, CEO and founder of the Oklahoma-based for-profit corporation claimed, that by ” being required to make a choice between sacrificing our faith or paying millions of dollars in fines, we essentially must choose which poison pill to swallow…We simply cannot abandon our religious beliefs to comply with this mandate.” Hobby Lobby claims that mandate forces the company’s owners to violate their religious beliefs or face heavy consequences including penalties, fines, and lawsuits. (more…)

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Improving Reproductive Health

Women aren’t fertile every day of the menstrual cycle. In reality, women are only fertile for a period of about 8 days per cycle, and it’s simple to pinpoint this fertile phase. I’ve encountered many people who can’t define ovulation and don’t know the role played by cervical fluid (or cervical mucus) in reproduction. But it’s not their fault. This isn’t something we were taught in sex ed. It wasn’t long ago that I was one of these people, and I now find myself on a mission to stop this trend.

When the female body is seen as mysterious and unpredictable, we end up missing an incredible opportunity to empower women. This lack of education about the female reproductive system leads many women to view our bodies as the enemy–something that we must constantly battle in order to remain in control. This mindset is a huge problem, especially since the female reproductive system, in most cases, is actually quite predictable. If we instead prioritize this type of education, I believe that we would set in motion a surge of powerful social changes. (more…)

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Finding the Words: Gender Affirmation and Language

UnknownThis article will be a little more personal than my previous articles. I want to share a bit about myself, my identity and what it means to me to be seen and affirmed.

Monday, March 31, was the International Transgender Day of Visibility, but I was just as invisible as any other day. You see, I’m not out on the job. I haven’t told my co-workers or my students that I’m genderqueer. They don’t know my preferred pronouns and they default to feminine pronouns based on who they perceive me to be. It hurts and I hate it.

I probably could come out. I know the laws in Illinois and I’m protected under anti-discrimination laws. My co-workers are pretty decent people, they might understand, right? I may never know. All I know is the tightness in my chest and stomach when I think about having “the talk” with them. I feel nauseous and anxious like I need to hide or curl up in a ball. I also feel dishonest and a bit deceitful. Fear keeps me silent and holds (more…)

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The City of Brotherly Love and the Kids We Need to Love Better

Glenna Crooks

April is National Child Abuse Prevention Month.  Each year, more than 6 million children are affected by abuse and neglect. In today’s post, Disruptive Woman Glenna Crooks touches on this important issue.

Disruptive Women posted wonderful videos last Friday.

I was especially drawn to ReMoved because I’ve been thinking about children in foster care. It was as member of a Board that raises funds for Philadelphia children’s charities I first learned something that stunned me. In our city, on average, foster children are placed in three different homes over a period of three-and-a-half years before they are adopted. And, that’s the average; some kids are in more than a dozen group homes during their teens.

I’ve tried to imagine what that would be like: (more…)

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Disruptive Stories to Watch

DWFeedburnerHappy Friday Disruptors ! Sometimes  important news and moving stories  are best conveyed through video. Check out our favorite videos from the past week including: a woman’s quest to raise money to fight her child’s debilitating disease; a campaign  that shows how makeup can actually empower women; and a woman ensuring that people in her home town get fresh water. What are some of your favorite videos from the week?


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Why Grandparents Matter

Displaying MOACGrands2.jpgAs the Baby Boomer generation begins to leave the workforce they’ll begin to face the enchantment of retired life.  So what’s next?  The awesome task of being full time grandparents of course!

My children are fortunate enough to have three grandparents and 5 great-grandparents alive and well.  We’ve worked hard to ensure that they have a special relationship with each one.  They’ve spent time living with their paternal grandmother and often Skype, G chat and FaceTime with their maternal grandmother and grandfather.  It’s really great to watch them interact physically and electronically with these people because it teaches them two basic concepts that are sometimes missing in our society:

Old people aren’t scary

Love and respect everyone (more…)

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No Joke

Janice Lynch Schuster

Now that I am nearly an empty-nester, I spend far too much time on social media, catching up on videos of silly animals and the late-night musical guests who air past my bedtime. My friends share news of grandchildren and photos of impossibly beautiful natural wonders, or updates on their lives. I do much of the same.

A few weeks ago, a coworker’s status said, “It is 2 good 2 be true: I’m pregnant.” I was stunned: she is middle-aged and single, and such news would have been a shock. Since I knit blankets for many pregnant women, I immediately commented, “Oh dear, congratulations, I’ll be a knitting fool.”

The next day, she sent me a direct message that said, in part, that I had been fooled by a Facebook game, the so-called 2014 Breast Cancer Awareness Game.

“You should not have liked or commented on my status,” she wrote, adding that she was sorry I had fallen for it, and that I should not break the chain. (more…)

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The Dilemma of Canceled Insurance Policies

Trudy-Lieberman -- biggerBy 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 (ACA). That is, the policies that did not offer coverage for services like maternity care, mental health treatment, physical therapy and hospital outpatient surgery that ACA supporters believed were essential for good, comprehensive health insurance.

Since last fall, backlash against what was intended to be a good consumer protection measure has been fired up by TV and news stories telling tales of woe from people whose policies were canceled. Those who lost their policies complained about having to buy maternity coverage, for instance, when having a baby would never be in their future. As I explained in a previous post, they did not understand that the law also called for some cross-subsidization among policyholders to keep premiums reasonably affordable for everyone. All insurance products include some degree of this kind of risk-sharing across an insured group. (more…)

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March 2014 Man of the Month: Matt Wallaert


A quick glance around the internet will tell you that there are a million blogs trying to help women be more frugal.  But how often do we talk about the other side of the equation, the money coming in instead of the money going out?  In an era where women are still dramatically underpaid, there is no amount of coupon clipping that is going to make up for a  20-30% difference in salary.

Matt Wallaert is a behavioral scientist at Bing and co-creator of GetRaised.com, a free site aimed at closing the gender wage gap.  GetRaised helps women understand if they are underpaid and to empower them to do something about it by creating a free letter that they can give to their boss to start the conversation around getting a raise.  They’ve achieved eye-opening success: a simple letter has been enough to help 70% of women get a raise, with an average increase of around $6,500.  And the site has helped tens of thousands of women, completely free.

As co-creator of GetRaised.com, I get the opportunity to speak fairly frequently about gender wage equity.  During Q&A, there is always the inevitable question: why do I keep saying equity, instead of equality?  This question is usually accompanied by some shifting in the seats, because people always hate it when terminology is discussed. Often, it feels simply like debating semantics. (more…)

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How (On Earth) I Got Into the Food Business

If you had asked me when I was in medical school what the odds were of my starting a food company, they would have fallen somewhere between winning the lottery and being struck by lightning twice…on the same day.

However, when I look back on my medical education, this actually speaks to a fundamental problem in how physicians are trained and in how we practice.

Simply put, we don’t do food.

Every day I’m astounded by what patients tell me they eat. Two doughnuts each day for breakfast? Six bottles of regular Coke a day? Dinner every night…out of a box? Zero fresh fruits or vegetables per week? Most food obtained from the gas station convenience store?  Nothing in my training ever prepared me for this.

When a physician sees a patient with high cholesterol or high blood pressure, step one in the care plan is to encourage “eating better.” The problem with this advice is that the vast majority of patients either don’t know what it means to eat a healthy diet, or they simply can’t sustain it. (more…)

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Fetal Harm Laws: Are They the Best Way to Protect the Unborn?

Danielle Brooks

She was just 15 years old. Not necessarily the honor student or homecoming queen, but nonetheless by societal standards still a child. And while most young girls her age are consumed with passing their first drivers test, Rennie Gibbs gave birth to her first child, Samiya, who was stillborn. Now, seven years after the death of her daughter, Gibbs is facing a possible life sentence for depraved heart murder, even though her daughter never took a breath.

So how does this story of misfortune equate to a potential sentence of life in prison? Though an autopsy revealed that Samiya most likely passed away as a (more…)

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Common Bias Ignored: Patients and Families Lose

jessie-gruman pic

There’s a pesky cognitive bias that creates a honking big barrier to patients and families making the most of the health advice and services available to us. It’s the tendency of experts to overestimate the knowledge of others.

One consequence of expertise – or even just easy familiarity with a topic or institution or practice – is the inability to remember not knowing what you now know. Think back to your first day of school: You felt clueless, right? Was I supposed to bring crayons? Where’s the bathroom? But within weeks, the whole thing was routine. You couldn’t remember what you didn’t know, and you couldn’t recall what you might have needed to know in order to concentrate on learning to spell.

Given my current, frequent brushes with health care, I experience this all the time: “Just go to the lab and ask them,” I’m told by my chemo nurse. I think: Huh? What lab? Where? Ask who? As my oncologist walks out the door, he says, “You should take folic acid to prevent side effects.” I think, sure. When? How much? Do I need a prescription? Will you write it? And the practice staff assures me, “Oh, you can ask any of us about your symptoms.” Who is ‘”us”? How do I get in touch with each of you? Will each of you know about me? What will you know? What if I only want to talk with you specifically? (more…)

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