Disruptive Women, along with media partner The Hill, held its first health briefing yesterday on the subject of Health eGaming, Healthy Patients: Supporting Stimulus Goals Through Health eGaming.

The Washington Post’s coverage of the event can be found here and The Hill’s video coverage is posted here.

To see pictures of the event, click here (for Facebook) and here (for Flickr).

Robin Strongin of Disruptive Women in Health Care

Congressional Staffer Attempts Health eGaming

The panel featured some very Disruptive Women including:

The Honorable Nancy L. Johnson Senior Public Policy Advisor for Baker Donelson Former Chair, House Ways & Means Health Subcommittee Glenna Crooks, Ph.D. President, Strategic Health Policy International, Inc. Julia Loughran Digital Media and Gaming Solutions Expert, iConecto—Gaming4Health Janet Venturino Vice President for Marketing Communications, Kaiser Robin Strongin President & CEO, Amplify Public Affairs Creator, Disruptive Women in Health Care blog

Health eGaming, Healthy Patients Panel

After the panel, attendees were able to try their hand at eHealth Games such as Wii Fit, Learning for Children Assessment Games, Re-Mission and Brain Games.

This guest post was contributed by Karen Sampson, who writes about health care degrees. She welcomes your feedback.

So we already know that women’s bodies absorb alcohol differently, but two very recent studies have noted at the possible link between alcohol and breast cancer. Is there a risk that outweighs the benefits of alcohol consumption?

The details of the studies.

The most recent study, conducted by the Fred Hutchinson Cancer Research Center in Seattle, reported that women regularly consuming 14 or more alcoholic beverages per week faced a 24 percent increase in breast cancer rates when compared to those who abstained. And previously published, larger British study revealed that alcohol in even smaller amounts, as little as one small glass of wine, liquor or beer, increased certain cancer risks. According to the study, possibly as much as a 6 percent increase in breast, rectum, liver and throat cancer by the time women reach age 75. (more…)

Dr. Troy Robbin Hailparn was interviewed by Disruptive Women’s Wendy Grossman.

Dr. Troy Robbin Hailparn, is board certified in obstetrics and gynecology by the American College of Obstetricians and Gynecology. She received her BA in Psychology from Barnard College of Columbia University and her MD with distinction in Reproductive Endocrinology from the Albert Einstein College of Medicine.

At the end of this post, you will find not one, but two polls. We hope you will respond to these and share your opinions.

Gynecological surgeon Dr. Troy Robbin Hailparn thinks the labia is the most ignored female body part.

She was the first female physician trained to perform laser vaginal rejuvenation, labiaplasty and the very controversial hymenoplasty.

In 2007, the American College of Obstetrics and Gynecology released a committee opinion against vaginal rejuvenation.

Dr. Hailparn wants to change their mind.

At the May annual clinical meeting, Dr. Hailparn plans to present her 500 labiaplasty patients, and the 11 reasons she’s discovered women have the surgery. Of those women only 70 out of 500 had the procedure for cosmetic reasons.

“Everybody thinks it’s a cosmetic procedure,” Hailparn tells Disruptive Women. “It’s not. People think it’s like genital mutilation. It’s not.”

Dr. Hailparn took the time to talk to Disruptive Women about why the work she does is so important to so many women and should be endorsed by ACOG and covered by health insurance.

DW: So, what are the reasons you’ve found that women have labiaplasty?

TRH: The big reasons are: clothing, exercise and activities and intercourse. The labia get pulled in and out with intercourse, so that can be painful.

DW: Oh God.

TRH: Whether it’s one lip or both lips they get pulled in and out. Think about the woman who has to actually move them out of the way in a spontaneous moment because she knows and anticipates it and she has to shove them out of the way because he’s about to enter. Somebody living with this extra tissue has to accommodate. Sitting, exercising, or clothing are the big three. They can’t fit comfortably. They can’t walk because they have chronic irritation or chafing. They tuck them up to get them out of the way. They stuff them up into the vagina to get them out of the way.

DW: Oh God. (more…)

The following is a guest post from Tamar Abrams, a communications strategist working with nonprofits, individuals and foundations. Until August 2008, Ms. Abrams was Vice President of Communications at Population Action International and has also been on staff at NARAL and Planned Parenthood Federation of America.

Below, Ms. Abrams shares her thoughts on children affected by homelessness.

One in 50 children in the U.S. is homeless each year, according to America’s Youngest Outcasts, a new report from the National Center on Family Homelessness released on March 10. An astonishing 1.5 million homeless children! Chances are you’ve met a child who has spent time in the uncertain and violent world of people without homes. You may not have known – often they look very much like our own children. But the things our kids worry about – grades, video games, iphone or blackberry? – are very different from children who worry about their peers discovering their living situations.

According to the report, children experiencing homelessness have twice the rate of moderate to severe health conditions compared to middle class children, and twice the emotional problems. They struggle in school, with an average 16% lower proficiency in math and reading, and an estimated graduation rate below 25%. Many are cared for by single moms, and a large number are under the age of five.

The report ranks each of the 50 states according to how many children are homeless, their well-being, how many others are at risk of homelessness, and what policies are in place to support them. The states that ranked as the best were Connecticut, New Hampshire, Hawaii, Rhode Island, North Dakota, Minnesota, Wisconsin and Massachusetts. At the bottom of the rankings were: Texas, Georgia, Arkansas, New Mexico, Louisiana, Nevada, North Carolina and Florida.

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Anthropologist Christine Gray, Ph.D., became a healthcare activist when her daughter was diagnosed with a sarcoma in 2003. Fourth in a five-part series on gender disparities in health care.

As excellent as Oprah and her guests may be, how ludicrous is it that American society has normalized the “Oprah-ization” of women’s health care, wherein the medical advice given invariably attaches to a consumer tie-in of some sort, like a book promotion? That would be akin to the population at large following advice on cholesterol reduction presented on a television show sponsored by Lipitor. As Simone de Beauvoir might say (rolling over in her grave), this phenomenon truly relegates women to the position of Other. For men to get a grip on basic healthcare issues, see your G.P. For women, try Oprah!?

Unfortunately, there are limitations to media magic – like reality. Besides recommending that women give up “extras” in their lives — dinners out, new shoes and costly children’s birthday parties — in order to pay out-of-pocket for hormonal relief, Robin McGraw recommends that women physician shop until they not only find practitioners who take menopausal symptoms seriously, but are willing to go off track to address them. Meaning re-invent medicine. If Oprah and Robin have trouble being heard by their physicians, and mainstream medicine regards symptomatic packages of stress-fatigue-depression-sleeplessness-hot sweats as bothersome (not easily dealt with) or inconsequential, and cutting edge treatments are regarded as experimental frou frah (not manufactured by Big Pharma), what of the rest of us? Particularly in hard economic times, the majority of the population cannot be constantly innovating in order to find solutions to routine health care problems.

There is yet another subtle and disturbing issue at hand, however. Can the (mostly male) romance with health information technology (HIT) , the rise of e-communities, participatory medicine, sophisticated medical websites and the like, obscure the possibility that there may be a near total disconnect between women’s ability to access reliable medical information and their ability to actually obtain that care? As per my own experience, being on the right side of the Digital Divide may guarantee naught but humiliation, delay, retaliation and denial of service.* The Surcharge for Disruption.

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Anthropologist Christine Gray, Ph.D., became a healthcare activist when her daughter was diagnosed with a sarcoma in 2003. Third in a five-part series on gender disparities in health care.

How does one identify gender disparities in medicine? Bird by bird (one by one), as author Anne Lamott might suggest. Unfortunately, these particular birds add up to the proverbial “ton of feathers” that knocks women out of academia, including medical academia — if not the flock of alleged Canadian geese that knocked US Airways flight 1549 into the Hudson River.

In California, for instance, it is legal for health insurance companies to impose gender ratings (meaning higher rates for women) on individual health care policies. This results in women paying as much as 39% more for coverage than men.

Historically, birth control, regarded by conservatives as one of the few legitimate “women’s issues,” has likewise been treated by insurance companies as “extra.” (Viagra, apparently not.) The first provision in Obama’s stimulus package to be targeted by outraged conservatives concerned contraception for low income women, an “add on” promptly dropped by Democrats.

Using Oprah, arguably the supreme female anecdotal source in the land, if not Robin McGraw as reference, one might reasonably assume that issues of aging for women are routinely “whited out” of diagnostic check lists, a nice cost-saving device for insurance companies.

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Anthropologist Christine Gray, Ph.D., became a healthcare activist when her daughter was diagnosed with a sarcoma in 2003. Second in a five-part series on gender disparities in health care.

Election and economy buzz aside, the public cannot have missed the January media blitz wherein Oprah reveals the big “secret”: millions of women suffer miserably from symptoms of menopause, depression, hot flashes, sleeplessness, lethargy and more. Despite this misery, physicians routinely dismiss their blood test results as normal (Oprah’s physician, even!). Ready to give up on life, Oprah’s prototypical Depressed Woman calls in to the show via Skype (one of the show’s sponsors), a spic-and-span kitchen gleaming in the background.

Assisting Oprah in “opening up the conversation” on this taboo topic are Robin McGraw, wife of Dr. Phil, and women’s health specialist Dr. Christiane Northrup, both of whom have books to promote. McGraw and Northrup speak of bio-identicals as a viable alternative to the now discredited (and hugely prescribed) hormone replacement therapy (HRT) of the last decade. All three speak to the need for careful decision-making in addressing these issues.

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Anthropologist Christine Gray, Ph.D., became a healthcare activist when her daughter was diagnosed with a sarcoma in 2003. First in a five-part series on gender disparities in health care.

My greatest irritation when I first moved to this large agricultural city more than a decade ago was the health club, where childcare hours were organized around the schedules of “ladies who lunch.” For this privilege, the “ladies” paid extra. In terms of dues, men and women were more than equal. Men had a steam room, women, not. Weight machines were calibrated for men, not women. Television channels featured men’s sports, with the occasional concession to some lame idea of women’s interests (cooking). The most memorable scene: an elderly gentleman abruptly switching television channels, triumphantly announcing to a room full astonished (female) patrons that he had to “check his stocks.” This was equality, 1990s style.

Switch scenes to the enlightened, delightful, family-oriented Strawberry Music Festival at Camp Mather in Yosemite that same decade. Lined up at dawn for gourmet coffee, men and women alike talked of stock portfolios or the latest book contract. Nary an eyebrow raised at the “equal” restrooms and shower facilities. Lines to the men’s facilities were short or nonexistent. Women, a stone’s throw away, waited patiently in the cold and mud, children in tow.

How deeply are these notions of “equality” embedded in our health care system today, particularly, if, as hospital CEO Paul Levy suggests, healthcare is decades behind other enterprises in terms of adopting effective process improvement methods? How do we identify these disparities? How do we remedy them, particularly if either operation entails . . . disruption.

Response to the “Spin”

Response to the “Spin” series on the crazy-making quest for a second opinion on an abnormal mammogram was mixed, as was the response to the companion piece on possible and extensive gender disparities in the early detection of cancer.

Two tennis partners, both businessmen, agreed that the medical profession was decades out of date on information technology (IT). Having had considerable experience in this regard, both characterized physicians as “terrible businessmen.” Wes, a professor in accounting, recalled having to fill out a paper questionnaire for a new GP. This he found profoundly ridiculous from a business standpoint.

Did he speak up?

No. He went along and filled out the questionnaire. He did not favor confrontational tactics, he said, besides which he thought remedies lay in another direction: encouraging medical schools to teach basic business principles so physicians would encourage IT innovation rather than resist it.

What would he do if his doctor omitted a critical diagnostic test, a PSA blood test, for instance?

Change doctors, of course.

Had that ever happened to him?

Blank look.

Would he not find the prospect of having constantly to second guess his physician a trifle disconcerting? Should any patient be put in the position of constantly having to switch doctors due to omission of basic tests?

Another friend, roughly Wes’s female equivalent in terms of race (white), class (upper-middle), occupation (professional) and age (Baby Boomer) had a far different response. For years, she and her husband shared the same GP, Bonnie wrote. Her husband, as he aged, was sent for all kinds of tests. For her, nothing. Her husband insisted that a family history of cancer and heart disease accounted for the referrals. Her mother suffered from terrible osteoporosis, Bonnie said, yet their physician, young and prominent, never thought to ask.

She finally insisted on being tested for osteoporosis, after which she was diagnosed with osteopenia and put on medication. Adding insult to injury, the new physician found a heart murmur and sent her for an EKG. The insurance company refused to pay for the new medication (or indeed any new medication) without a fight. Her response: “I hate them all.”

“Of course, dear, you challenged his authority” said Diane, a woman in her 70s, response to the story of the bombast (and implied threats) of the radiology specialist when asked to commit his opinion to writing. Despite her wealth, sincere good manners and standing in the community, Diane expects little of physicians. She has learned to mask her anger, a cultural habit of African Americans most recently, and notably, dropped by U.S. Attorney General Eric Holder.

Next: Oprah’s “Secret” about Menopause

Ted Eytan, MD MS MPH

This month’s Man of the Month is Dr. Ted Eytan, who interviews Holly Potter, Kaiser Permanente’s VP for Public Relations, on the use of social media in health care below.

Ted Eytan currently works as a Medical Director for Delivery Systems Operations Improvement for The Permanente Federation, LLC. His experience is in working with large medical groups, patients, and technologists to bring health care consumers useful information and decision-making health tools, to ensure that patients have an active role in their own health care.

He attended medical school at the University of Arizona. He received his master’s of public health degree from the University of California, Berkeley, and his master’s of science, health services degree from the University of Washington. He completed his residency training at Group Health and his fellowship training in the Robert Wood Johnson Clinical Scholars Program at the University of Washington.

In my Man of the Month-ness (or as I’d like to say, my Honorary Woman-ness), I’d like to highlight the contribution of a leader in health care, in this case, Holly Potter, who is the vice president of Public Relations for Kaiser Permanente.

I met Holly several years ago through her work on KP HealthConnect, Kaiser Permanente’s national electronic health record and personal health record. More recently, Holly’s been a mentor to myself and others in understanding the use of social media in health care. One of the most important things she’s done as a leader is to start with the idea that there is a use for social media in health care, and it’s made a difference for many at Kaiser Permanente and beyond.

Read on, and thanks, Disruptive Women in Health Care, for the opportunity to bring these stories forward!

Holly Potter, vice president for Public Relations for Kaiser Permanente (on the right), with Anna-Lisa Silvestre, vice president for Online Services (on the left), at the United States Senate, April, 2008

Ted: “Holly, tell me about when you began your career with Kaiser Permanente. How did you choose KP and what was your first position?”

Holly: “After spending six years running HTPotter Communications, a small firm specializing in nonprofit and public health communications, I joined KP in late 2004. I was initially attracted to KP because I had a been a long-time, satisfied member. In addition, the launch of the Thrive advertising campaign just the year before, signalled to me that it could be an exciting place to do the kind of work I love. I was right.

I feel very fortunate that my first role at Kaiser Permanente was as the communications lead for the implementation of KP HealthConnect, our electronic health record system. In that role, I worked directly with the IT, clinical and operational leads to support end-user adoption and promote the rollout internally. I joined just as our eighth region was completing their first installation of KP HealthConnect and was with the project team up through the completion of our outpatient and online implementations.”

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The following is guest post from Dr. Val Jones, M.D., and it is cross-posted on her blog, Getting Better.

Merrill Goozner has been speculating about who will be nominated as the new Secretary of HHS. He reviewed his most likely candidates (David Cutler or David Blumenthal), and threw in a “dark horse” potential nominee: Ken Thorpe (whom I’ve interviewed several times on this blog and spent time with during Obama’s inauguration ceremony).

Tommy Thompson told me that the nominee is likely to be a current or former democratic governor (such as Kathleen Sebelius or Howard Dean).

But I’ve been pondering the “long shot” question and think that Goozner may have missed a more obvious choice – someone who works with Ken Thorpe at the Partnership to Fight Chronic Disease: former Surgeon General Dr. Richard Carmona.

Here are the 10 reasons why Richard Carmona would be a smart choice for Secretary of HHS (in random order): (more…)