The phrase, Medicalization of Life refers to “society’s growing trend to classify more and more life problems as medical problems” and treating those problems with pharmaceutial or surgical intervention. Many advertisements describe how to treat problems like restless leg syndrome, sexual dysfunction and insomnia with a physician visit and a prescription drug.  These are examples of medicalization of life issues today that, 20 years ago, we did not even have a medical diagnosis for, let alone a treatment.  Determining the proper level of medicalization involves asking questions such as, when does a deviation from normal need medical intervention? and, what are appropriate alternative treatments?  Medicalization speaks to an issue of fear - fear that society continues to lower the bar in defining what is a disease and in need of medical treament.  Achieving a balance in the growth of medicalization requires a group effort:  proactivity on the part of the patients, open mindedness from treating physicians, and information, education and research support from the government.

I was recently called an “audist” by a sign language interpreter on my staff, and believe me, it was not a compliment. Audism is a term used to describe attitudes and actions by people in the hearing world that oppress those who are Deaf. Audism, like racism…judges, labels and limits…The belief is that hearing people feel they are superior to Deaf because they can hear. It might be because I am Jewish but words that end in ISM such as anti-Semitism, racism, sexism and now AUDISM are words that are powerfully repugnant to me.

I told the interpreter that I wanted to share a story with her. A long time ago I had an assistant who I was very fond of, and she, me. One day an elderly Jewish lady, whom I’ll call Mrs. Goldstein, had an appoinment to purchase hearing aids. When she left without purchasing them, Katie, my assistant, asked “did Mrs. Goldstein try to Jew you down on the price?” What was so upsetting to me was that she had absolutely no idea that what she was saying was offensive, bigoted, insulting and just plain ignorant. I explained that to Katie and vowed to myself that I would help teach her the truth…it is the only way to combat prejudice.

I asked my staff person to help me in the same way. I am not an audist…but I may occasionally say things that might make it seem, out of ignorance that I am. Rather than make derogatory comments I asked her to take the time to educate me. I am very open to listening and learning.

Today is Public Health Thank You Day, honoring legislators, researchers, government agency employees, and other professionals who focus on community-wide health. Take a look at profiles of public health heroes, and spread the word!

One task for the new administration will be to turn our healthcare rights into reality. Just as he was able to unite us on election night, President-elect Obama should unite us all through equal rights in healthcare. In America, healthcare is only considered a “right” for certain classes of individuals, including those over 65, those with certain diseases, and those with either enough money or not enough money. However, once you become a patient, regardless of your ability to pay, you have additional rights guaranteed to you – at least on paper. And yes, because we are America, our rights come along with additional responsibilities as well. Problem is, it’s not clear that we are even all aware of these rights and responsibilities. A good place to start is by communicating and informing.

Our healthcare rights are published in the Patient’s Bill of Rights and Responsibilities, but even this did not happen until 1998. The bill gives us the right to accurate and easily understood information to help us make informed decisions about our healthcare. We also have the right to choose our provider, access to emergency services, care without discrimination, privacy, speedy complaint resolution. We also have the right and the responsibility to be a full partner in our healthcare decisions. The bill also states that patients must also take greater responsibility for maintaining good health.

While the Obama administration has a long road ahead in many areas, including healthcare, we all have a key role to play as well. If we go back to the original objectives of the Patient’s Bill of Rights, it may provide both us, as healthcare consumers, and the new administration some initial guidance. The original objectives of the bill were to:

· Strengthen consumer confidence by assuring the healthcare system is fair and responsive to consumer’s needs

· Encourage consumers to take an active role in improving and assuring their health

· Reaffirm the importance of a strong relationship between patients and their healthcare professionals

· Reaffirm the critical role consumes play in safeguarding their own health by establishing both rights and responsibilities for all participants in improving healthcare status.

As the nation goes to the polls to cast important votes tomorrow, it does so at a time of one of the most challenging global economics period in recent memory. Some policy wonks say that these times will shove health below the radar, as the nation struggles to address more basic productivity concerns. Others disagree, saying rising unemployment will trigger the ‘intolerability quotient’ on the uninsured as we reach the ‘tipping point’ at which a solution, regardless of popularity – or even wisdom – will be legislated.

It will be unfortunate if health care is positioned as merely the ‘problem,’ when health is also the solution. It would be unfortunate if we voted on Tuesday for the candidate we felt might offer the better health care solution, but did not take important health steps ourselves.

Health is an important component of our national and personal economy: half of economic growth in the US in the past 100 years is estimated to be related to improvements in our health.¹ The value of health has also been demonstrated with more recent data, showing that improvements in survival and health between 1970 and 1999 accounted for at least 8% of the increased output of the formal labor force.²

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Chronic diseases are the number one cause of death and disability in the U.S.—accounting for 70% of all deaths and more than 75% of the $2 trillion the US spent on health care during 2005.

Most of us know personally the devastation caused by chronic diseases like cancer, heart disease and diabetes. It’s overwhelming—but there is something everyone can do.

Take a look at this video produced by the Partnership to Fight Chronic Disease (PFCD)—pass it on to everyone you know—and VOTE.

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Last week, the Better Health Care Together coalition held a briefing at the National Press Club to unveil a new study written by economist Dr. Robert Litan.

The study, entitled Vital Signs Via Broadband: Remote Health Monitoring Transmits Savings, Enhances Lives, found that the United States could cut $197 billion from its health care bill over the next 25 years by the widespread use of remote monitoring to track the vital signs of patients with chronic diseases such as congestive heart failure and diabetes.

But, and here’s the catch: Dr. Litan warned that adoption of remote monitoring and other telemedicine opportunities will be slowed and benefits reduced unless the United States does a better job of reimbursing health care organizations for remote care and encouraging continued investment in broadband infrastructure that can be tailored to meet the privacy, security, and reliability requirements for telemedicine applications.

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Last Monday, Stephanie Mensh wrote about her experience with medical homes. Dr. Pamela Mitchell, President of the American Academy of Nursing, has provided Disruptive Women with another perspective.

Guest post by Pamela H. Mitchell, RN, PhD, FAHA, FAAN

There is much talk these days in health professional, health payer, and even legislative circles about the “medical home.” This is a term coined in 1967 by the American Academy of Pediatrics. The medical home was originally meant as a single place for a child’s medical record and was particularly salient for children with special care needs. It later expanded to denote the one place that families with children with special care needs might obtain coordinated, continuous, family-centered and culturally effective care.¹ The concept of a medical home has additional roots in recognized needs for care coordination for people with chronic illness in managed care, case management, disease management and comprehensive discharge planning for complex or chronic illnesses. Most recently, a coalition of the American Association of Family Practice, American College of Physicians, American Academy of Pediatrics, and American Osteopathic Association developed and disseminated “Joint Principles of the Patient-Centered Medical Home.” This document defines the Patient-Centered Medical Home (PC-MH) as “an approach to providing comprehensive primary care for children, youth and adults. The PC-MH is a health care setting that facilitates partnerships between individual patients, and their personal physicians and, when appropriate, the patient’s family.”¹ At its best, this new movement promises quality, coordinated care for people, rather than their diseases. Further, it recognizes that care coordination and management is a complex skill that deserves payment in our current payment system. However, because of the consistent emphasis on physicians as the home “owner” and leading partner, it connotes care centered in a particular practice profession rather than care for the person or family who comes “home.”

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Don’t neglect your ovaries during Breast Cancer Awareness Month.

Earlier this week, the Ovarian Cancer National Alliance (OCNA) released both a 30 second public service announcement (that ran in New York taxi cabs in late September) and a more personal, in-depth interview with Kathy Bates—about her experience with ovarian cancer.

I wanted to share this information with as many people as possible—men and women.

Please help educate others about ovarian cancer.

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The current state of health care systems in the United States is not accidental. It has a history and that history counts. Though there are many dimensions to that history, some that fly under the public discourse radar are worth exploring. I want to share my thoughts about a few of these “elephants in the room” that haunt me. This is not an exhaustive report; it simply highlights one of many processes that set the stage for the current conditions in health care today. I will be writing about other ones…

Some social commentators called the 1980s the decade of greed in the United States. I thought it was more accurately a cultural drift where greed was confused with success, embraced as a worthy motive. It was not the Baby Boomers finest hour, or decade for that matter. Just ask their offspring who are inheriting the inevitable results of this greed.

This drift was in part shaped by a conviction held by many that the free market could and would correct itself, even in the context of a complex emerging global economy. (It seems self-evident to note that the last few weeks beg to differ). This worldview created the conditions for the 90s where health care systems, seeing health care reform deep-sixed early in the Clinton administration, drifted toward a cost-containment marketplace mentality. (more…)

In an ironic twist, the same person who helped me develop into a disruptive woman in healthcare has asked me to become a founding member of the Disruptive Women in Health Care blog. She is my big sister. When we were in high school, she had the coolest job ever; she was a “medical assistant” in the office of a local internist. He was a sole practitioner who believed in giving young women an opportunity to get experience in the medical field. Many of them have, in fact, gone on to careers in healthcare. Just before my junior year in high school, with my sister heading off to college, the baton was passed to me. After thoroughly prepping me for the interview (I can still count backwards from 100 in increments of 7 flawlessly and remember the spelling of such important words as phlegm and pneumonia), she was off and I was running.

Initially, my role was pretty basic. Interviewing the patients meant asking, “What is the reason for your visit?” to open and closing with, “Are there any other complaints or is there anything else you wish to speak to the Dr. about?” As I gained valuable experience, I was given more responsibility: setting up for and developing x-rays, performing EKGs, analyzing urine and stool samples and writing prescriptions. By the time I was mid-way through college, I had occasionally been given the opportunity to “assist.” That meant helping with pap smears, casting fractures, administering chemotherapy and suturing. Finally, throughout graduate school, I became known as the Medicare expert. The staff would save up hundreds of claims for me to complete when I came home for vacations and summers.

Can you imagine how simple things were then and how different they are now?  We had no computers; the forms were filled out using a pen. I knew what a LBBB was and why PVD was bad. My boss signed, by hand, each and every form I filled out. Although times were much more innocent in the late 1970s and early 1980s, I learned lifelong lessons in that office. I was the most comfortable audiology graduate student in my class when it came to interviewing patients. I wasn’t afraid of touching ear wax or giving difficult test results to families. I owe much of my success initially as an audiologist and currently in my role as Director of a clinic to my first employer, and of course, to my big sister.