Shaw's Eco-Logic

We still don't care about doctors

Think of this HND piece as a follow-up to a story from 2010.  We focus on yet another insult to medical residents—the heart and soul of our healthcare system. As an "experiment," the maximum number of hours they can work, which was recently lowered, has now been increased. This by ACGME—the very organization that lowered them. Welcome to the world of predatory healthcare NGOs. Too bad there are dozens more of them, and virtually all of them are bad.  It's bad enough that the feckless Feds are financing these, uh...studies, but the academic institutions behind the work actually claimed that humans were not involved. Oh, and neither the docs or the patients were told of these arrangements, thus totally violating rules for voluntary informed consent.  And you wonder why are healthcare system simultaneously sucks and is too expensive.  Read the complete article.

Obamacare was supposed to reduce healthcare costs, right?

This HND piece discusses the recently published finding that US healthcare spending increased 5.3 percent to $3.0 trillion in 2014. That represents 17.5 percent of the gross domestic product. You might recall that O-care was supposed to save us money, but every single thing increased, as well as per capita costs.  So, now that the insurance part of Obamacare has imploded, and I promise you this will continue, the brain trust has no choice but to remind us about all the other provisions of the Affordable Care Act. Only, most of those, including the highly touted ACOs (Accountable Care Organizations) have tanked, as well. In fact, the O-care fanboys resorted to dinking the number big time to make the ACOs look much better than they are.  Read the complete article.

Do no cyber harm: A Hippocratic oath for healthcare websites

This HND piece was inspired by the uneven experience most of us get when surfing through various health-related websites. It is ironic, of course, that in this era of endless communications media, too many of us have forgotten how to communicate effectively. Perhaps it has something to do with the rise of social media, and the old adage that the opposite of communication is ego.

We touch on the big topic of customer-centric website design, as championed these days by our friends at LCN.com. Of course, this is hardly revolutionary, as this very same idea was being stressed at the dawn of Web 2.0. Back to the basics, right?  Also included are five best practices, that should be followed in everyone's web design. Read the complete article.

Over the river and through the wood: Healthcare observations for Thanksgiving week

This HND piece invokes the first line from Lydia Maria Child's "The New-England Boy's Song About Thanksgiving Day" (1844). Child was always on the side of the oppressed, and I suspect that she would have a few things to say about our present day healthcare system.  The article examines the continuing saga over infection control issues relating to certain types of endoscopes. We're talking about a double recall involving 2800 units of a commonly used "reprocessor" for these scopes. That the FDA was asleep at the switch on this one is quite an understatement.  We also open the huge topic of conflicts of interest in healthcare (such as Big Pharma buying influence), even though this matter seems to downplayed by the New England Journal of Medicine. I'm sure that NEJM's position has nothing at all to due with the fact that absent Big Pharma advertising, it would cease to exist.  Read the complete article.

We're number one: Paying the most for the worst

This HND piece examines the 500 pound gorilla in the health care "room"—Why does the U.S. pay substantially more than any other country in the world for healthcare, only to realize mediocre outcomes?  Some observers suggest that these findings prove that a for-profit healthcare system is a recipe for disaster. However, profit per se is not the problem. Cutting to the chase, all the incentives built into the healthcare system are completely bass-ackwards. You see, with our fee-for-service model—that even in itself puts a premium on procedural rather than cognitive medicine—we are incentivizing procedures, rather than outcomes. Or to put it another way, there is no incentive to keep people healthy. Rather, all the incentives are geared to treat sick people. Meanwhile, the public is obsessed on how much they don't pay, rather than how much they are not sick.  Read the complete article.

The only thing we have to fear...are the fear entrepreneurs themselves

This HND piece goes after the absurd—but widely publicized—IARC findings regarding red and processed meat products. Bear in mind that of the 985 substances IARC has tested for carcinogenicity, only one has been put into its Group 4 (Probably not carcinogenic to humans).

Note also that in epidemiological terms, relative risks of 1.18 and 1.17—as are indicated with processed meat products and red meat, respectively—are statistically insignificant, and one wonders why the "experts" at IARC ignored this. Indeed, as a rule of thumb, an RR of at least 2.0 is necessary to indicate a cause and effect relationship, and a RR of 3.0 is preferred.

Compounding this epic journey into junk science, IARC does almost nothing to change the public perception of its ratings. Its classification system does not assess the carcinogenic risk of the given agent, but rather, its rating of the quality of supporting evidence.

Thus, included in the dreaded Group 1 (Carcinogenic to humans) are alcoholic beverages, asbestos, benzene, diesel exhaust, mustard gas, tobacco products, and now...processed meat. However, this does not mean that processed meat is as carcinogenic as tobacco products or asbestos, even if that's what any number of bogus authorities and fear entrepreneurs are now claiming.

The irony here is that IARC has recently been mocked by real scientists for its nonsensical work on formaldehyde. Among other things, it based its cancer assessment on an unpublished and ridiculously flawed and inconsistent study from China. At least, formaldehyde is a chemical with known dangerous properties. But red meat?   Read the complete article.

Medical idolatry and healthcare outcomes

This HND piece takes aim at credentialism, and in a sense is a follow-up to an earlier posting.

Among other things, we go after the almost comically greedy American Board of Internal Medicine, and cover their latest attempts at becoming a true life version of Dr. Evil. You'll love their ludicrous stance on copyright. Heck, even people who disagree with my views on the notion of copyright being mostly indefensible are appalled by how far into the wild blue yonder ABIM has taken it!
As to the benefits of board certification, you'd think that with a nearly 80-year history and a complete monopoly, they would have reams of data supporting their cause. But, you'd be wrong.  Read the complete article.

More on walking back the low fat    

This HND piece continues the saga on how officialdom is trying to cover itself over the rapidly deteriorating diet/fat/cholesterol/heart disease meme. The elites are in full crisis mode now, as certain members of Congress are mocking them openly. Many people—from all walks of life—are criticizing the "Scientific Report of the 2015 Dietary Guidelines Advisory Committee." But no one has done a better job than investigative journo Nina Teicholz, bestselling author of The Big Fat Surprise.  The elites can only fight back by calling to authority, except that authority has been bankrupt for over 30 years.  Read the complete article.

HuffPo picked up the "Dietary fat no longer the bad guy" piece

Check it out. More coming soon on this issue, in collaboration with the wonderful Nina Teicholz.

Dietary fat is no longer the bad guy, or Why does anyone listen to the experts?

This HND piece looks behind the current walking back of the "fat is evil" dietary theory. Readers of this blog know that the dietary fat/cholesterol/coronary heart disease meme has been disproved hundreds of times, but I guess bad ideas die very slowly. The change in the wind is likely a direct result of the feckless bureaucrats behind this garbage finally sensing that the party's over. Maybe we can find some genius economist to help us determine how many lives have been ruined or even lost because of this deadly wrong advice. Read the complete article.