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Why Are These Doctors So Mad? What It Means for You

Rosemary Gibson, author of The Treatment Trap and Wall of Silence, has just published a terrific article  that asks the question whether doctors should be periodically independently assessed for whether they are keeping up to date. Leah Binder, CEO of Leapfrog, has dedicated her life to

Centenarians have bad habits too

The NYT published a good article with that title. It was written by Anahad O’Connor. According to a new study of people who’ve lived to age 100, most of them have had some pretty bad habits.  “The centenarians in the study indulged in smoking and drinking just as

Obesity both Increases and Decreases risk of dementia. Say what?

Yes, you read the headline right. It just depends on which study you look at. Here’s part of an article published in the Guardian: “People who are obese in middle age are at almost four times greater risk of developing dementias such as Alzheimer’s disease in

Doctors doing a 180 degree flop on many blood transfusions

According to a Business Insider report by Elle Kincaid, “…evidence is mounting that a substantial portion of blood transfusions are not necessary.” As they’ve reduced blood transfusions, patient admissions have become shorter and patient death rates are down. Stunning, no? Why? For one thing, “transfusions can trigger immune and

Adopting a culture of good health—no so fast

You don’t change cultural affectations of organizations overnight. That often takes an intergenerational time frame. Look at the US auto industry. They had a culture of making poor to mediocre cars for 50 years, then only after losing 60% of their business to Japanese car makers did

Why Are These Doctors So Mad? What It Means for You

Rosemary Gibson, author of The Treatment Trap and Wall of Silence, has just published a terrific article  that asks the question whether doctors should be periodically independently assessed for whether they are keeping up to date.

Leah Binder, CEO of Leapfrog, has dedicated her life to patient safety. Leah’s work saves lives. Period. She spoke up in favor of continued assessment of doctors…go Leah… and has been pilloried in social media by the bad guys. Too bad. That makes her detractors look…umm…not so dedicated to patient safety.

 

Cheers,

Tom Emerick

 

 

 

Centenarians have bad habits too

The NYT published a good article with that title. It was written by Anahad O’Connor.

According to a new study of people who’ve lived to age 100, most of them have had some pretty bad habits.  “The centenarians in the study indulged in smoking and drinking just as much as their shorter-lived counterparts.”  

They also didn’t weigh less, exercise more, or eat better than those who died much younger.  A study at the Albert Einstein College of Medicine found that “… the people who lived to 95 and beyond did not seem to exhibit healthier lifestyles than those who died younger.”

These studies are significant because they use actual measurements, not surrogate measurements

“What,” you ask? “That’s crazy,” you say?  How can that be?

Here’s the hard truth. I want to inculcate readers of Cracking Health Costs with this truth: lack of exercise, being overweight, and smoking are risk factors… but only three of a hundred risk factors each of us have.  If any three are out of bounds but the other 97 are right, you’ll likely do well. Conversely if those three are just right, and the other 97 are out of sync, you know the answer.

Wellness true believers would have you believe that they have a simple formula for a long healthy life, and they want to charge your company a ton of money to use it. Their formulas involve being over-tested by doctors. Nonsense. The real formula, if there were one, would require a balance among at least 50-100 variables.

There is no simple formula. Period.

 

Cheers,

Tom Emerick

 

 

 

 

 

 

Obesity both Increases and Decreases risk of dementia. Say what?

Yes, you read the headline right. It just depends on which study you look at.

Here’s part of an article published in the Guardian: “People who are obese in middle age are at almost four times greater risk of developing dementias such as Alzheimer’s disease in later life than people of normal weight, according to a study released today.”

This is from a Press Association article: “Obese middle-aged people are nearly 30% less likely to develop dementia than those of a healthy weight, a study has revealed. It also found that underweight people of the same age were a third more likely to develop the condition than those who had a healthy body mass index (BMI).”

No wonder the public is confused…not to mention wellness true believers. This is yet another reason why meddling with peoples’ health and wellness does not belong in the workplace.  You may be seriously steering people in the wrong direction again, as was the case with Vitamin E supplements, etc.

 

Tom Emerick

Doctors doing a 180 degree flop on many blood transfusions

According to a Business Insider report by Elle Kincaid, “…evidence is mounting that a substantial portion of blood transfusions are not necessary.”

As they’ve reduced blood transfusions, patient admissions have become shorter and patient death rates are down. Stunning, no? Why? For one thing, “transfusions can trigger immune and allergic reactions if the patient’s body and transfused blood cells do not get along.”

“In fact, The Joint Commission, a nonprofit that accredits hospitals, included blood transfusions in a 2012 report as one of five overused hospital procedures.” (Emphasis mineThat’s saying a lot, I know.

If they want to give you a blood transfusion, make sure they give you a good reason.

Tom Emerick

Adopting a culture of good health—no so fast

You don’t change cultural affectations of organizations overnight. That often takes an intergenerational time frame.

Look at the US auto industry. They had a culture of making poor to mediocre cars for 50 years, then only after losing 60% of their business to Japanese car makers did they make real changes, and they’re really not that close yet.

Many companies simply wither because they could not change a destructive culture. See Sears, Kmart, Montgomery Ward, Studebaker, Bethlehem Steel, Eastern Airlines, Pan Am, and on and on.

No, truly changing an organization’s culture sounds like a piece of cake, but is extremely difficult. Bandaids, like adding more salad in the company food service, are easy but that’s not real change.

 

Tom Emerick is a consultant and co-author of the book Cracking Health Costs, an Amazon trade best seller. Tom is the President of Emerick Consulting and co-founder of EdisonHealth.

Don’t sweat the small stuff

A number of years ago, and older and successful executive at British Petroleum once advised me to not sweat the small stuff.  He said being bothered by things you can’t change is a big waste.  That was good advice.

Well, it turns out that sweating over things you can’t change is quite unhealthy.  A WSJ article by Elizabeth Bernstein titled “It’s Healthy to Put a Good Spin on Your Life” explains how we handle life problems has a big impact our our health.

She writes about a male triathlete who had a very unexpected heart attack while training for his next event.  (Yes, wellness true believers, he was in tip top physical condition.) If something like that happens to you, it can be emotionally devastating, true.  But how you process that kind of life changing event will make a big difference in your future health. Those who adopt a depressing and miserable personal “narrative” about things like that will not recover as well as those who accept it and move on.

A heart attack is not “small stuff” by any means. But are you going to get angry about all the changes you face in life? Or are you going to try to make the best of it and move on?

“When reframing negative events, acceptance is crucial”, says Hal Shorey, a psychologist and assistant professor for the Institute for Graduate Clinical Psychology at Widener University in Chester, Pa., who helps clients with this issue. ‘If negative events and their impacts are not first acknowledged, the experience of invalidation can actually lead people to hold on to the negative narrative,’ he says. But there eventually comes a point when it’s healthier to just move on, he says.”

 

__________________________________________________________________________ Tom Emerick is a consultant and co-author of the book Cracking Health Costs, an Amazon trade best seller. Tom is the President of Emerick Consulting and co-founder of EdisonHealth.

 

Longevity is determined by hundreds of risk factors—too many to simplify

Longevity is determined by a hundred or so risk factors we all have, perhaps too many to truly understand and manage. Someday history will judge today’s understanding of health risk factors as poor, at best, dangerous at worst.

Wellness fans would have us believe that if we follow certain diet, exercise, bio-measurement, and primary care protocols, we will optimize our health. Alas, there are deep problems with that notion. Those protocols aren’t working well. It’s extremely difficult to eke out ROIs following the majority of wellness vendor programs.

Most importantly, we have only a crude understanding today of what our health risks really are. As I’ve written here often, factors such as boredom, loneliness, job satisfaction, etc, are huge risk factors, as are family relationships, genetics, anger, worry, resilience, finances, stress, aspirations, spirituality, community, contentment, and many more.

You can drink three Dr. Peppers a day and live to be a hundred. Egad! (BTW: scientists themselves do not agree whether sugar-free sodas are better then sugary ones.)

Some people smoke all their adult lives and live to be a hundred. Yikes! (My own Grandfather is a good example.)

Some people eat bacon nearly every day of their lives and make it to a hundred. Impossible, say wellness true believers!

Some obese people live to be a hundred too. How can that be?

Well, the plain truth is our health and longevity is determined by hundreds of risk factors. (The combinations and permutations of those risk factors is mind boggling.) That applies to all of us, every single one.  Simply put, if you do some wicked behaviors like drinking sugary sodas every day, but your other 100 or so risk factors are in sync, you’ll probably be just fine.

__________________________________________________________________________ Tom Emerick is a consultant and co-author of the book Cracking Health Costs, an Amazon trade best seller. Tom is the President of Emerick Consulting and co-founder of EdisonHealth.

Angry Outbursts Really Do Hurt Your Health, Doctors Find

That is the title of an article in the WSJ by Jeanne Whalen. (Subscription required.)

Outbursts of anger can greatly increase your risk of a heart attack. “New evidence suggests people increase their risk for a heart attack more than eightfold shortly after an intensely angry episode. Anger can also help bring on strokes and irregular heartbeat, other research shows. And it may lead to sleep problems, excess eating and insulin resistance, which can help cause diabetes.”

According to Redford Williams, director of the Behavioral Medicine Research Center at Duke University Medical Center and co-author of Anger Kills: Seventeen Strategies for Controlling the Hostility That Can Harm Your Health“Anger is bad for just about everything we have going on physically.”

Anger can cause your body to produce unhealthy levels of adrenaline and other hormones that can in turn increase your blood pressure, etc., and may even increase your blood sugar levels.

Typical corporate wellness programs try to address the symptoms of unhealthy conditions such as stress, anger, and loneliness, but do not deal with the root causes. In fact workplace wellness programs probably will never be able to address such root causes in a meaningful way.

A wise person once told me, “don’t sweat the small stuff”. That advice sounds  better and better all the time.

__________________________________________________________________________ Tom Emerick is a consultant and co-author of the book Cracking Health Costs, an Amazon trade best seller. Tom is the President of Emerick Consulting and co-founder of EdisonHealth.

 

 

 

 

 

 

 

A guest post by Kathleen Bartholomew: A Billing Code for Loneliness

In June of 2013 the AMA officially recognized obesity as a disease. This designation occurred despite the Association’s Council on Science and Public Health’s recommendation advising against it. Just semantics? Hardly. This move set up obesity as a money maker with the potential of being ultimately as profitable as Cancer.
Obesity treatments can now qualify as a tax deduction. Advocates said we would focus more attention on the issue – and pharmaceutical companies certainly have. Vivus and Arena aggressively market their chemical solutions to a complex social and economic behavioral problem, while processed and fast food conglomerates continue to soak up huge profits. Once again the focus shifts to profit making therapies vs. addressing the major root cause: our food supply and a serious education deficit.
It is time to re-assess. Dr. Patricia Harris from the AMA Board said that naming obesity a disease would also help fight diabetes and heart disease. Has this designation really helped our obese population? And since a study by Brigham Young University following 3 million people found that “Loneliness is as damaging as obesity” (link recent post), will Loneliness inevitably follow the same path?
In 1985 only 10% of our population had no one to confide in about serious matters; and by 2004 that number jumped to 24%. People living alone has jumped from 17 to 28% (1970-2011). In only a ten year period form 2000-2010 an AARP study found that people over 45 who were lonely more than doubled – from 20-45%. Furthermore, loneliness is a predictor of functional decline and mortality (12 vs. 22%) and is associated with depression, poverty, arthritis, and heart and lung disease. We can even order lab tests for Loneliness now that Dr. Cacioppo has discovered higher levels of epinephrine, the stress hormone, in the morning urine of lonely people (Atlantic Monthly).
Keep this to yourself or within 72 hours you will be witnessing lobbying initiatives for a “Billing Code for Loneliness” and drug advertisements on T.V. marketing Dejectacillan, and Forlornazole. Let’s recognize the impact of Loneliness on our health and do something about strengthening community before it turns into yet another treatable commodity.

http://www.nytimes.com/2013/06/19/business/ama-recognizes-obesity-as-a-disease.html?_r=0

http://minnesota.cbslocal.com/2015/03/16/study-being-alone-as-bad-as-smoking-excessive-drinking/

Is Facebook Making us Lonely? By Stephen Marche in the Atlantic Monthly May 2012
Dr. John Cacioppo, Director, Center for Cognitive and Social Neuroscience, Univ. of Chicago
Higher mortality rate – Proceedings of the National Academy of Sciences

Clinical Man by Clifton Meador, MD

Dr. Meador posted a must-read article in The Health Care Blog.

In that article he describes a new evolution in mankind…okay it’s a little tongue in cheek but has much truth in it. He describes a new species of mankind, one characterized by an obsession with personal health.

Writes Meador, “Nothing has changed so much in the health-care system over the past 25 years as the public’s perception of its own health. The change amounts to a loss of confidence in the human form. The general belief these days seems to be that the body is fundamentally flawed, subject to disintegration at any moment, always on the verge of mortal disease, always in need of continual monitoring and support by health-care professionals. This is a new phenomenon in our society.”

“Clinical Man is neither sick nor well. He is simply in clinical limbo.” Clinical Man is obsessed with and emotionally needful of constant medical overwatch.

A trait of Clinical Man is that he “knows his cholesterol level within 10 milligrams percent.”  Another is that he “never goes more than twelve months without medical contact.”

This is a bizarre and destructive trend induced by a wide range of factors, including, in my opinion, a national obsession with wellness that scares people into believing the healthcare Sword of Damocles is constantly hanging over their heads.

__________________________________________________________________________ Tom Emerick is a consultant and co-author of the book Cracking Health Costs, an Amazon trade best seller. Tom is the President of Emerick Consulting and co-founder of EdisonHealth.