Articles Posted in Primary Care

emergency-services_overviewResidents of the nation’s capital will participate in a public health test every time they pick up the phone to dial 911 for help. How their calls get answered says a lot about common sense, as well as the availability and affordability of medical services in Washington and the nation.

National Public Radio reported that a bunch of new faces now will join dispatchers in DC’s already hectic and often overloaded 911 center. They will be registered nurses specializing in urgent triage. And when 911 callers want what they claim is emergency medical help, dispatchers will hook in the nurses who will try to determine what kind of fast assistance might be appropriate.

This might raise hackles: Why can’t 911 dispatchers just get on with it and send ambulances with lights flashing whenever a caller reports an “emergency”? Here’s the problem, as NPR reported:

hjobs-300x169Although Americans’ spending for prescription drugs has taken a surprising dip, overall costs of medical care keep heading north. The rise this year is faster than it has been in a while. The culprit? Look to big, shiny hospitals. Or look around at people flocking to well-paying jobs in the health care sector.

Modern Healthcare, a trade industry publication, reported that “rising hospital price growth in March [of 2018] drove overall health care price increases to their highest rate since January 2012.”

It’s unclear exactly why hospitals increased prices, except maybe because they can, the magazine said, citing research by the nonprofit health research group Altarum. Its experts, and those quoted by Modern Healthcare, suggested that hospitals may have taken an earlier hit to their finances due to rising drug costs. Hospitals, after lagging, only now may be trying to recoup those costs by hitting patients with price increases at a time when the economy seems more solid.

lettuce-300x225After fading from the headlines in 2015-16 when a major restaurant chain struggled with meals that sickened dozens in multiple states, big worries have erupted anew about the safety of the nation’s food. That’s because federal officials and a supersized-farmer are struggling with salmonella outbreaks tied to more than 200 million now-recalled eggs, even as growers, grocers, and eateries  wrestle with dozens of E. coli illnesses linked to romaine lettuce.

The worrisome poultry products came from Rose Acre Farms’ North Carolina operation, which produces 2.3 million eggs a day from 3 million hens. Its products go to stores and restaurants in Colorado, Florida, New Jersey, Pennsylvania, Virginia, West Virginia, and the Carolinas, the Washington Post reported. Those eggs have been blamed for Salmonella braenderup infections that have sickened 23 people from nine states. No deaths have been reported.

Rose Acres, which has 17 facilities in eight states, has acted with “an abundance of caution,” federal officials noted, and recalled more than 200 million eggs, sold under the brand names  Great Value, Country Daybreak, and Crystal Farms. Waffle House restaurants and Food Lion stores also were sold the potentially bad egg.

microbiome-300x150Trust your gut: If anyone hypes a diet to you, saying it’s beneficial because it’s somehow tailored to the makeup of your complex, prehistoric, and individual intestinal microbiome, just wink and walk off. You know better, right?

Healthnewsreview.org, the watchdog about accuracy of medical news reports, rightly has taken after the Wall Street Journal for its recent story headlined, “The Food that Helps Fight Depression.”

Writer Michael Joyce reported about the WSJ piece:

walmartclinic-300x209Americans are showing with their feet and their money how they feel about doctors’ offices and  shiny hospitals, places they’re shunning more and more. They’re racing to neighborhood clinics and urgent care centers that seem to be popping up on every suburban street corner and shopping mall.

Before these facilities transform U.S. health care, would it be worth asking what this trend might mean, not just for profit-seeking retailers, drug store chains, and, yes, also hospitals and doctors who are shifting into new lines of business?

The New York Times found that:

mom-300x171Big Medicine can paper over its troubles with basic fairness by slapping fancy terms on them: take “health and gender disparities,” for instance. But doctors, hospitals, and the rest of us can’t make medical care more equitable, accessible, safe, and affordable without looking at inequities, square on.

That’s why the New York Times, Washington Post, and Associated Press deserve credit for recent deep digs into the struggles of women, poor women, and especially black women with modern medicine:

antidepressant-300x225Even as the nation enters an even scarier phase in its battle against the raging opioid abuse epidemic, new and sterner warnings are flying about antidepressants. The costs of these powerful drugs add up, as does the toll of depression and its care. Users say antidepressants are a nightmare to get off of. And medical experts cast growing doubt about whether their benefits outweigh their risks.

The New York Times deserves credit for detailing the worrisome plight of an estimated 15.5 million Americans who have been taking antidepressants — sold as brand drugs like Zoloft, Effexor, Paxil, Prozac, and Cymbalta — for at least five years. The rate of the psychiatric medications’ use “has almost doubled since 2010, and more than tripled since 2000,” the newspaper reported, adding that “nearly 25 million adults … have been on antidepressants for at least two years, a 60 percent increase since 2010.”

Users who try to wean themselves from the drugs find themselves, fast, in nasty situations with “dizziness, nausea, headache and paresthesia — electric-shock sensations in the brain that many people call brain zaps,” patients told the New York Times.

juul-300x197Big Tobacco, Big Sugar, and technology may be targeting the well-being of young people faster than regulators can prevent them from heading back to the future in a bad way:  Teens getting hooked on nicotine, while tots take in excess calories with super sweet breakfast cereals.

The Wall Street Journal and the New York Times each have big take-outs, reporting on the “explosive” and “epidemic” trend, mostly by more affluent teens, of vaping with so-called e-cigarettes,  notably a hot new device called the Juul.

It’s about the size of a computer flash drive, and it uses fruity-flavored liquids to deliver a jolt of nicotine — more than what users might get by puffing a pack of old-fashioned cigarettes.

NORC-chart-300x179Although the United States remains the world’s most affluent nation, it also is a country where money plays a driving, negative role in its people’s well-being. Sudden financial losses  may shorten some Americans’ lives, while dismal finances may keep many others from seeking medical care.

So why are politicians still pushing to slash the nation’s social safety net, even as millions of individuals and families are voting with their wallets to protect their health?

Lethal ‘wealth shocks’

superbugs-300x118Hospitals may be providing us all with too many causes for high anxiety, with reports on increasing findings of “nightmare” bacteria stalking more health care facilities than had been known, more disclosures about how taxpayers may foot an even bigger bill to deal with a beleaguered public hospital in Washington, D.C.,  and a respected reform advocate’s detailing of just how traumatizing many hospital stays may be.

Let’s start with the new research by the federal Centers for Disease Control and Prevention, a study that tried to determine just how many cases there might already be of patients infected in hospitals, nursing homes, and other medical care facilities with so-called Superbugs, bacteria that resist treatment not only with most standard antibiotics but also drugs that are deemed therapies of last resort. These include three types of bacterial infections deemed especially urgent but difficult to control: Clostridium difficile (C. difficile), aka C-diff; carbapenem-resistant Enterobacteriaceae (CREs, as shown above); and Neisseria gonorrhoeae.

CDC officials weren’t sure how many of the Superbug cases — which leave doctors and hospitals little option but to provide only supportive care — they might detect by scrutinizing records from pathology labs nationwide.

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