Friday, August 11, 2017

Top US hospitals aggressively promoting alternative medicine offerings

GOOP and Gwyneth: Blame mainstream media

It is easy to mock the ridiculous and potentially harmful health advice and product lines promoted by Gwyneth Paltrow and her team at Goop. Sleeping near healing crystals, lugging around jade eggs in the vagina, swilling moon juice, undergoing raw goat milk cleanses, dabbing on sex dust, and snapping photos of your aura are just some of the ridiculous treatments and remedies offered at high prices to those looking for health ideas from a movie star.

Secrets of the jade yoni

If you want to add Yoni treatment to your practice, Check out this site.

They come in different sizes, colors and customizable extraction devices. It is advisable to not microwave your YONI JADE EGG.  They are available online
The mocking may be a bit understated. How does this company and other equally daffy outfits pull off these highly lucrative health scams?

Note,  Disclaimer:  The author makes no recommendation as to the safety or efficacy of manufacturers of the YONI

Besides placing a YONI in a vagina, the author says this with 'tongue or Yoni in cheek' or a Yoni
Mainstream medicine is partly to blame.

Without going into much detail, who would not feel better in the setting above, whether you are at end-stage disease or in remission from a cancer.

When is a supplement an approved drug ?  Two pharmaceutical-grade drugs are being market as a drug in Russia and as supplement in the U.S. 

In addition to the drug/supplement conundrum there are a multitude of alternative treatments, reiki, vaginal crystals (a la Paltrow), magnetic therapy, essential oils, and accupuncture,

Supplement manufacturers are powerful financially and often take legal steps to protect their products.  There is a huge financial at stake.  Manufacturers have often attacked research scientists and their peer reviewed article, causing financial personal harm to them personally.

Pieter Cohen, a highly respected medicine specialist and who has a long list of peer reviewed articles has been attacked in the past for his articles.

The issues are not polar opposites.  Many patients are reticent to tell their allopathic doctor if they take supplements.  It is important because some of the supplements increase or reduce the actions of prescription drugs.  Intelligent doctors listen quietly and do not judge, offering suggestions and focused warnings about possible interactionsl

Top US hospitals aggressively promoting alternative medicine offerings

Hospice, Designed For The Dying, Is Discharging Many Live Patients : Shots - Health News : NPR

How to fail at Hospice 

Hospice was designed for in home care for end of life care.  Medicare reimburses the hospice agency for all care and medications while the patient is at home.

Has treatment improved, or do hospice agencies profit more by discharging prior to dying ?

Some who study aging are concerned that certain hospices are gaming the system. That's a worry of Susan Enguidanos, an associate professor in the Leonard Davis School of Gerontology at the University of Southern California. For example, she says that some hospices may be trying to avoid paying for costly treatments by discharging patients temporarily when they need to go to the hospital.
"Individuals that are going in for these very brief health issues are coming out and then, they're being readmitted to those [same] hospices," says Enguidanos.
That's not a good reason to discharge someone, says John Keyserling, senior vice president for communications and policy at the National Hospice and Palliative Care Organization, the trade association for hospice providers.
"Any association between profit margins and clinical decision making is inappropriate and not something that the hospice community supports," Keyserling says.
That hospice community has nearly doubled in size since 2000. Susan Enguidanos says it's also changed a lot.
"Hospice organizations started as grass root efforts and were largely non-profit for a long time," she says. "Now we've had a huge increase in for-profit hospices." There's a concern, says Enguidanos, that by discharging patients early, some hospices may be "trying to avoid costs that they should be responsible for.
Whatever the short-comings of some hospices may be, Keyserling says that his biggest worry is that people who could be helped by hospice aren't taking advantage of it in time. He says about half of patients die within 17 days of being admitted. And that turns hospice into "crisis care" instead of the comfort care it's intended to be.

Tuesday, August 8, 2017

2017-18 Best Hospitals Honor Roll and Overview | Best Hospitals | US News

Somewhere in America, at a pace of about once per second, a patient checks into a hospital. With more than 33 million hospitalizations a year and so many patients on whom to sharpen their skills, hospitals could be expected to meet the most demanding standards for quality and safety.

To help readers narrow their search, U.S. News evaluates hospitals in 16 areas of complex specialty care and nine important procedures and conditions. (GETTY IMAGES

Readers should use caution when making choices or conclusions from the list.  Choosing a physician rather than a hospital can be more important than the hospital.  Some of the specific results are from statistical averaging, and do not report other statistical information, such as standard deviations,mean, or mode.

FAQ: How and Why We Rank and Rate Hospitals . from US News

Readers must remember, U.S. News is not an accrediting organization and bases their reports from many sources. The authors of the article are By Ben HarderAvery Comarow and Geoff Dougherty |

The authors of the US News report are verified, all are credible sources and have been vetted by US News.  (This is probably as good as it gets. (gml)

Ben Harder | Professional Profile - LinkedIn

More specific information can be found at these resources.

Patient safety indicators are defined by the Agency for Health Research and Qualit

2017-18 Best Hospitals Honor Roll and Overview | Best Hospitals | US News

Friday, August 4, 2017

University Of Vermont To Phase Out Lectures In Med School : Shots - Health News : NPR

William Jeffries, a dean at the University of Vermont's Larner College of Medicine, is leading the push to end lectures for medical students.
Courtesy of UVM Larner College of Medicine Photography

The University of Vermont is launching itself into the brave new world of Health 3.0.

Back in the last century (1964) when I matriculated at George Washington University I expected to spend almost 40 hours each week for the next two years studying basic science,  then returning to my home and spending another 4-6 hours studying for the next day's marathon lectures.  With minor modifications this method has remained until most recently.

The school has begun to phase out lectures in favor of what's known as "active learning" and plans to be done with lectures altogether by 2019.

For students starting medical school, the first year can involve a lot of time in a lecture hall. There are hundreds of terms to master and pages upon pages of notes to take.
But when the new class of medical students begins at the University of Vermont's Larner College of Medicine next week, a lot of that learning won't take place with a professor at a lectern.

Proponents of the new curriculum state,

"The issue is that there is a lot of evidence that lectures are not the best way to accumulate the skills needed to become a scientist or a physician. We've seen much evidence in the literature, accumulated in the last decade, that shows that when you do a comparison between lectures and other methods of learning — typically called "active learning" methods — that lectures are not as efficient or not as successful in allowing students to accumulate knowledge in the same amount of time."
While several other medical schools have been using PBL or AL(Harvard Medical School) there are some who are reticent.
Below are comments from students and educators (from Redditt)

REQUIRED PBL is terrible. It's a massive waste of time. At least with recorded lectures, I could practice the type of ''active learning'' that was best FOR ME and not be stuck in aggravating, long PBL sessions where each hour yielded very little actual knowledge.
I am old school and like to read textbooks - I managed to do that by reading first, watching lectures on fast speed to make sure it all made sense and follow up by active spaced repetition and practice questions + Q/A study sessions with a close friend. If I was forced to sit in PBL for 4-6 hours/day I would not have had time to learn this way and my education would have suffered. If my medical school ever goes full PBL instead of the 1 hr/week session we have now, I would strongly voice a negative opinion.An 

My first two years of medical school had 1-2 Problem based learning modules each month. About a week before the session my school would assign a reading from one of those large 18 pound textbooks that would give us (if we read it) the foundation over the topic to be covered.
We'd then spend an hour applying these foundational concepts to 3 or 4 cases and end with a 20 minute informal lecture on the high points of the material. When organized well I think it's a valuable teaching tool. My team mates were assholes and I hated going because of this. I wouldn't want this to be 100% of my information delivery system, but it added a lot to general didactic lectures.
But your scenario sounds like garbage. Putting students in a situation that they have no foundation in is a waste of everyone's time.

Now adapting to a single model of teaching is dangerous. A university in Japan built their entire campus on the model of PBL, but between they started building and the building was finished they figures out that wasn't the best way to learn.
Then you have TBL, which seem to be a random number of letters.
Now the buzzwords are "flipped classroom" and "active learning". Yes, but is that the best use of the students time or money? I don't know.

There are US medical schools that use the 100% TBL/PBL model. Data shows that the students historically perform above average on boards, but having talked to them in person they make it sound miserable. I was rejected from my #1 choice that was one of these all PBL schools. It was a blessing in disguise.
What the studies I've read say, and what was presented at the last AMEE conference I attended, was that pretty much regardless of whichever pedagogy you elect to follow medical students will learn.
They will pretty much learn the same, and pretty much be as good physicians as those that used other methods.
There are some differences, which indicate PBL and TBL score higher on the USMLE, but at a significant cost in time and money.

It seems a combination of lecture based learning, advanced study and PBL will serve best.No one method is sufficient to educate a physician.

University Of Vermont To Phase Out Lectures In Med School : Shots - Health News : NPR

King George and the Health Care Revolt

Sean MacStiofain said, “most revolutions are caused … by the stupidity and brutality of governments.” Regulation without legitimacy, predictability, and fairness always leads to backlash instead of compliance.  (

More stress for patients and another example of wanton practices by insurers ahead.

Here we are, several weeks after Independence day 2017. Physicians have always been proponents of independence and free will.

It is time for all physicians to declare their own Declaration of Independence. There has been a change by physicians from murmur to rumble. The situation is much like that of 1775 where endless argument with King George led to a revolution.

Men do not go to war unless diplomacy fails, and diplomacy has failed to resolve the failure of our health system with talk.

Just like politicians physicians have their own 'base' . Those individuals who talk amongst themselves under the fray of their representatives, not in formal organizational discussions.  The 'base' know that their ideas become diluted, distorted and compromised by politicians and organizations. Then there is the niche that simply do not belong to organizations. Implicit in this choice there is little accomplished by supporting them.  Some belong only to their specialty society which improves their access to continuing medical education and a means to socialize with immediate peers.

During the past decade numerous paramedical organizations have spontaneously emerged, often pioneered by one or two physician leaders, at first relatively unknown to the majority of physicians.  Although overshadowed by well funded established medical and subspecialty societies private contributions have kept these new organizations alive.  Most important to their growth has been the increased regulatory environment and ennui of congress.

Health reform: It’s time for Congress to grow up and do their jobs

Health – /helTH/ – The state of being free from illness or injury
Care – /ker/ – The provision of what is necessary for the health, welfare, and protection of someone or something.
System – /’sistÉ™m/ – A set of things working together as parts of a mechanism or an interconnecting network.
It’s not keeping us Healthy, it doesn’t seem to Care, and it’s certainly no kind of System. What we’re got is more about hostile parties protecting their turf and income than a system that’s working together. The docs fight the insurance companies to get things covered; the patients fight the hospitals over inflated, inscrutable bills; the insurance companies fight the pharmaceutical companies over the eye-popping prices of new drugs. The people least suited to fight end up losing the most — that’d be the “patients.”
Meanwhile: The peeps we’ve hired to fix this mess are too busy trying to make each other look bad — which, by the way, is like shootin’ fish in a barrel these days, amirite? — to pass some kind of legislation to even begin to help fix this fine mess. Ever get hired to do a job that you don’t do for 2 or 4 or 8 or 20 years? Didja keep that job? Mind: boggled.
I will now specifically criticize the approach of both parties. Those of you with strong loyalties may want to skip the next (Democratic) or following (Republican) paragraphs, lest you be exposed to a worldview that’s not aligned with your own. But for the few of you left who are still capable of seeing two sides of an issue, start here:
Democrats: Obamacare has problems. The insurance marketplaces in many places are collapsing, and premiums are going thru the roof. Even people who have “insurance” often have huge deductibles that they can’t afford. In short: just having “insurance” isn’t the same as “having access to health care.” Obamacare didn’t do a thing to rein in the biggest problem: health care costs too much, and too many people (sorry, “market stakeholders”) are chewing up huge slices of the pie without contributing anything useful to helping patients. I know you’re feeling hurt that you lost the last election, but can you please grow up, talk to the other side, and come up with some common ground to start to address the problems?
Republicans: The free market, alone, cannot save health care. The barriers to entry are too huge (it’s hard to become a doctor, harder to open up a company to manufacture medicines, and even harder to open up a hospital) — which means competition is artificially stunted, and won’t pop up automatically to reduce prices. Also, emergency departments are required, by law, to offer care to people who cannot pay; that’s morally the right thing, and don’t even think about removing this safety net. Health care choices are also difficult and fraught, and often made under the duress of pain and worry. People cannot be expected to call around to different ambulance companies to check their prices when they’re experiencing crushing chest pain. You have to admit: Health care is unique, and you can’t depend on free market principles, alone, to fix it. The solution is going to include regulations and guidelines and (gasp) some guarantees of coverage, and might even require ways to rein in insurance companies, hospital, doctor, and pharmaceutical profits. I know you’re feeling giddy that you won the last election, but can you please grow up, talk to the other side, and come up with some common ground to start to address the problems?
It’s not easy, I know, but at this point, it’s clear that members of both parties aren’t keeping their eyes on the ball. Your job isn’t about re-election, and payback, and “If you play with Susie than you can’t be my friend anymore.”
The foundation of that system and our profession is the doctor-patient relationship. But this sacred and uniquely human interaction does not exist in isolation.  It occurs in a complex, fragmented framework of physicians, nurses and other healthcare providers, hospitals, third-party payers, pharmaceutical and medical device companies, federal and state policymakers, lawyers, and more.
In other words, if you’re in medicine, you’re in politics.

Blue Cross Blue Shield Wants People in Georgia to Self-Diagnose Before Heading to the Emergency Room