Senior citizens rarely consult Dr. Google for medical advice, study says - LA Times

Senior citizens need more medical care than anyone else in the United States. And the Internet is chock full of health information. Yet seniors are far less likely than other adults to tap into it, new research shows.

 A report published Tuesday in the Journal of the American Medical Assn. found that only about 18% of participants in the National Health and Aging Trends Study got health information online in 2014.

 That pales in comparison with the approximately 60% of adults of all ages who have told the Pew Research Center that they consult Dr. Google at least once a year -- including the 35% who said they rely on the Web to diagnose their own ailments or the maladies of people they know. 

Since 2011, thousands of Medicare beneficiaries in the aging trends study have been completing annual surveys that gauge their use of technology. In the survey’s first year, 64% of the survey takers had computers and 43% were hooked up to the Internet. Their average age was 75.

Among all 7,609 initial study participants, only 16% said they went online to learn something about health. In addition, 8% said they filled prescriptions online, 7% used the Internet to get in touch with their doctors and 5% dealt with their insurance claims on the Web.

Altogether, 21% of seniors who were surveyed in 2011 used the Internet for at least one of these four health-related tasks, according to the JAMA report. By 2014, that figure rose to 25% — a small yet statistically significant increase, the study authors wrote.

Some senior citizens were more likely to go online for health-related reasons than others. For instance, the odds were twice as high for white seniors than for their black and Latino counterparts. College graduates were seven times more likely to handle health issues online than were seniors who didn’t finish high school. Seniors who rated their own medical condition as “excellent” were twice as likely to boot up their computers for the sake of their health than were seniors who rated their medical condition as “poor.”

Apparently, these seniors had better things to do than research ways to prevent heart disease, manage symptoms of diabetes or stave off dementia. Email was far more enticing. Electronic banking (but not online shopping) was also more popular.

Apparently, these seniors had better things to do than research ways to prevent heart disease, manage symptoms of diabetes or stave off dementia. Email was far more enticing. Electronic banking (but not online shopping) was also more popular.

“Digital health is not reaching most seniors,” wrote the authors, all from Brigham and Women’s Hospital in Boston. That means the Internet isn’t living up to its potential as a tool to “improve quality, cost, and safety of their health care.”

And perhaps that may not be a bad thing.

But perhaps seniors are right to eschew the health information available online. A 2014study in the Journal of the American Osteopathic Assn. found that Wikipedia entries for nine common health conditions -- coronary artery disease, lung cancer, major depressive disorder, osteoarthritis, chronic obstructive pulmonary disease, high blood pressure, diabetes, back pain and high cholesterol -- contained a significant amount of information that was at odds with the latest medical research.

Senior citizens rarely consult Dr. Google for medical advice, study says - LA Times

Google misfires as it aims to turn Star Trek fiction into reality

Tri-corders ?  Glucose measuring contact lenses  ? Truth or fiction ?

Hype plays a large role in media publications. Perhaps well intentioned,  but often written to attract more readership by an unsophisticated readership.  The front counters of grocery checkout stands share space with The Enquirer, The Hollywood Reporter, People Magazine, or Popular Science about what is 'gossip' in the health science space.

Large multi-billion dollar companies purchase smaller competitors to kidnap intellectual property,  hire scientific luminaries and inventors with what they consider to be petty cash from their vaults of gold and greenbacks. Money is seductive....even  to reputable scientists and especially to inventors and entrepenurs anxious to capitalize on the singularity of exponential growth in health technology. To lose out on a possible chance of success (even if the odds are 1 our of ten or even 1 out of 1000 would appear foolhardy when the stakes are so high and the rewards in virtual wealth are just that....virtual (not real).

A new term I shall coin is  'virtual estate'...the polar opposite of 'real estate'.  During the time when our economy and real estate values crashed, Virtual estate thrived.

Runaway (not to be considered a bad thing) fuels rapid advances and also has a high failure rate.

Google misfires as it aims to turn Star Trek fiction into reality









Beam me up, Scotty !  Kirk out.

5 rituals that will help your brain stay young | World Economic Forum

5 rituals that will help your brain stay young | World Economic Forum

Panic prompted ObamaCare lawlessness

Obama faced major reluctance on the part of  insurance companies to join and remain in the Health Insurance Exchange.  A last ditch agreement funded by what was yet to be approved congressional approval of a budgetary allotment.

Panic prompted ObamaCare lawlessness

By Doug Badger
The Hill, July 15, 2016

Senior Obama administration officials took a series of decisions beginning in late 2013 that ranged from the reckless to the illegal in an effort to keep insurers participating in health insurance exchanges.

A report issued last week jointly by the House Ways and Means and Energy and Commerce committees explores how the administration came to unlawfully funnel $7 billion in unappropriated money to insurers through a single ObamaCare program.

The program — known as cost-sharing reduction (CSR) — requires insurers to reduce deductibles and other out-of-pocket spending for certain low-income people who signed up for coverage through health insurance exchanges. In turn, the statute authorized the administration to seek an appropriation from Congress to reimburse insurers for the cost of providing these coverage enhancements.

The congressional report chronicles how the administration determined as early as 2010 that it needed an appropriation to make CSR payments to insurers. In April 2013, the president submitted a budget to Congress formally requesting the appropriation.

But in July, the Senate Appropriations Committee, then controlled by Democrats, expressly denied the president's request. Sometime after Congress refused to fund the program, the administration contrived the theory that it could spend money without an appropriation.

Senior officials at the Office of Management and Budget (OMB) drafted a legal memorandum during late 2013 declaring that the government could make billions in CSR payments to the insurance industry without congressional approval. The administration began making the unlawful payments in January 2014.

Although the administration continues to stonewall the congressional investigation into how it arrived at this decision, the committees have learned that several Treasury Department officials raised concerns about the OMB memo. Those officials were permitted to read the document, but were forbidden to make copies or take notes.

The administration has denied Congress even that courtesy, defying congressional subpoenas for copies of the OMB memorandum and other material relevant to the investigation. It has supplied them with a memorandum that Treasury Secretary Jack Lew signed in January 2014 directing his subordinates to begin making CSR payments. But that memorandum has been redacted to omit the department's legal justification.

The administration also has slapped a gag order on current and former employees, instructing them not to answer the committees' questions about the legality of the unappropriated spending.

The administration has good reason to stonewall. Its ostensive reason — that the legitimacy of the CSR payments is under review by the courts — is a smokescreen. The Supreme Court settled that matter in a 1929 case arising from the Teapot Dome Scandal, holding that congressional inquiries cannot be thwarted by ongoing litigation.

The administration's defiance has a much simpler explanation: Its actions have no legal basis. Even The New York Times has acknowledged that if the administration were permitted to continue spending unappropriated money, "it could have major — some might say huge — consequences for our constitutional democracy."

At least one federal judge agrees. In a lawsuit filed by the House of Representatives, Federal District Court Judge Rosemary Collyer in May ruled that the CSR payments were unlawful. The Justice Department has appealed Collyer's ruling.

My July 8 testimony before the House Energy and Commerce Subcommittee on Oversight and Investigations showed how the government's unlawful spending on the CSR program fits into a broader pattern of malfeasance in ObamaCare implementation. That malfeasance includes decisions made during the first half of 2014 to unlawfully divert $3.5 billion to $4.5 billion from the Treasury to insurance companies through the "reinsurance" program. It also involves the attempt by the government to turn the law's "risk corridor" program into a new version of the Troubled Asset Relief Program (TARP), forcing taxpayers to cover losses resulting from bad business decisions made by insurance executives.

Those abrupt and unlawful policy reversals were occasioned by a serious miscalculation of demand for health insurance among relatively healthy people.

It turns out that millions don't want it, unless premiums are steeply discounted. ObamaCare does the opposite for people in relatively good health, requiring insurers to overcharge them for a product they may not want or need, while discounting premiums for those in poorer health.

The result is a dysfunctional "market" that attracts high-risk enrollees and repels low-risk ones, leaving insurers with a losing proposition: a pool of customers who are disproportionately older, less well and paying premiums that are too low to cover their medical bills.

When the consequences of this dysfunctionality dawned on the administration, panic set in, prompting a series of regulatory improvisations providing for the payment of billions in corporate subsidies to the insurance industry.

Although the administration is not especially fond of insurers (as the president demonstrated this week with his renewed embrace of the "public option"), the exchanges would collapse without them. To avoid the political embarrassment of insurers withdrawing en masse from the exchanges, it has chosen to supply them with unlawful payments and stonewall congressional inquiries into this misconduct.

The administration's actions raise concerns that transcend the fractious politics of ObamaCare: They are institutional and constitutional in nature. Institutional because Congress's core lawmaking and oversight functions are being effaced. Constitutional because its power of the purse is under legal assault.

In such circumstances, Congress cannot be passive. It must act to require the administration to follow the law.

Badger, a former White House and U.S. Senate policy adviser, is a senior fellow with the Galen Institute. This piece was adapted from his July 8 testimony before the House Energy and Commerce Subcommittee on Oversight and Investigations.

Read the article in The Hill

Information provided to Health Train Express by Galen Institute

Laboratory Results: Do you receive them ?

https://www.dropbox.com/s/9598jagn1oso8w9/One%20of%20the%20problems%20with%20medical%20care%20is%20the%20lack%20of%20internal%20controls%20in%20a%20practice.doc?dl=0

One of the problems with medical care is the lack of internal controls in

a practice.

Example:

About two weeks ago I noted a growing lump on my scalp. I went t

o see a dermatologist (a former

colleague of mine). He did a biopsy and said he would call me in t

wo or three days with the diagnosis.

He also said that if the biopsy was

positive

he would refer me to a plastic surgeon that used a surgery

center. (he did not have hospital privileges). There was some concern since I am

on blood thinners for a

stroke and several AMIs with several stents following multiple angioplasties

placing me at a higher risk. I

was concerned about the possibility of another stroke or AMI if Clopid

ogrel was stopped.

I waited four days with no telephone call. Finally, I called to find o

ut what the diagnosis was, and I was

told it was a squamous cell skin cancer. I then spoke to a receptionist who said

she would speak to the

medical assistant

...

.still no call back. I asked if they were going to make a referral to the

plastic surgeon

or should I call ? Answer

“

we will call you later this afternoon and let you know.

Good morning, it is now tomorrow and six days have gone by since the

biopsy.

My gut feeling is to find another plastic surgeon (not the one he referred m

e to) (birds of a feather, flock

together.)

Moral of the story

...

..do not be passive about lab results. Call, call, call until you

get an answer. Not

hearing anything creates great anxiety for anyone. You paid for the lab work

, you paid for the doctor

visit. This type of thing borders on negligence. Do not be passiv

e

...

it

s your life.

I have

fired

my dermatologist, especially in light of the fact I chose him sinc

e he was a former

colleague. (30 years ago). If your MD is over the age of 60 ask if they

have hospital privileges. An

unknown secret is that many senior MDs give up their hospital privileges due

to age or an unwillingness

to take call. Being an MD is a

marathon

, not a sprint. That is not to say that MDs who do not use

hospitals are bad doctors

......

..just prudent and self-aware.

Of course this is an anecdotal story. Perhaps he does call and respond to ot

her patients he has operated

upon.

P.S. He advertises himself as a

cosmetic surgeon

using lasers, creams and anti-aging compounds. In

today

s world almost any MD can call themselves

“

cosmetic surgeons

. I have seen Family Doctors

offering skin laser surgery for age spots. Always check with a hospital about th

eir privelges and what

department in the hospital they are assigned to. They should be a surgeon wi

th a designated specialty.

If this can happen to a physician, God help the rest of you. One of the problems with medical care is the lack of internal controls in

a practice.

Example:

About two weeks ago I noted a growing lump on my scalp. I went t

o see a dermatologist (a former

colleague of mine). He did a biopsy and said he would call me in t

wo or three days with the diagnosis.

He also said that if the biopsy was

positive

he would refer me to a plastic surgeon that used a surgery

center. (he did not have hospital privileges). There was some concern since I am

on blood thinners for a

stroke and several AMIs with several stents following multiple angioplasties

placing me at a higher risk. I

was concerned about the possibility of another stroke or AMI if Clopid

ogrel was stopped.

I waited four days with no telephone call. Finally, I called to find o

ut what the diagnosis was, and I was

told it was a squamous cell skin cancer. I then spoke to a receptionist who said

she would speak to the

medical assistant

...

.still no call back. I asked if they were going to make a referral to the

plastic surgeon

or should I call ? Answer

“

we will call you later this afternoon and let you know.

Good morning, it is now tomorrow and six days have gone by since the

biopsy.

My gut feeling is to find another plastic surgeon (not the one he referred m

e to) (birds of a feather, flock

together.)

Moral of the story

...

..do not be passive about lab results. Call, call, call until you

get an answer. Not

hearing anything creates great anxiety for anyone. You paid for the lab work

, you paid for the doctor

visit. This type of thing borders on negligence. Do not be passiv

e

...

it

s your life.

I have

fired

my dermatologist, especially in light of the fact I chose him sinc

e he was a former

colleague. (30 years ago). If your MD is over the age of 60 ask if they

have hospital privileges. An

unknown secret is that many senior MDs give up their hospital privileges due

to age or an unwillingness

to take call. Being an MD is a

marathon

, not a sprint. That is not to say that MDs who do not use

hospitals are bad doctors

......

..just prudent and self-aware.

Of course this is an anecdotal story. Perhaps he does call and respond to ot

her patients he has operated

upon.

P.S. He advertises himself as a

cosmetic surgeon

using lasers, creams and anti-aging compounds. In

today

s world almost any MD can call themselves

“

cosmetic surgeons

. I have seen Family Doctors

offering skin laser surgery for age spots. Always check with a hospital about th

eir privelges and what

department in the hospital they are assigned to. They should be a surgeon wi

th a designated specialty.

If this can happen to a physician, God help the rest of you.

The Illicit Perks of the M.D. Club and why Physicians are burning out The New York Times

The Illicit Perks of the M.D. Club

By VATSAL G. THAKKARJUNE 30, 2016

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Now and then I share the experiences physicians witness, even in their own nor family's care. For them it is also a challenge. Pity the ordinary patient citizen.

I received an email from Doximity, a closed professional social media site restricted to physicians. On Doximity we all share elevator talk...the few seconds of intercourse discussing patient experiences among peers. (probably illegal under the shield of HIPAA regulations.  These regulations have become more than burdensome, because they do effect patient care.

Continue reading the main storyShare This P

• Share
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• SThe article illuminates what insurance companies have done to the physician-patient relationship. This further requires the physician to impose his lessened authority on those who are supposed to serve both patient and physician. Yes there are those who abuse the system.  Physicians learn the workaround to obtain what the patient need

This story spells out one or more such situations a  physician experiences in his own care or that of a friend or family.   This process consumes an inordinate amount of time during an appeal process. One case in particular concerning a serious lumbar disc illuminates the tension of reading a guideline of prior treatment pursuant to approving a request for an MRI. MRIs by the way are considered standard practice for serious back injuries. Prolonged herniated disc problems often lead to permanent nerve injury and disability.The insurance company insisted on a six week waiting period before an MRI was approved. Their decision is based upon the fact and MRI costs $ 1,000, not the welfare of a patient.

From a Medical-legal standpoint this places the physician in jeopardy, despite his order for an MRI. Had the patient presented at an emergency department an MRI most likely would have been ordered. And since it was in an acute emergent condition it would have been pefrormed immediately and without a prior authorization.  The risk of a legal incident in the emergency setting would pre-empt any decision by the insurer. The hospital or MRI center would be the loser if an insurer retroactively did not authorize a payment. (they do not like losing money with smaller margins.).  The insurance company is under control, unless the physician insists using his authority to protect the patient.

This scenario occurs multiple times a day for most MDs.   It is a major cause for burnout, which most patients are aware occurs often early in a physician's career.

Many articles now discuss the rising tide of physician burnout, and suicide. How can it be prevented?

The loss of physician authority and the complex tension between advocating for the patient and the bottom line for health insurers creates a conundrum for the doctor. She (he) has been placed in a repeating cycle of conflict, a chronic emotional enui leading to a similar state as PTSD.(post traumatic stress disorder). Only in this case it is not post-traumatic, it is ongoing on a daily basis.

This may be the primary cause for physician burnout and suicide Doctors have been trained to work long  hours and to deal with emergencies, even in the middle of the night.

Read the entire article here...

The Illicit Perks of the M.D. Club - The New York Times

Next time you are denied a test or procedure, call your insurance company and protest vehemently. You probably won't get very far.

Insurers must share liability for thier medical malfeasance...It must not sit on the shoulders of  your physician.

Gates Annual Letter Health Initiatives

Gates Annual Letter 2013_AL_English.pdf

Affordable Care Act causing more mega=-mergers

Two mega-mergers in the health insurance industry are sparking intense debate over cost and competition.

California has two health insurane regulatory agencies:  1. Commissioner Dave Jones, and 2.Shelley Roullaard and the Dept of Managed Health Care.  The Department of Manged Health Care came into existence about 20 years ago when the boom in  HMOs occured.  

California Insurance Commissioner Dave Jones has criticized both deals — Anthem-Cigna andAetna-Humana — as being anti-competitive, and he has asked the U.S. Department of Justice to block the mergers on antitrust grounds. Jones has questioned whether policyholders will see much of the savings these companies tout in their proposed acquisitions.

But California’s other insurance regulator, Shelley Rouillard at the Department of Managed Health Care, approved the Aetna deal with a condition that the company try to keep future rate increases to a minimum. She hasn’t weighed in on Anthem’s merger.

Meanwhile, another key regulator reviewing the deals — Connecticut Insurance Commissioner Katharine Wade — has come under scrutiny because of her extensive ties to Cigna.

Chad Terhune of California Healthline discussed these developments, and the potential impact of industry mergers on consumers and market competition, last Friday on WNPR’s “Where We Live” in Connecticut.

Key regulators disagree in  approving these consolidations. Some who are smaller insurers or those forming new entities say there is adequate competition in the market place.

California’s Bifurcated Regulatory View of Health Insurance Mergers | California Healthline