Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

How Our Progress Since 9/11 Has Benefitted Public Health Efforts

The events of 9/11 will forever be engrained in our memories. The attacks on the twin towers, Pentagon, and the anthrax attacks which followed were unimaginable at the time. Ten years after these tragic events, what’s changed?

September 11 Newspapers and Headlines

We now know that terrorist threats are ever present and that our nation must be in a constant state of vigilance in order to protect our communities. We’ve come a long way since 2001 in bolstering our nation’s ability to prepare for and respond to catastrophic events whether natural, accidental, or intentional. We are also learning more and more every day that the resources we need for the big disasters are much the same as the ones we use for everyday public health activities.

Check out my list of top 5 accomplishments in the years after the 2001 attacks: Read more »

*This blog post was originally published at Public Health Matters Blog*

Judging Illness Severity And The Financial Implications Of Dialing 911

Nora misjudged the height of the stair outside the restaurant, stepped down too hard, jammed her knee and tore her meniscus.  Not that we knew this at the time.  All we knew then was that she was howling from the pain.

There we were on a dark, empty, wet street in lower Manhattan, not a cab in sight, with a wailing, immobile woman.  What to do?  Call 911? Find a cab to take her home and contact her primary care doctor for advice?  Take her home, put ice on her knee, feed her Advil and call her doctor in the morning?

Sometimes it is clear that the only response to a health crisis is to call 911 and head for the emergency department (ED).  But in this case – and in so many others we encounter with our kids, our parents, our co-workers and on the street – the course of action is less obvious, while the demand for some action is urgent.

The question “which action?” has become more complicated of late because:

  • In some communities, there are alternatives to an ambulance or a drive to the nearest ED, such as Urgent Care centers.
  • Disincentives exist for going the route of the ED: in many cash-strapped municipalities we are charged for the cost of ambulance ride; we risk not having our ED visit covered by insurance if we make the wrong decision or fail to notify our health plan in a timely manner.  Or we don’t have insurance and the ED care is expensive.
  • Some of us have a number of clinicians who could guide us about ED versus self care on any urgent health matter, plus our health plan may have a nurse advice line that could do the same.  Which among them to call?  How long will it take to get an answer in the middle of a busy workday or a late night?
  • Many of us have no primary care clinician to call. Read more »

*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*

911 Disclaimers Are Absurd

I’m sure you’ve seen them on medical blogs:  Disclaimers that remind readers to call 911 in the event of emergency.

But is someone choking on a hot dog really going to dial up KevinMD or SeattleMamaDoc for help?  Does anyone really believe that 33 charts is the place to deal with your acute airway obstruction when you have a just a couple of minutes to live?

Here’s my theory:  I suspect that the first attorney who came up with the 911 disclaimer did so as some sort of perverse joke.  And rather than seek the input of their own lawyers, all those who followed simply copied the this original language believing it to be judicious and most conservative.  Now it’s the longest running gag in legal history. Read more »

*This blog post was originally published at 33 Charts*

Online ER Booking: Is There A Real Emergency?

This is so wrong.

You can’t make this stuff up.

It seems an emergency department in Memphis, Tennessee is now taking online reservations for their services. Yes, you heard that right, you can now hop online and select the time you would like to be seen for your “emergency”. Just pay $15.00 and you can give your chief complaint, your medical history and your list of medications ahead of time, saving you time and trouble when you pop in with your pesky problem!

What if the problem is serious?

The computer won’t let you register and flashes a “Call 911″ sign at you.

But wait! There’s more!

If you are not seen within 15 minutes of your scheduled time, you money is cheerfully refunded!

I’m not kidding. Read more »

*This blog post was originally published at Emergiblog*

A Medical Alert Bracelet Inside Your iPhone

mzl.ahygqfzq.320x480-75.jpgOnCall Defender Medical Alert (available via iTunes) is an iPhone app that features 3G connection to a 24-hour security monitoring service. Via a subscription service, you can use your iPhone to send an emergency notification to the service after which local law enforcement or EMT services, depending on the type of alarm, will be dispatched.

The advantage over using 911 is that the monitoring service automatically receives GPS localization of your whereabouts and that you can cancel the emergency call within 15 seconds. The service costs $16.99 a month or $9.99 with a one-year subscription. Read more »

*This blog post was originally published at iMedicalApps*

Latest Interviews

The Surprising Economic Burden Of ADHD (Attention-Deficit Hyperactivity Disorder)

If you can read this you need to download a more recent browser It is estimated that as many as million U.S. adults have ADHD Attention-Deficit Hyperactivity Disorder A recent research study publication-pending suggests that the economic burden of ADHD on America could be as high as billion annually. I…

Read more »

Is The Adderall Shortage A Harbinger Of Future Drug Supply Problems?

If you can read this you need to download a more recent browser Today most- if not all- Doctor’s offices are strained by the shortage of some prescription medication or vaccine. A month ago President Obama signed his executive order directing the FDA to take steps to reduce drug shortages…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: The First Step To Improve Health Care Is A Close Examination Of How It’s Delivered

My friend and former Chair of the CFAH Board of Trustees Doug Kamerow has written a book that I think you will like. Besides being a mensch and witty as heck Doug is a family doctor and a preventive medicine specialist. In his new book Dissecting American Health Care Commentaries…

Read more »

“Your Medical Mind” Explores Factors That Influence A Patient’s Medical Decisions

Recently I had a conversation with Shannon Brownlee the widely respected science journalist and acting director of the Health Policy Program at the New America Foundation about whether men should continue to have access to the PSA test for prostate cancer screening despite the overwhelming evidence that it extends few…

Read more »

Book Review: Food Truths, Food Lies

Food Truths Food Lies written by family physician Eric Marcotte M.D. may be the most refreshingly evidence-based diet book of the decade. You will not find a single mention of super-foods magical berries or supplement must-haves in the entire book. What you will find is the cold hard truth about…

Read more »

See all book reviews »