Discounts in Health Care Change the Dental Economy | Dental Marketing and Practice Management: "The health care market is changing. Here’s an example of just how different things are these days…
In this tight economy, some dentists are offering sales and discounts.
One consolation in this economy: Some medical costs will be cheaper. Orthodontic work is on sale, with many dentists offering big discounts to make up for a 20% decline in business. Other discretionary medical services, and anything not covered by insurance, are also widely on sale to attract customers.
Cosmetic surgery is 10% to 25% cheaper. Sales, too, on LASIK eye surgery."
In this time of recession, many patients from the US will consider going overseas for elective medical treatment. This will put further pressure on US doctors, and force them to become more cost-efficient, as they will have to compete with doctors from all over the world.
Wednesday, January 28, 2009
When less is too much - unnecessary surgery for infertile women
While it is true that minimally invasive surgery ( such as laparoscopy) is better for infertile patient as compared to open surgery ( because of the reduced risk of post operative adhesions, for example) , one major disadvantage of these procedures is the fact that they are so overused.
Because it is such "simple" surgery which "does not involve making a cut" and is done on a day-care basis, many doctors overuse and misuse this. It's quite easy to convince patients to undergo laparoscopic surgery, because the procedure is short and simple, and healing occurs quickly.
However, no surgery is always far better than "minimal surgery" - and often these procedures are not needed at all. Unfortunately, many doctors tend to subject patients with minor abnormalities on vaginal ultrasound scanning to laparoscopic surgery, so they can "check out" what the abnormlity is; and then fix it.
The combination of vaginal ultrasound scanning and minimally invasive surgery has led to a huge surge in unnecessary surgery for infertile women . Ultrasound machines can easily pick up "lesions" such as small cysts and fibroids. These are often just normal anatomic variants, which are often found in fertile women, and have no impact on fertility at all. However, infertile women are emtionally very vulnerable; and are desperate to "find the reason for the infertility" so that it can be corrected. Doctors are often happy to exploit this, and many patients are thus subjected to procedures which they did not need in the first place !
Let the patient beware !
Because it is such "simple" surgery which "does not involve making a cut" and is done on a day-care basis, many doctors overuse and misuse this. It's quite easy to convince patients to undergo laparoscopic surgery, because the procedure is short and simple, and healing occurs quickly.
However, no surgery is always far better than "minimal surgery" - and often these procedures are not needed at all. Unfortunately, many doctors tend to subject patients with minor abnormalities on vaginal ultrasound scanning to laparoscopic surgery, so they can "check out" what the abnormlity is; and then fix it.
The combination of vaginal ultrasound scanning and minimally invasive surgery has led to a huge surge in unnecessary surgery for infertile women . Ultrasound machines can easily pick up "lesions" such as small cysts and fibroids. These are often just normal anatomic variants, which are often found in fertile women, and have no impact on fertility at all. However, infertile women are emtionally very vulnerable; and are desperate to "find the reason for the infertility" so that it can be corrected. Doctors are often happy to exploit this, and many patients are thus subjected to procedures which they did not need in the first place !
Let the patient beware !
Thursday, January 22, 2009
India's health kick expands shelves for nutraceuticals
India's health kick expands shelves for nutraceuticals: " Since the last couple of months, Mohan Mehta's shopping pattern has changed. The 48-year-old banking professional makes it a point to browse through the health supplements
section of a retail mall in Kandivli in Mumbai, which he visits once a week.
Without fail, Mehta scans through the shelves displaying products such as multivitamin tablets, memory tonics, calcium tablets, and Chyawanprash. Due to this, his weekly shopping budget has swelled to about Rs 1,000, from Rs 880 earlier, never mind the slowdown.
Mehta and his family of seven --his wife, three daughters, and his aged parents -- have been bitten by the fitness bug, and feel a little extra in the nutrition department is a necessity.
'We may not get all the necessary nutrients from our daily diet alone. And so, we need additional nutrition through vitamin tablets and health drinks,' he says. So the Mehta family spends on various probiotic drinks, vitamins, calcium tablets, protein biscuits, etc. Like the Mehtas, several other families are waking up to the health kick. "
section of a retail mall in Kandivli in Mumbai, which he visits once a week.
Without fail, Mehta scans through the shelves displaying products such as multivitamin tablets, memory tonics, calcium tablets, and Chyawanprash. Due to this, his weekly shopping budget has swelled to about Rs 1,000, from Rs 880 earlier, never mind the slowdown.
Mehta and his family of seven --his wife, three daughters, and his aged parents -- have been bitten by the fitness bug, and feel a little extra in the nutrition department is a necessity.
'We may not get all the necessary nutrients from our daily diet alone. And so, we need additional nutrition through vitamin tablets and health drinks,' he says. So the Mehta family spends on various probiotic drinks, vitamins, calcium tablets, protein biscuits, etc. Like the Mehtas, several other families are waking up to the health kick. "
Wednesday, January 21, 2009
Why Healthcare Matters - - Calculating ROI for Corporate Healthcare
Why Healthcare Matters - - Calculating ROI for Corporate Healthcare: " Sometimes the biggest obstacle to corporate change is the 'What if?' question. 'What if we try it, and it doesn't work?' 'What if it doesn't improve our way of doing business?'
As a result, the burden of changing is quite often avoided or delayed by the 'prove it' challenge. 'Show me precisely what we will gain, and we'll consider doing it - if you can guarantee the outcome.'
There are few guarantees in employee health, but for corporations truly committed to transforming their approach by leveraging healthcare consumerism, there is mounting evidence of successful outcomes. However, companies adopting consumer-driven health plans, health savings accounts, wellness programs and the array of related support programs also need to establish their own standards and metrics for success. What results will be significant enough to continue to support health care consumerism in a substantial and meaningful way? The answer will vary from company to company, but having the tools to measure the results will be a key step forward. This article will outline ideas and principles to consider in the ROI planning process."
As a result, the burden of changing is quite often avoided or delayed by the 'prove it' challenge. 'Show me precisely what we will gain, and we'll consider doing it - if you can guarantee the outcome.'
There are few guarantees in employee health, but for corporations truly committed to transforming their approach by leveraging healthcare consumerism, there is mounting evidence of successful outcomes. However, companies adopting consumer-driven health plans, health savings accounts, wellness programs and the array of related support programs also need to establish their own standards and metrics for success. What results will be significant enough to continue to support health care consumerism in a substantial and meaningful way? The answer will vary from company to company, but having the tools to measure the results will be a key step forward. This article will outline ideas and principles to consider in the ROI planning process."
Why Healthcare Matters - About the Book
Why Healthcare Matters - About the Book: "Why Healthcare Mattersoffers a big picture perspective on what’s wrong with healthcare in the US, and provides a set of practical, market-based strategies and solutions.
The book explores an array of contributing factors and competing interests that have fed the decline in the healthcare system and led to out-of-control health insurance costs, higher disease incidence and sub-optimal medical care. This includes discussions around medical errors, medical malpractice, healthcare quality, administrative costs, and the uninsured along with a complete evaluation of the Medical Marketing Model and its inbred biases"
The book explores an array of contributing factors and competing interests that have fed the decline in the healthcare system and led to out-of-control health insurance costs, higher disease incidence and sub-optimal medical care. This includes discussions around medical errors, medical malpractice, healthcare quality, administrative costs, and the uninsured along with a complete evaluation of the Medical Marketing Model and its inbred biases"
Wednesday, January 14, 2009
Embryo Implantation Support : IVF Herbal Support
Embryo Implantation Support : IVF Herbal Support: "Embryo Implantation Herbal Support is a treatment by Herbal Medicine that complements IVF hormone treatments and increases the rate of success for embryo implantation.
How does Embryo Implantation Herbal Support Work?
Embryo implantation Herbal Support comprised of a balanced combination of herbs containing medicinal qualities that helps:
1. Increasing chance of implantation
2. Relieving stress
3. Preventing weight gain."
This is a great example of how easy it is to take patients for a ride. Patients doing IVF are desperate and will clutch as straws. This site sells "natural herbs" - which means they are relatively inexpensive; and because they are "natural products", they don't have side effects. Most patients will be very happy to buy them to "try " them out - after all, how can they hurt ? Most IVF doctors will also not stop their patients from trying these, because they don't understand too much about herbs anyway - and if taking the herbs keeps the patient happy, then why not ?
The problem is that these products create false hope - and waste the patient's time and money. Fuzzy claims that they "increase implantation" or " improve egg quality" can never be proven or disproven. And for every 100 patients who take them, one will get pregnant ( though this may not be a result of the herbs - and could even be inspite of the herbs). However, this patient will be happy to provide a glowing testimonial - and this will end up creating a negative cycle, since no one will bother to document the failures.
How does Embryo Implantation Herbal Support Work?
Embryo implantation Herbal Support comprised of a balanced combination of herbs containing medicinal qualities that helps:
1. Increasing chance of implantation
2. Relieving stress
3. Preventing weight gain."
This is a great example of how easy it is to take patients for a ride. Patients doing IVF are desperate and will clutch as straws. This site sells "natural herbs" - which means they are relatively inexpensive; and because they are "natural products", they don't have side effects. Most patients will be very happy to buy them to "try " them out - after all, how can they hurt ? Most IVF doctors will also not stop their patients from trying these, because they don't understand too much about herbs anyway - and if taking the herbs keeps the patient happy, then why not ?
The problem is that these products create false hope - and waste the patient's time and money. Fuzzy claims that they "increase implantation" or " improve egg quality" can never be proven or disproven. And for every 100 patients who take them, one will get pregnant ( though this may not be a result of the herbs - and could even be inspite of the herbs). However, this patient will be happy to provide a glowing testimonial - and this will end up creating a negative cycle, since no one will bother to document the failures.
MyConsult: Second Medical Opinions From Doctors at The Cleveland Clinic
MyConsult: Second Medical Opinions From Doctors at The Cleveland Clinic: "For over 80 years, patients and families have looked to Cleveland Clinic for quality medical advice and treatment. Now you may consult with our world-renowned physicians from the comfort of your home by utilizing the MyConsult online medical second opinion service.
The MyConsult online medical second opinion service connects you to the specialty physician expertise you need when you are faced with a serious diagnosis. Following a thorough review of your medical records and diagnostic tests, Cleveland Clinic experts render a medical second opinion that includes treatment options or alternatives, as well as recommendations regarding your future therapeutic considerations.
When it comes to your health and well-being, confidently understanding your condition and your options is a crucial step in pursuing what is best for you."
The US healthcare system has always been a market leader in providing high quality medical care for complex and rare problems. However, since it's hard for patients to fly down to the USA, US institutions are now exploring clever ways of using their brand name to reach out to more patients !
The MyConsult online medical second opinion service connects you to the specialty physician expertise you need when you are faced with a serious diagnosis. Following a thorough review of your medical records and diagnostic tests, Cleveland Clinic experts render a medical second opinion that includes treatment options or alternatives, as well as recommendations regarding your future therapeutic considerations.
When it comes to your health and well-being, confidently understanding your condition and your options is a crucial step in pursuing what is best for you."
The US healthcare system has always been a market leader in providing high quality medical care for complex and rare problems. However, since it's hard for patients to fly down to the USA, US institutions are now exploring clever ways of using their brand name to reach out to more patients !
Saturday, January 10, 2009
Physicians as coaches, part 2: “Embrace knowledge symmetry” | e-Patients.net
Physicians as coaches, part 2: “Embrace knowledge symmetry” | e-Patients.net: "It is a good wake up call for physicians. We need to embrace the ‘ePatient Revolution’, recognize that the patient MUST be the one who is in control of their own health care, assist them in achieving this, and not be tempted to allow that to interfere with our professional self esteem because, in my view, it in no way threatens it!”"
Repairing the Healthcare System: Innovations in Healthcare
Repairing the Healthcare System: Innovations in Healthcare: "The pressures on physicians today to see more patients, to test for everything so you do not miss a diagnosis, the lack of reimbursement for cognitive therapy, the constant threat of financial penalties and continuous assault on physicians’ judgment has served to decrease the ability of physicians to relate in a human way.
“There is considerable healing power in the physician-patient alliance. A patient who entrusts himself to a physician's care creates ethical obligations that are definite and weighty. Working together, the potential exists to pursue interventions that can significantly improve the patient's quality of life and health status. “
The simple way to put it is medical care has and is being commoditized and dehumanized. These attributes are the common denominator to patients’ complaints about the medical care system in 2008. I cannot justify or condone physicians’ behavior.
Our healthcare system has to change. It must support the humanizing elements or the patient physician relationship. It has to nurture mutual trust rather than distrust between patients and physicians. A healthcare system that supports distrust, physician and patient penalties and adversarial interrelationships does not permit this princely profession to offer the kind of care physicians are capable of."
“There is considerable healing power in the physician-patient alliance. A patient who entrusts himself to a physician's care creates ethical obligations that are definite and weighty. Working together, the potential exists to pursue interventions that can significantly improve the patient's quality of life and health status. “
The simple way to put it is medical care has and is being commoditized and dehumanized. These attributes are the common denominator to patients’ complaints about the medical care system in 2008. I cannot justify or condone physicians’ behavior.
Our healthcare system has to change. It must support the humanizing elements or the patient physician relationship. It has to nurture mutual trust rather than distrust between patients and physicians. A healthcare system that supports distrust, physician and patient penalties and adversarial interrelationships does not permit this princely profession to offer the kind of care physicians are capable of."
Repairing the Healthcare System: The Therapeutic Magic Of The Physician Patient Relationship: Part 2
Repairing the Healthcare System: The Therapeutic Magic Of The Physician Patient Relationship: Part 2: "The role of patients with chronic diseases and their physicians must be clear to both patients and physicians. Physicians are coaches. Patients are players. They live with their disease 24 hours a day. Day to day fluctuations occur in the management of chronic disease. An excellent example is patients with hypertension. Blood pressure fluctuates all day long. A single blood pressure measurement during a visit to a physician once every six month is meaningless. Patients must continually monitor their blood pressure to evaluate the effect of their medication. Physicians have to help patients evaluate these data points to make logical medication adjustments.
Patients must to be inspired to manage their chronic disease. This requires patients having confidence in their coaches."
Patients must to be inspired to manage their chronic disease. This requires patients having confidence in their coaches."
Free EMRs to Bail Out US Healthcare - Medgadget - www.medgadget.com
Free EMRs to Bail Out US Healthcare - Medgadget - www.medgadget.com: "PracticeFusion, for example, offers a free EMR service that is hosted online and requires no additional infrastructure, nor expensive IT people to support it. It might not be the answer for everyone (on the other hand, maybe it is!), but the fact is that a lot of software is free and is being practically used in a host of industries. Having found success with the initial release, PracticeFusion this week will be making available version 2.0 of its EMR suite (shown below). Ryan Howard, CEO of PracticeFusion, tells Medgadget that the new EMR version is based on Adobe's Flash technology, and it includes features for patient demographic, diagnosis and medication management, vital gathering, SOAP note creation, along with integrated video-based training. In addition, Practice Fusion supports Mozilla Firefox 3, Internet Explorer 8, Google Chrome and Apple/Mac Safari 3 browsers."
Crowdsourcing the Definition of Participatory Medicine | e-Patients.net
Crowdsourcing the Definition of Participatory Medicine | e-Patients.net: "Participatory Medicine is a cooperative model of medical care, actively involving the patient (or the patients caregiver as appropriate) as an integral part of the full continuum of care.
It requires:
* a patient enabled by information, software and community
* equal access to all the clinical and scientific data related to the patient and,
* a well defined shared decision-making process."
It requires:
* a patient enabled by information, software and community
* equal access to all the clinical and scientific data related to the patient and,
* a well defined shared decision-making process."
The Health Care Blog: Confessions of a Physician EMR Champion
The Health Care Blog: Confessions of a Physician EMR Champion: "My message is that the best uses of health IT are those that support participatory medicine, reduce costs, make care more convenient, and close the 'collaboration gap' between doctors and their patients in much the same way that online banking and online airline reservation systems have done. I'm encouraging patient portals, community health data exchanges, shared clinical data collection, and intelligent online tools from Health 2.0."
Friday, January 09, 2009
The Health Care Blog: "The Innovator's Prescription": Christensen's Book Offers Insightful Dx, Unrealistic Rx
The Health Care Blog: "The Innovator's Prescription": Christensen's Book Offers Insightful Dx, Unrealistic Rx: "The authors present many insightful ways to analyze and understand the dysfunction of the U.S. health care system. A few that we found particularly useful include:
* Describing the two major enablers of disruptive opportunities in health care — 1) technologies enabling less skilled individuals to do tasks that previously required specialized expertise, and 2) business models allowing care to move from centralized locations (hospitals and doctors offices) to distributed environments (home, work and community). See slide 8 here for a helpful visual presentation.
* Explaining the critical role of standardized personal electronic health records
* Introducing a new terminology around intuitive medicine, empirical medicine, and precision medicine
* Describing three key elements for DI: technological enabler, business model innovation, and value network"
* Describing the two major enablers of disruptive opportunities in health care — 1) technologies enabling less skilled individuals to do tasks that previously required specialized expertise, and 2) business models allowing care to move from centralized locations (hospitals and doctors offices) to distributed environments (home, work and community). See slide 8 here for a helpful visual presentation.
* Explaining the critical role of standardized personal electronic health records
* Introducing a new terminology around intuitive medicine, empirical medicine, and precision medicine
* Describing three key elements for DI: technological enabler, business model innovation, and value network"
Amazon.com: Patient, Heal Thyself: How the "New Medicine" Puts the Patient in Charge: Robert Veatch: Books
Amazon.com: Patient, Heal Thyself: How the "New Medicine" Puts the Patient in Charge: Robert Veatch: Books: "That's what this book is about: fitting the recommendation to the client's values, not the other way around.
This theme connects the chapters of the book. Veatch argues that doctors should not have a decision-making role because (a) they simply don't have all the information, (b) they are not qualified to make decisions involving resource allocation and (c) they cannot override an individual person's values.
Veatch illustrates with cases apparently used in medical school teaching environments. For example, a young man is diagnosed with liver disease. His HMO decides he is not a candidate for a transplant, but nobody tells him about options elsewhere. He dies soon afterward. He's wealthy so he might have chosen to pay for his own transplant elsewhere.
Veatch focuses on the individual physician's moral dilemma. The real question is, 'Can we rely on just one source for expertise?' People still get advice to 'Ask your doctor.' We'd do better to be told, 'Search the Internet.' The real conflict comes from the typical physician's arrogant attitude combined with the customer's need to fill the gaps on his own. ."
This theme connects the chapters of the book. Veatch argues that doctors should not have a decision-making role because (a) they simply don't have all the information, (b) they are not qualified to make decisions involving resource allocation and (c) they cannot override an individual person's values.
Veatch illustrates with cases apparently used in medical school teaching environments. For example, a young man is diagnosed with liver disease. His HMO decides he is not a candidate for a transplant, but nobody tells him about options elsewhere. He dies soon afterward. He's wealthy so he might have chosen to pay for his own transplant elsewhere.
Veatch focuses on the individual physician's moral dilemma. The real question is, 'Can we rely on just one source for expertise?' People still get advice to 'Ask your doctor.' We'd do better to be told, 'Search the Internet.' The real conflict comes from the typical physician's arrogant attitude combined with the customer's need to fill the gaps on his own. ."
Science-Based Medicine
Science-Based Medicine: "When we were forming the National Council against Health Fraud I wondered aloud to the president, Bill Jarvis, what we would do if society solved the chiropractic problem. Bill laughed and said there would never be an end to quackery claims.
How right he was. But why? Many express surprise that at this time of remarkable intellectual and scientific advance, so many people choose to believe in irrational medical claims. The answer I am used to is the one that explains the difference between the attraction of subjective versus the dryness of the objective; between reflex and conditioned responses and rational thought, and between immediate emotionally gratifying, low-level mid-brain reactions and slow-reacting, cool, higher level intellectual thought."
How right he was. But why? Many express surprise that at this time of remarkable intellectual and scientific advance, so many people choose to believe in irrational medical claims. The answer I am used to is the one that explains the difference between the attraction of subjective versus the dryness of the objective; between reflex and conditioned responses and rational thought, and between immediate emotionally gratifying, low-level mid-brain reactions and slow-reacting, cool, higher level intellectual thought."
eDocAmerica
eDocAmerica: "But, consider the possibility that, for certain situations, on line interaction may actually be superior to in 0ffice care! I have been amazed at the number of times that clients using eDoc have said that our physicians have been even more helpful for their situation than their own doctor has been after several office visits. How could this be?
On line dialogue, both for the physician and the patient, provides a much more relaxed environment to think about a response to a question or problem. There is no embarrassment and, consequently, often more comfort in sharing unpleasant or personal details about symptoms. If a physician is 'pretty sure' how to answer a question, but is unclear on some of the details, he has plenty of time to consult a text or a web site and review a situation briefly before he responds. Patients then have an unlimited opportunity to clarify issues or respond back to physicians' questions.
Finally, physicians have an incredible treasure chest of web sites and resources called the internet that they can use to enhance their responses with patient education materials. So, in the end, many online episodes result in a patient who is more fully informed and more satisfied with their plan than they might be following one or more brief in office visits with their physician."
On line dialogue, both for the physician and the patient, provides a much more relaxed environment to think about a response to a question or problem. There is no embarrassment and, consequently, often more comfort in sharing unpleasant or personal details about symptoms. If a physician is 'pretty sure' how to answer a question, but is unclear on some of the details, he has plenty of time to consult a text or a web site and review a situation briefly before he responds. Patients then have an unlimited opportunity to clarify issues or respond back to physicians' questions.
Finally, physicians have an incredible treasure chest of web sites and resources called the internet that they can use to enhance their responses with patient education materials. So, in the end, many online episodes result in a patient who is more fully informed and more satisfied with their plan than they might be following one or more brief in office visits with their physician."
Thursday, January 08, 2009
HealthWrights: Workgroup for People's Health and Rights
HealthWrights: Workgroup for People's Health and Rights: "Just as death from diarrhea is determined, to a large extent, by socioeconomic factors, the same is true for most of the other major health problems affecting the poor. Thus, primary health care - if it truly involves the people in seeking solutions for themselves - creates a demand for fairer social structures. The primary health worker who earnestly works with people and learns from them the obstacles to health, will necessarily become politicized. Thus the community health worker can become 'an internal agent of change, not only for health care, but for the awakening of his or her people to their human potential and ultimately to their human rights.'
Today, it is often said that primary health care is an experiment that was tried and failed. But in most countries, it has never really been tried, at least by the governments. Is this not because primary health care has a liberating and empowering potential? By helping people gain control over some aspects of their lives it can catalyze collective action for social change. In its fullest sense, primary health care is, indeed, revolutionary. It is no surprise, therefore that in most countries, primary health care has not been allowed to succeed. The very few countries where governments have given it a fair chance are mostly those where social transformation has recently taken."
If we need to improve healthcare , we need to start by understanding that making these changes is an intensely political process - and there will be lots of resistance from the entrenched forces, who want to maintain the status quo !
Today, it is often said that primary health care is an experiment that was tried and failed. But in most countries, it has never really been tried, at least by the governments. Is this not because primary health care has a liberating and empowering potential? By helping people gain control over some aspects of their lives it can catalyze collective action for social change. In its fullest sense, primary health care is, indeed, revolutionary. It is no surprise, therefore that in most countries, primary health care has not been allowed to succeed. The very few countries where governments have given it a fair chance are mostly those where social transformation has recently taken."
If we need to improve healthcare , we need to start by understanding that making these changes is an intensely political process - and there will be lots of resistance from the entrenched forces, who want to maintain the status quo !
Sunday, January 04, 2009
Kalorama: EMR market to grow by 14 percent annually through 2012
Kalorama: EMR market to grow by 14 percent annually through 2012: "Kalorama Information forecasts the EMR market to grow by 14.1 percent annually through 2012, from $9.5 billion in 2007.
The emerging personal health record trend will have a vast impact on the electronic medical records market and on healthcare in the upcoming year, according to the New York-based marketing research firm.
The report, 'U.S. Markets for EMR Technology,' examines how the focus of ownership of medical records is shifting from one that is distributed among various healthcare providers to one that is shared and controlled by both the patient and the provider.
Patients' and physicians' interest in viewing records online has increased, since giving patients online access to their own charts is expected to enhance the doctor-patient relationship and reduce healthcare costs.
'The driver for EMR sales has always been hospital-side, as in 'this can reduce your costs,'' said Bruce Carlson, publisher of Kalorama Information.'That's still true, but with PHRs, the driver is also on the consumer side, as in 'this can make your organization seem friendly and modern to healthcare consumers.' '"
The emerging personal health record trend will have a vast impact on the electronic medical records market and on healthcare in the upcoming year, according to the New York-based marketing research firm.
The report, 'U.S. Markets for EMR Technology,' examines how the focus of ownership of medical records is shifting from one that is distributed among various healthcare providers to one that is shared and controlled by both the patient and the provider.
Patients' and physicians' interest in viewing records online has increased, since giving patients online access to their own charts is expected to enhance the doctor-patient relationship and reduce healthcare costs.
'The driver for EMR sales has always been hospital-side, as in 'this can reduce your costs,'' said Bruce Carlson, publisher of Kalorama Information.'That's still true, but with PHRs, the driver is also on the consumer side, as in 'this can make your organization seem friendly and modern to healthcare consumers.' '"
Busting the common myths about pregnancy
Pregnancy is one of the most exciting times in a woman’s life and every pregnancy is truly a miracle. Because women having been having babies for centuries, there are still many myths and old wives tales about pregnancy, which modern obstetrics is just starting to dispel.
Myth 1. Pregnancy care starts after you get pregnant
Most women register with their obstetrician for medical care after they get pregnant. After all, we are all familiar with the adage: ‘Be good to your baby before it is born’. However, in reality, the best time to start taking care of your unborn baby is even before you conceive! Such care is called pre-pregnancy or pre-conception care.
Why is this care so important? Remember, that the foetal organs are actively developing during first 12 weeks of pregnancy (this crucial period is called organogenesis). The embryo is highly susceptible to external insults during this time, so that any damage can lead to crippling birth defects.
The beauty about pre-pregnancy care is that it is so simple: all that is involved is visiting your doctor before you are planning to get pregnant, rather than after you've missed your menstrual period! The doctor normally undertakes the following procedures: (1) takes a medical history; (2) carries out a physical examination; and (3) performs some simple laboratory tests. These procedures are inexpensive and easy to conduct and signify examples of preventive medicine at its best!
Pre-pregnancy care also leads to other benefits. For instance, it allows the doctor (duly assisted by you) to identify problems and rectify them. If, on the other hand, these problems were to be spotted only after you became pregnant, detailed testing can become very difficult, because the very presence of the delicate embryo, can impede testing. The harsh reality is that not all problems are preventable, but you can, nevertheless, increase your chances of having a healthy baby by identifying the risks you face and trying to eliminate them, if possible. After all, most doctors go in for a battery of tests before performing major surgery, to make sure that the patient is healthy enough to withstand the stress generated by the operation and the anesthesia. Pregnancy can also stress the body, and it is important to screen the woman for potential problems before she embarks on one of the most important journeys she will ever make!
A simple precaution you can take is to ensure a regular intake of a vitamin called folic acid. Folic acid greatly reduces the chances of your baby being born with birth defects such as spina bifida or anencephaly if taken before you become pregnant and during the first six weeks of pregnancy.
Myth 2. Modern medical care is essential if you want to have a healthy baby
While modern obstetric care can ensure that pregnancy and childbirth are very safe for both mother and baby, unfortunately, today doctors have ‘medicalized’ pregnancy to such an extent that what is otherwise a normal event has been converted to one which needs rigorous and frequent medical assistance.
Every mother naturally wants a normal baby, and technology can be very useful in reassuring her that all is well. However, it's easy to misuse technology. One particularly disturbing trend stems from the fact that many obstetricians nowadays overuse medical technology; such overuse can often prove detrimental to both the mother and the baby. Common tests which are misused include: blood tests for TORCH infections; ultrasound scans; and foetal monitoring. Another area of misuse relates to the tests available for screening the baby for a possible birth defect. Many doctors routinely subject their patients to a ‘triple test’ during the pregnancy to screen for birth defects. While this is an easy test (it’s a simple blood test which measures the levels of 3 hormones in the blood) to carry out unfortunately, it has still not been standardized for Indian women. Such a drawback leads to a large number of tests yielding abnormal results, even though the babies are completely normal. An ‘abnormal’ result creates a lot of anxiety – and then the doctor needs to perform a battery of other tests to confirm that the baby is, in fact, normal to reassure the mother. The second tier of tests can be expensive, and risky as well, because some of them can cause the mother to miscarry. Thus, it is not uncommon for a mother to lose a healthy baby because of a test which was not really required in the first place!
Myth 3. More is better
A lot of medical technology during pregnancy is overused and misused.Foetal monitoring to document fetal wellbeing is a good example. While this procedure was initially designed to serve as a tool to monitor the well-being of the foetus and to help reduce the need for medical intervention, today it is often used to justify an LSCS (Caesarean section) in order to forcibly take out a baby ‘in foetal distress’! A much simpler alternative would be to opt for “ kick counts” in which the mother acts as her own fetal monitor, by counting how many times her baby moves. A baby which moves actively is sure to be healthy!
Myth 4. Hospitals are the best places to have a baby
Despite tremendous advances in medical science, it’s a sad fact that the rituals associated with childbirth in hospitals have unfortunately been designed for the doctor's convenience, rather than the patients'! Harmful practises include: forced induction of labour; routine use of enemas and intravenous drips, foetal monitoring, making the patient lie down (rather than allowing her to walk about) — it's a long list! Don't let the hospital/clinic staff patronize you — you need to assert your rights! It's very useful to draw up a birth plan (which includes things you will allow and those you won't ) and make sure your doctor agrees with the procedures. The presence of a doula has been proven to be your very helpful for women in labour. Also, should encourage your husband to participate in this adventure as actively as possible !
A significant recent development is that many women in the West are turning back to natural childbirth once again, often either at home or what are known as ‘birthing centres’. In other words, they would like to keep as far away from a hospital as possible! Despite the fact many doctors scare women into believing that the hospital is the safest place to deliver a baby, recent international studies have shown that the home is often much safer and much more congenial for normal births. For example, Holland, where over 60 per cent of births occur at home, under the supervision of midwives, can justifiably boast of having one of the world's lowest neonatal mortality rates! The midwifery model seeks to remind women that childbirth is a natural process for healthy women and women need to learn (or rather, relearn!) to trust their bodies!
Myth 5. Mothers need anesthesia to cope with the pain of labour and childbirth
Yet another minus point pertains to the application of anaesthesia for pain relief, which has become the norm nowadays. Epiduran analgesia has become a status symbol in most hospitals. We have mindlessly aped this Western ‘advance’, much to the detriment of both the mother and the child. While techniques for pain relief a valuable resource, can be they should be used only when absolutely necessary. Simple techniques such as yoga and meditation can help you manage the pain of labour very effectively.
Myth 6. A caesarean section is safer for the baby than normal vaginal birth
We are witnessing a virtual epidemic of Caesarean sections today. Whereas a CS once used to be the method of last resort to deliver the baby, it has at present, tragically, become the norm in some hospitals, accounting for 50 per cent of all births. The reason, of course, is obvious: a CS is financially much more lucrative to the doctor than a normal delivery. As a senior obstetrician wryly put it: ‘The only indication for a normal delivery today seems to be if a patient delivers before the doctor reaches the hospital!’ The alarming spurt in CS has taken on the dimensions of a major scandal today, which needs to be tackled actively. What steps can you take if you don't want to end up as another statistic? It would be a prudent idea to find out the rates your doctor charges for a CS and for a normal birth. You can also ask him what proportion of his patients successfully delivers normally. Other patients in the clinic, as well as the hospital nursing staff, can prove to be valuable sources of information, which you should effectively tap to alert you to a "knife-happy" obstetrician, from whom you need to stay away!
Myth 7. It’s not safe to have sex during pregnancy, as this can hurt the baby
This is not true. The baby is safe inside its own private swimming pool in the uterus, and sex will not affect it. In fact, many women find that their libidio increases dramatically during the first few weeks of pregnancy, and it’s safe to have sex if you so desire.
Myth 8. It’s not safe for pregnant women to fly
Modern aircraft cabins are pressurized, which means that it’s safe for women to fly in the first 32 weeks of their pregnancy. After this time, most airlines will not allow you to fly, because they are worried you may go into labour in the plane.
Myth 9. You can tell your baby’s gender by the way you are carrying
How you carry your baby depends upon many variables, including your build; the baby’s size; and whether the baby’s head has entered the pelvis or not. This has nothing to do with the baby’s gender – but you always have a 50% chance of being right !
Tips for a Healthy Pregnancy
The following pointers can prove useful during your pregnancy.
• Learn as much as possible about the wonderful ways in which your body is changing and about how your baby is growing. Talk to your mother, your friends, and other women about pregnancy, labour and birth. Attend pregnancy-related classes, read the relevant books, and watch videos about normal pregnancy and childbirth. You can find a wealth of resources free at HELP – Health Education Library for People, Excelsior Business Center, National Insurance Building, Ground Floor, Near Excelsior Cinema, 206, Dr.D.N Road, Mumbai 400001. Tel. No.:65952393/65952394, www.healthlibrary.com.
• Remain active! Continue with the exercise programmes that you were following before you became pregnant, modified, if needed, according to the recommendations of your doctor. If you were not exercising at all before becoming pregnant, consider going in for walking or swimming. Start with short periods of exercise, and gradually increase the amount of time.
• Get plenty of rest. Listen to your body to determine if you need short breaks during the day as well as to determine how many hours of sleep you need at night.
• Talk to your baby and enjoy your growing bond with him. Research now shows that babies can react to the sense of touch as early as ten weeks of pregnancy! A little later, they can react to light, your voice, music, and other sounds.
• Try to minimize the stress in your life by practising stress management techniques such as slow and deep breathing, yoga and relaxing various muscle groups when you feel stressed.
• Plan your baby's birth. For most women, the process is normal, natural, and healthy. nd healthy.
• Enjoy this special time in your life! Your husband and, your family and friends can help you make the most of this wonderful transition. Have confidence in your body's ability to grow, nourish, and give birth to this baby just as women have done for centuries.
• During pregnancy, many women are highly motivated to remain as healthy as possible, so that they can give their baby the best start in life. Pregnancy is an excellent opportunity to develop good health habits; you can use these habits to keep yourself healthy for the rest of your life!
Myth 1. Pregnancy care starts after you get pregnant
Most women register with their obstetrician for medical care after they get pregnant. After all, we are all familiar with the adage: ‘Be good to your baby before it is born’. However, in reality, the best time to start taking care of your unborn baby is even before you conceive! Such care is called pre-pregnancy or pre-conception care.
Why is this care so important? Remember, that the foetal organs are actively developing during first 12 weeks of pregnancy (this crucial period is called organogenesis). The embryo is highly susceptible to external insults during this time, so that any damage can lead to crippling birth defects.
The beauty about pre-pregnancy care is that it is so simple: all that is involved is visiting your doctor before you are planning to get pregnant, rather than after you've missed your menstrual period! The doctor normally undertakes the following procedures: (1) takes a medical history; (2) carries out a physical examination; and (3) performs some simple laboratory tests. These procedures are inexpensive and easy to conduct and signify examples of preventive medicine at its best!
Pre-pregnancy care also leads to other benefits. For instance, it allows the doctor (duly assisted by you) to identify problems and rectify them. If, on the other hand, these problems were to be spotted only after you became pregnant, detailed testing can become very difficult, because the very presence of the delicate embryo, can impede testing. The harsh reality is that not all problems are preventable, but you can, nevertheless, increase your chances of having a healthy baby by identifying the risks you face and trying to eliminate them, if possible. After all, most doctors go in for a battery of tests before performing major surgery, to make sure that the patient is healthy enough to withstand the stress generated by the operation and the anesthesia. Pregnancy can also stress the body, and it is important to screen the woman for potential problems before she embarks on one of the most important journeys she will ever make!
A simple precaution you can take is to ensure a regular intake of a vitamin called folic acid. Folic acid greatly reduces the chances of your baby being born with birth defects such as spina bifida or anencephaly if taken before you become pregnant and during the first six weeks of pregnancy.
Myth 2. Modern medical care is essential if you want to have a healthy baby
While modern obstetric care can ensure that pregnancy and childbirth are very safe for both mother and baby, unfortunately, today doctors have ‘medicalized’ pregnancy to such an extent that what is otherwise a normal event has been converted to one which needs rigorous and frequent medical assistance.
Every mother naturally wants a normal baby, and technology can be very useful in reassuring her that all is well. However, it's easy to misuse technology. One particularly disturbing trend stems from the fact that many obstetricians nowadays overuse medical technology; such overuse can often prove detrimental to both the mother and the baby. Common tests which are misused include: blood tests for TORCH infections; ultrasound scans; and foetal monitoring. Another area of misuse relates to the tests available for screening the baby for a possible birth defect. Many doctors routinely subject their patients to a ‘triple test’ during the pregnancy to screen for birth defects. While this is an easy test (it’s a simple blood test which measures the levels of 3 hormones in the blood) to carry out unfortunately, it has still not been standardized for Indian women. Such a drawback leads to a large number of tests yielding abnormal results, even though the babies are completely normal. An ‘abnormal’ result creates a lot of anxiety – and then the doctor needs to perform a battery of other tests to confirm that the baby is, in fact, normal to reassure the mother. The second tier of tests can be expensive, and risky as well, because some of them can cause the mother to miscarry. Thus, it is not uncommon for a mother to lose a healthy baby because of a test which was not really required in the first place!
Myth 3. More is better
A lot of medical technology during pregnancy is overused and misused.Foetal monitoring to document fetal wellbeing is a good example. While this procedure was initially designed to serve as a tool to monitor the well-being of the foetus and to help reduce the need for medical intervention, today it is often used to justify an LSCS (Caesarean section) in order to forcibly take out a baby ‘in foetal distress’! A much simpler alternative would be to opt for “ kick counts” in which the mother acts as her own fetal monitor, by counting how many times her baby moves. A baby which moves actively is sure to be healthy!
Myth 4. Hospitals are the best places to have a baby
Despite tremendous advances in medical science, it’s a sad fact that the rituals associated with childbirth in hospitals have unfortunately been designed for the doctor's convenience, rather than the patients'! Harmful practises include: forced induction of labour; routine use of enemas and intravenous drips, foetal monitoring, making the patient lie down (rather than allowing her to walk about) — it's a long list! Don't let the hospital/clinic staff patronize you — you need to assert your rights! It's very useful to draw up a birth plan (which includes things you will allow and those you won't ) and make sure your doctor agrees with the procedures. The presence of a doula has been proven to be your very helpful for women in labour. Also, should encourage your husband to participate in this adventure as actively as possible !
A significant recent development is that many women in the West are turning back to natural childbirth once again, often either at home or what are known as ‘birthing centres’. In other words, they would like to keep as far away from a hospital as possible! Despite the fact many doctors scare women into believing that the hospital is the safest place to deliver a baby, recent international studies have shown that the home is often much safer and much more congenial for normal births. For example, Holland, where over 60 per cent of births occur at home, under the supervision of midwives, can justifiably boast of having one of the world's lowest neonatal mortality rates! The midwifery model seeks to remind women that childbirth is a natural process for healthy women and women need to learn (or rather, relearn!) to trust their bodies!
Myth 5. Mothers need anesthesia to cope with the pain of labour and childbirth
Yet another minus point pertains to the application of anaesthesia for pain relief, which has become the norm nowadays. Epiduran analgesia has become a status symbol in most hospitals. We have mindlessly aped this Western ‘advance’, much to the detriment of both the mother and the child. While techniques for pain relief a valuable resource, can be they should be used only when absolutely necessary. Simple techniques such as yoga and meditation can help you manage the pain of labour very effectively.
Myth 6. A caesarean section is safer for the baby than normal vaginal birth
We are witnessing a virtual epidemic of Caesarean sections today. Whereas a CS once used to be the method of last resort to deliver the baby, it has at present, tragically, become the norm in some hospitals, accounting for 50 per cent of all births. The reason, of course, is obvious: a CS is financially much more lucrative to the doctor than a normal delivery. As a senior obstetrician wryly put it: ‘The only indication for a normal delivery today seems to be if a patient delivers before the doctor reaches the hospital!’ The alarming spurt in CS has taken on the dimensions of a major scandal today, which needs to be tackled actively. What steps can you take if you don't want to end up as another statistic? It would be a prudent idea to find out the rates your doctor charges for a CS and for a normal birth. You can also ask him what proportion of his patients successfully delivers normally. Other patients in the clinic, as well as the hospital nursing staff, can prove to be valuable sources of information, which you should effectively tap to alert you to a "knife-happy" obstetrician, from whom you need to stay away!
Myth 7. It’s not safe to have sex during pregnancy, as this can hurt the baby
This is not true. The baby is safe inside its own private swimming pool in the uterus, and sex will not affect it. In fact, many women find that their libidio increases dramatically during the first few weeks of pregnancy, and it’s safe to have sex if you so desire.
Myth 8. It’s not safe for pregnant women to fly
Modern aircraft cabins are pressurized, which means that it’s safe for women to fly in the first 32 weeks of their pregnancy. After this time, most airlines will not allow you to fly, because they are worried you may go into labour in the plane.
Myth 9. You can tell your baby’s gender by the way you are carrying
How you carry your baby depends upon many variables, including your build; the baby’s size; and whether the baby’s head has entered the pelvis or not. This has nothing to do with the baby’s gender – but you always have a 50% chance of being right !
Tips for a Healthy Pregnancy
The following pointers can prove useful during your pregnancy.
• Learn as much as possible about the wonderful ways in which your body is changing and about how your baby is growing. Talk to your mother, your friends, and other women about pregnancy, labour and birth. Attend pregnancy-related classes, read the relevant books, and watch videos about normal pregnancy and childbirth. You can find a wealth of resources free at HELP – Health Education Library for People, Excelsior Business Center, National Insurance Building, Ground Floor, Near Excelsior Cinema, 206, Dr.D.N Road, Mumbai 400001. Tel. No.:65952393/65952394, www.healthlibrary.com.
• Remain active! Continue with the exercise programmes that you were following before you became pregnant, modified, if needed, according to the recommendations of your doctor. If you were not exercising at all before becoming pregnant, consider going in for walking or swimming. Start with short periods of exercise, and gradually increase the amount of time.
• Get plenty of rest. Listen to your body to determine if you need short breaks during the day as well as to determine how many hours of sleep you need at night.
• Talk to your baby and enjoy your growing bond with him. Research now shows that babies can react to the sense of touch as early as ten weeks of pregnancy! A little later, they can react to light, your voice, music, and other sounds.
• Try to minimize the stress in your life by practising stress management techniques such as slow and deep breathing, yoga and relaxing various muscle groups when you feel stressed.
• Plan your baby's birth. For most women, the process is normal, natural, and healthy. nd healthy.
• Enjoy this special time in your life! Your husband and, your family and friends can help you make the most of this wonderful transition. Have confidence in your body's ability to grow, nourish, and give birth to this baby just as women have done for centuries.
• During pregnancy, many women are highly motivated to remain as healthy as possible, so that they can give their baby the best start in life. Pregnancy is an excellent opportunity to develop good health habits; you can use these habits to keep yourself healthy for the rest of your life!
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