Parker Pope's selects studies that matter to us. And she deftly places in perspective those studies that should matter to us, because they concern the insane complexities of modern healthcare. A recent refreshing look at the economic costs to patients for their office wait time proves her point. We're all paying for a system that has unrealistic expectations of how much can be done in a 15 minute clinical visit. The result? chronic logjams in physician offices.
Other NYT Health articles online reveal the ways patients are abandoned by the system once surgery and other reimbursable services end. The article "Health scares reduce smoking not waistlines, study finds," reaches broadly into issues of insurance reimbursement and its typically grotesque outcomes.
In our system, there's this nutty bias toward more surgery over cheaper, behavioral therapy (like yoga therapy or psychotherapy).
Exercise-based weight loss programs seem expensive, at least upfront. The programs require clinical supervision, stress reduction techniques, counseling, nutrition education, blood tests for thyroid etc, and ongoing coaching/counseling. In contrast, smoking cessation groups are ridiculously common and usually free.
According to the article, the study's cardiac patients, who desperately need to lose weight and to quit smoking, only gave up ciggies, and maintained the same weight that helped lead to their heart attacks. Or the most overweight cardiac patients opted for costly bariatric surgery -- that's stomach-stapling to you and me. A bariatric procedure is ineffective when performed without vital but unreimbursed coaching and counseling afterwards. But what do we reimburse? Surgery without counseling ... and tragically, the ER costs from the (now, more likely) second heart "event". Crazy!
Hospitals like Martha Jeff are so committed to patient care that they try to retain at least some of their patient education programs in the current climate. But they deserve to be reimbursed by Medicare/Medicaid, no question.
Cancer survivor students participate in the Yoga for Life program, offered free at the studio thanks to the Martha Jeff Cancer Care Center. Students tell me one of the reasons why the class means so much is that it provides individual guidance and caring from someone trained to understand their needs beyond the treatment stage.
Parker Pope is not only a great editor, but from her choices we see she has a public health agenda. Her blog regularly includes research on the scarcity of good, old-fashioned, hands-on, low-tech healthcare. Check out a recent piece on insurance mandates that FORCE physicians to be "unethical" in their care. Then ... let's all think about how we change this. Viva la revolucion!
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