Stephen C Schimpff's Blog (101)

Is it possible that health care can become more effective, more personalized, more attuned to real health and wellness in a manner that truly benefits you the customer? 

At the recent health and wellness conference celebrating the 20^th anniversary of the University of Maryland Center for Integrative Medicine there was a panel discussion moderated by Center director Brian Berman, MD on the topic of health care of the future. Here are some excerpts from the comments made by…

Can integrative medicine add value to standard western practices? Some would say absolutely not; others point to new scientific evidence that demonstrates the value of specific modalities in specific situations.

Health care is complex, expensive and often depersonalizing. It shouldn’t be. At the University of Maryland Center for Integrative Medicine, the staff focuses on evaluating and involving complementary medicine into traditional…

Genomics Part 4 -- Medical Megatrends

Are you concerned about a family history of heart disease? Or cancer? Worried that you genes will be your fate? We know that good dietary habits are generally good for us but can foods affect our genes? The new science of nutrigenomics suggests that they can.

Nutrigenomics is about using what you eat to change your gene expression (meaning how your genes function) to optimize your health.

Nutrigenomics is the science of how bioactive…

Medical Megatrends – Genomics Part III

Genomics promises to fundamentally change much of medical care as described in the two prior posts on this subject.  But the ultimate value of this new understanding of basic human biology will in many cases come with fits and starts. The saga of belimumab (Benlysta) and Human Genome Sciences is illustrative.

Systemic lupus erythematosus (SLE) occurs in somewhere between 300,000 and 4 million Americans according to the…

In the previous post I discussed the field of pharmacogenomics. Today I will focus on

            Disease classification

            Disease prognostication

            Early and rapid diagnosis

            Prediction of diseases to develop later in life

Genomics is proving to be very valuable in disease classification, especially with cancer. A pathologist’s evaluation looking at a microscopic slide has been the basis for most cancer…

There are a series of medical megatrends outlined in my book The Future of Medicine – Megatrends in Healthcare that will profoundly affect health care in the coming five to fifteen years and beyond. Some are due to the explosion of basic understandings of cellular and molecular biology. Others are related to advances in engineering and computer science. Here is a very brief overview. 

These are the megatrends in medical care that are…

Do you need a good incentive to exercise? Check out this set of pictures. They may well surprise you.

Tis is not a typical topic for MedTechIQ but it is relevant to all of us. I just turned 70 so I am going to the gym after I post this.

We all know we should exercise. It feels good during and we feel even better after. We know it burns calories and that our bodies were meant to be used. But all too many of us are sedentary; it just the result of modern life.…

For a parent of a child with cystic fibrosis, a new drug that could eradicate symptoms could be a God send. The same could be said of a parent of child with Angelman’s syndrome. For a patient with lung cancer, a drug that is more than marginally effective would be wonderful. And for a person with early Alzheimer’s or their loved ones, a drug that might actually reverse the disease would be incredible.

New drugs are approved by the Food and Drug Administration (FDA) regularly.…

Many harbor the concept that the recently passed reform legislation – The Patient Access and Affordable Care Act – will mean even greater advances in medical science.  This is a misconception.

The reform bill is all about access to care – getting those without insurance to get insurance either through the commercial market place or through Medicaid. This will create at least 31 million more individuals with Medicaid, will keep young adults on their parent’s insurance for a…

There are many misconceptions about health care and medical care. This includes the discussions over the last few years about healthcare reform but is not limited to those discussions. I plan to write about these over the coming days and weeks in some detail. Here is the first one. “American has the best healthcare system in the world.”

One of the first problems with this statement is that we really have a medical system in America not a healthcare system. We focus on…

Some 80% of healthcare costs go to just a few very serious complex chronic diseases including the likes of diabetes and heart failure. But these are all largely preventable with lifestyle adjustments. Unfortunately, we Americans are an over fed (on non-nutritious diets), under exercised, chronically stressed population with 20% of us still smoking. One third of us are frankly obese and another one third are overweight. 

Health care costs could plummet if we could only become a health…

A decade ago there was much hope and hype for gene therapy. Then came the death of Jesse Gelsinger , an 18 year old, as a result of uncontrolled infection from the viral vector used to insert the gene change. That led to a near total stop of gene therapy clinical trials and the development of multiple new regulations, especially multiple levels of extensive reviews. 

Now some new developments are coming to fruition and there is some legitimate reason for enthusiasm that gene therapy…

My Colleague and pedicatiric oncologist Dr Curt Civin and I wrote the folowing Op Ed which appeared December 7, 2011 in the Baltimore Sun.

Hospitals nationwide are experiencing shortages of critical generic intravenous drugs. We believe a fundamental reason for this national shortage is government price controls. With these limits there is little incentive to invest…

Our children (and grandchildren) are the future and we are responsible for their growth and development. As responsible parties, we are clearly failing. 

That is my interpretation of the report issued a few days ago by the Centers for Disease Control (CDC) as part of the National Health and Nutrition Examination Survey on seven criteria known to the associate with ideal cardiovascular health. They are defined, briefly, as 1) a diet with…

Americans are aging – fast. And that means more chronic illnesses like arthritis, heart failure and cancer. It also means more falls, more osteoporotic fractures, poorer hearing and vision and myriad other problems we equate with aging. It also means some older folks become “frail,” irrespective of chronologic age.

You know a person is frail when you see him or her – instinctively you will think a person is “frail” if they are “skinny,” weak, tired, inactive and slow. But…

I toured a major medical center recently to get a look at the robots in the pharmacy and to understand how the electronic medical record worked there. I was particularly interested in the new robot that made up “injectables,” the fluid bags filled with medications to be given intravenously, such as antibiotics. There was also a robot that selects pills and tablets based on bar code technology. A third robot actually delivers the medication to the individual nursing units, a little “R2D2.”…

Melanoma is the most virulent form of skin cancer with a rapidly rising incidence due to prior sun exposure. About 40,000 men and 30,000 women per year in the USA develop melanoma. In addition to sun exposure, there are independent genetic risk factors such as a variation in the “red hair” gene that increases in frequency the further one’s ancestral home is north of Africa.  …

In an earlier post I described the problem of excessive and inappropriate drug prescribing when a patient with multiple chronic illnesses did not have good care coordination by a single primary care physician. In this post I will relate the story of a lady who had an excellent primary care physician but the communication system broke down when she went elsewhere for a single visit. In her case the problem was the recommendation of an inappropriate medical technology for her chronic…

This is the fourth post in a series on care coordination; this time focusing on other examples of team-based care.  Patients with diabetes not only have to deal with the diabetes itself and its management, such as insulin and drugs, but they have to deal with nutrition, weight and exercise.  They need to cope with potential side effects of the diabetes, such as damage to their eyes or kidneys or the blood vessels running into the lower legs that can lead to ulcerations, infections and even…

This is the third post in a series on care coordination and the importance of the electronic medical record to effect that coordination.

Medical images such as CT scans, MRI and pathology specimens are largely all digitized today so they can be transmitted to any location in an instant.  This means that the most experienced physician at a distant institution can be called upon to review, say, a mammogram that has raised questions for the initial local reviewers or for a…