Stephen C Schimpff's Blog (101)

Watching TV is Bad for Your Health But Sitting Still is the Culprit

Did you see the stories in the newspapers that TV watching is bad for your health? It is but probably not for the reasons you might think. Certainly being a couch potato is unhealthy and if we sit there for long periods, eating chips, drinking beer and smoking cigarettes, our health will obviously take a turn for the worse. But a new study from Australian researchers observed 8800 adults for over six years and recorded the deaths from heart disease, cancer and all causes. The results were… Continue

Added by Stephen C Schimpff on January 27, 2010 at 2:43pm — No Comments

Misconception - Primary care physicians do not deal with the expensive aspects of medical care so they can have little impact on reducing medical expenditures.

Two major reasons for cost escalation are lack of good care coordination of those with complex chronic illnesses and inadequate attention to prevention and screening. PCPs are key to both of these but they have too little time per patient and are not paid for either activity. About 5% of all healthcare expenditures go to PCPs but they can have a major impact on the other 95%, especially with good care coordination of chronic illness and with a focus on prevention.

To fix this, PCPs… Continue

Added by Stephen C Schimpff on January 14, 2010 at 5:19pm — No Comments

Misconception– Health care is or should be a right – not a privilege and not a responsibility

During the presidential debates, Tom Brokow asked “is healthcare a right, a privilege or a responsibility?” The candidates did not answer the question but now would be a good time for Congress and the Obama Administration to balance the rights being offered as part of reform with corresponding responsibilities.

We are the only developed country that does not assure all of its citizens basic medical care insurance access – shame on us. We spend more per capita for medical care than any… Continue

Added by Stephen C Schimpff on January 6, 2010 at 10:15am — No Comments

Healthcare Reform Misconception - Giving patients more control of their healthcare expenditures will lead to lower costs

It makes good sense to have all of us more involved in our healthcare decision-making and with that its payments. But individuals purchase healthcare in a manner unlike any other purchase. Patients or their loved ones do not “shop” for the best price the way they shop for a new washing machine. They shop for the best [as they understand it] physician, hospital, etc. Mostly they accept the advice of their personal physician as to drugs, surgery or rehab. That said it makes sense to have high… Continue

Added by Stephen C Schimpff on January 4, 2010 at 10:24am — No Comments

Healthcare Reform Misconception - Costs are rising because of the avarice and greed or just unregulated “bad guys

Drug and technology companies, doctors, hospitals, malpractice lawyers and third-party payers/insurers deserve some approbation and bear some responsibility at the margin, but these are not the major reasons why costs are rising. But it seems that politicians, the media and so many others seem to believe what’s convenient rather than what is accurate.

The real culprits are: 1) the poor coordination of care of those with chronic illness resulting in excess visits to specialists,… Continue

Added by Stephen C Schimpff on December 29, 2009 at 11:05am — No Comments

Misconception - Universal coverage for all Americans will reduce costs

Unfortunately that is not the case; indeed it will create substantial added expenditures. Today we spend about $7500 per capita for medical care each year. That is built into our insurance whether it is commercial or Medicare along with co-pays and deductibles. In my view it is unfortunate that Congress has not done much to address the high and rising costs of medical care in the reform bills.

America is the only country in the developed world that does not have some system to ensure… Continue

Added by Stephen C Schimpff on December 23, 2009 at 11:59am — No Comments

Misconception – Healthcare reform will fundamentally improve how we receive care going forward.

This is also not at all likely except for those who do not now have medical care insurance. For the rest of us, medical care delivery will change but it will change not because of reform but because of some fundamental societal and demographic reasons along with a marked change in the types, severity and chronicity of illnesses that is occurring right now. The combination of an aging population and our non-healthy lifestyles (obesity, poor nutrition, lack of exercise, stress and smoking) are… Continue

Added by Stephen C Schimpff on December 21, 2009 at 2:12pm — No Comments

Misconception – The remarkable medical scientific advances are rapidly made available to the care delivery system.

We should so hope but often that it is just not the case.

Laparoscopic surgery took medicine by storm 20 years ago but some new technologies of great value are slow to be adopted, such as simulation for teaching procedures rather than learning by practicing on the patient. Sometimes it is because the old way is “the way we have always done it” and sometimes it is because those holding the purse strings just do not appreciate the underlying value. Laparoscopic surgery got patients out… Continue

Added by Stephen C Schimpff on December 16, 2009 at 5:20pm — No Comments

Video Conference with Becton Dickinson – The Future of Medicine

I was recently invited to present my thoughts on the Future of Medicine, based on my book of the same name, to the worldwide medical affairs group at Becton Dickinson, the giant medical device and diagnostics company headquartered in Franklin Lakes, New Jersey. Their senior vice president for medical affairs, Dr David Durack, requested that I review the basic megatrends developing as a result of the scientific advances from genomics, stem cells transplantation, vaccines, pharmaceuticals,… Continue

Added by Stephen C Schimpff on December 14, 2009 at 9:36am — 1 Comment

Misconception - “Health care reform” will improve the delivery of care and offer us better care opportunities.

In fact, healthcare reform is not about healthcare; it is mostly about paying for medical care for the uninsured and only somewhat about the rising costs of medical care. I use the term medical care here to emphasize that today American “healthcare” is all about treating disease and injury and very little about promoting wellness and preventing illness. The reforms being proposed are about addressing the financing of medical care but not the quality, the safety or the way that healthcare will… Continue

Added by Stephen C Schimpff on December 12, 2009 at 3:41pm — 2 Comments

Misconception - Healthcare reform will have an impact on the advances in medical science.

This sounds logical but there are frankly amazing advances in medicine that are around the corner no matter what “reform” occurs. These advances are related to our national commitment to basic science and to engineering and computer science developments and their translation to clinical care. The National Institutes of Health, research organizations such as our medical schools, the pharmaceutical and biotechnology industries and the medical device industry are constantly bringing forth new… Continue

Added by Stephen C Schimpff on December 11, 2009 at 9:53am — No Comments

Common Misconceptions About Healthcare Reform

American medicine must change - and the change will be both substantial and difficult to achieve but change is critical if we are to have a well functioning healthcare system that affords all of us safe, quality care at a reasonable cost in a customer-focused manner. Today there are many misconceptions about healthcare reform - misconceptions about who will have access, how much it will cost, who will pay the bills, whether it will benefit those who currently have insurance, whether there will… Continue

Added by Stephen C Schimpff on December 9, 2009 at 10:01am — 3 Comments

Mammograms as a Stalking Horse for Issues in Healthcare Reform

As we watch the reform movement in Washington, we see and hear so many misconceptions. A current one relates to mammography. A few weeks ago guidelines were published in the prestigious Annals of Internal Medicine stating, in effect, that women between ages 50 and 75 with no history of breast cancer in their family and normal mammograms to date could probably switch from annual to biannual exams. And women between ages 40 and 50 probably did not need to get mammograms as had been previously… Continue

Added by Stephen C Schimpff on December 7, 2009 at 9:44am — 2 Comments

World Class Health Care - A Medical Imperative

In appropriating funds for the new Walter Reed National Military Medical Center and the new Fort Belvoir Community Hospital, Congress determined that the military should receive only “world class healthcare” but did not define the meaning of the term. When the Health Systems Advisory panel of the Defense Health Board described in the previous blog was assembled, it decided that its first order of business was to establish a benchmark for world class. After much discussion, research and debate,… Continue

Added by Stephen C Schimpff on August 2, 2009 at 4:23pm — No Comments

Personal Behoviors and the Costs of Medical Care

A very important reason for medical care cost escalation has to do with our own personal behaviors. We are a country of people who are overweight --one-third are overweight and one-third or more are frankly obese --, under-exercised, poorly fed from a nutritional perspective and highly stressed. And it gets worse each year. Even children have progressively declining physical activity from about three hours per day at age nine to less than an hour by age fifteen. And this will correlate to… Continue

Added by Stephen C Schimpff on July 31, 2009 at 9:08am — No Comments

World Class Health Care at Walter Reed

Last fall I was asked by Maryland Senator Benjamin Cardin to join a group evaluating whether the new Walter Reed National Military Medical Center [WRNMMC], when completed in a few years, would be “world class.” The group, a subcommittee of the Defense Health Board, met multiple times to learn about the plans and develop a report for Congress. The report is now available at http://www.health.mil/dhb/meetings/NCR%20BRAC%20HSAS%20Report%20-%20Final.pdf . Here is a brief summary. The Base… Continue

Added by Stephen C Schimpff on July 26, 2009 at 3:23pm — No Comments

Lack of Care Coordination Hinders Care Quality and Escalates costs

The switch from acute to complex chronic diseases and the wide variation in care patterns are closely related. It is the complex chronic diseases that need the most attention and hence are most expensive to treat. But as a country we have long had the tradition of the independent, autonomous practioneer in the community taking care of us. This was fine for acute illnesses. The physician could either treat you him or herself or else would refer you to a particular specialist for needed care.… Continue

Added by Stephen C Schimpff on July 20, 2009 at 10:00am — 1 Comment

Medical Care Varies By Geographic Region

Recently Conrad Cyburn posted a note about the approach of Kaiser to keep costs down while quality high. They do a good job of avoiding the variations in care that exist across the country and which are part of thereason that caare is both expensive and not as good as it could or should be. There are wide variations in care expenditures from geographic region to region. One might assume that those regions with higher expenditures reap better health but that is simply not the case.… Continue

Added by Stephen C Schimpff on July 16, 2009 at 10:13am — No Comments

Complex, Chronic Illnesses That Last a Lifetime and Are Expensive to Treat

I appreciate the comments to my earlier post on the state of America's health care delivery system. We have incredible medical advances, of the type often referred to on MedTecIQ, but if they cannot be dellivered to the right people at the right time, then they are not being fully utilized to best advantage. One pressing need is to recognize the marked shift in disease prevalence from acute illness to chronic illnesses that has occured over the years; it is a real… Continue

Added by Stephen C Schimpff on June 29, 2009 at 2:14pm — No Comments

America Has a Sick Care Not a Health Care System

We Americans like to pride ourselves as having the best healthcare system the world but unfortunately that is not the case. We have a medical care system, not a healthcare system. We give lip service to prevention and spend only about 3% of our $2 trillion in medical expenditures on public health. By many measures we do not rate favorably compared to many of the other industrialized societies. As citizens we have behaviors that are driving more and more illness, illnesses that at chronic,… Continue

Added by Stephen C Schimpff on June 14, 2009 at 8:04am — 3 Comments