Wednesday, December 31, 2008

Resolutions For 2009 - “Ten Things to do in 2009 to Improve Health”

As we welcome in 2009 a year filled with hope and promise I thought it would be a good time to make up a list of Ten Things to do in 2009 to Improve Health.

1. Make it the norm for everyone to have health insurance and access to care.

2. Pay health care providers to communicate with consumers in the language the consumer understands.

3. Give consumers information in a useful format; there are more people who can watch a DVD than there are persons who can read.

4. Give consumers questions they can ask and provide answers so they understand what they may be told.

5. Encourage each person to talk about the level of care they want and include end of life issues.

6. Develop solutions for long term care that include a mix of private, public, and home based alternatives.

7. Encourage the sale of fresh vegetables and fruits in all communities.

8. Work to increase opportunities for persons of all ages and sizes to engage in physical activity.

9. Have EPA enforce clean air and water standards so we can breathe freely and safely drink tap water.

10. Remember that health care is more than science and numbers it is about body, mind, and spirit.

And a healthy and happy New Year to you too!

Tuesday, December 30, 2008

Future Health Solutions - Part II (of many)

Health is full of “trendy” words or things that sound good until you look at it more closely and try to decipher what will be the real impact. For example, much is written about the need for evidence-based medicine. Sounds like a good idea but the implication is that either, before, medicine was not based on evidence, or that now we have a better way to analyze the evidence. Unfortunately, much of what is discussed today is evidence based on studies that are over a decade old and are based on research on non-Hispanic white males.

It is not surprising that existing evidence-based protocols fail us as individuals. Too often the data that define the evidence do not include the other 2/3 of the population that is female or something other than non-Hispanic white. The evidence fails to acknowledge what we have documented during the first part of the 21st century, i.e., that there are gender differences and that there are differences in how individuals metabolize medicines and everything else we ingest or absorb. The challenge remains to acknowledge that there are persons excluded from our current models of evidenced based medicine.

It is no wonder I shudder when I hear that future treatments, and of course the reimbursements to which they will be linked, will be based on the existing evidence.