CHW Healthcare Blog

The Company Doctor is Back

Business Week covers health care reform, corporate style. It's a new trend that's catching on -- instead of cutting costs by reducing coverage, companies are building their own in-house health clinics:

...in a climate of deepening health-care woes, company-based medical centers are winning dozens of fresh converts. These include the North American units of Toyota and Nissan, Harrah's Entertainment, and Walt Disney Parks & Resorts.

The corporate doctor used to be the norm in America, but it fell out of favor in the 1940s when workers claimed that the physicians were working in the employers' interests. But it seems to be catching on again (there are plenty of calls for the clinics to be owned by physicians):

At the San Antonio plant, Toyota workers find little reason to venture outside. The on-site medical team can take X-rays, treat broken bones, and handle various emergencies. The doctors perform many of these procedures for as little as half of the physician fees charged by a specialist or a local hospital. And when medicines are required, an on-site pharmacy steers patients to generic drugs that have proven just as effective as the branded products. That seems to suit Toyota employees: some 60% of the San Antonio staff uses the clinic.

This may be an exciting new means for employees to retain their company-paid insurance and drive down costs at the same time.

Do you work for a company with an in-house clinic? What has your experience been? Do you think this kind of medicine is the wave of the future, or a flash in the pan? Start the conversation by adding a comment to this post.

Medpedia

For all you Wikipedia fans out there, there's a new service that's about to launch called Medpedia, which is being billed as a "global effort to collect, organize and make understandable, the world’s best information about health, medicine and the body and make it freely available on the web."

The site hasn't launched yet, but they're calling for contributors and editors. So if you're knowledgeable about medicine or health policy check out the site and contribute your expertise.

Health Applications for Your iPhone

U.S. News & World Report has a fun article about the widgets Apple has made available for its iPhone.

1. Absolute Fitness. For $14.95, users can keep a food and exercise diary, monitor nutrition and weight goals, and track and graph health metrics, including cholesterol, calories, saturated fat, and sodium.
2. Quitter. Is a program to help smokers kick the habit.
3. ICE. This In Case of an Emergency card lets you enter emergency contacts, medical conditions and any allergies.
4. iScale. Is another food diary feature.
5. Kenkou. It means "health" in Japanese and lets users keep track personal health and wellness data. The authors notes it's particularly useful for diabetics.

(the above summary was posted first at The Health Care Blog)

At Odds With Your Doctor?

A recent New York Times article reports on a growing trend in American medicine -- that patients no longer trust their doctors:

The distrust and animosity between doctors and patients has shown up in a variety of places. In bookstores, there is now a genre of “what your doctor won’t tell you” books promising previously withheld information on everything from weight loss to heart disease. The Internet is bristling with frustrated comments from patients.

But doctors say the situation is not hopeless. Patients who don’t trust their doctor should look for a new one, but they may be able to improve existing relationships by being more open and communicative.

Go to a doctor’s visit with written questions so you don’t forget to ask what’s important to you. If a doctor starts to rush out of the room, stop him or her by saying, “Doctor, I still have some questions.” Patients who are open with their doctors about their feelings and fears will often get the same level of openness in return.

Compassion in Mental Health

A powerful and scathing opinion-editorial was published in a recent issue of the Fort Lauderdale Sun-Sentinel. Written by Bob Sharpe, president of the Florida Council for Community Mental Health, the editorial calls the question about compassion for those suffering from mental illness:

Esmin Green sat alone in the emergency room. Suffering from psychosis and severe anxiety, she waited nearly 24 hours for help. After sitting alone in a waiting room chair for almost a day, Esmin fell from her seat, collapsing face-down on the floor at 5:32 a.m. One hour later, she was dead...Though this tragedy took place on June 19, it was largely ignored until a surveillance video surfaced weeks later showing the incident in its entirety.

When people witness such abuse, they are naturally shocked and outraged. Few people realize, however, that just one year ago something very similar happened to Edith Rodriguez at Martin Luther King Hospital in Los Angeles. Edith bled to death on the emergency room floor — a death that also was caught on video.

It is time to wake up and learn from these tragic events:

Thousands who desperately need care are not getting it.

Most of those in need of care do not have insurance to pay for it.

Our country would rather pay for criminal justice costs than mental health treatment.

Our health system far too often responds to poor, mentally ill people with a lack of compassion.

The real question here is not whether we CAN do better by people like Esmine Green and Edith Rodriguez, but whether we have the WILL to do better. We're spending the money in either event, and the real tragedy is that these women, and so many more people like them, are trapped between two broken systems -- the broken health care system and a broken criminal justice system. We are always looking for partners in our advocacy and community health efforts. If you have ideas, or think you might like to work with us to advocate on behalf of the mentally ill, send us an email.

Blogs Helping Patients

An article in the Seattle Post reports on the use of blogs to help people cope with and learn about disease. Blogging has become more than a venue for promoting opinions or summarizing news - it's a way to network with others and gain support during life's triumphs and tragedies.

The three blogs featured in the Seattle Post's story are:

Deanna Kingston: Dee's Updates
Deanna Kingston, 44, an anthropology professor at Oregon State University, was diagnosed with breast cancer in 2002. Last fall, the cancer spread to her skin and bones. While Kingston's blog is more an update for friends and family, others around the country also read it for its humor and real life daily journals. She posts "boob jokes" from her friends and family.

Jeanne Sather: Assertive Cancer Patient
Sather's Assertive Cancer Patient blog is her soapbox, she said. It shares her experiences as she's battled hospital billing nightmares, cancer recurrences, new treatments and often her opinion about almost anything going on in the cancer world.

Teresa Hartman: The Cheeky Librarian
Teri Hartman, 47, a university librarian was diagnosed with a rare cancer in the salivary glands in her cheek in July 2006. A month later, she began her "Cheeky Librarian" blog. She already had a professional librarian blog, but wanted an outlet for her cancer and posted links to sites that helped her cope. For example, a blog warned her she would lose her sense of taste after radiation destroyed her salivary glands. She was able to have her "last meals" as a result.

If there are other blogs out there about health and health care, the environment, or health care reform let us know. We are always looking for partners in our work to improve the quality of life.

Loans Available During Budget Crisis

California's budget crisis has led to a Medi-Cal payment freeze for thousands of community health clinics. According to the Los Angeles Times, "During last year's budget standoff, many providers reported paying astronomical interest rates for temporary credit. This year promises to be tougher. Banks are financially squeezed and reluctant to offer bridge loans."

We're pleased to report that it won't be as difficult as this report claims. In early June Catholic Healthcare West partnered with the California Primary Care Association and made $5 million in loan money available for California's community clinics to draw upon until the state budget is ironed out. We've been working with the CPCA to encourage others to make similar funds available. Since our initial contribution to the loan pool Sutter Health and HealthNet have each made $5 million available for community health clinics. We strongly urge others to join us in helping to keep these vital community services open.

CHW is California's largest private Medi-Cal provider so we have a very deep understanding of how important these clinics are to maintaining the viability of our already fragile health system. By helping keep their doors open we are helping to ensure that our most vulnerable residents continue to have access to the care they need, when they need it.

Humanitarian Medicine

A new collection, "Concepts and Practice of Humanitarian Medicine," lays out the rationale, circumstances, and conditions under which humanitarian medicine can flourish. The book seeks to define the field of humanitarian medicine and includes new and previously-published articles and speeches that set out the principles of humanitarian medicine, starting with the idea of health as a human right, and examining topics such as quality of life, torture, and nuclear conflict. Contributors are all major world figures in health and human rights, including Nobel laureates Kofi Annan and Joseph Rotblat.

Read a review of the book here.

Money quote:

Sun Yat Sen, a Chinese physician who died in 1925, challenged oppressive power structures and improved the lives of millions of his countrymen. "Physicians," he believed, "are the natural attorneys of the poor and social problems fall to a large extent within their jurisdiction."

You Are What You Eat

According to the PB&J Campaign, you can reduce your carbon footprint by eating more plant-based foods. Certainly vegetarianism isn't for everybody, but, like reducing your water and gas usage, every bit helps. And your body may thank you for it, too.

For more healthy eating tips, visit our online Health and Wellness Center.

Greenhouse, Explained

Looking for answers on how greenhouse gases are effecting our environment? Look no further than the BBC.