Health Cares

The statistics are everywhere: most of the adults in the United States are overweight or obese. These conditions are, of course, responsible for increased health care costs owing to chronic diseases such as diabetes, high blood pressure, high cholesterol, and heart disease. The patient may pick up some of these excess expenses, but society incurs the majority of the costs in the form of increased insurance premiums across the board, bigger taxes to pay for government-sponsored medical care or unemployment benefits, and decreased productivity including lost wages and reduced workplace efficiency.

I once treated a patient who was in her 90s. She was less than 5 feet tall and had never weighed more than 90 pounds. But, she was tough as nails and had lived a great life. I came to advocate for her when the internist at the skilled nursing facility in which she lived insisted that she have a mammogram. She had already been diagnosed with breast cancer in her 70s, but was healthier than anyone else her age now. She knew that even if she did receive another diagnosis of breast cancer at this stage in her life, it would probably not be treated and it almost certainly would not shorten her life. She refused the mammogram, much to the dismay of the healthcare providers that treated her like a checklist of tests and screenings and medications. She lived to be well over 100 years old, without her mammogram.

The search for eternal youth is as old as time itself. The theme of immortality winds its way through religion, mythology, poetry, fiction, and modern movies. Usually, stories of those who have achieved immortality expose the curse of eternal life, rather than the blessing of perpetual youth. While living forever may never be possible, life expectancy is steadily increasing, and healthier — that is, more youthful — aging may actually be possible.

Groucho Marx once said, “A clown is like an aspirin, only he works twice as fast.” Indeed, research suggests that humor can minimize our perceptions of physical pain. Various theoretical explanations have been offered to explain the analgesic effects of humor, and humor’s potential role in pain therapy appears promising.

The first doses of vaccine for the Influenza A H1N1 virus (“swine flu”) should be available in October of 2009. Due to an initial limited supply, the World Health Organization (WHO) recommends that healthcare workers should be first in line to receive the vaccine. Immunizing healthcare workers against the H1N1 virus not only provides personal protection for the workers, but also protects patients and reduces absenteeism in healthcare settings. Unfortunately, a recent study published by the British Medical Journal (BMJ) reports that less than half of healthcare workers surveyed are willing to be vaccinated against pandemic flu

Scientists love to solve the unanswerable questions in life, wrapping up tidy answers with equations or charts or definitions, leaving no gray area. Unfortunately for some researchers, not everything is so black and white. Can we really define love? Is success simply the sum of the right variables put into the right equation? Does happiness have a graph or flow-chart that guarantees statistically significant results?

The misuse of antibiotics around the world is increasing due, in part, to diagnostic uncertainty and patient expectations. One of the most common causes of antibiotic use in the United States, as well as other industrialized nations, is lower respiratory tract infections (LRTIs). Unfortunately, LRTIs are, for the most part, unresponsive to antibiotics. The inappropriate use of such antibiotics, therefore, increases medical costs, increases the risk for side effects and drug interactions, and — most importantly — increases the risk for the development of antimicrobial resistance.