USA: The World's Best Medical Care?

I seldom read the New York Times, because I pretty much know what I'm going to get even before picking up the paper. (image credit) But, in this morning's editorial section, there is an essay called, "World's Best Medical Care?" Here's the opening paragraph:

Many Americans are under the delusion that we have “the best health care system in the world,” as President Bush sees it, or provide the “best medical care in the world,” as Rudolph Giuliani declared last week. That may be true at many top medical centers. But the disturbing truth is that this country lags well behind other advanced nations in delivering timely and effective care.

Groups like the World Health Organization and the Commonwealth Fund have ranked the US low in certain areas. The NYT piece goes on to outlines eight areas in which the US could do better which include areas like lack of universal health care, high infant mortality rate, low life expectancy at age 60, poor patient satisfaction, and being slow to adopt electronic medical records.

I'm not going to dispute most of this article. There are some good points and it is a decent analysis of how the American health care system could improve. But, like most things in the New York Times, I took it as a political commercial as opposed to an informative piece of journalism.

After throwing the US health care system under the bus for two pages, the NYT does try to make a comeback with this kind of backhanded compliment - or maybe it's not a compliment.

Top-of-the-line care. Despite our poor showing in many international comparisons, it is doubtful that many Americans, faced with a life-threatening illness, would rather be treated elsewhere. We tend to think that our very best medical centers are the best in the world. But whether this is a realistic assessment or merely a cultural preference for the home team is difficult to say. Only when better measures of clinical excellence are developed will discerning medical shoppers know for sure who is the best of the best.

Is health care the most important issue in the upcoming US presidential election? Some people think yes and this editorial is proof of that. For me, it's just too early. It's a long 15 months until the election. However, I do appreciate that health care issues are probably getting a little more press than they did a year or two ago. Nothing will change without getting the public's attention. As I always say, we'll just have to see how this all plays out....

Paintball practice

In today's addition of Dr. A's small town news, here's a funny quote from the police blotter. It's always interesting to see what our citizens are doing around here.

A state Route 9, Salem, man reported Wednesday someone in a passing car fired paintballs that struck his son-in-law’s vehicle and nearly some children playing outside. Denny reportedly chased the vehicle into Perry Township, where it was stopped by police.

Viewing the video above, I never knew that paintball is such a big deal to some people. Of course, who am I to judge? I mean, for enjoyment and relaxation, I hit a little white ball around - but I love it!

Microburst

The weather experts were in town yesterday examining the damage (image credit) to declare if indeed a tornado went through here two days ago. In my meteorlogically naive mind, I thought it was self evident. I mean, there's wind and rain, and what looks like tornado damage. If it walks like a tornado and talks like a tornado, isn't it a tornado?

I guess not. In today's local paper, the official ruling is that what happened on Thursday is called a microburst. Huh? To me, that sounds like some like of science fiction term where Martians fly down, blow up your supermarket and gas station, and then leave.

“We were lucky,” Salem police Chief Robert Floor said after a Friday press conference on the storm damage at Eastgate Plaza.

“Yes, you were,” said Richard Kane of the National Oceanic and Atmospheric Administration.

Kane, a meteorologist based in Pittsburgh, was in Salem to advise city officials and the media that Thursday’s storm damage was not caused by a tornado but an 85 mile-per-hour microburst. Kane placed the event at 1:15 p.m.

Of course, being a skeptic on this, I did my own research on this. Don't get too excited. It was just a couple of Google searches. I did find some interesting information - at least for my education.

According to weather.com, here is the definition of a tornado: A tornado is a violently rotating column of air extending between, and in contact with, a cloud and the surface of the earth.

According to this article on the NOAA website, here is the definition of a microburst: A downburst is a strong downdraft which induces an outburst of damaging winds on or near the ground. Damaging winds, either straight or curved, are highly divergent. There are some interesting illustrations here.

Fortunately, there were no fatalities (there were rumors to the contrary) and there were no serious injuries -- just minor cuts and abrasions from flying glass and debris. Life is pretty much back to normal now.

The people around here (including me) will be trading "Where were you when it happened?" stories for a long time. Stuff like this never happens around here. Here's my favorite quote from the article.

No one was sucked out the door [of a local business during the microburst], the spokesperson said debunking a rumor, but a customer’s money was.

How funny is that? When I read that quote, I couldn't help but think of the 1996 movie called Twister with Helen Hunt (Ah... Helen Hunt...) and that what's his name guy. I remember seeing farm equipment and even animals being drawn up into the special effects tornados. Cool stuff - especially for 1996. Here's the trailer.

Tornado

This is what happened to my car (just kidding). Very weird here yesterday afternoon. I saw patients here at the office in the morning, and then actually had the afternoon off. This means that I went to the hospital and was in the medical records department doing some paperwork.

As the rain and wind got worse, at around 1:30pm, I said to myself, "At least I can finish more of my paperwork." I did hear some fire engines and police sirens outside. At the time, I didn't think it was that big of a deal. I mean, it is a hospital. There are sirens blaring around here all the time.

Little did I know what was going on outside. Less than a mile from where I was sitting, there as a possible tornado taking place. You'll see pictures of what was happening here, here, here, and here. Sheesh!

Where the picture was taken above was less than half a mile from our office. Authorities had to evacuate the area around the supermarket above because of a propane tank that came loose.

So, what our office staff told me today (because I wasn't here), was that authorities came into the office around 2:30pm yesterday afternoon and evacuated this entire medical complex/plaza. (I was at home at this point underneath my desk.)

It calmed down a bit for a couple of hours, then another line of storms came through. The winds were not as strong later in the afternoon - but a lot more rain. This storm will definitely be the talk of the town today. I may have an update for your later.

Update: Here's a quote from the AP story on the storm -- "Wind also damaged a restaurant and blew out car windows in a supermarket parking lot in Salem, about 15 miles southwest of Youngstown."

Genes may influence friendships

What really influences you - Genetics or Environment? This is a question that researchers have been asking for a long time. And, they have been applying this question to all aspects of the human condition. (image credit)

What about the friends that you pick? Is it the outside environment that influences you more, or your genetic make up? A study published in the Archives of General Psychiatry tries to answer this question. The researchers interviewed about 1,800 male twins aged 24-62 born in Virginia and listed in the Virginia Twin Registry. (WebMD)

In Kendler's study, identical twins were more likely than fraternal twins to make similar choices in their friends. So the researchers reason that genetics may play a role in choosing friends.

That doesn't mean that identical twins always chose the same type of friends. The findings aren't quite that iron-clad.

But Kendler's team estimates that when kids are 8-11 years old, genes explain 30% of their choice in friends, wiih that percentage rising to about 50% from age 15-25, as people mature into independent adults.

As always happens when this question is asked, the answer is somewhere in the middle. Yes, genetics play a role somewhat. And, yes, the environment plays a role somewhat.

For me, it's just interesting to think back to the friends that I had in childhood and compare them to the personalities and people who I am friends with today. I guess I do see some trends. I will be interesting to see as the rest of my life plays out to see if this trend continues.

Take cover!

Days and days of hot and humid weather around here culminated with big storms this afternoon - even with some tornados. It's still very windy and lots and lots or rain - as the above radar picture shows. Don't worry. I'm hiding under my desk - and blogging! I'm just a blogaholic, I guess....

Vasectomy for iPhone?

No, this is not a personal anecdote. But, this does beg the question, what would you do for an iPhone?

There's a story in today's Denver Post about one Sean Johnson (Yes, Mr. Johnson - How can I make this up?). Apparently, he was vacationing in Colorado Springs for a family reunion. He purchased an iPhone, but, according to the story, did not seek the permission of his wife first. Here's the rest of the story...

"We have five kids combined - sort of like our very own Brady Bunch ... and we have two children together," Johnson explains. "And she had made me promise that I would get a vasectomy at some point. I love having children, so I always thought in the back of my mind that there would be a chance that she would change her mind. But she didn't seem like she was going to be convinced. She didn't really want to go through another labor."

Who could blame iWife?

When the family met up at Denver International Airport to complete the trip, however, Johnson was "pouting" and carrying on as children often do without their toys.

That's when the wheels were set in motion for one of the most infamous deals in the history of nerds.

The deal stipulated that Johnson obtain a vasectomy, putting an end to the idea of more Johnson children. In turn, Johnson would be allowed to splurge on his iPhone.

Now, who would ever do this? I can just picture what this guy looks like and what his computer room at home looks like. There is no way that I (a post-modern and metrosexual man) would give into a deal like this - HA! So, did Mr. Johnson do through with this? This final quote sums it up...

"It's far from perfect, but it's by far the most perfect phone I've used."

(thanks to the Today in iPhone podcast for the story) (image credit)

Pinoy Prisoner Thriller

Judging by the almost 4 million views already on YouTube, I'm probably the last person to hear about this video. But what do you get when you put the above three words together? Courtesy of Wikipedia, here's what I found.

Pinoy: Pinoy is a demonym used by Filipinos for their compatriots in the Philippines and around the world.

Prisoner: A person incarcerated in a prison or jail or similar facility.

Thriller: Thriller is a 1984 hit single recorded by Michael Jackson.

Being a Filipino-American myself, I'm not sure whether to take pride in this video, or be really embarrassed. I mean, this is prison! I'm trying to think about how all of this was organized. And, in doing more YouTube searches, this is not the only song that this group does. Oh well, what did you think the first time you saw this?

Fechr.com

This is Doctor Anonymous for Fechr.com. I apologize if this post sounds like a commercial, but this is an interesting website that is worth checking out - especially for new blogs. (Disclaimer: I have not and will not receive any financial compensation for this post.)

Bobby Griffin and his former blogger site, The Bestest Blog of All Time, have definitely driven more traffic my way, and I very much appreciated that. His new project is described below, in his own words...

Fechr.com (pronounced feature) is a new site with a simple idea. 1 site, 1 day, 100+ visitors! Every day, at around midnight EST, a new site is “fechr-ed” on the home page. Get featured is FREE for a limited time! I specialize in bringing traffic to those who deserve it! So if you think you deserve it, just stick with me and we’ll get you some.

How can your site be featured? It's FREE! Eventually, once the site grows a little more in popularity, I plan charging in the neighborhood of 1-4 cents average per visitor to be featured (ex. if site is averaging 1000 visitors per day, would charge in the $10-$40 range, depending on demand). But until we get to at least 500-1000 average visitors per day, getting featured is FREE!

All you need to do is write up a short blog post about Fechr.com (ex. what we do, what you think of the idea, explain to readers how to get their site featured, etc.) and submit it at our site.

Since the free features idea is brand new, if you submit your site today, you have a good chance of being featured (and receiving 100+ visitors) as early as tomorrow! Even if the line does get a little long and you aren't featured immediately you'll still have a link in our buzz directory in the mean time.

If you have any other questions about the site, you can check out the FAQ or email me BobbyGriffin@gmail.com! Thanks!

Dr. A & iPhone: Episode deux

Welcome back to the adventures of Dr. A & iPhone. (Cue theme music) Let me get iPhone out of my trusty utility belt (Insert cool sound effect here). Here we go! (image credit)

Even though I'm still pretty much a novice at this, I've already received a couple of questions. The first is from Rahul.

Hi Doctor, I'm a medical student preparing to begin MSIII. Would you recommend usage of iphone as a PDA w/ medical software? Thanks -R

The second is from Mary Lu:

Yo Doc A! Welcome back from the boonie's of iPhone-land. You've been missed. The PharmD Husband is looking at one of those things to enhance his work as well.. (he's a hospital director of pharmacy,)

He asked me... to ask you... if you get any good ideas or finds on applications that can make his time/life more productive let us in on the info, please? Between us, I know he's looking for any excuse to get a new iPhone!

Let me tell you, I am very much flattered by these questions. In combing the medical blogosphere, I'm not really seeing much as far as resources for those of us with the iPhone. I have no idea how helpful this post will be, but I'm happy to share some thoughts.

First of all, Rahul, good luck as you begin your third year of medical school. I very much remember those days, and, to he honest, I'm glad that I'm done with them (hehe). At least for me, third year was tough. But, if I got through, I know that you can.

Getting back to your question (and this kind of relates to Mary Lu's questions as well), as far as I know, there is no medical software specifically written for use on the iPhone (yet). The stuff that I've seen out there makes use of the iPhone's wireless internet connection.

For example, I've read some things on medgadget that promote themselves as software for the iPhone. What I've seen them do is have the iPhone log into their medical website - and that's what they're calling medical uses of the iPhone. I don't really buy that.

I used to have a palm product as my PDA. At least for me, the most useful medical software I was using was epocrates. I was using this both in the office and in the hospital. ("Mandatory" conflict of interest statement: In no way am I compensated by the company mentioned above. I'm just a happy consumer of their product).

As of this point, there is no epocrates software specifically written for iPhone (yet). That being said, my hospital does have wireless internet, and what I do instead is that I log into the epocrates website via iPhone to find out the medication information that I need. This workaround is doing ok for now. But, if there are any epocrates employees out there - Please write software for iPhone - Pretty please.....

Mary Lu asked about "applications that can make life more productive." In reading the blogs, there's a bunch of stuff that people are writing, but it seems like all of them involve entering programming code into the iPhone - meaning there is not really an easy user interface (yet) to do these things.

I'm always weary of breaking into the software code of iPhone. I call myself tech "educated" but not necessairly tech "savvy." Call me chicken, but I'm afraid of crashing my iPhone and then missing an important call or text or whatever. So, I'm eagerly awaiting easier ways to get cool applications on my iPhone.

Thanks so much for your questions. I have no idea if this was helpful, or not. At least it was fun for me. Keep those questions coming and I'll do what I can to answer them. Well, that's it for now. (Cue theme music). Join us next time for the Adventures of Dr. A & iPhone.....