Traveling Patients, Traveling Disease, Ebola

Traveling patients, traveling disease, and Ebola | OUPblog: "... the terrifying truth is that Ebola is just the tip of the iceberg. Diseases have long traveled with patients, and as the phenomena of medical tourism and the more general globalization of health care grow, these problems are likely to grow as well. Medical tourists are very good targets of opportunities for pathogens. Many are traveling with compromised or suppressed immune systems to destination countries for treatment with relatively high infection rates, including the risk of exposure to multi-drug–resistant pathogens. Doctors typically distinguish commensals—the bugs we normally carry on our skin, mouth, digestive tracts, etc.—from pathogens, the harmful bacteria that cause disease through infection. But what is commensal for a person in India might be an exotic pathogen for a US population. Medical tourist patients are transporting their commensals and pathogens to the hospital environments of the destination countries to which they travel, and are exposed to the commensals and pathogens of hospitals and population at large in the destination country. These transmissions tax the health care system and the knowledge of physicians in the home country to whom the new microbe may be unknown, and diagnosis and treatment more difficult." (Read more at link above.)

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Majority of doctors opposed to full access to your own electronic records

Doctors oppose transparency, patient access to records--

Majority of doctors opposed to full access to your own electronic records | Ars Technica: "Technology is making transparency easier than ever and with the advent of electronic medical records, you might think doctors and other caregivers would embrace transparency for patients. After all, in the US and most modern counties, you have the right to review your own health records. Yet a recent survey by Harris Interactive reported first at Computerworld reveals that doctors aren't big fans of full transparency. A survey of 3,700 doctors in eight countries revealed that only 31 percent believe that patients should have full access to their own medical records via electronic means. That's less than one in 3. The majority of those surveyed, some 65 percent, supported "limited access," while the remaining 4 percent believe there should be no access granted to patients. So, despite the fact that we have rights to review and amend our records, doctors don’t want it to be easy for us to do so via electronic means. I find these numbers incredibly disappointing, although not surprising. While there might be many motivations for wanting to deny patients full access to their medical records, I know firsthand one such motivation: these documents can be terribly inaccurate. Mistakes can run from the serious to the banal. Ars’ own Casey Johnston told me her medical records reported the wrong birthdate for her. Not a huge deal, but also, sort of a silly mistake to make. I experienced something a little more serious. A few years ago I decided it was time to get some life insurance for both my wife and myself. Because we were seeking a significant policy, we were put through a fairly intense wringer, including a battery of medical tests conducted in our home and an extensive review of our medical records, in addition to multiple interviews. Through this process, I came to realize that my own medical records were littered with inaccuracies. . . . " (read more at the link above)


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Patients Should Think About Costs

Getting Patients to Think About Costs - NYTimes.com: " . . . A majority of the participants refused to consider the expenses borne by insurers or by society as a whole when making their choices. Some doubted that one individual’s efforts would have any real overall impact and so gave up considering cost-savings altogether. Others said they would go out of their way to choose the more expensive options, viewing such decisions as acts of defiance and a kind of well-deserved “payback” after years of paying insurance premiums. Underlying all of these comments was the belief that cost was synonymous with quality. Even when the focus group leaders reminded participants that the differences between proposed options were nearly negligible, participants continued to choose the more expensive options as if it were beyond question that they must be more efficacious or foolproof. The study’s findings are disheartening. But Dr. Goold and her co-investigators believe that public beliefs and attitudes about cost and quality can be changed. They cite the dramatic transformation in attitudes about end-of-life care as an example of how initiatives to improve understanding can lead people to make higher quality and more cost-effective decisions, like choosing hospices over hospitals. “We need to begin to talk about these issues in a way that doesn’t turn it into a discussion pitting money against life, and we need to find ways of getting people to think about not spending money on things that offer marginal benefit” Dr. Goold said. “Because it’s going to be tough otherwise trying to implement any cost-saving measures, if patients don’t accept them.”


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