NPR’s Kelly McEvers talks to Dr. William Nelson, director of the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, about Obama’s ambitious plan to end cancer and why we haven’t found a cure.
By Shefali Luthra
A growing number of primary care doctors, spurred by the federal health law and frustrations with insurance requirements, are bringing a service that generally has been considered “health care for billionaires” to middle-income, Medicaid and Medicare populations.
It’s called direct primary care, modeled after “concierge” practices that have gained prominence in the past two decades.
Those feature doctors generally bypassing insurance companies to provide personalized health care while charging a flat fee on a monthly or yearly basis.
Patients can shell out anywhere from thousands to tens of thousands of dollars annually, getting care with an air of exclusivity.
Patients pay about $100 a month or less directly to the physician for comprehensive primary care, including basic medication, lab tests and follow-up visits in person, over email and by phone.
The idea is that doctors, who no longer have to wade through heaps of insurance paperwork, can focus on treating patients.
They spend less on overhead, driving costs down. In turn, physicians say they can give care that’s more personal and convenient than in traditional practices. Continue reading
Most unintended pregnancies within two years of a woman giving birth could have been prevented or postponed if women had access to the long-acting contraception of their choice, according to a study in Texas.
Liberia was declared free of the Ebola virus by global health experts on Thursday, a milestone that signaled an end to an epidemic in West Africa that has killed more than 11,300 people.
But the World Health Organisation (WHO) warned there could still be flare-ups of the disease in the region, which has suffered the world’s deadliest outbreak over the past two years, as survivors can carry the virus for many months and could pass it on.
Health specialists cautioned against complacency, saying the world was still underprepared for any future outbreaks of the disease.
By Christine Vestal
For substance abusers like White, they aren’t good.
In the first two weeks after a drug user is released from jail, the risk of a fatal overdose is much higher than at any other time in his addiction.
After months or years in confinement, theoretically without access to illicit drugs, an addict’s tolerance for drugs is low but his craving to get high can be as strong as ever.
Most inmates start using drugs again immediately upon release. If they don’t die of an overdose, they often end up getting arrested again for drug-related crimes.
Without help, very few are able to put their lives back together while battling obsessive drug cravings.
By Michael Tomsic
Veteran Dave Manning served two combat deployments in Iraq and was the sole medical provider for more than 100 people on a Navy ship.
But as he contemplated his post-military job prospects, he struggled.
“Nothing I’ve done really translates over [to civilian jobs] beyond basic EMT,” said Manning, who served 15 years in the Navy and five more in the Army. “Trying to find something in the medical field without any credentials, without any licensure is tough. There’s nothing out there.”
Manning is in the inaugural class of a physician assistant training program launched this month by the University of North Carolina at Chapel Hill and geared at recruiting non-traditional students — specifically, veterans, as the country seeks to improve health care by expanding the number of primary care providers.UNC staff worked with Army officials at Fort Bragg to figure out how to translate troops’ medical experience into jobs.
Manning’s story is becoming more common as the U.S. winds down wars in Iraq and Afghanistan, and it’s especially important for North Carolina which is home to eight military bases, including some of the country’s largest installations.
Manning has experience that can’t be found in a classroom, and some in the UNC medical community wanted to capitalize on that.
“The medics and the corpsmen are often very skilled in acute medical care of younger people,” said Dr. Paul Chelminski, the director of UNC’s new Physician Assistant Program. “They’re extremely skilled in trauma care if they’ve been deployed.” Continue reading
More than 5,000 people in Washington took their own lives during the five-year period of 2010 to 2014.
Washington’s new Suicide Prevention Plan aims to reduce that toll through unified efforts involving people and groups across the state.
For many years, the state’s suicide rate has been above the national average, prompting Governor Jay Inslee to address the tragedy of suicide in an executive order last week.
“We can stop these tragic deaths, but it’ll take coordination and cooperation,” said Washington’s Secretary of Health John Wiesman. “We know there are ways we can make a difference and this plan maps out strategies to save lives in our state.”
“Suicide is a preventable public health problem, not a personal weakness or family failure,” asserts the first core principle in the plan, which the Washington State Department of Health created in response to 2014 legislation. “Everyone in Washington has a role in suicide prevention. Suicide prevention is not the responsibility of the health system alone.”
The plan divides the work of suicide prevention into four strategic directions based on the National Strategy for Suicide Prevention.
Washington has already made headway in battling suicide with a network of coalitions, student- led clubs, support groups, behavioral health treatment, culturally tailored initiatives, trainers, and community leaders.
The state has groundbreaking suicide prevention training requirements for health professionals. The Department of Health has been involved in youth suicide prevention work for more than two decades.The new plan builds on that base to address a problem that claims an average of three lives in Washington each day.
The intent of the plan is to use data and community input to customize short- and long-term prevention and intervention tactics to best serve specific populations, avoiding a one-size-fits-all approach.
Toward that end, a broad range of contributors and steering committee members participated in drafting, reviewing and completing the plan. As the document makes clear, suicide is a serious public health problem that everyone can play a role in solving.
There are small easy steps that we can take to tackle the burgeoning problem of obesity. One of those solutions is surprisingly simple: use smaller plates.
There have been over 50 studies examining whether or not smaller plates help in reducing consumption. Despite all these studies, there is surprisingly little consensus on the effect of smaller plates. Some find that smaller plates help reduce consumption, but others do not.
New research published in the Journal of the Association for Consumer Research examines all these prior research projects together and finds that overall, smaller plates can help reduce consumption under specific conditions.
The researchers collated 56 previous research studies examining the effect of smaller plates on consumption. The various studies examined whether smaller plates reduce consumption for a wide variety of conditions:
Combining all the studies showed that halving the plate size led to a 30% reduction in amount of food consumed on average. In the case of plates, reducing the diameter by 30% halves the area of the plate and reduces consumption by 30%. Continue reading
What if we treated gun violence as a public health issue the way there were campaigns against drunk driving? Or safer sex practices during the HIV/AIDS pandemic?
NPR’s Kelly McEvers talks with Daniel Webster, director of the Johns Hopkins Center for Gun Policy and Research about what this would look like, and the political and personal challenges to doing research on gun violence.
Millions of consumers get health information from magazines, TV or the Internet. Some of the information is reliable and up to date; some is not. How can you tell the good from the bad?
First, consider the source. If you use the Web, look for an “about us” page. Check to see who runs the site:
Focus on quality. Does the site have an editorial board? Is the information reviewed before it is posted?
Be skeptical. Things that sound too good to be true often are. You want current, unbiased information based on research.
Where to start:
By Michelle Andrews
For people whose income changes shift them above or below the Medicaid threshold during the year, navigating their health insurance coverage can be confusing.
Ditto for lower income people who live in states that may expand Medicaid this year.
Under the health law, states can expand Medicaid coverage to adults with incomes up to 138 percent of the federal poverty level (about $16,000 for an individual). Thirty states and the District of Columbia have done so.
This week I answered three questions from readers about how Medicaid interacts with plans on the health insurance marketplaces.
Q. In my state, if my income drops below 138 percent of the federal poverty level, I have to drop my marketplace plan and sign up for Medicaid. But if my income increases and I become eligible for a marketplace plan again, what happens to any payments I’ve made toward the deductible and out-of-pocket maximum for that plan? Do they reset to zero so I have to start all over again? Continue reading
Daphne Brown, 65, was putting away the dishes in her Washington kitchen when she fell to the floor. Jane Bulla, 82, fell at home in Laurel, Maryland, but managed to call for help with the cellphone in her pocket.
Susan Le, 63, who has trouble walking due to arthritis, hurt her leg when she tripped on a pile of leaves in Silver Spring. And late one night when no one was around, Jean Esquivel, 72, slipped on the ice in the parking lot outside her Silver Spring apartment.
Falls are the leading cause of injuries for adults 65 and older, and 2.5 million of them end up in hospital emergency departments for treatment every year, according to the Centers for Disease Control and Prevention.
The consequences can range from bruises, fractured hips and head injuries to irreversible calamities that can lead to death. And older adults who fall once are twice as likely as their peers to fall again.
Despite these scary statistics, a dangerous fall does not have to be an inevitable part of aging. Risk-reduction programs are offered around the country. Continue reading
Will Roberto be able to carry the heavy boxes his job requires if he donates a kidney to his brother, Jorge? How will his family pay their bills if Roberto has to take several weeks off from work to recover from the surgery?
Will Mama consider a kidney donation from her daughter, Carla, or turn her down, worried the procedure will keep Carla from having another baby?
These two telenovela plots have gripped some viewers in the past few months. But don’t expect to see the Spanish-language dramas on a network or streaming service. They’re customized for Infórmate, a new bilingual website dedicated to using culturally familiar methods to educate Latinos about options for living kidney donation.
The marketing strategy is intended to address a growing need among Latinos. Kidney failure in this population has increased by more than 70 percent since 2000, and more than 23,000 Latinos are on the kidney transplant list, according to federal statistics.
But too often, researchers and doctors said, families are not aware of the transplant regimen involving a live donor and have unfounded fears about what could happen if they volunteer to offer a kidney to a relative or friend.
“Right now, Latino patients often don’t learn about live kidney donation until they are in crisis, and that is a bad time to be learning about something complex and somewhat foreign to their culture,” said Junichiro Sageshima, a transplant surgeon at the University of California, Davis. Continue reading
By Christine Vestal
Dr. Marvin Seppala wrote a book on conquering drug addiction with counseling and group therapy.
The spiritual, abstinence-based strategy pioneered by Alcoholics Anonymous helped him overcome his own alcohol and cocaine addiction when he was 19. As medical director of Minnesota’s fabled Hazelden clinic, he watched it work for patients.
As the country’s opioid epidemic worsens — every day, more than 70 Americans die from overdoses, and the numbers are climbing — only about a fifth of the people who would benefit from the medications are getting them.
In 2007, Seppala began working at Beyond Addictions, a now defunct treatment center in Beaverton, Oregon. Instead of relying solely on counseling, the center gave its patients a relatively new medication, buprenorphine, to relieve their drug cravings.
Back in Minnesota, his patients had been bailing out of treatment to use illicit drugs again. In Oregon his patients on buprenorphine weren’t relapsing or overdosing — they reported feeling “normal” again.
Nearly a decade later, doctors and brain researchers agree that medications such as buprenorphine, methadone and naltrexone are the most effective anti-addiction weapons available. Nevertheless, more than two-thirds of U.S. clinics and treatment centers still do not offer the medicines. Many refuse to admit people who are taking them.
The result is that hundreds, perhaps thousands, of Americans are dying unnecessarily, victims of an epidemic that killed more than 28,000 people in 2014 — more than auto accidents, homicides or suicides.
The research is unassailable: Staying in recovery and avoiding relapse for at least a year is more than twice as likely with medications as without them. Medications also lower the risk of a fatal overdose.
Addicts who quit drugs under an abstinence-based program are at a high risk of fatally overdosing if they relapse. Within days, the abstinent body’s tolerance for opioids plummets and even a small dose of the drugs can shut down the lungs.
And yet as the country’s opioid epidemic worsens — every day, more than 70 Americans die from overdoses, and the numbers are climbing — only about a fifth of the people who would benefit from the medications are getting them, according to a new study by the Johns Hopkins Bloomberg School of Public Health. Continue reading