Doctors Need to Put Greater Effort into Helping Patients take Better Health Decisions

Twelve years ago, the then 16-year-old boy Brian Zikmund-Fisher stood in front of the toughest choice of his life: Die from a blood disorder within a few years, or endure a bone marrow transplant that could cure him, OR kill him within weeks.

Zikmund-Fisher, now a 28-year-old assistant professor at the University of Michigan School of Public Health, chose to gamble. After nine long months of blood transfusions, a bone marrow match was found in Australia. Zikmund-Fisher then had to spend another month in isolation until his new immune system began working. Zikmund-Fisher was lucky, he survived, and decided to devote his professional life to medicine.

Having that experience, Zikmund-Fisher decided to go on to study health communication, and medical decision making. “Unfortunately, today many patients don’t learn what they need to in order to make informed medical decisions.”

To document the challenges patients face in deciding their own medical care, Zikmund-Fisher and his colleague Mick Couper, research professor in survey methodology at the U-M Institute for Social Research (ISR) led a national survey of medical decisions. The study surveyed more than 3,000 U.S. adults about nine common medical decisions and conducted that the majority of patients don’t have sufficient information to make the best decisions.

Zikmund-Fisher goes on; “I want to raise the awareness of how important medical decision making is in the lives of all Americans and how unprepared most people are to make these decisions. I see this is a public health issue.”

The findings are reported in this month’s Medical Decision Making, and below are some of the key findings from the study:

• Healthcare providers don’t always ask patients what they want to do or how they feel. For instance only 50% of patients deciding about cholesterol medications reported being asked whether they wanted them or not.
• Patients often don’t know as much as they think they do. Many patients feel well informed even when they don’t know key facts that could help them make a better decision.
• Most patients think they are more likely to get cancer than they are, and tend to think cancer screening tests are more accurate than they are.
• Men and women tend to think differently about cancer risks. Women are more active participants in cancer screening decisions regardless of how at risk they feel, whereas men tends to get involved only if they feel that they are at high risk.
• Most patients don’t use the Internet to help them make common medical decisions, and healthcare professionals remain the most important information source.
• African-American and Hispanics are less knowledgeable than other patients about medications to treat high cholesterol and more likely to say that their doctor made decisions about cholesterol medication for them.

Zikmund-Fisher is supported by Dr. Michael Barry, professor of medicine at Harvard Medical School and president of the Foundation for Informed Medical Decision Making, which also funded the study. Dr. Barry says “Informed consent isn’t real if patients understand so little about the tests and treatments they are getting.”

So, what is to be done to ensure that patients are part of the decision making, and carefully informed of their options? The Patient Protection and Affordable Care Act, signed by President Obama earlier this year, has many provisions aimed to ensure patients are partners in medical decision making. This includes making patient decision aids for common healthcare decisions more widely available and promoting their adoption in the U.S. health care. Zikmund-Fisher summarizes; “Recognize that you have a right to be involved in your own medical care. If your doctor only tells you why you should do something and doesn’t discuss reasons why you might not do it, ask for that information anyways. Don’t think of it as medical care. Think of it as your care.”

Making informed decisions about healthcare is vital! The Novasans website is dedicated to supply you with as much information as possible so that you feel secure in your decision before choosing to go abroad for healthcare. We look forward to engaging with you on the website and on the Novasans Facebook page.

U.S. Doctors Travel Abroad to Treat American Medical Tourists

American patients going abroad for surgery is common these days. But American doctors working abroad to cater to patients from their own country is a notable new phenomenon. The California based medical tourism company Global Medical Excellence LLC has entered into contracts with U.S. Board Certified surgeons who agree to travel to Lebanon or India (and soon other countries) to perform sugeries on GME’s patients. They will also provide a comprehensive insurance coverage to the patients to mitigate all risks.

This is seen as a step to cater to those patients that are more security oriented, and according to Dr. Khoury, an expert in International Finance, this is a sensible option for the safety-conscious medical tourism patient, especially those with limited insurance coverage or high co-payments. GME is right now in various stages of negotiation with doctors, and expects to have around 400 doctors in 7 major specialties by the end of June this year. Wheter their new take on patient service will be a success is yet to see.

Would you rather be treated by an American doctor abroad, or would you prefer the native doctors? Comment below or on our Facebook page.

New Video on Healthcare Reform’s Affect on Medical Tourism

The Medical Tourism Association has now released a video of their CEO, Jonathan Edelheit, discussing the American Healthcare Reform’s affect on the medical tourism industry. This topic was also addressed at the 1st Global Healthcare & Medical Tourism Conference in Seoul, Korea, earlier this spring.

In the video, Edelheit emhpasizes the positive impacts on outbound medical tourism in the United States. Accordig to Edelheit, health insurance costs will significantly rise with the passage of the healthcare reform, resulting in making global healthcare more attractive to US citizens.

The video is available on the new informational center launched by the Medical Tourism Association, containing updates on the healthcare reform’s affect on medical tourism.

Study Supports Acupuncture Treatment for Pain Treatment

Acupuncture has been widely used as pain relief for a long time. But some health practitioners have questioned its authenticity. However, a new study, performed at the University in Munich, proves that the traditinal Chinese method can be used for pain treatment.

In the study, performed on 24 healthy volunteers, Dr. Philip Lang with colleagues used quantitative sensory testing to identify changes in pain sensitivity with acupuncture. When applying acupuncture to the leg, the researchers found that pain thresholds actually increased by up to 50 percent, even in the untreated (contralateral) leg.

In spite of the small quantity of research patients, and the modest effects, the researchers believe it provides the basis for future studies in individuals with chronic pain, where the effects may also be more dramatic.

The leading author of the study, Dr. Dominik Irnich says that the results provide a scientific background for the ancient practice of acupuncture. “Our results show that contralateral stimulation leads to a remarkable pain relief. This suggests that acupuncturists should needle contralaterally if the affected side is too painful or not accessible – for example, if the skin is injured or there is a dressing in place.”

Dr. Steven L. Shafer, Professor of Anesthesiology at Columbia University acknowledges the results as an important preliminary finding. “Reproducible findings are the cornerstone of scientific inquiry. The authors have clearly described their methodology, and their findings. If other laboratories can reproduce these results in properly controlled studies, then this provides further support for the scientific basis of acupuncture. Additionally, the ability of quantitatie sensory testing to identify specific types of nerves involved in pain transmission may help direct research into the mechanism of acupuncture analgesia.” says Shafer.

The study is published in the May issue of Anesthesia and Analgesia, which is the official journal of the International Anesthesia Research Society (IARS).

Calculate Your Heart’s Exact Age

A new online tool that calculates the exact age of your heart, and when you are most likely to have a heart attack or stroke, has been developed by scientists at the Heart Foundation and Auckland University, New Zealand.

The heart forecaster is known as Know Your Numbers. The name springs from your heart numbers, which are your blood pressure and your cholesterol ratio. These two numbers give you insight into how healthy your heart is and also the effect that your lifestyle has on your body.

With a few simple questions the Heart Age Forecast will estimate the current condition of your heart. If you want to have very accurate answers you need to submit your cholesterol levels and blood pressure. However, it will also do the calculations based on average numbers for your age and other risk factors.

If you find yourself to be in the risk zone for any heart condition, the Heart Foundation will provide you with a six-week health plan to help you turn back the clock. With the aid of the program, you will address areas in your life that affect your heart health and are most in need of change. At the end of the program, your heart’s age will hopefully have dropped, and you will be both healthier and happier.

Have you calculated your heart age, and enrolled in the program? In that case, comment below or on our Facebook page.

How to Manage Shoulder Arthritis

Arthritis is a medical condition that affects joints, causing pain, swelling and stiffness. Many times it is characterized by inflammation in the joints, such as knees, wrists, ankles, elbows or hands. There are over 100 types of arthritis, and the illness usually affects elderly. Arthritis is more common in women than men at all ages, and affects all ethnic groups, cultures and races.

Arthritis is defined as a chronic disease, but there are possible treatments to relieve the pain. Below is a list for common treatments for shoulder arthritis.

• Get physical therapy
• Apply ice to the shoulder several times a day for up to 30 minutes at a time
• Take Anti-Inflammatory medications (NSAIDs)
• Rest your arm as much as possible, and avoid activities that could strain the shoulder
• Get cortisone injections
• For some specific symptoms of shoulder arthritis, shoulder arthroscopy might be helpful
• Take joint supplements, such as Glucosamine
• Apply moist heat to the shoulder

It is important to remember that not all treatments are appropriate in every patient. Therefore, you should have a discussion with your doctor to determine which treatments are appropriate for your shoulder arthritis.

Botox Injections May Relieve Tennis Elbow

Botulinum toxin, also known as Botox, canprovide relief for “tennis elbow”, a new study claims.

The study was performed at Imam Khomeini Hospital Complex, which is affiliated with the Tehran University of Medical Sciences in Iran. All the 48 participants had undergonde previous therapeutic interventions that failed. When injecting Botox, the physicians determined the injection site based on each patient’s forearm lenght, instead of a fixed injection site which has been used before. Botox needs to be injeted properly to avoid potential paralysis. When paralyzing a muscle it is very important to know the appropriate injection site. Injection at a fixed distance from anatomic landmarks could result in inadequate paralysis.

Dr. Mohamad Mortazavi at the Iman Khomeini Hospital in Iran says “We found that pain at rest and pain during maximum pinch were significantly reduced in patients with lateral epicondylitis (tennis elbow) after botulinum toxin was injected at the site based on precise anatomic measurement of each patient’s forearm lenght. However, this method caused a decline in maximum strenght and resulted in extensor lag.”

The conclusion from the autors is that precise measurement to guide injection of Botox can be effective in the management of chronic “tennis elbow”. However, it should be used for patients whose job does not require finger extension. Treating “tennis elbow” is a new possible way to use Botox, but as the researchers themselves states, more studies have to be done before this could take out other current treatments.

Gaming Addiction is Just as Bad as Alcohol and Drugs

Believe it or not, but addiction to computer games can be as serious and as strong as an drug and alcohol dependence. This is presented in a new study, performed at the Royal Australian and New Zealand College of Psychiatrists.

Amongst the 1,945 participants, about 8 per cent were identified as problem gamers. Most of the gamers had been gaming for extended periods. They had fewer friends in real life, and had lost a significant relationship due to excessive play. Additional problems were restlessness, a craving to play even more, and irritability if they weren’t allowed to play.

One of the co-writers of the paper, psychiatrist Guy Porter, said: “Any pleasurable activity has the potential to become addictive or to form a repetitive pattern of use. Games are very enjoyable and provide a very positive experience for most people who use them. But there are a small number of people out there – those who are playing for eight hours plus a day – who have got a problem with it.”

Do you know anyone who is addicted to gaming, or have you yourself had problems with too much gaming? When the Novasans website is lauched, you can read more about gaming addiction, and contact healthcare providers all over the world specialized in treating gambling addictives. Comment below or on our Facebook page.

New Breakthrough in Stem Cell Research Creates Hope for Heart Patients

So called “Master” cells from veins left over from lifesaving bypass surgery may belp treat future heart problems, scientists at University of Bristol claims. With this new finding, treatments to repair damaged heart muscle will come one step closer.

The researchers extracted stem cells from the veins, then used them to stimulate new blood vessel growth in mice. A section of vein, usually from the patient’s leg was removed, and used to replace a blocked or narrowed section of the heart artery. The researcher took a leftover piece of the vein section, and in the laboratory, they managed to extract “progenitor” cells from the veins and persuaded them to increase in number. When the stem cells then were injected into the leg muscle of a mouse, the cells appeared to trigger the development of new blood vessels and improve blood flow.

Pr. Paolo Madeddu, who led the research says, “This is the first time that anyone has been able to extract stem cells from sections of vein left over from heart bypass operations. These cells migth make it possible for a person having a bypass to also receive a heart treatment using their body’s own stem cells.”

While the findings are viewed as very good news by the stem cell research industry, some experts are claiming that much more work is needed before such cells could be used widely in humans.

IVF Errors are on the Rise

During the last year, mistakes made by fertility clinics have nearly doubled. These new figures were released by tht Human Fertilisation and Embryology Authority (HFEA) recently.

According to the statistics, insidents rose from 182 to 334 between 2007-2009. The accounted mistakes range from wrong embryos being implanted in women, clinics accidently switching of fridges containing embryos, or using a different man’s sperm to fertilize eggs.

These new figures are staggering, and have caused the HFEA to call on the British government to impose strict laws in order to make the clinics accountable for their mistakes.

However, the organization is also being accused of not making sure that their suggestions are being implemented amongst the embryologists. “I think the key failure of the HFEA is that when they ask clinics to put in special procedures, they’re not enforcing them. It’s important that when you’ve identified a weakness in a procedure, you quickly enforce it, and don’t wait a year to do so,” Sammy Lee, one of London’s leading embryologists, says.

It is important to remember that IVF is a fairly new procedure, the universal guidelines have not been wholly outlined yet, and as the inspections are getting more rigid, more mistakes are discovered.