Healthy Dining On the Fly

I clipped an item from the Wall Street Journal a couple of weeks ago about "the Calories Lurking in Restaurant Food" (Health Journal 7/29/08). There was reference to a website - HealthyDiningFinder.com - that proved useful just this week as I found myself looking for restaurants while on the road.


Believe it or not, you can enjoy a good meal and consume just 750 calories (or less) in the process. Check it out for yourself.

Coming Soon; Another New Hospital Near You!

Here in the Milwaukee area - as is happening all over the country - we learned yesterday of plans for yet another new hospital. The news reports centered on the need for another facility and the impact on costs. Perhaps a more pragmatic view of this news would be beneficial.

The notion that the best hospital is always the nearest hospital is laughable. And yet in an emergency, when you call 911, the chances are the local fire department responding will only take you to the nearest ER. Wouldn't it be prudent to be better rehearsed for such an event? Say I have an acute heart attack. On the one hand, the local fire responders could take me to a hospital only 8 minutes away but then I might lay waiting for the 'on call' team to arrive; a team that might be only slightly experienced to treat my condition. A better scenario might be to call a private ambulance company that drives me an extra 15 minutes to a facility equipped 24/7 to give me the best care possible. Despite the extra drive time, I could actually receive care faster and from a better team of experts.

Convenience is great when it comes to fast food restaurants or drug stores. But when you need critical hospital services should convenience be anywhere near the top of your selection criteria? "Shopping" for health care when you are unconscious strapped to a gurney is unlikely. But why can't you do your homework now? It could save the life of you or a loved one.

The Health "Blogosphere"

I had the good fortune Tuesday to attend an on line "HealthCast" (webinar) sponsored by the Kaiser Family Foundation entitled "The Health Blogosphere: What It Means for Policy Debates and Journalism". Jeepers! Did I really think the RauserHealthReview was ahead of the curve . . . . . . . . ?!

I was surprised to learn HHS Secretary Michael Leavitt is a blogger. Given his enormous influence over health care policy, those with a serious interest should connect to the Secretary through an RSS feed. Ditto a Wall Street Journal Blog on health care. In fact, there are dozens of really good health care sites with a wealth of information. The Kaiser Network and WSJ blog serve as great aggregators of information from many sources while Secretary Leavitt's site - like the RauserHealthReview - is based on more personal experiences from our daily work; he of course at the very pinnacle of the health care industry while I am just a foot soldier.

Secretary Leavitt revealed he has been writing his blog since August of 2007 and now has about 2100 visitors each week; yours truly started late in May. Recent traffic is on pace for about 270 weekly visitors. (I can only imagine how many daily 'hits' the Kaiser Foundation receives at their site.) The appetite for good information on health care can only grow with the aging of America. I would sure welcome any suggestions (comments) for posts.

How To Add Years To Your Life

Wellness, wellness, wellness; everyone is talking about wellness. And with good reason. The best way to reduce your health care costs is quite simply to not get sick! ("Brilliant!")

Do you put off going to the doctor for your annual exam afraid of what he/she may find? Are you wary of how your health insurer or employer may misuse the information you provide through their on line Health Risk Assessment. These are natural (most likely unfounded) concerns we can deal with another time. For today, I'd like to make you aware of a wellness 'tool' you can access right now. At no cost. And with no worry about privacy.

Please visit RealAge; a website where you will find a wealth of information on health and wellness. You can enroll as a member and take the RealAge Test. I did. It tells me I am just a few years younger than my chronoligical age thanks in part to some generally good diet choices and regular excercise. It also coaches me in several ways to take easy steps to further cheat father time.

George Carlin used to joke that "life's journey is not to arrive at the grave safely in a well preserved body, but rather to skid in sideways, totally worn out, shouting ....holy sh*t ....what a ride!" George did have a great ride but I sure wish it could have been a little longer?

Good luck on your RealAge Test. I'd enjoy hearing how you did and if it motivates you to make changes.

Where Is The Outrage - Part II

Here is a true story about an "elderly lady" living very independently and alone until recently, in a city with no other family members anywhere close. She falls and breaks a hip, often a sure sign of decline for this age group. Taken unconscious by ambulance to the nearest hospital, she has very successful orthopaedic surgery. The break is easily fixed and the surgeon predicts a full recovery after extensive physical therapy.

Discharged from the hospital after 6 days to a rehab facility across town, her physical and mental condition deteriorates badly instead of improving. Only after three full weeks does anyone finally contact her primary care physician who reveals she had been on an antidepressant for years. This med had not been administered at the hospital or the rehab facility. The complete loss of appetite (which makes her too weak for the PT critical to her recovery), disorientation and anxiety are consistent with the withdrawal symptoms from the antidepressant.

How could such antediluvian behavior occur in today's modern world of medicine? Is it possible a patient could be so unaware of her own drug regimen (or, incapable of communicating)? Is it possible the patient's family - out of state or not - could so poorly advocate for her care coordination? Is it possible a hospital could be so uninterested in contacting the primary care physician (in this case, from a different "integrated health system"), relying instead on their own "hospitalists" to develop from scratch a treatment plan?

A national database of patient health histories would go a long way toward improving the care of patients like the one in this anecdote. There are innovative initiatives that can make this a reality; Google Health may be one of the best because their on line patient records tool is portable and users can access and control them from anywhere.

People change insurers and doctors. Emergencies obviously do not always happen near our hospital or health system of choice. Some might like the idea of an Orwellian Big Brother owning our health records but personally, my family and I will learn from the story above and take charge of our own records and be better prepared than the "elderly lady" above . . . . . . .. who just happens to be my mother . . . . . . . . and is still teaching her kid, even so late in her life.

Lessons From Another Health Encounter

At the tail end (an apt choice of words) of my annual exam the other day, my doc asked me if I wanted to have a vaccine for shingles. Then he handed me some information about this condition from the Centers for Disease Control (CDC). I have a friend who suffered from shingles for over two years so this had my attention. My first question: "what does it cost?" The answer: "$300 and your insurance probably won't cover it." I gave him the green light anyway.

That decision puts me in the top 5% of my "class" (finally!); e.g. of the 45 million folks boomer age and older who should be vaccinated for shingles, only 2.3 million have done so. It seems besides the influenza vaccine most of us know about, there are other "adult immunizations" most of us do not hear about; tetanus, pneumonia, even cervical cancer! Perhaps this is largely because our health plans don't cover them. That seems like another of the many confounding financial decisions we allow our insurers to make for us. [Actually, if I were (way) older and covered by Medicare Part D, the shingles vaccine would be covered subject to a copay I found as low as $37 with one carrier.]

I also found that had I simply delayed my decision, I could have had the same injection at a Walgreen's Take Care Clinic for just $219.99. The moral of the story: listen well to your doctors advice but then if conditions allow a little time, shop for the best deal. Of all the people who should have known that, you'd think it would be me. My Health Savings Account will be minus $300 instead of $219. Darn! And, since my risk of getting shingles has now been halved, I'll be asking my insurer for a discount when the renewal premium arrives. Which brings me full circle on this post . . . . . .

Scans or Sneakers

How sad, the sudden death of Tim Russert. (My blog of June 2nd on AED's now seems somewhat prescient!) Like this article from USA Today, there has been so much written about Tim Russert's heart. I think he would be pleased to be teaching such an important lesson even in death.

So as I contemplate the extra pounds I see in the mirror each morning, I wonder if I am also a candidate for a cardiac event. How many others are thinking the same? There would seem to be two courses of action; spend a ton of money on scans and tests and statins and more or, a little less money on a pair of sneakers. Our health insurers will no doubt see a big spike in claims over the next few months. That's OK but I also wish the health clubs would see a spike in new memberships.

I went for a jog this morning. and had a salad for lunch. Thanks Mr. Russert!

Buckle Up for Wellness

There is a growing focus on work site promotion of wellness except in the small business marketplace (90% of all businesses have fewer than 50 employees), where budgets are particularly tight and the "return on investment" (ROI) is hard to measure. That is frustrating to me. One might just as well ask, "What is the ROI for buckling your seat belt every time you get in your car?"

The best way to reduce health care costs is to not get sick. Promoting wellness is the right thing to do. And through free resources such as those available from The Wellness Councils of America (WELCOA), costs can be minimal.