Shaw's Eco-Logic

This HND piece explores the reasons behind the inescapable fact that better health correlates with more wealth, all the way from the poorest to the richest. This correlation is simply another demonstration of the so-called "social determinants of health," and we should focus on breaking the molds.

We look at the possible influence of national health insurance on this phenomenon, but a comparison of general health between similar American and British cohorts brings another finding: Brits have better health, even if we tend to have similar longevities. That is, we get sicker sooner, and can be kept alive longer.

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This HND piece begins with the origin of the proverb "Physician, heal thyself," and then gets into the significant problem of physician burnout. We include the somewhat sanitized version of this issue, as provided by a federal agency, and expand on it. We give you the reasons behind the causes of burnout, going beyond the agency's treatment.

Then we segue into the story of Debra Blaine, MD, a professional coach who helps docs in need. She knows her stuff, as she was a burnout herself after 30 years in practice. Since burnout is said to affect more than 50 percent of physicians, this problem needs to be dealt with! Who wants to be treated by a burned-out doctor?

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This HND piece discusses the mostly ignored matter of fraud in scientific research. While such fraud can occur in several ways, the most grotesque method is to simply fudge the data, so that the desired conclusion is reached. Given the large number of technical journal articles that are retracted each year, this is a big deal. Moreover, it is not just a "victimless" crime, even if you don't care about the funding agency being defrauded. Deaths, lots of them, can occur if fake data is used to establish medical guidelines.

The trouble is, research fraud is seldom acknowledged, let alone punished. We spotlight a case in which evidence of fraud was overwhelming, but the university involved did nothing, and the professor who fudged the data remains employed. Given the poor quality of academic research, not to mention the utter lack of any conceivable practicality in so many instances, flat-out fraud makes an already bad situation so much worse.

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This HND piece defines the two very different meanings of "corporate medicine," and then proceeds to discuss the more negative one. That is, "The overall ethos of much of modern American medical practice, whereby the healing professions are increasingly controlled by people not directly involved in patient care, who have lost contact with the realities of day-to-day clinical practice."

In other words, our current situation, in which healthcare is just another commodity to be bought and sold. Patients are now customers, and physicians are too often judged by the variety of Keurig pods in their waiting rooms, the quality of the free Wi-Fi, and their willingness to write unneeded scripts. Not much is left of the doctor-patient relationship, compared to pre-Medicare days.

We spotlight some of the ideas of former doc turned coach (to physicians) Debra Blaine, MD, for straight-up truth and commentary.

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This HND piece is a reaction to an article in The BMJ entitled "Time to stop commercial distortion of healthcare evidence and practice, experts urge." The gist of the story is that we have to figure out a way to temper the influence of evil corporate interests (read Big Pharma) in research results. A related issue is the matter of overdiagnosis and "too much medicine." As the authors put it, evidence needs to be more "trustworthy."

And, of course, since the article was written by academics, the recommendations tend to favor government and the academy having more of a say in these matters. As if neither greed nor bias exists in those worlds.

Besides, very few people would argue that there has been a net improvement in healthcare since the Feds starting controlling it in 1965 with Medicare.

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