Healthcare Coordination for the 1%

Private Health Management is a company founded in 2007 that serves “high net worth individuals” and corporate executives that basically collects and double-checks all of its clients’ health records (and digitizes them) and uses “proprietary algorithms” to find the best of the best physicians for whatever condition they have. Their primary benefit seems to be when a client has a medical emergency or particularly complex condition. Private Health Management will step in with a clinician who compiles a brief on the patient, double-checks all tests, and gathers a team of research scientists to gather the most up-t0-date information on treatments for the patient’s condition. It seems like what they do is ensure their clients get the best treatment option from the best doctors for their exact condition rather than what is the best treatment on average the average patient like the client.

Right now the model sounds incredibly expensive, but the goal does seem to be to expand it. It’s certainly an intriguing idea for how to solve the problems of coordination and optimization of healthcare.

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I Said What What…

I haven’t done a digital rectal exam yet, but I feel certain that my ‘scumbag brain’ won’t let me not think of this when I do one for the first time. Also, I really hope that someday I have a patient who’s cool enough to say this to me when I’m about to do one. The internet has clearly ruined me.

“I said what what–in the butt”

 

Too Fat to Scan

I’ve been surprised to find that one of my favorite parts of studying anatomy has been our radiology sessions. Radiology seems to have a reputation, surpassed perhaps only by pathology, as a specialty for doctors who aren’t good with people. I like to think that I’ve got a good bedside manner and I love talking with patients, so radiology has never been on my radar. But we’ve got an excellent professor and there really is something fascinating about looking inside the body without cutting it open. Plus, it’s fun to identify all the relevant anatomical structures and figure out what (if anything) is pathological (i.e. what’s causing the problem).

These days, everyone knows that obesity is a huge problem in the United States. But, did you know that Americans are getting so fat hospitals are having to buy larger and larger machines to scan them? As the Wall Street Journal reports, large CT scanners, which can often accomodate patients weighing over 600 lbs., cost 40% more (as much as $650k). It’s not as simple as just throwing more money at the problem to buy bigger machines, though. All that extra fat, which absorbs/deflects X-rays, means that higher (and more dangerous) doses and better software are needed to see inside obese patients.

Sources: CDC; Siemens (photo & specs) via WSJ

The obvious best solution would just be to prevent people from getting obese. But, this is ‘Merika, so we’ll probably just keep on super-sizing our CT scanners along with our Happy Meals.

Breakthrough in Skin Cancer Detection

Researchers at Harvard have discovered a new biomarker for melanoma that could lead to new tests to detect it earlier and possibly even new treatments. What’s really cool is that it’s not a mutation in the genetic code itself, but the loss of a particular epigenetic marker–in this case 5-hmC (5-hydroxymethylcytosine). It’s great to have a new biomarker for this deadly disease, but it’s even better that this is an epigenetic one, since it’s really hard to change the DNA in the cells of a live animal. In fact the researchers also found, in their paper published in the Sept. 14th issue of Cell, that the downregulation of 2 enzymes was likely responsible for the loss of the 5-hmC epigenetic marker and that reintroducing those enzymes into mice with melanoma suppressed growth of the cancer and increased survival. That’s right – in a single paper, these scientists found a new way to test for melanoma and a potential new therapy for it.

 

Science FTW!

Mother-to-daughter Uterus Transplants!

This past weekend, surgeons at the University of Gothenburg, in Sweden, performed not one but two mother-to-daughter uterus transplants! Both recipients are in their 30s and had IVF started before surgery, so that their own eggs can be implanted in their new uteruses (the ones that they themselves were born from!). Though the donors and recipients are recovering well, doctors are careful to say that they will not consider the operations complete successes “until this results in children.” One recipient was born without a uterus and the other had hers removed because of cervical cancer. These aren’t the first uterus transplants, nor the first with live donors, but they are the first mother-to-daughter transplants. Very cool.

A Better Pain Chart

Thought this might help patients more accurately describe the severity of their pain.