Thursday, September 25, 2008

Dr Val Pays a Housecall (to IB)

Medblog maven Dr Val Jones is a graduate of Columbia University College of Physicians and Surgeons, and completed her residency in Physical Medicine and Rehabilitation at Saint Vincent's Hospital in New York City. Formerly blogging at Revolution Health, she's recently "gone Indie." Her new blog isn't online yet, but we're expecting great things from her there.
In this first of a two-part guest-blog series, Dr Val asks if perhaps there might be some wasteful spending in the health insurance arena:
Are Health Insurance Dollars Being Wasted Due To Medication Non-Compliance?
In case the answer to that question isn’t obvious, it is a resounding “yes.” Non-compliance costs the health insurance industry a staggering 177 billion dollars a year. It is estimated that fifty percent of patients forget to take their meds and over 30 percent don't refill their prescriptions. Twenty percent say they don't take the full course of treatment and fifty percent of patients don't take drugs as directed. So much for preventing that heart attack, stroke, or limb amputation.
The health insurance industry (as well as pharmaceutical companies) have invested heavily in patient compliance initiatives, most of which have failed to produce substantially improved outcomes. The reason? Although there are quite a few variables here, I believe that the common denominator is that medication reminders, text messages, automated emails, online educational materials, brochures and handouts are all missing the human element. The most dramatic power of persuasion rests with the patient’s healthcare provider – when a caring physician takes the time to look their patient in the eye and carefully explain why missing that medication could result in them eventually missing a limb, patients often take heed. This is the kind of conversation that galvanized Governor Mike Huckabee into losing 110 pounds through diet and lifestyle changes, and probably saved his life.
Of course, behavior modification may not require a face-to-face encounter, though it still needs a caring connection. I’ve had great success with an online weight loss initiative where I offer guidance and information to those seeking healthy weight loss strategies. Because I’m regularly present in the group, genuinely concerned, and offer accurate and helpful information as a credible source – my membership is 10 times larger than any other expert-led group. Although I can’t confirm the weight loss reported by the members since I don’t see them in my office, I believe that there are substantial health improvements occurring.
In Part 2, Dr Val will offer some possible solutions to this dilemna.
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