This monthly feature was conceived by writer and Nation editorial board member Walter Mosley as a kind of do-it-yourself opinion and action device. Most often "Ten Things" will offer a brief list of recommendations for accomplishing a desired political or social end, sometimes bringing to light something generally unknown. The purpose of the feature is to go to the heart of issues in a stripped-down, active and informed way. After getting our visiting expert–or everyday citizen–to construct the list, we will interview that person and post a brief online version of "Ten Things," with links to relevant websites, books or other information. Readers who wish to propose ideas for "Ten Things" should e-mail us at [email protected] or use the e-form at the bottom of this page.
As the House and Senate move toward final resolution of what could be the most important healthcare legislation in decades, there’s little doubt we’ll be stuck with a flawed, if probably somewhat improved, system. It might seem that there’s little individuals can do at this point, but Donna Brook, a poet, associate editor of Hanging Loose Press and avid Nation reader, suggests ten ways we can cut costs and improve outcomes no matter what happens in Washington. In addition to the obvious–not smoking, not abusing alcohol or drugs, avoiding fast food, getting regular exercise–you can use the information below to make a significant impact on your life and the lives of your loved ones. These ten items focus on prevention, the key to saving money and minimizing suffering.
Wash your hands! It may seem ridiculously simple, but according to the Centers for Disease Control and Prevention, it is the best way to reduce infection and the spread of illness. The Mayo Clinic provides details.
Carry with you at all times a list of your medications (including vitamins and supplements). It should include the drugs and dosages, how often you take them and the conditions they are treating. Also have on you your blood type, your emergency contact and your doctor’s phone number, plus any drug allergies or special information (if, for example, you’ve had a hip replaced or have a pacemaker). You’ll benefit in an emergency.
Do not choose a primary-care physician simply because his/her office is near your home. Find one who has privileges at the best hospital in your vicinity, can refer you to the best specialists and treats you with compassion. And make sure he/she follows hand-washing guidelines.
The Surgical Safety Checklist is reducing bad outcomes around the world. If you have to have an operation, ask the surgeon if the checklist will be used. And don’t have elective surgery without getting a second opinion–preferably from a doctor who does not do surgery. The New England Journal of Medicine found that a vertebroplasty (where bone cement is injected into vertebrae) is no better than a placebo, and the same is true for arthroscopic "clean-out" of the knee, just to name two of many interventions that have no detectable benefit. If back surgery is suggested, first read Dr. John Sarno‘s books.
If you are pregnant or looking for an obstetrician, keep in mind that the US rate of C-sections is more than double what the World Health Organization considers acceptable. You should not have this major surgery–with all its risks–simply for the sake of convenience. Read more at thebirthsurvey.com.
Beware of the overuse of diagnostic imaging procedures such as MRIs and CAT scans. They add to costs and radiation exposure. If a doctor owns an MRI, he/she may want to use it to pay for it.
Most end-of-life care is too aggressive and expensive. Without improving or changing patient outcomes, it lets patients with incurable illnesses die in hospitals separated from loved ones and suffering from invasive procedures. Choosing hospice and palliative care gives people more tolerable deaths while saving millions of dollars.
Education is key. When Japanese public schools began telling students to brush their teeth after every meal, the decline in tooth and gum disease was dramatic. More should be done in schools, but since we probably can’t get adequate sex education in our public schools soon, parents or doctors must inform kids before sexual activity begins how to avoid STDs and use contraception. Right now, one out of four young American women has an STD. Go to Michigan HIV News for more teen health
The Librarian Recommends
This list comprises books to guide the layperson’s medical thinking, and several books by physicians who describe how doctors learn through practice. They are selected to assist in understanding medical decision-making, the day-to-day practice of medicine, and the lives of physicians.
Doctoring: The Nature of Primary Care Medicine by Eric J. Cassell
The Healer’s Art by Eric J. Cassell
The Nature of Suffering and the Goals of Medicine by Eric J. Cassell
The Checklist Manifesto: How to Get Things Right by Atul Gawande
Complications: A Surgeon’s Notes on Performance by Atul Gawande
Better: A Surgeon’s Notes on Performance by Atul Gawande
How Doctors Think by Jerome Groopman
Worried Sick: A Prescription for Health in an Overtreated America by Nortin M. Hadler
The Last Well Person: How to Stay Well Despite the Health-Care System by Nortin M. Hadler
Intern: A Doctor’s Initiation by Sandeep Jauhar
How Patients Should Think: 10 Questions to Ask Your Doctor About Drugs, Tests, and Treatment by Ray Moynihan and Melissa Sweet
The Soul of Medicine: Tales from the Bedside by Sherwin B. Nuland
Medicine in Translation: Journeys with My Patients by Danielle Ofri
Singular Intimacies: Becoming a Doctor at Bellevue by Danielle Ofri
Technological Medicine: The Changing World of Doctors and Patients by Stanley Joel Reiser
Direct Red: A Surgeon’s View of Her Life-Or-Death Profession by Gabriel Weston
CONCEIVED by WALTER MOSLEY with research by Rae Gomes