In a note today:
The patient is doing well on the amateur plane so we will continue to monitor the dosage and effectiveness.
Hmmmm.......not sure I can count that as med management in your medical decision making.
Friday, May 2, 2014
Thursday, May 1, 2014
Obese vs. Smoking
I am truly tired of two things:
1. The grant paid studies that I read that are STILL talking about the impacts of smoking.
2. The grant paid studies I read that we need to help the obese.
Look, back in the day, I smoked. We are talking 80's here. As the years rolled by there were less and less places I could smoke. Plus, it was socially encumbering because the new friends I met did not smoke. People would sneer at me in public, walk by waving their hands in front of their faces clearly disgusted by the smell. The enjoyment of nicotine was purely selfish on my part and that enjoyment was clearly aggravating my fellow society members. Then there was the cost and the negative health issues....so I quit.
Yet still, decades later, there are studies that I read about the impact of smoking. Just the other day I read a study on Med Page that talked about the impact of children seeing smoking on television and how likely the viewing was to make the child inclined to smoke. Two words: OLD NEWS. We've been down that path. We get it. The smoking population is down to 18% according to the CDC. But are we talking about the bowl of chips those children are munching down on while they watch TV? What about the big glass of soda? Nope.I mean we are talking about it, but we aren't talking about it in any meaningful way.
Now, obesity. The new smoking? Ahhh yes. It's not much different. I don't need to help the obese people find a way to lose weight. I don't need to be empathetic. No one was empathetic to me when I smoked. We don't need to legislate and outlaw the consumption of fast food and super-sized soft drinks. All we need to do is sneer at the obese in public, look on in disgust at an obese family in the local fast food joint, and ask to be moved to another table at a buffet so we don't have to be subject to the orgy of gluttony. In short, we have to make being obese just as socially unacceptable and encumbering as smoking once was (and still is).
Obesity is a huge problem. Thirty six percent of the adult population is obese according to the CDC. Yet we coddle the obese. No one wants to talk about it and be direct. Why? because we don't want to hurt someone feelings. Calling someone fat is rude I guess. But telling someone they smell like an ashtray isn't. I don't get that one.
Providers, in vain, make referrals to weight management. Those referrals go unscheduled and ignored by the patient. There is no real effort to reel obesity in and target the obese. There is no accountability.
As a society, we need to jump on this fast. We don't need to sit around and wait until obesity is more rampant than it is now. Let's not wait decades like we did with smoking to do something about it. There needs to be hard core counseling going on during office visits. There needs to be consequences that hit the wallet like the higher premiums smokers pay.
First, I'd throw in BMI. Too high? A year later still the same or higher? You now have a surcharge on your premiums to offset your higher risk and healthcare costs due to diabetes, hypertension, DJD, and my favorite, chronic back pain. Also, bye bye Medicaid/Medicare. People cannot continue bad health behaviors and receive free healthcare. Sorry. Not on my dime.
This country needs serious solutions. Not just studies and lip service.
1. The grant paid studies that I read that are STILL talking about the impacts of smoking.
2. The grant paid studies I read that we need to help the obese.
Look, back in the day, I smoked. We are talking 80's here. As the years rolled by there were less and less places I could smoke. Plus, it was socially encumbering because the new friends I met did not smoke. People would sneer at me in public, walk by waving their hands in front of their faces clearly disgusted by the smell. The enjoyment of nicotine was purely selfish on my part and that enjoyment was clearly aggravating my fellow society members. Then there was the cost and the negative health issues....so I quit.
Yet still, decades later, there are studies that I read about the impact of smoking. Just the other day I read a study on Med Page that talked about the impact of children seeing smoking on television and how likely the viewing was to make the child inclined to smoke. Two words: OLD NEWS. We've been down that path. We get it. The smoking population is down to 18% according to the CDC. But are we talking about the bowl of chips those children are munching down on while they watch TV? What about the big glass of soda? Nope.I mean we are talking about it, but we aren't talking about it in any meaningful way.
Now, obesity. The new smoking? Ahhh yes. It's not much different. I don't need to help the obese people find a way to lose weight. I don't need to be empathetic. No one was empathetic to me when I smoked. We don't need to legislate and outlaw the consumption of fast food and super-sized soft drinks. All we need to do is sneer at the obese in public, look on in disgust at an obese family in the local fast food joint, and ask to be moved to another table at a buffet so we don't have to be subject to the orgy of gluttony. In short, we have to make being obese just as socially unacceptable and encumbering as smoking once was (and still is).
Obesity is a huge problem. Thirty six percent of the adult population is obese according to the CDC. Yet we coddle the obese. No one wants to talk about it and be direct. Why? because we don't want to hurt someone feelings. Calling someone fat is rude I guess. But telling someone they smell like an ashtray isn't. I don't get that one.
Providers, in vain, make referrals to weight management. Those referrals go unscheduled and ignored by the patient. There is no real effort to reel obesity in and target the obese. There is no accountability.
As a society, we need to jump on this fast. We don't need to sit around and wait until obesity is more rampant than it is now. Let's not wait decades like we did with smoking to do something about it. There needs to be hard core counseling going on during office visits. There needs to be consequences that hit the wallet like the higher premiums smokers pay.
First, I'd throw in BMI. Too high? A year later still the same or higher? You now have a surcharge on your premiums to offset your higher risk and healthcare costs due to diabetes, hypertension, DJD, and my favorite, chronic back pain. Also, bye bye Medicaid/Medicare. People cannot continue bad health behaviors and receive free healthcare. Sorry. Not on my dime.
This country needs serious solutions. Not just studies and lip service.
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