By Clarisse Douaud
More than a third of Americans use complementary medicine

Another survey has highlighted a need for better communication between consumers and their physicians over the use of herbal supplements.

In a survey of 1,559 people age 50 and older, while 63 percent have used one or more complimentary and alternative medicine (CAM) therapies, only 31 percent of these have discussed it with their doctors. The survey, conducted by the National Center for Complementary and Alternative Medicine (NCCAM) and the nonprofit AARP, defined CAM as including products and practices such as herbal supplements, meditation, chiropractic care and acupuncture.

The survey adds to the body of reports and studies raising the issue of a lack of sufficient communication and information on herbals, which could hamper both the efficacy of these supplements – and, in some instances, result in interactions.

For example, a recent study at Yale School of Medicine suggested that black cohosh, a plant commonly used by breast cancer patients to alleviate the menopause-like side effects of therapy, may alter the effects anticancer drugs.

Other studies have linked herb drug interaction between St Johns Wort and selective serotonin re-uptake inhibitors or the contraceptive pill.

Yet, if the medical establishment does not address the practice of taking herbals, patients will not feel comfortable raising the issue with their doctor.

The main reason respondents cited for not telling their doctors about CAM therapies was that their doctors never asked.
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By Suzanne Bohan

AT the Kaiser Permanente Medical Center in Redwood City on Thursday afternoon, a nurse checked on what a chart described as an 89-year-old woman who was recovering well from a procedure.

But the nurse instead heard groaning when she approached the bedside, and saw signs that the patient was barely clinging to life.

“Can you open your eyes for me?” the nurse asked urgently. “Are you in pain?” When there was no response, a second nurse in the room called for help.

Soon the room was a buzz of activity, as the hospital’s in-house emergency team arrived, including Dr. Stella Clavecilla.

After 10 hectic minutes, with Clavecilla and nurses asking for blood tests, X-rays, the “crash cart,” monitors and chest compressions after staff reported that the patient’s pulse rate had dropped dangerously. After the medical team reported that the woman’s condition had stabilized, she was readied for transfer to the intensive care unit. (more…)

By Christopher Rowland

Some doctors and hospitals are teaming up with financial-services companies to market credit cards to patients, reducing healthcare providers’ dependence on bill collection, and causing more low- and middle-income consumers to pay interest on their medical debts.

While hospitals in Massachusetts are not pushing such credit cards, they are attempting to get patients to pay up front for services not covered by insurance, and are routinely asking them to provide credit card information before they receive treatment.

Patients can be turned down for elective procedures if they don’t pay in advance, but hospitals are required to treat emergency cases. The state doesn’t keep statistics on the number of people denied elective procedures because of financial reasons.

In states such as Texas and North Carolina, financial-services companies have joined with healthcare providers in an effort to promote the use of charge cards for medical expenses. For instance, Citibank’s Citi Health Card is offered to patients through participating healthcare providers.

The card features monthly payments as low as $10, and has a no-interest option for patients who agree to pay down their debts quickly by making higher monthly payments. But those who do not meet the terms of the payment plans pay annual interest on their balance of more than 20 percent.
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Record births at Mercy in 2006
By Chuck Slothower

The stork has been busy.

Mercy Regional Medical Center reported a record number of births in 2006, an increase of 8.7 percent over the previous year.

Hospital officials said it is difficult to know whether the baby boom is the result of migration to La Plata County or the attractive force of the new $82 million facility. Patients from New Mexico, Silverton and other locations outside the county chose to give birth at Mercy, hospital spokesman David Bruzzese said.

Births totaled 914 at Mercy in 2006. They were split about evenly between the old hospital near downtown and the new hospital in Grandview. The move occurred in late June – basically midway through 2006.

The new hospital has private birthing rooms, options for mothers such as birthing tubs and digitized medical records. Midwives, obstetricians and family practice doctors all deliver babies at Mercy.

“Our goal in a delivery is to have a healthy mom leave with a healthy baby, ” said Dr. Patrick Kearney with Durango Family Medicine. He delivered about 30 babies in 2006.
experience in Durango Real Estate

One notable change in obstetrics has been the popularization of epidural painkillers, doctors said. Epidural anesthesia is injected near the base of the patient’s spine and gives a constant dose of medicine. Doctors like that they treat pain while keeping patients alert and able to push.

The trend of the 1960s and ‘ 70s toward more “natural” childbirths has petered out, said Dr. Martin Pirnat with Durango Family Medicine. ” It is a different generation, and they are looking more toward pain-relieving services. ”

Another major change in childbirth has been the length of stay, doctors said. Thirty years ago, mothers routinely stayed at the hospital for three days after giving birth. Now, stays of as little as four hours are common.

Much of the reason for shorter stays is financial, Pirnat said.

“In the heyday of managed care in the ‘ 90s, insurance companies pushed very hard ” to shorten stays, he said. But another reason has been experience that has shown babies and mothers are usually OK when sent home soon after birth, Pirnat said.

Another change? The Palm Pilot. Instead of thumbing through a reference book, Pirnat uses it to track medication dosages and guard against harmful interactions and side effects.
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Sen. Obama Joins Other 2008 Presidential Candidates in Proposing Universal Health Care, Says All U.S. Residents Should Have Health Coverage Within Six Years

Sen. Barack Obama (D-Ill.), a 2008 presidential candidate, on Thursday said all U.S. residents should have health care coverage within the next six years, the AP/Seattle Post-Intelligencer reports. According to the AP/Post-Intelligencer, Obama was “previewing what is shaping up to be a theme of the 2008 Democratic primary.” Rival Democratic presidential candidates former Sen. John Edwards (N.C.), Sen. Hillary Rodham Clinton (N.Y.) and Rep. Dennis Kucinich (Ohio) also support universal health care. At a Families USA conference, Obama said, “I am absolutely determined by the end of the first term of the next president, we should have universal health care in this country” (Pickler, AP/Seattle Post-Intelligencer, 1/25). He said the U.S. must consider whether “the employer-based system of health care itself is still the best for providing insurance to all Americans” at a time “when businesses are facing increased competition and workers rarely stay with one company throughout their entire lives.” He added, “I think there are a variety of ways” to achieve universal coverage, “but I think that one of the things that we’re going to have to look at is portability. I don’t think we immediately replace the employer-based system, but I think that setting up pools that provide a capacity for more and more people to not be dependent on an employer for their health care is important.”

Obama did not introduce a universal health plan, but said after his speech that he would be working to develop one “over the next several months.” Obama said broad bipartisan interest in the issue has “effectively ended the debate over whether or not we should have universal health care in this country.” According to CQ HealthBeat, Obama’s speech appeared to give him “a rhetorical jump on [Rodham] Clinton on the health care issue” by saying universal health care should become law no later than 2012. Rodham Clinton has not given a timetable for her own plan (Reichard, CQ HealthBeat, 1/25).
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