MATURE MARKET HEADLINES POSTED 10/9/98
Doc's Bedside Manner Top Patient Concern
The personal manner of the physician is much more important to patients than his or her technical skills, according to a study to be presented at the 67th Annual Scientific Meeting of the American Society of Plastic and Reconstructive Surgeons (ASPRS). "Most patients do not know how good a doctor's surgical skills are," said Kevin C. Chung, MD, professor of plastic and reconstructive surgery, University of Michigan, Ann Arbor. "What is most important to the patient is that initial encounter and how the doctor presents himself or herself."
Patients who were happy with the personal manner of the physician were 18 times more satisfied than patients who were not. This prospective study included a total of 345 patients who attended a university outpatient plastic surgery clinic. Each was asked to complete the Visit Specific Patient Satisfaction Questionnaire (VSQ) after their clinic visit. Patient response rate was more than 95 percent. Sixty percent rated their overall satisfaction with the visit as "excellent;" 30 percent gave the visit a rating of "very good." Satisfaction ratings, such as these, help providers improve care and assist third-party payers in determining who should provide health care services. This study showed that the most important predictors of patient satisfaction were those related to the quality of patient-physician interaction and efficient clinic operation.
The most significant predictor of patient satisfaction was the personal manner of the physician. Other important predictors included time spent with the physician; length of time to get an appointment; and explanation of what was done. Other factors, long thought to be important to patients, were shown to be less important (not statistically significant), including length of wait in the clinic; getting through to the clinic by phone; convenience of the clinic's location; and technical skills of the physician. "Physicians who want to improve their patient satisfaction need to pay attention to their patients and becaring," says Dr. Chung.
See related articles in the AgeVenture archives.
"Patients Want Docs to Share Any Bad News"
"Strengthening Doctor-Patient Relationships"
AgeVenture News Service, www.demko.com
BACK TO TOP
Gerontrepreneurs: Skin Rejuvenation Research
Biochemists at Hong Kong University of Science and Technology (HKUST) have given a boost to Hong Kong's biotechnology industry by developing a cost-effective process to produce a protein that stimulates skin cells to regenerate. This protein--human epidermal growth factor, or hEGF--"has been shown to be capable of expediting the healing of wounds to epidermal tissues," said Dr Wan-Keung R. Wong, the project leader. "The only problem before was that it was very expensive to produce."
With support from Hong Kong's Industry Department, Dr Wong and his colleagues developed an innovative process based on recombinant DNA technology and a unique E. coli excretion system that allows them to produce extracellular hEGF. Because E. coli is the most studied organism on earth and is readily available, its use "offers the advantages of easy and economical production, making a large-scale process for the production of hEGF feasible," said Dr Wong. The proof was soon forthcoming.
The University recently signed a technology transfer agreement with Leader Gene Ltd, a Hong Kong biotechnology firm that will use the system to produce hEGF for commercial use. "We plan to produce hEGF and sell the product to cosmetic manufacturers in China and around Asia who will use it to formulate their own skin care products," said Dr Kai Tam, Leader Gene's CEO. "After about age 30, our ability to produce our own EGF diminishes," said Dr Tam. "By making supplemental hEGF available in skin care products, we can promote skin cell regeneration and meet the market demand of a fast-growing segment of the population.
"This agreement is a local success story and an example of the sort of working relationship that Hong Kong needs," Dr Tam added. "Through the Industry Department, the government should continue to sponsor research that yields technology that can be transferred. Companies can then step in to commercialize the technology. We wish biological scientists would transfer more innovations like this to local industry."
See related articles in the AgeVenture archives.
"Gerontrepreneurs: Form & Figure Media Inc"
"Plastic Surgery Popular, Routine, Affordable "
"Plastic Surgery Surge"
AgeVenture News Service, www.demko.com
BACK TO TOP
Aspirin Raises Cataract Risk for Boomers
You're one of America's 78 million baby boomers "pushing" age 50. Lately, you've noticed that bright sunlight and glare are interfering with your vision. Maybe the problem is bothersome enough to give you a headache. So you reach for the aspirin. Bad move. Here's why. The Blue Mountains Eye Study, an Australian study published in the September 1998 issue of Ophthalmology, the Journal of the American Academy of Ophthalmology (AAO), reports that many commonly used medications (such as those used to treat gout, heart disease, high blood pressure, kidney stones, cholesterol, and water retention problems) do not cause cataracts.
However, this population-based cross-sectional study of 3,654 individuals 49 to 97 years of age also reports that long-term aspirin use does not prevent cataracts, as several previous studies have claimed, and in fact may cause increased numbers of posterior subcapsular cataracts, the most common and visually disabling type of cataract. A cataract, says the AAO, is a cloudy area in the normally transparent lens of the eye. As the opacity thickens, it prevents light rays from passing through the lens and focusing on the retina.
Symptoms of cataracts may include blurred vision, excessive sensitivity to bright light and glare, increased nearsightedness, or distorted images. People who have taken one or more aspirin tablets a week for ten years or more have twice the risk for developing cataracts than those who rarely take aspirin. This association was found to be strongest in people younger than 65 years of age. So, while the elderly are affected by aspirin use, the under 65 baby boomer generation seems most at risk.
The study also found that major tranquilizers such as largactil and melleril, frequently taken by people in nursing homes, cause cataracts. According to the American Academy of Ophthalmology (AAO), adults "between the ages of 52 and 64 have a 50% chance of having a cataract". However, most adults age 75-plus have a cataract, and half of those will experience some vision loss. Older Americans who are at most risk for cataracts will find the National Eye Care Project (NECP) a valuable source of eye care information. A public service project of the American Academy of Ophthalmology and the Knights Templar Eye Foundation, Inc., the NECP provides medical referrals to qualified seniors at no out-of-pocket cost to the patient.
The toll-free NECP Helpline may be reached at 1-800-222-EYES, and is available from 7:30 am to 4 pm Pacific time, Mondays through Fridays year-round except holidays. The AAO says that within one week of contacting the Helpline, eligible callers will be mailed the name of a volunteer doctor in their community with instructions for making an appointment. Concerned about undetected eye disease, these doctors provide a comprehensive examination and treatment for any condition diagnosed at the time of the visit.
See related articles in the AgeVenture archives.
"These Symptoms Indicate Vision Problems"
"Aspirin Alone Protects Some Against Stroke"
"Optometrist Calls Eyes Windows to Wellness"
"Boomers: Sunglasses Now, or Cataracts Later"
AgeVenture News Service, www.demko.com
BACK TO TOP
Medicare's MSA Risky Business for Seniors
The new medical savings account option under Medicare is off to an even slower start than the pilot project launched last year in the private market, says Geri Aston, AMNews staff, American Medical Association. The Medical Savings Account (MSA) is a new Medicare option in which the beneficiary chooses a Medicare MSA Plan -- a health insurance policy with a high deductible. Medicare pays the premium for the MSA Plan and makes a deposit into the Medicare MSA that is established by the beneficiary. The beneficiary uses the money in the Medicare MSA to pay for services provided before the deductible is met and for other services not covered by the MSA Plan.
Unlike other Medicare plans, there are no limits on what providers can charge above the amount paid by the Medicare MSA Plan. Unlike other Medicare+Choice options, individuals who enroll in MSAs are locked in for the entire year, with a one-time option of withdrawing by December 15 of the year in which they enrolled. No insurers have applied to the government for approval to offer Medicare MSAs when open enrollment for the new Medicare+Choice program is held in November. So the high-deductible insurance policies coupled with savings accounts for medical expenses will not be an option for the program's 38 million beneficiaries when the new Medicare+Choice plans begin operations in January 1999.
The top reason for insurers' failure to apply is the short time frame between the release of the Medicare+Choice regulations in June and the August application deadline, several MSA supporters said. "The rules of the road are so new, it's just a timing issue," said Dean Rosen, senior vice president of policy at the Health Insurance Association of America. Gail Shearer, director of health policy analysis for the Consumer Union's Washington office, discounted the argument that insurers simply haven't had the time to develop Medicare MSAs. "If there was pent-up demand by seniors, insurers would have rushed in to offer products to fill that need," she said. Medicare MSAs suffer from the public's lack of knowledge about the product, several officials predicted.
With seniors, education will be even more important, said Greg Corrie, a managing partner at American Health Value. MSAs will be a hard-sell initially in Medicare, where most seniors buy medigap policies that shield them substantially from insurance costs. The accounts will be especially attractive to younger seniors who are open to new ideas and accustomed to managing financial products, such as individual retirement accounts. But some experts predicted that Medicare MSAs will never become popular with beneficiaries, who are regarded as being more reluctant to assume financial risk for their insurance than the under-65 population. That could further dampen insurers' interest in offering Medicare MSAs. "You can't sell a product no one wants to buy," says Dr. Rodgers, director of health policy at Pricewaterhouse Coopers.
See related articles in the AgeVenture archives.
"New Medicare+Choice Health Options"
"Is The New Medicare Careless Healthcare?"
AgeVenture News Service, www.demko.com
BACK TO TOP
Assisted Suicide Law May Erode Patient Care
Declaring that The Lethal Drug Abuse Prevention Act of 1998 would have a chilling effect on good patient care, the American Academy of Family Physicians (AAFP) sent a letter to members of the U.S. House of Representatives and the U.S. Senate Judiciary Committee in opposition to the legislation.
The legislation, S. 2151 and H.R. 4006, intends to use the Controlled Substances Act (CSA) to "prohibit the dispensing of a controlled substance for the purpose of causing, or assisting in causing, the suicide or euthanasia of any individual." The original purpose of the CSA is to prevent drug trafficking and drug abuse. The bill could make family physicians liable for criminal penalties for prescribing pain medication for terminally ill patients.
"The prospect of criminal penalties for physicians who are doing their best to control their patients' pain at the end of life is objectionable," said Patrick B. Harr, M.D., Board Chairman of the AAFP, in recent letters to members of the U.S. House of Representatives and the U.S. Senate Judiciary Committee. "The Academy has consistently and steadfastly opposed Congress defining what constitutes the standard practice of medicine," Harr explained. "We believe that expanding the authority of the Drug Enforcement Agency (DEA) into the oversight of physicians' methods and practices in caring for patients at the end of life is an unacceptable federal intrusion into the practice of medicine."
See related article in the AgeVenture archives.
"Heaven's Waiting Room Studies End-of-Life"
AgeVenture News Service, www.demko.com
BACK TO TOP
Headache Diary Offers Pain Relief Strategy
Forty-five million Americans experience recurring headaches. Of those who suffer, nearly 23 million have migraine annually. In response, the National Headache Foundation (NHF) offers suggestions and strategies to help your doctor help relieve headache pain. One way to help your doctor help you is to come prepared to your initial consultation, says NHF. Keep a diary to track the characteristics of your headaches. Patterns identified from your diary may help your doctor determine which type of headache you have and the most beneficial treatments. Here's a list of questions that you should respond to in your headache diary.
1. When did you start having headaches?
2. How often do they occur? Time of day? Duration of pain?
3. Identify the location of the pain.
4. Describe the pain: throbbing, pounding, splitting, stabbing, blinding?
5. What triggers the headache: foods, physical activities, temperature, etc?
6. What symptoms do you experience prior to the headache?
7. Does anyone else in your family suffer from headaches?
8. Do you notice visual disturbances before or after your headaches?
It's important, says the NHF, to make an appointment with your doctor for the specific purpose of addressing your headache history rather than discussing headaches as part of a routine physician visit. Your doctor can take a complete medical history including your family background and ask about any medications you currently take. To confirm the diagnosis, NHF believes that your doctor may require blood tests, x-rays, a CT-scan, or MRI. The Chicago-based NHF was founded in 1970 to research causes of headache, identify treatment options, and educate the public.
See related articles in the AgeVenture archives.
"Group Takes Great Pains To Cure Headaches"
"AGS Launches Pain Management Guidelines"
AgeVenture News Service, www.demko.com
BACK TO TOP
Click here to view more Headlines
AgeVenture News Service, 21946 Pine Trace, Boca Raton, FL 33428 USA
Dr. David Demko, Editor
E-mail: newsdesk@demko.com
the media may use these headlines free-of-charge