VIDEO: Take Back Health: Join the #RightCare Alliance

Although the USA is a slightly different animal, with more emphasis on health care as a for-profit industry, many of the same problems exist in Canada and other nations with a primarily single-payer, public system.

The solution to health care interventions that are unnecessary, unwanted, or even harmful is: a social movement. That's what the Lown Institute thinks, and the Right Care Alliance is gaining momentum.

Watch this:


JOKE: Your Duck is Dead #overdiagnosis

An friend of mine (LL) sent this story to me and I think you'll find it illumniating. No, it's not about quacks!

Your Duck is Dead

A woman brought a very limp duck into a veterinary surgeon. As she laid her pet on the table, the vet pulled out his stethoscope and listened to the bird's chest.

After a moment or two, the vet shook his head and sadly said, "I'm sorry, your duck, Cuddles, has passed away."

The distressed woman wailed, "Are you sure?" "Yes, I am sure. Your duck is dead," replied the vet.

"How can you be so sure?" she protested. "I mean you haven't done any testing on him or anything. He might just be in a coma or something."

The vet rolled his eyes, turned around and left the room. He returned a few minutes later with a black Labrador Retriever. As the duck's owner looked on in amazement, the dog stood on his hind legs, put his front paws on the examination table and sniffed the duck from top to bottom. He then looked up at the vet with sad eyes and shook his head.

The vet patted the dog on the head and took it out of the room. A few minutes later he returned with a cat. The cat jumped on the table and also delicately sniffed the bird from head to foot. The cat sat back on its haunches, shook its head, meowed softly and strolled out of the room.

The vet looked at the woman and said, "I'm sorry, but as I said, this is most definitely, 100% certifiably, a dead duck."

The vet turned to his computer terminal, hit a few keys and produced a bill, which he handed to the woman. The duck's owner, still in shock, took the bill. "$150!" she cried, "$150 just to tell me my duck is dead!"

The vet shrugged, "I'm sorry. If you had just taken my word for it, the bill would have been $20, but with the Lab Report and the Cat Scan, it's now $150."

Showing surgeons ‘massive’ cost of disposable supplies leads to big savings for hospitals | National Post

In our disposable culture, it is unsurprising that the bleed of this trend into healthcare has gone largely unchecked.

Operating rooms now use scads of throwaway equipment, saving sterilizing time and shaving off some intra-operative minutes by using devices that are slightly more specialized for components of the procedure.

Surgeons, nurses, and patients are all unaware of the cost. In fact, "Surgical residents and staff have a generally poor knowledge of the cost of common consumable products used in the operating room," according to a recent study in Laryngoscope by Canadian otolaryngologists.

Tom Blackwell of the National Post highlighted the issue and discovered some of the simple changes that administrators and surgeons could make to save costs without significantly impacting operation times. These efforts would also reduce landfill waste, something not emphasized in the article, but a very important consideration for the long term sustainability of our health care system.

See the video and article: Showing surgeons ‘massive’ cost of disposable supplies leads to big savings for hospitals.


Perspective: Want to learn the value of healthcare? Try to diagnose your own mother

Dr Ranjana Srivastava is a specialist. Specifically, she is an oncologist (cancer doctor).

Naturally, she thought the worst when her mother became ill and started thinking up a series of diagnoses, implications, tests, and treatments. She struggled a little to decide how much would be important and good advocacy for her mom, and how much was "too much" and might do more harm than good.

Her husband, a GP, interrupted and helped Dr. Srivastava's mother decide what to do next - and in doing so, also answered Dr. Srivastava's bigger question:

Why is it so hard to see the value of experienced GPs?

Read the full article in the Guardian to understand her answer.


BIG NEWS! QMA Unveils Action Plan for Overdiagnosis, Cost Savings

The Quebec Medical Association (QMA) just unveiled an Action Plan around Overdiagnosis!!

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This is an exciting day in "Less is More" !! This is a tangible and significant step forward towards making sure our patients get the right care.

Here is the hope- and awe- inspiring release, from the QMA


MONTREAL, Aug. 18, 2014 - The Québec Medical Association (QMA) is embarking on a new phase today in its effort to tackle the issue of overdiagnosis by unveiling an action plan that would allow major health budget savings. The plan is a result of concerted action between the main stakeholders in the health care system - physicians, representatives of medical and professional associations, the Collège des médecins du Québec and other professional orders, regional agencies and patient advocacy groups - subsequent to the first Québec Symposium on Overdiagnosis.

Following the release of this action plan, the QMA requested a meeting with the Minister of Health and Social Services, Dr. Gaétan Barrette, in order to coordinate the efforts to be deployed over the next few years to reach the expected results.

This action plan is the culmination of a process started in April 2013 with the publication of a discussion paper in which the QMA addressed the urgent need to optimize clinical practice in order to redirect approximately $5 billion to those activities that are most useful and relevant to patients. The goal of the action plan released today is to guide the actions that will be taken to reduce and prevent overdiagnosis. It presents the main orientations and potential solutions.

The issue of overdiagnosis generated considerable interest among the general public and health care stakeholders at the symposium and the launch of the Choisir avec soin campaign last April. The latest newsstand version of L'Actualité focuses on this priority issue for the Québec health care system.

Because overdiagnosis is a global phenomenon, the QMA's initiatives are also stirring international interest. At the suggestion of the well-known British Medical Journal, the QMA will give an account of its work and achievements in this area at the second international conference on the prevention of overdiagnosis in Oxford, England, in a few weeks. At the request of European government agencies/EU paying agents, the QMA will present the results of its efforts in November.

"Overdiagnosis greatly impacts the quality and accessibility of the health care offered to patients, and as a result, the efficiency of the entire health care system," stated QMA President Dr. Laurent Marcoux. "This problem has become a priority and we can no longer ignore it."

It will be exciting for me to meet the QMA representatives at the Preventing Overdiagnosis conference in Oxford this Sept and you can bet your bippy I'll be discussing this in BC with my Doctors of BC colleagues!

Teaching Costs of Care: Opening Pandora’s Box

Educating medical students and residents about the costs of care seems to be an important part of equipping them to deliver 'the right amount' of care. However, there is lots of hesitation; this article highlights 5 barriers to avoiding overtesting: fear of malpractice, patient demands, pressure from attending physicians, questions about whose money is being saved, and whether education will make a difference.

Dr. Arora reaches a poignant conclusion, which happens to be consistent with the goals of THIS (Less is More Medicine) website:

And in the words of notable educational psychologist Robert Gagne, the first step in creating a learning moment is getting attention. And, by that measure, this exercise was successful – it certainly did get attention. Yet, it also did something else…it created the tension for change, a necessary prerequisite for improvement. It certainly cultivated a desire to learn more about how to achieve this change

Read more at Costs of Care.