Enabling Healthy Decisions

I have included some articles like this before.  Money magazine always does a good job of coming up with these, but they are a little scary sometimes.

We all know that errors are possible, but error rates and calling them “common” is worrisome.  For example, they say “patients sometimes wind up sicker than when they arrived”.  And, they also say to “avoid hospitals late at night and in July”.

“At least 1.5M patients are harmed each year from being given the wrong drugs”  [one person per US hospital per day]  Institute of Medicine of the National Acadamey of Sciences

One reason these mistakes persist: Only 10% of hospitals are fully computerized and have a central database to track allergies and diagnoses, says Robert Wachter, the chief of medical service at UC San Francisco Medical Center.

Although I agree, I find it troubling that one of the article’s recommendations is that “patients should always have a friend, relative or patient advocate from the hospital staff at their side to take notes and make sure the right medications are being dispensed”. 

Of course, we can’t always choose our hospitals.  Where does our doctor practice.  Which one is near our house.  It would be great to have a flashing sign above the hospital that says “our error rate is only X”.  Obviously, this is what people are focused on and hopefully they are applying concepts like Six Sigma and other statistical tools to identify the reason for errors and develop a process for eliminating them. 

To read the whole article, click here. 

First off, most adults don’t provide a good example for their kids on many levels especially around eating.  It is easier to preach then do.  “Don’t eat fast food.”  “Don’t snack.”  “Eat vegetables with each meal.”

So, I struggled with an article I read last week which talked about kids menus “growing up”.  Non-alchoholic chardonnay and merlot juices – really?  Marshmellow sushi with fruit roll-ups as wrappers and a piece of candy on top.  Kiddie sushi with chicken-fingers.  On the one hand, kudos for creativity.  On the other hand, none of these jump out to me as great examples of what we want kids eating. 

It makes me think about kids drinking soda (or pop as I called it growing up).  I agree that we don’t need soda machines in the grade schools, but what good is that if we have kids growing up drinking soda.  I was at a kid’s birthday party a few weeks ago and saw a kid drinking root beer out of a bottle.  That seems a little bit unnecessary.  But, again, how many of us drink soda or coffee or other drinks other than water in front of our kids.  What should they expect?

I don’t think any of us are surprised that we feel more stress. We get 100s of e-mails. We are accessible 24×7. We get voicemails. We get letters, faxes, text messages, etc. We try to multi-task. We expect everything to be done immediately. (You get the point.)

USA Today (you can tell I am traveling) had an article about this today with lots of interesting statistics:

• 82% of women and 71% of men have experienced a physical symptom of stress in the past month (sleep problems, overeating, skipping meals, or using prescription drugs).
• 58% of married people said were more likely to fight with family members when stressed.
• 52% of employees have considered or made a career decision based on workplace stress.
• Lower income adults are more likely to experience symptoms of stress – physical and psychological (irritability, anger, nervous, sad, lack of energy).

These paint a bad picture. The article says that 32% of those responding regularly experience extreme levels of stress.

There are lots of suggestions on managing stress. AARP offers a series of information on the topic. Revolution Health offers information on stress.

And, I am sure that lack of sleep contributes to stress. So sleep more…meditate…and enjoy life.

For many people, college is a great opportunity to experiment with lots of things. For me, one of the things that I was fascinated by was different work styles. I remember one semester at University of Michigan where I:

• Worked part-time
• Took 21 credits
• Was president of my fraternity
• Was the treasurer of a magazine
• Studied for my GMAT and GRE
• Studied Czech (non-credit) in preparation for a trip to the Czech Republic
• Planned a 3-month trip around Europe

In retrospect, it was crazy. The only solution that I came up with was to make sure I never slept more than 30 hours per week. That ultimately translated to a minimum of 2 and often 3 all nighters (probably not the healthiest strategy). The next semester I tried getting a regular night’s sleep every night. My conclusion…I got more done in less hours by being more focused and making less mistakes. Not a true study, but as I learned, it seems to be supported by lots of facts.

At the time, someone was trying to convince me of a theory on life doubling which was basically to take a power nap every 3-4 hours and being able to go without any full nights sleep. (I was…and remain…fairly skeptical.)

If you look at sleep, here are some things to consider:

• “Scientists have found that sleep deprivation increases levels of a hunger hormone and decreases levels of a hormone that makes you feel full. The effects may lead to overeating and weight gain.” (USA Today)
• “an estimated 63% of American adults do not get the recommended eight hours of sleep a night, according to the National Sleep Foundation. In fact, the average adult gets 6.9 hours of sleep on weeknights and 7.5 hours on weekends, for a daily average of seven hours.” (USA Today)
• “found that the women sleeping 5 or fewer hours per night were 32% more likely to experience major weight gain, defined as an increase of 33 lb or more, and 15% more likely to become obese during the 16-year study period than the women who slept at least 7 hours per night.” (Study on Medscape)
• “You are just as dangerous driving sleepy as driving drunk.” (BBC story)
• “negative side-effects of sleeplessness may range from physical problems such as headaches, forgetfulness and lethargy to mental problems such as increased stress and depression” (Cornell article)

I wish I had known. It would appear that my grades would have been better, and I would have been thinner if I slept more. But, it is a serious problem. People are busy, stressed, and never have time to sleep. Even knowing all this, I can’t image sleeping 8+ hours per day.

I used to tell my team that since I slept 1-2 hours less then them every day (or 365-730 hours per year) that I enjoyed an extra year of being awake every decade (exact math not important). I love life and enjoy maximizing the day. The challenge is finding that right medium to enjoy it productively.

I was looking at how to embed slides in my blog and came across this.  Not only is it interesting, but I think the analysis is well done.

I never gave it whole lot of thought, but we had an interesting policy at Express Scripts.  The more money you made then the more you paid for your benefits.  It looked something like the following:

• <$40,000 in salary – pay $150/mo.
• $40,001 – $65,000 – pay $225/mo.
• $65,001 – 85,000 – pay $300/mo.
• $85,001 – $110,000 – pay $375/mo.
• >$110,001 – pay $500/mo.

Although it is against my Republican tendencies about money, it made sense.  I think it is a reasonable strategy for companies.  Every time I bring it up, people think it is a novel idea so I thought I would mention it here.

CNN Health has several interesting items including:

• 5 Commonly Misdiagnosed Diseases
• 5 Alternative Medicines That Work
• Penalizing Unhealthy Workers
• 5 Diagnoses Where You Should Get a Second Opinion
• When to Fire Your Doctor
• Mistakes to Avoid When Fighting Insurance Company

I am always so amazed at how much kids pick up.  They come to learn about companies and brands through advertising (something that has been proven many times through studies).

So, I began wondering what we are doing to influence our kids on wellness now.  Usually, patient programs are focused on sick people rarely on prevention for people that are healthy.  And, given childhood obesity issues, there is a lot we have to do although I found a lot of sites talking about this (e.g., Alliance for a Healthier Generation).

I see plenty of kids that don’t get out an exercise or eat all types of junk food.  My 6-year old has been running races with me since she was 2.  Just 1/2 mile or a mile, but it is great to see her excitement about this.  (Now, this can go too far.  I remember one race where the dad was pushing the little kid so hard that they were crying.)

It is also important that they understand healthy eating versus junk food.  Halloween is a good example.  My kids enjoy one day of candy and then they can trade their candy for a toy rather than eating it all.   It’s all about setting an example.

Since the 1970s, the percentage of overweight kids and adolescents in the United States has more than doubled. Today, 10% of 2- to 5-year-olds and more than 15% of children between the ages of 6 and 19 are overweight. If you combine the percent of kids who are overweight with the percent of kids who are at risk of becoming overweight, about one out of three children are affected.  (From KidsHealth)

Some childhood obesity facts (from the NIH):

• Obese children and adolescents have shown an alarming increase in the incidence of type 2 diabetes.
• Many obese children have high cholesterol and blood pressure levels, which are risk factors for heart disease.
• One of the most severe problems for obese children is sleep apnea (interrupted breathing while sleeping). In some cases this can lead to problems with learning and memory.
• Obese children have a high incidence of orthopedic problems, liver disease, and asthma.
• Overweight adolescents have a 70 percent chance of becoming overweight or obese adults.

I am a big reader of Money and SmartMoney and all those other books that tell you how to save and optimize your money.  I found a few things the other day on savings money and what you should know about your dentist, etc.  Here are links to some of the articles:

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         1. Save money on prescriptions
         2. 10 Things Your dentist won’t tell you
         3. Better Health for Pennies a Day
         4. 10 Things Your Eye Doctor Won’t Tell You