Archive for the 'health care innovation' Category

Assorted Links

Wednesday, March 12th, 2014

Thanks to Patrick Vlaskovits.

Back Pain Cured by Sarno’s Ideas

Saturday, November 2nd, 2013

Two years ago, a professor of decision science wrote me to say that Vitamin D3 in the morning greatly improved his sleep. Recently he wrote again:

Once again you have dramatically improved my life through your blog.

In this Assorted Links post you offered:

The back pain of a friend of mine, which had lasted 20 years and was getting worse, went away when he followed this doctor’s advice

I read the link about Dr. Sarno and went to Amazon to check out his book, “Healing Back Pain”. 700 reviews with a 4.5 star rating. I spent two hours reading the reviews. Person after person saying, “my back is better” and nobody really described what the book had them do. I bought it two weeks ago.

In a nutshell, Sarno says that this type of back pain is caused by oxygen deprivation of some back muscles/tendons, and that the mind has does this as a defense mechanism so I don’t have to confront my subconscious anger.

I don’t have to pinpoint the source of my anger. I don’t have to come to grips with it and stop being angry. I just have to acknowledge the anger. That’s it. I read half the book in one sitting. I thought, this is crazy, but it has 700 4+ stars at Amazon. Maybe it does work.

My wife and I have two cars. One of them is a small Saturn. I hate it. It hurts my back to get in or out of it, and if I drive for more than five minutes I have to squirm to keep the back pain under control. Last week I took the Saturn for two half hour drives with only one wince of pain. Today I took it to the gym (a five minute drive) but it didn’t hurt to get in or out.

In the morning, to get out of bed, I have to roll over and swing my legs out toward the floor and then prop myself up into a sitting position. At least, that’s how I’ve done it for the past year. This week, I just sat up in bed with no pain. Every morning.

I am still a bit weak in the lower back, after more than a year of restricted physical activity. But this is amazing.

Interview with Sarno on Larry King Live (1999).

Assorted Links

Friday, March 1st, 2013
  • An Epidemic of Absence (book about allergies and autism)
  • Professor of medicine who studies medical error loses a leg due to medical error. “Despite calls to action by patient advocates and the adoption of safety programs, there is no sign that the numbers of errors, injuries and deaths [due to errors] have improved.” Nothing about consequences for the person who made the error that caused him to lose a leg.
  • Doubts about spending a huge amount of research money on a single project (brain mapping). Which has yet to produce even one useful result.
  • Cancer diagnosis innovation by somebody without a job (a 15-year-old)
  • Someone named Rob Rhinehart has greatly reduced the time and money he spends on food by drinking something he thinks contains all essential nutrients. Someone pointed out to him that he needs bacteria, which he doesn’t have. (No doubt several types of bacteria are best.) He doesn’t realize that Vitamin K has several forms. I suspect he’s getting too little omega-3. This reminds me of a man who greatly reduced how much he slept by sleeping 15 minutes every 3 hours. It didn’t work out well for him (his creativity vanished and he became bored and unhappy). In Rhinehart’s case, I can’t predict what will happen so it’s fascinating. When something goes wrong, however, I’ll be surprised if he can figure out what caused the problem.

Thanks to Amish Mukharji.

Interview with Doron Weber, Author of Immortal Bird, About What He Learned From a Hospital Tragedy

Monday, December 31st, 2012

Immortal Bird by Doron Weber, a program director at the Sloan Foundation, is about his son, Damon, who had a rare medical condition, and his son’s heart transplant operation (cost = $500,000) at New York Presbyterian/Columbia University Medical Center. Damon died after the operation. The post-operative care was so bad his father sued. “Three years into the lawsuit, the medical director [of the hospital] claimed Damon’s post-op records couldn’t be located,” said the New York Times.

How can such tragedies be prevented? To find out, I interviewed Doron Weber by email. (more…)

Assorted Links

Saturday, December 8th, 2012

Thanks to Charles Platt and Adam Clemens.

Personal Science and Varieties of DIY

Wednesday, February 29th, 2012

How does personal science (using science to solve a problem yourself rather than paying experts to solve it) compare to other sorts of DIY?

Here’s an example of personal science. When I became an assistant professor, I started to wake up too early in the morning. I didn’t consider seeing a doctor about it for several reasons: 1. Minor problem. Unpleasant but not painful. 2. Doctors usually prescribe drugs. I didn’t want to take a drug. 3. Sleep researchers, based on my reading of the sleep literature, had almost no idea what caused early awakening. They would have said it was due a bad phase shift of your circadian rhythm. They often used the term circadian phase disorder but never used the term circadian amplitude disorder — apparently they didn’t realize that such a thing was possible. I decided to try to solve the problem myself — an instance of DIY. Except that, if I made any progress,  that would be better than what the experts could provide, which I considered worthless.

There are thousands of instances of DIY, from fixing your car yourself to sewing your own clothes to word processing. Here is one dimension of DIY:

1. Quality of the final product. Better, equal, or worse to what you would get from professionals. Richard Bernstein’s introduction of home blood glucose testing led him to much better control of his blood glucose levels than his doctors had managed. Same as my situation: DIY produced acceptable results, the experts did not.

In contrast to Bernstein, who reduced his blood glucose variability within months, it took me years to improve my sleep.  That is another dimension:

2. Time needed. Personal science, compared to other DIY, is orders of magnitude slower.

Here are some more dimensions:

3. Training needed. I don’t know how much training personal science requires. On the face of it, not much. I had acne in high school. I could done self-experimentation at that point. It just didn’t occur to me. On the other hand, I think effective personal science requires wise narrowing of the possibilities that you test. For most health problems, you can find dozens of proposed remedies. How wise you need to be, I don’t know.

4. Commercialization. Some forms of DIY are entirely the creation of businesses — cheap cameras, home perms, IKEA, etc. Bernstein’s work happened because of a new product that required only a drop of blood. The company that made it wanted doctors to do DIY: measure blood glucose levels in their office (fast) rather than having the measurement made in a lab (slow).  When I started to study my sleep, no business was involved. Now, of course, companies like Zeo and the makers of FitBit want users to do personal science.

5. Price. My sleep research cost nothing, which in the DIY world is unusual. The term DIY is almost entirely a commercial category: Certain books and goods are sold to help you DIY.

6. Customization possible. Some kinds of DIY give you the tools to build one thing (e.g., IKEA, home perms). Other kinds (e.g., Home Depot, word processing) give you the tools to build a huge range of things. This dimension is variation in how close what you buy is to the finished product (Ikea = very close, word processing = very far). Personal science allows huge customization. It can adjust to any biology (e.g., your genome) and environment (your living conditions).

7. Benefit to society.  If I or anyone else can find new ways to sleep better — especially safe cheap easy ways — and these solutions can be spread, there is great benefit to society,  by comparison to DIY that allows non-professionals to reproduce what a professional would create (e.g, IKEA).

You might say that personal science isn’t really DIY because, compared to other DIY, (a) it is much slower and (b) the potential benefit to society is much greater. But those features are due to the nature of science. Any form of DIY has unique elements.

My mental picture of DIY is that there are two sides, producers and consumers, and in many domains (health, car maintenance, word processing, etc.) they creep toward each other in the sense that what producers can make slowly increases and what consumers are capable of slowly increases.  When they meet, DIY begins. In some cases, the business has done most of the changing; the DIY is very easy (e.g., Ikea).  In other cases, the consumer has changed a lot (literacy — not easy to acquire). Either way, the new DIY causes professionals who provided that service or good for a living to lose business.

Lame Response of the AMA to HealthTap

Friday, February 24th, 2012

Many years ago, when I was a professor at Berkeley, I sought out David Freedman, a professor of statistics, for comment on an idea of mine. I knew he would dislike it — he was negative about everything — and I wondered how strong his reasons for disliking it would be. It turned out, as I expected, that he disliked it but — I was glad to see — had no convincing reasons. That was helpful, I thought.

Likewise, it is obvious that the AMA would dislike HealthTap, a website that solicits doctors’ answers to medical questions (along the lines of “I have X symptoms. What should I do?”). Here’s the AMA response:

Dr. Peter W. Carmel, president of the American Medical Association, says he is concerned about the use of online medical information, which should “complement, not replace, the communication between a patient and their physician,” he wrote in an e-mail. With online health information sites, “a medical history is not taken, a physical exam does not occur and any suggested treatment is not monitored or assessed,” he said. “Using this information in isolation could pose a threat to patients.”

These comments could have been made by someone with no medical training. Practically everything has a hypothetical downside (“could pose a threat”). Since he fails to call into question the obvious upside (patients will get questions answered much faster and cheaper), he is practically endorsing it.