The questions and lingering concerns surrounding the overuse of antibiotics is an age-old and well-worn conundrum for physicians and patients. Even the latter group, well-informed as consumers of healthcare, can agree that most acute upper respiratory infections are most often the result of viral infestations which play themselves out in spite of antimicrobial treatment.
The decision to (over)use them in standard medical practice is often the point of debate, as physicians weigh factors such as patient satisfaction and lingering medical and health policy issues surrounding resistance.
Last year, this blog reported on these issues as background for a program in which some retail pharmacy chains were giving away for free antibiotics to patients with prescriptions from their physicians as a way of helping with affordability in the wake of the debate on reform. The CDC offered a statement promoting the responsibilities providers, pharmacists, and patients should consider in taking part in such a program.
Smaller chain pharmacies are trying to compete with the big boys, and in trying to earn store-brand loyalty among their (un- and underinsured) consumers, they are throwing free antiobiotics their way. Last week, the CDC sent out letters those several chain pharmacies that offer no-cost prescription antibiotics to low-income consumers urging them to promote responsible use of antibiotics.
While the program was essentially successful in its efforts to bridge the gap between affordable, accessible healthcare and patient responsibility, no one was really prepared for the massive policy decisions that would have to be made as the June ‘09 H1N1 pandemic loomed — after its initial discovery just one month after this initial Doctor Pundit posting.
Sunday § February 21, 2010
It’s often said that the beleaguered emergency department (ED) is the initial point of care for many patients. In this current broken healthcare delivery system, that means an umbrella which “covers” the uninsured as well as those who are underinsured. The total cost for these points of acute care notwithstanding, how is the best way to explain new numbers out of the CDC this week?
The CDC’s National Center for Health Statistics reported the numbers in its annual summary of U.S. data on disease conditions, health behaviors and use of medical services. The scan figures are based on visits to roughly 500 hospitals and 3,000 doctor’s offices and outpatient clinics.
According to this survey data, the CDC says that the use of imaging modalities in the ED has quadrupled since the mid-1990s. Besides being just another point of confirmation of the origin of skyrocketing healthcare costs in this country, the heavy emphasis placed on tech will not abate anytime soon. Issues pertaining to defensive medicine, integration of such tech into ingrained training of new physicians, and the cost of using such technology within the medical device market are all good reasons to try to begin attacking this startling — yet, unsurprising — statistic. | LINK
President Obama appears to have pulled a one-two punch on his selection for the CDC chiefdom, Dr. Thomas Frieden. The LAT has a piece on him, and Obama’s choice turns out to be a rather prudent one. Of course, he wouldn’t have it any other way. Frieden’s marriage of public health activism and renown in the area of public health preparedness makes his choice a perfect one.
Where else would Obama’s need for stern healthcare reform and public policy acceptance by the average healthcare consumer for his ideas be adequately met? In a leader whose background reads like an Obama clarion call to action for a back-to-basics mechanism for healthcare cost cutting (read: heavy emphasis on preventive medicine and wellness, and sound public health principles) — that’s where. Frieden’s experience also personifies the political bridge Obama has sought between the ideological chasm between parties. In a completely soft healthcare economic environment which forces Democrats and Republicans to work together toward solutions, a frontline manager who does Obama’s talking points on this issue is not only necessary, but it’s also an asset. (Additionally, it doesn’t hurt that Frieden is extremely literate in his field of public health policy, having authored over 200 white papers and articles.)
Yep, score one important notch on the long road to public acknowledgement of Obama’s seriousness with respect to the issue of healthcare reform — whether you agree with him or not. | LINK
Although his press people say that an HHS secretary is not essential during this time of a major flu pandemic worldwide, while using less direct and more obfuscatory language in the process, a greater level of criticism is coming from both sides of the political aisle concerning the matter of the relative lack of political appointees to prominent healthcare posts in the Obama cabinet. This stands as an obvious direct contrast to an issue so central to his administration’s platform. A new op-ed in the NYT calls this juxtaposition a “deeply disquieting” leadership scenario for a president who thrives on strictly scripted control and management. So, how will the Obama administration be judged on his response to the 2009 swine flu crisis? Without stable CDC and HHS appointments, it will be an interesting case study in the bridge between his First 100 Days and the meat of his remaining (first) term. | LINK
Saturday § January 24, 2009
President Obama has picked a new CDC head. The candidate is a 49 year-old, CDC veteran with wide public health experience. A pediatrician by training, he served in the CDC’s Epidemic Intelligence Service, tracking foodborne diseases, followed by several years working on infectious disease issues. He spearheaded a national campaign to prevent overuse of antibiotics, a practice which helps to spawn antibiotic resistant infectious agents.
Hopefully, Obama will use this vetting experience into choosing a more appropriate Surgeon General. | LINK
Wednesday § January 14, 2009
It’s the classic chicken-and-egg argument. What’s responsible for the recent rise in certain sexually transmitted infections (STI)? According to the CDC, the rate of new infections from the atypical pathogen Chlamydia set a new record with 1.1 million new cases in 2007. Together, with frequent comorbid agent, N. gonorrhea, the number of new infections topped 1.5 million in that time frame. Better testing techniques lead to accurate and timely reports to state health departments, without a doubt. But one has to wonder, are we doing enough to drive home the message of safe sexual methods to prevent these rates of STIs? | LINK
