Gotta love those ice packs!

Unless you’ve been living under a rock, pretty much everyone must be aware that Kevin Everett suffered a severe spinal cord injury this weekend in the Bills game.  At first, the prognosis was expectedly grim after an estimated impact force of 2/3 of a ton to Everett’s spine.  Now it seems a more positive outcome may be expected.

In listening to some of the interviews, a physician from the Miami Project made a statement that Everett benefited from the earliest application of moderate hypothermia after a spinal cord injury…ever.  That is rather profound.  From what I can gather as a very outside observer, doctors began lowering Everett’s body temperature in the ambulance and further reduced it once at the hospital by means of an IV catheter.

It is widely understood that cooling tissues reduces the damage cause by inflammation.  It is practiced in neurosurgery, with neonates, after sprained ankles, and now with spinal cord injuries.

This image demonstrates the reduction in neural tissue possible with hypothermia treatment.  The top two tissue samples were controls, and the bottom sample was cooled to 32 degrees C.  The highlighted parts of the image shows areas of tissue death.  Pretty amazing!

And, in a big example of "what comes around, goes around," it was reported that the Buffalo Bills owner is a large donor to the Miami Project.

One final note, the Miami Project doctor I cited earlier did upset me with the quote, "…will walk out of the hospital."  This is far from a foregone conclusion and seemed a bit overzealous and self-promoting to say that on ESPN.  Either way, I’m writing about him.

A sadly growning market


The US Census announced today (pg 26-28 of pdf) the latest numbers on income, poverty and health insurance for 2006.  For the 6th year in a row, the number of uninsured Americans rose.  For 2006, the number was 15.8% of all Americans or 47 million were uninsured.

While this is a somber fact, I would like to look at it another way:  a growing market.  Whoever figures out how to provide inexpensive health care to this population has a steadily growing market on their hands.  It could be good business.  Again, I refer you to retail health clinics.

The intellectual downhiller


This story about professional mountain biker Neven Steinmetz, caught my eye for sure.  I have a special place in my heart for downhill mountain bikers, people who survive smashing into things, intellectual pursuits and stories about physical therapy.  This one has it all! An inspiring tale of what a driven person can accomplish.  I’m so inspired, I’m going to start commuting to work on my downhill bike!

Steinmetz has been nominated to represent the United States at the upcoming 2007 UCI Mountain Bike World Championships in Fort William, Scotland, Sept. 3-9.  I will be watching her results for sure!

As an interesting note, this woman suffered a head injury that went undiagnosed, a very popular story in the media right now as it relates to injured troops.

Labels: , ,

Will consumers fix healthcare?

All the rage of late in the medical business world is about retail medical clinics (or more aptly named, "convenience health clinics").  For Wall Street Journal readers, you know what I’m talking about.  You may also know that the American Medical Association has declared war on these clinics.  You may read their declaration here.

 

So far, customer satisfaction for this clinics has been high, around 97%.  Its not surprise then, that this business model is taking off, with clinics popping up in Walgreen’s and Wal-Marts all over the country.  It is obvious that the AMA’s opposition to these clinics is simply a turf battle and not legitimately about patient care quality.  It reminds me of physician’s opposition to direct access to physical therapists, and the battle over referral for profit arrangements; both battles also fought under the guise of physician’s altruism.

The all-seeing Seth Godin, had a nice post a while back on "Stuck Systems."  Here is a quote from that post:

"So, the marketer faces a challenge similar to the disruption challenge that most marketers face–how do you take a system filled with an inefficient, annoying, time-consuming, wasteful and yes, even stupid task and make it better in a way that serves all sides? 

If it were me, I’d focus on being cheap and fast and viral. And the more you break the system, the better your upside."

 

Healthcare is a stuck system.  I don’t think it can stay that way for long.  In the end, consumer choice of convenient services will rule the day.  It could be an incredibly ironic moment in the upcoming presidential election, where health policy is expected to play such a large role, that consumers have already chosen their "fix" for healthcare in the marketplace.

Physical Therapists must acknowledge they are part of a stuck system!  Third-party payment, regulatory woes, and limited access characterize our jobs.  The convenience model needs greater attention.  We are continually growing the research evidence base to support this model for physical therapist practice.  We might think about acting quickly, it could be embarrassing for a physical therapist to get beat in a race by a nurse practitioner!

Labels: , ,

Some good science reading


The LA Times is in the third installment of a series entitled, "Chasing Memory."  I have enjoyed the stories, although a bit length.  They chronicle neuroscientist Gary Lynch at UC Irvine.  Here is my favorite Lynch quote so far:

"If you’re good, if you’re any good at all, you put yourself in a situation where reality could come around and — WHACK! — knock you down. That’s what you really are afraid of. If you don’t have that, you’re not playing science,"

Labels:

The next big advance?

At one point in time, scientists did not know that germs caused disease.  The reason:  they were not able to see the germs.  Well, as optical technology improved, it became easy to study and examine the little buggers causing our body harm.  The knowledge now seems commonplace today.

One lasting barrier to all imaging is the ability to see inside living cells.  An MRI can image tissue well, but not at a cellular level. A study in the online journal, Nature Methods, discusses a technology that could change the way we think about how our bodies work.  Scientists have been able to construct an view of the inner workings of living cells in your body!

Tomographic Phase Microscopy.

Labels:

Dr Google and Dr Microsoft

Here is another update on the evolving role of our our nation’s two big software powerhouses in the healthcare arena.

"By combining better Internet search tools, the vast resources of the Web and online personal health records, both companies are betting they can enable people to make smarter choices about their health habits and medical care."

Hmmm.  Enabling people to make smarter choices about healthcare sounds like a good thing.  Now, how do we figure out, as a medical community, what those smarter choices really are?  One of the biggest barriers these types of efforts will face is being able to assess performance and outcomes from various health practices and medical care.  Is physical therapy superior to surgery for back pain?  In what cases is this so?  Is all physical therapy the same, or does it vary widely, preventing an across the board recommendation as to its effectiveness?

Well, I know the answers, but how does Google or Microsoft know the answer?

Labels: