Grand Rounds: Bettor’s Guide to the Key Bowl Games in Health Care

January 4th, 2011 | Sources: Commentary

Several key health care bowl games will be played in 2011. Their outcomes will affect the health and well-being of a hundred million Americans and help determine the timing of the nation’s inevitable economic double-dip. They’ll also help health insurance CEOs decide whether to re-decorate their offices with fur or linoleum, and who knows? They may even help Mrs. Farquhar find a PCP.

Before you gamble your hard-earned reimbursement check on the outcomes of these tilts, be sure to consult our handy bettor’s guide for insights and advice! We’re so sure we can help you get rich quick, we’re offering these guaranteed locks to you for free. If you like what you see here and want an even bigger edge, we recommend contacting the experts listed below. 

Florida Citrus Bowl
Republican-appointed Judges vs. Democrat-appointed Judges: My civics class teacher told me that the judicial branch of government was not subject to partisan politics. So how come every time a GOP-appointed judge rules on the Big O’s health reform law the verdict comes out unconstitutional, and every time a Clinton-Obama appointee rules, it’s cool? This is Bush-Gore 2000 all over again. We know how that turned out. GOP Judges to prevail by a hanging chad.

Sugar Bowl
Contrave vs. the FDA: Drug companies have spent billions developing a pill for obesity and have gornisht to show for it. The FDA gonged rimonabant three years ago and trashed Qnexa and Lorcaserin more recently. But in a shocking development last month, FDA scouts said Orexigen’s Contrave was the real deal. Forget that it was minimally effective and had a lousy side-effect profile! The FDA will probably approve it later this month. Over/Under = 10 pounds lost per user. Take the under.

Alamo Bowl
Texas Governor Rick Perry threatened to pull his state out of Medicaid, then backed-off amid catcalls from his advisors and top docs in the state. It also dawned on Perry that he’d lose $15 billion a year in federal matching funds if he pulled out, and that Texans would still be paying federal taxes and thus subsidizing Medicaid programs in other states. Perry to win the Grady Little Manager of the Year Award.

Fiesta Bowl
EMR companies enjoyed soaring profits and stock prices in 2010, but official scorers refused to re-write the record books saying the performance was wind-aided by HITECH. And even though virtually all reputable EMRs have nailed Meaningful Use by now, their systems still look like they were designed by Rube Goldberg on blotter acid. Fifteen yard penalty for unsportsmanlike conduct!

BCS Championship Bowl
The latest chapter in the health reform grudge match between the Pelosis and the Boehners features a new twist now that the latter kicked serious donkey in the midterms. Casual fans can’t figure out if that’s Mitch McConnell or a wax figure of Mitch McConnell on C-SPAN, but it’s not going to matter. Boehners score early and often, and win by 2 touchdowns.

The Doctor-Patient Relationship                                                                                                   
MariaYang’s terrific new blog, In White Ink contains short character sketches and vignettes drawn from her work as a psychiatrist and from her observations of the world at large. The pieces are insightful, funny and poignant. In a post titled Lucky, Yang describes a person who hears voices and believes she alone can reunite North and South Korea, yet she is surprisingly capable of an occasional astute observation. In Aging, we observe the mannerisms of an elderly man who is befuddled, if not particularly stressed-out by his surroundings. Our pick to click!

Boomers 2011 is a moving, introspective post by John Schumann over at the GlassHospital Blog. Schumann reminds us that this year, the oldest Baby Boomers turn 65 and hence become eligible for Medicare. Then, to illustrate the challenges faced by these folks, Schumann shares a letter he received from a patient. “Ted” is acutely aware of his growing infirmities, and his letter amounts to a lament for times gone by. Thankfully though, a second patient offers Schumann a fresh approach to helping people like Ted. And the approach has nothing to do with prescribing more drugs or ordering more tests.

Health IT
According to Michael Kirsch at MD Whistleblower, electronic medical records (EMRs) are a double-edged sword when it comes to litigation risk. In his post titled “EMRs: Medical Malpractice Shield or Magnet?” Kirsch presents a balanced summary of their risks and benefits in this regard, but in the end Kirsch remains skeptical: “I fear that, at least in the short term, the legal risks for (physicians) exceed legal protections. We need to be vigilant, not only to protect our patients’ health, but also to protect ourselves.”

Quality and Safety
In a post titled, Joint Commission: Anti-Safety in Action, WhiteCoat lambasts the agency for designating suicides in the emergency department as Sentinel Events. Writing for the CallRoom Blog, WhiteCoat calculates that the incidence of suicide in the ED is about one per 25 million visits. As a result, ED staff is more likely to win the lottery than find a patient who will commit suicide. Nevertheless, WhiteCoat writes, staff must now be on the look-out for suicidal patients and document its activities every step of the way.

In The Downside of Understanding, Nick Fogelson marvels at the deluge of new medical knowledge that has become available since he entered practice 10 years ago. But as he points out, the new information is often complex and nuanced. It’s a challenge, he writes, to present this information in a way that patients can understand. The post appears at Academic OB/GYN.

Legal Matters
For Ed Pullen, the ongoing litigation involving Myriad Genetics and a bevy of plaintiffs led by the ACLU has taken-on personal overtones. Myriad holds patents on a pair of genes in which certain mutations confer increased risk of breast and ovarian cancer. As a result, it owns exclusive rights to tests that detect these mutations. In BRCA Gene Patent, Pullen explains why the matter has become personal for him, and why he feels the patents should be invalidated.

In a scathing, hilarious post titled, Zippity Zappity, Powerbands and AMI, Sheepish lauds recent actions by regulators against 3 companies engaged in quackery and shonky medicine in Australia. Despite the interventions, Sheepish reports in his blog, Paper Mask, that at least one  company remains in business, and another still operates a web site (albeit from the USA).

Over at Colorado Health Insurance Insider, Louise summarizes the recent expansion of her state’s Medicaid program. The successful expansion, she writes, was driven by a “presumptive eligibility” policy in which applicants are automatically enrolled when they first apply. If they are subsequently determined to be ineligible, they are removed from the program at that time.

Social Media
Over at InsureBlog, Henry Stern skewers Oregon Democrat Earl Blumenauer for overlooking a fundamental tenet of life in Internet Age: Never write anything in an email that you wouldn’t want showing up the next day in the New York Times. The Congressman did just that, and sure enough, the next day his top-secret email was reprinted in the Newspaper of Record. To find out what Blumenauer wrote, please see Henry’s post.

Behavioral Health
Eating healthier is a common New Year’s resolution, but most people find it tough to undertake wholesale dietary changes overnight. Recognizing this, Dr. Charles presents a manageable list of unhealthy foods that consumers will, hopefully, cross-off their shopping lists. The post is titled 7 + 3 Foods to Avoid. It can be found in The Examining Room.

Recognizing that many people experience painful flares of their gout during the holidays, Irwin Lim presents a timely, patient-focused review of the affliction on the BJC Health Blog. Lim’s post reminds us that flares can largely be prevented with a combination of reduced alcohol intake, dietary modification, weight loss and urate-lowering medications.

In a post titled, Universal Curative Processes, psychologist Will Meek offers a list of 10 behaviors (ranging from accepting one’s self to engaging in creative activities) that he believes can be used by most people to improve their sense of well-being.

Thanks to everybody who submitted posts to this week’s Grand Rounds! Have a great day and best of luck in the New Year!

Buyer Beware: This Bettor’s Guide Picked the Team in Red




  1. rlbates | 4/01/11

    Great edition!

  2. hgstern | 4/01/11

    Now THAT’S a winning combination!

    Thanks for hosting a GREAT ‘Rounds, and for including our post.

    Happy New Year!

  3. Maria Gifford | 4/01/11

    Excellent version of Grand Rounds! Many thanks for hosting for us. Well done!

    Our best,
    Maria & Dr. Val
    Better Health, LLC

  4. Sheepish | 4/01/11

    Thanks for including my blog! What a great collection!

  5. Michelle W | 5/01/11

    Thanks for the great layout to the first Grand Rounds of the year. I expect there will be many more “bowls” before the year is up.

  6. drcharles | 6/01/11

    very creative 🙂 looking forward to finally getting a chance to read through the links today. thank you for organizing.

  7. Tina | 9/07/11

    Thanks for posting this, it was a great read. However I do have my own thoughts and feelings about proposed obesity pills. Currently there are ALOT of weight loss pills on the market. You’ve got Hydroxycut, Ali, Apidextra, and Fenphedrine (just to name some). All of which has some weird side effect because the drug is unnatural to the body.

    I think appetite suppression and a steady workout plan would be the better direction to go in because you will lower the intake of calories, will burning other calories off.

    In theory yes, I know that it sounds the same as what everyone else is saying, but how ALOT of these companies get rich is by promising you a pill that will magically make you as slim as a super model with little to no work, and that can be very deceiving to people who are trying to lose weight.

  8. Dan | 16/11/11

    Good opportunity, I don’t see any reason to refuse it.

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