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3 posts from February 2013


Dr. Susan Bennett Discusses the Prevention and Treatment of Heart Disease, the #1 Killer of Women (and Men) (February, 21, 2013)

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Heart disease is the leading cause of death for women (and men) in the US, accounting for one in every four deaths, however, among women, only 50% recognize heart disease is their #1 Bennett[1]killer.  Additionally, almost two-thirds of women who die suddenly of coronary heart disease have no previous symptoms.  (February is American Heart Month.) 

During this 27 minute podcast Dr. Bennett discusses the prevalence of heart disease particularly among women and what are primary prevention measures - that if achieved cardio vascular disease (CVD) could be reduced by over 80 percent.  She explains what accounts for women's limited awareness of CVD, the benefits of cardio protective drugs and statins (to lower cholesterol), female versus male symptomology and the lack of adequate CVD research specific to women.  Dr. Bennett notes the varying reasons why cardio rehabilitation, despite its substantial benefits, is woefully under utilized at rates under 30 percent and what can be done to improve patient utilization or participation.  The interview concludes with bottom line recommendations to avoid CVD and mention of federal programming efforts to reduce CVD via the "Million Hearts" campaign (www.millionhearts.hhs.gov) as well as related work by the American Heart Association (www.heart.org) and WomenHeart (www.womenheart.org).  (The interview failed to discuss or note the association between CVD and mental health or mental illness.  For example, depression even in mild forms can increase CVD risk and that depression is twice as common in women as in men.) 

Dr. Bennett is a Consulting Cardiologist of the Women's Heart Program at the MedStar Heart Institute.  She is the past Director of the Women's Heart Program at The George Washington University Hospital.  Prior to that she was an Assistant Professor in the Division of Cardiology at the U. of Maryland.  Dr. Bennett is on the Scientific Advisory Board of WomenHeart: The National Coalition for Women and Heart Disease, served as Chair for the National Heart, Lung and Blood Institute's Advisory Panel on Women and Heart Disease, she is Past-President of the Greater Washington Area American Heart Association (AHA), a national spokesperson for the AHA and is the author of numerous clinical publications.  She earned her MD degree from the Eastern Virginia Medical School.



Discussion with Dr. Steven Woolf on the IOM's Recent Report, "US Health in International Perspective: Shorter Lives, Poorer Health" (February 15, 2013)

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In January 2013 the Institute of Medicine released "Shorter Lives, Poorer Health" a 404-page report that found Americans die sooner, experience higher rates of disease and injury than people in 16 other like high-income countries and that these health disadvantages exist at all ages from birth to age 75. 

During this 22 minute podcast Dr. Steven Woolf, the chair of the IOM panel that authored the report, discusses the pervasiveness of problem or the diversity of health problems that exist across our entire lifespan, how social factors contribute to poorer health and the fact that higher educated and higher income Americans are also too in poorer health compared to their peer group overseas.  Dr. Woolf discusses worse birth outcomes in this country, the importance of antecedents for good health and possibly why the only subpopulation of Americans, those over 80, do comparatively well.  Finally, Dr. Woolf outlines the report's three policy recommendations and identifies a few foreign health care policies, that if adopted, might prove effective in the US.  Woolf2

Dr. Woolf is Professor at the Departments of Family Medicine, Epidemiology and Community Health at  Virginia Commonwealth University.  In 2001 he was elected to the Institute of Medicine.  He has published more than 100 articles that have focused on evidence-based medicine with a special focus on preventive medicine, cancer screening, quality improvement and social justice.  He is the associate editor of the American Journal of Preventive Medicine and served as North American editor of the British Medical Journal.  He received his MD from Emory and his MPH from Johns Hopkins.


Dr. Kavita Patel Discusses the Promise of Accountable Care Organizations (February 11, 2013)

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One of the most discussed provisions of the Affordable Care Act promising to "bend the cost curve" are Accountable Care Organizations (ACOs).   CMS has now selected over 250, moreover physician-led, organizations as ACOs coverning four million Medicare beneficiaries.   ACOs offer the promise of improved coordinated care, care quality and reduced Medicare costs.  During this 27-minute interview Dr. Patel explains the impetus for and creation of Accountable Care Organizations, how rapidly ACOs are growing in number and what are some of the barriers limiting participation in the “shared savings” program.  She explains further how Medicare reimburses ACOs (Type 1 and 2) and the concern among providers regarding the freedom Medicare beneficiaries have in seeking care outside their ACO.  What ACO activity is occurring beyond Medicare or among large physician groups and private insurers, how and why ACOs might be successful and how and why ACOs serve as a catalyst for provider integration (and the downside risks involved with accelerated consolidation) are all also discussed.  The interview concludes with a brief summary of the Brookings-Dartmouth ACO learning network (www.acolearningnetwork.org).

Dr. Kavita Patel is a Fellow in the Economic Studies program and Managing Director for clinical transformation and delivery at the Engelberg Center for Health Care Reform at the Brookings Institution.  She is also a practicing primary care internist at Johns Hopkins Medicine. She served previously in the Obama Administration as Director of Policy for the Office of Intergovernmental Affairs and Public Engagement in the White House.  Dr. Patel also served as Deputy Staff Director Echr238_16x9[1] for the late Senator Edward Kennedy.  She too has an extensive research and clinical background having worked as a researcher at the RAND Corporation and as a practicing physician in both California and Oregon.  She earned her medical degree from the University of Texas and her masters in public health from the UCLA.