genomeboy.com

Three-fourths of the nation’s doctors practice in small offices, with 10 doctors or fewer. For most of them, an investment in digital health records looks like a cost for which they are not reimbursed.It is scarcely surprising, then, that only about 17 percent of the nation’s physicians are using computerized patient records, according to a government-sponsored survey published last year in The New England Journal of Medicine.

“This is really not a technology problem,” observed Erik Brynjolfsson, an economist at the Sloan School of Management at the Massachusetts Institute of Technology. “It’s a matter of incentives and market failure.”

That market failure is a principal target of the Obama administration’s plan. A main feature of the legislation calls for incentive payments of more than $40,000 spread over a few years for a physician who buys and uses electronic health records.

Better late than never. 

Bob, who’s owned wild animals all his life, admits Higgins has not always been a model pet. When Higgins was 3, he slept with the couple, often awakening Bob in the morning by climbing to the bedroom rafters and dropping onto Bob’s stomach. On one occasion, they got in a wrestling match, and Higgins put one of his “steel-like fingernails” through Bob’s scrotum.

Bob has considered moving him to a sanctuary, but “I’m just too attached to him,” he says.

…

Bob has been bitten several times by Higgins, who now weighs 50 pounds and has large incisors. Once, when Bob was leading him from an outdoor enclosure back to his cage in the house, Higgins exploded and the two got into a battle so ferocious that despite the steel mesh glove Bob was wearing, he screamed for Carlie to get his .22 rifle and put a bullet in Higgins’s head. She got Higgins a slice of raisin bread instead, quickly defusing the fight. But Bob accepts it: a wild animal will never be domesticated, he says.

…

“He shivered and I leaned over and said, ‘Come here, baby, are you cold?’ and he exploded,” Ms. Bowers says. “He started biting and screaming at me, biting any place he could touch. It was a nightmare. We tipped over furniture, I would have killed him if I could. But he was so strong. I tried to choke him to make him stop. We fought for I don’t know how long. I was trying to hold him so he couldn’t bite me. I took one of my big fabric books and held it on his throat.”

…

JUDIE HARRISON, 50 and three times married, is an extreme example of monkey love. She once demanded that her 15-year-old son give up his bedroom for a chimp, and today she is estranged from all three of her children because she put the primates first. Her passion also cost her her home.

Words fail. 

The doctor who sparked the scare over the safety of the MMR vaccine for children changed and misreported results in his research, creating the appearance of a possible link with autism, a Sunday Times investigation has found.

It remains to be seen whether this will mollify the conspiracy theorists.

(via Balk)

I’m not sure why, but lately I’ve been thinking about organ transplantation. This 2006 article from living kidney donor and writer Virginia Postrel is a jaw-dropper:

Many hospitals and bioethicists seem to believe a demeaning set of assumptions:

• Normal people won’t give up an organ except under coercion.
• Anything that encourages a decision to donate is coercion.
• To avoid coercion, living donors should be discouraged.

Some transplant centers require intrusive psychological probes that scare people off. Some bioethicists treat benevolence or religious conviction as a mental disorder. Even relatively supportive transplant centers like mine make it easier to quit than to go through with it.

The scrutiny is particularly nasty when people want to give to “strangers”– not truly unknown people but patients they’ve gotten to know through Internet sites or news coverage. Many centers flatly refuse “directed donations” to specific strangers, forcing donors to lie about how they met recipients.

Ms. Darling, who was pregnant when her insurance ran out, worked at Archway for eight years, and her father, Franklin J. Phillips, worked there for 24 years.“When I heard that I was losing my insurance,” she said, “I was scared. I remember that the bill for my son’s delivery in 2005 was about $9,000, and I knew I would never be able to pay that by myself.”

So Ms. Darling asked her midwife to induce labor two days before her health insurance expired.

“I was determined that we were getting this baby out, and it was going to be paid for,” said Ms. Darling, who was interviewed at her home here as she cradled the infant in her arms.

As it turned out, the insurance company denied her claim, leaving Ms. Darling with more than $17,000 in medical bills.

But we wouldn’t want to rush into anything.

If you don’t want to look at Alzheimer’s because you’re afraid that you would be unable to face the fact that you’re likely to lose the little God gave you, then you just don’t click on it.

- Kari Stefansson, DISCOVER magazine, September 2008

“Our genes are not our fate,” he says. I couldn’t agree more.

But do I have to eat kale?

Six.

That’s how many times I was asked to repeat my name, social security number and date of birth to the technicians at the American Red Cross today. This is how we protect blood recipients?

Genetic Future (about which I can’t say enough good things) points to Jennifer Couzin’s Science article on genetic risk:

Some concerns about the public’s reaction have already eased. Two years ago, behavioral epidemiologist Colleen McBride and human geneticist Lawrence Brody, both at the National Human Genome Research Institute, began examining how healthy individuals respond to disease risk information. They offered volunteers in Detroit, Michigan, the chance to learn whether they carried deleterious variants for eight health conditions, including diabetes, colon cancer, and osteoporosis. Because the variants are common, virtually everyone was expected to harbor at least a couple. Those monitoring the study’s safety “were really worried, literally, that people were going to jump off bridges” when they learned that their risk of disease was increased, says McBride.

Among the 300 or so who have participated, that hasn’t happened–quite the opposite. “They’re not having big emotional responses,” says McBride.

If that’s true–as it appears to be in Alzheimer’s as well–then how does that jibe with the “people-will-freak-out-if-you-tell-them-so-don’t” argument?

I am frequently asked what it will take to make personalized medicine a reality. If I’m being honest and not full of my usual bloated self-regard, I will shrug and say, “I have no idea. You should ask someone who might actually know.”

But if pressed and palpated, I would submit that if there’s a single thing missing from the roadmap to personalized medicine, it’s this:

A mascot.

Other folks have recognized this. To wit: Ladies and gentlemen, meet Prosty the Spokesgland©…

But wait, there’s more. The theme song, sung to the tune of Frosty the Snowman and meant to encourage the use of imaging rather than digital exams (yay!), is truly inspired. Dig the last verse:

Lumpety lump lump
Lumpety lump lump
Look at Prosty grow
Lumpety lump lump
Lumpety lump lump
No more bending over so