Posts Tagged ‘Pew Internet & American Life Project’

Walking and Texting – Hazard To Your Health

Monday, August 6th, 2012

In the old days, it was people reading a book while they walked. But these days, one of the most perilous activities to your health may be: texting on foot. Police are even enforcing 60 year old jaywalking laws in order to get people to watch where they’re going. 

According to the Consumer Product Safety Commission, 1,152 people wound up in hospital emergency rooms in the last year for injuries caused when walking and using a cell phone or electronic device. Injuries to distracted walkers have quadrupled in the past seven years, according to emergency room numbers, and that’s probably a low estimate because either patients don’t admit a cell phone was involved or doctors don’t include that sort of detail on hospital reports.

No one is impervious.  According to a recent Newsweek article, “texting has become like blinking: the average person, regardless of age, sends or receives 400 texts a month, four times the 2007 number.” Teens are particularly vulnerable. That same Newsweek article clocked the average teen processing 3,700 texts a month, double their 2007 numbers.  Another report by the Pew Internet & American Life Project looked at the behavior of nearly 800 teens ages 12 to 17 during a three-part survey between April and July 2011 and a series of focus groups involving 57 people ages 12 to 19. Teens on average were shown to be sending and receiving 60 texts each day, up from 50 in 2009. The increase is being led by older teens ages 14-17 who went from a median of 60 texts a day to 100 two years later (that’s 6 texts an hour assuming you sleep for 8 hours).  Girls are still the most active texters, sending and receiving a median of 100 texts a day compared to boys sending 50. However, boys are texting more than they were just two years ago — in 2009, they sent about 30 each day. Worldwide, the highest average is in the Philippines, with an average of 27 texts sent per day by subscribers.

Why Aren’t Physicians Paid For Talking To Their Patients?

Tuesday, July 5th, 2011

One possible reason that more physicians do not choose family practice as their specialty could be the fact that an essential part of the job is spent talking with patients – an activity that pays less than does performing procedures.   According to a recent study published by the Journal of the American Medical Association, just two percent of medical students plan a career in general internal medicine, pediatrics or ob/gyn.

Writing on the KevinMD.com website, Jennifer Adaeze Anyaegbunam says that “Family doctors spend more time talking to patients than performing procedures, but these doctors don’t get paid much to chat.  According to Dr. Sameer Badlani, a professor at the University of Chicago School of Medicine, when physicians are paid on a fee-for-service basis, specialists have the opportunity to make four to five times as much as a family physician.  Given the increasing debt of medical students, it is no surprise that the overwhelming majority choose to specialize.  In order to increase the supply of primary-care providers and meet the anticipated demand, family physicians need to be reimbursed more for their services.  Congress is looking into legislation that includes provisions for loan forgiveness and increased Medicare/Medicaid payments to primary-care providers.  Additionally, there have been talks of expanding the National Health Service Corps, program that utilizes scholarships and loan repayment to recruit primary care professionals to work in underserved areas.”

Primary-care physicians spend more time talking to patients and helping them avoid health crises to cope with chronic and incurable diseases than they spend performing tests and procedures. These doctors ask relevant questions, about health and life circumstances, and listen carefully to their patients.  These are physicians who know their patients and the circumstances and beliefs that can make health problems worse or hamper effective treatment.  The problem is that reimbursements are dictated by Medicare and other insurers.  As a result, physicians are not compensated well for taking the time to talk to patients.  They are primarily paid for procedures – such as blood tests and surgery — and for the number of patients they see.  Most spend long hours doing paperwork and negotiating treatment options with insurers.  The payments they receive have not increased along with increases in the costs of running a modern medical practice.  To earn a reasonable income of $150,000 a year, many primary-care doctors squeeze more and more patients into the workday.  “If you have only six to eight minutes per patient, which is the average under managed care, you’re forced to concentrate on the acute problem and ignore all the rest,” said Dr. Byron M. Thomashow, medical director of the Center for Chest Diseases at New York-Presbyterian Columbia Medical Center.  In a study of more than 3,000 patients with chronic obstructive pulmonary disease, 50 to 60 percent had one or more other illnesses, and 20 percent had more than 11 other conditions that required medical attention.  “There just isn’t the time to address them all,” Thomashow said.

Dr. Alan J. Stein, an infectious disease specialist in private practice in Brooklyn who treats many patients with HIV, described his practice as “heavily cognitive.  I spend a lot of time talking to patients — listening to them, examining them, interpreting tests and figuring out what’s wrong,” he said.  “I don’t do procedures in the office.  Over the last 10 or 15 years, the income of procedure-based physicians like cardiologists has increased significantly, whereas for those in primary care it has remained the same.”

Despite this, many physicians are reluctant to talk to their patients via e-mail.  Suzanne Kreuziger, a Milwaukee registered nurse, said.  “It makes sense to me to have the words laid out, to be able to re-read, to go back to it at a convenient time,  If I were able to ask my physician questions this way, it would make my own health care much easier.”  Her experience is shared by the majority of Americans: They want the convenience of e-mail for non-urgent medical issues, but fewer than 33 percent of doctors use e-mail to communicate with patients, according to surveys.

“People are able to file their taxes online, buy and sell household goods, and manage their financial accounts,” said Susannah Fox of the Pew Internet & American Life Project.  “The health care industry seems to be lagging behind other industries.”  Physicians have good reasons for avoiding e-mail exchanges with their patients.  Some are concerned that it will increase their workload.  Others worry about hackers compromising patient privacy.