When I read stories that appear throughout the book, the room becomes pin-drop silent. Not uncomfortable, but attentive. People lean forward. Some close their eyes. Others quietly wipe away tears. Even after reading these stories again and again, my own eyes still mist. These are not reactions to theory or argument. They are responses to a painful reality many recognize.

What becomes clear in those rooms is that the frustration is not isolated to one role or perspective. Patients speak about waiting and uncertainty. Clinicians describe exhaustion and moral strain. Innovators and policymakers wrestle with systems that move more slowly than the problems they are trying to solve. The details differ, but the throughline is the same: people want care that recognizes their presence and treats them as more than a process to be managed. When that recognition happens, the tone of the conversation changes.

Since its listing, the book has spent several consecutive weeks on Amazon’s Top New Releases list. That matters in a conventional sense. Still, rankings, whether in print or digital format, do not explain what happens when people hear their own experience reflected back to them with clarity and respect. Stories do that work. Many are weary of facts and figures deployed to justify positions rather than illuminate lived reality.

Human experience carries a different kind of truth. It does not compete with data, but it precedes it. When experience is named accurately, people do not feel persuaded. They feel recognized. That recognition opens space for reflection, dialogue, and ultimately for change.

A Question That Changes the Room

I finished a book talk and signing with The Marfan Foundation, and the impact lingers beyond the formal program. During the signing, people ask thoughtful, personal questions. I often ask permission to respond by reading a short passage from the book. Then I listen to stories of courage, love, and endurance that surface naturally and without prompting.

Parents speak about children. Siblings talk about one another. Families describe navigating medical uncertainty and emotional trauma over years, sometimes decades. Individuals share how they discover the strength they did not know they possessed, and how they learn to share that strength with others walking similar paths. These are not stories of abstraction. They are lived, detailed, and deeply human.

The Marfan Foundation is one of the patient and professional communities reflected in the book, and in the room, the reason is unmistakable. Physicians are spoken of by first name – Alan, Duke, Kim and Reed – not title. They are described not as distant experts, but as people who show up consistently and with care. These stories remind everyone present that even in the most complex conditions, care is sustained by relationships as much as by scientific excellence.

Between Two Meetings, on a Moving Train

As I board a Brightline train for the next meeting, the contrast stays with me in a quiet, persistent way. I am traveling from a gathering centered on shared human experience to SCOPE Summit 2026, a global convening focused on clinical trials and research infrastructure. The agenda centers on development planning, protocol optimization, patient-centric trial design, site engagement and recruitment, generative AI, and the technologies that move science from hypothesis to evidence.

One meeting is rooted in lived journeys, where science is received as hope amid uncertainty. The other is grounded in structure and precision, where science is designed, measured, and scaled. Both spaces matter deeply, and both are essential to progress. Clinical research is where rigor lives and where uncertainty is reduced in ways that allow care to advance responsibly.

Yet the transition between these two gatherings and two cities reveals something essential. People do not leave their humanity at the door of the operating room or the halls of science. They carry it with them into protocols, endpoints, enrollment decisions and trial participation. Patients do not experience trials as abstractions. They experience them as acts of trust layered onto already complex lives.

When Structure Forgets Experience

Too often, human experience is treated as something to be accounted for after systems are built, rather than as a foundation for their design. Trials are optimized for efficiency and compliance, yet struggle when recruitment falters, participation drops, or trust erodes. These outcomes are not solely technical failures. They are relational failures.

Patient-centric trial design is not a feature added late in development. It is a mindset that shapes questions, assumptions, and priorities from the start. Site engagement is not a procedural step, but a relationship built over time. Technology reduces burden only when shaped by empathy, context, and understanding.

Rare disease communities such as The Marfan Foundation understand this instinctively. When systems fall short, patients and families organize, advocate, and collaborate more intentionally. In doing so, they model what the broader system aspires to scale: trust, continuity, shared language, and partnership. People do not fragment their lives the way systems fragment care.

When Experience Finally Counts

At SCOPE, this question becomes practical rather than theoretical. I moderate a fireside chat with StuffThatWorks executives Yael Elish and newly appointed CEO Julie Ross, exploring what happens when patient experience is treated not as a marginal input but as the foundation of artificial intelligence itself. Billions of dollars are invested in pre-clinical discovery, yet clinical trials remain a costly bottleneck, often stretching beyond seven years before therapies reach patients.

One story from the book captures why this matters. A woman living with a chronic autoimmune condition follows treatment guidelines faithfully yet struggles with side effects that force her to stop therapy repeatedly. Her medical record reflects non-adherence, not struggle. It is only when she joins a patient-driven community where thousands share lived experience that patterns emerge her clinicians have never seen.

Within weeks, she learns how others adjust dosing, manage side effects, and balance treatment with daily life. When these experiences are aggregated and analyzed, they do not contradict clinical science. They complete it. What once looks like noise becomes a signal when the human story is allowed to remain intact.

This is why patient-derived models matter. Real-world evidence is not simply post-market surveillance. It is the accumulated story of how people actually live with disease, navigate treatment, and make trade-offs that controlled environments rarely capture. These data are not neutral artifacts. They are lives rendered into patterns with meaning.

Restoring What Was Lost

What I witness in quiet rooms, at signing tables, and in conversations that follow readings is not resistance to science. I see the same truth as a fireside chat moderator, alongside people dedicated to bridging patient voice, data, and science in ways that honor those it seeks to serve. What emerges, again and again, is a longing for connection.

People are not asking to be spared complexity, nor do they believe science belongs only in a sterile laboratory. They are asking not to be erased by it. They want science that recognizes them even as it advances, and systems that remember who they are designed to serve.

This is where Why People Matter ultimately resides. Healing does not begin when systems are optimized or when data moves faster. It starts when relationships are restored and when people feel recognized within the structures meant to help them. Science advances when trust is present, and trust grows when listening is treated not as an accessory but as a foundation.

If there is a path forward, it is not found by choosing between humanity and innovation. It is found by refusing to separate them. Data matters because people do. And when science remembers that progress becomes worthy of the lives it touches.

The post Why Healing Still Begins with Relationship appeared first on Medika Life.

The proper terminology is “epistemic injustice,” whereby a person’s concerns are dismissed by someone else, causing that person to question their own perception of reality, or to make them feel “crazy.”

The article was describing the experiences of patients who were referred to a specialized clinic for vulvovaginal disorders. When I read the article and the term “medical gaslighting,” I reached out to the primary author, Dr. Chailee Moss, to have her come on my podcast (the link the episode is at the end of this article) to discuss her article and the “medical gaslighting” itself.

The findings of the article were eye-opening: less than half of patients said that past practitioners were supportive; a little more than a quarter were actually belittling, and one fifth were described as not believing the patient. What shocked me was that 20.6% of patients were given a recommendation to drink alcohol to relieve their symptoms. Moreover, 16.8% of patients felt unsafe during a medical encounter and 39.4% said they were made to feel crazy.

The actual narrative responses were also instructive, and they are reproduced here:

The most important takeaway from the article and my conversation was that we must do all that we can to ensure patients feel heard. Even if we can’t find something specific to treat, we should do our utmost to ensure that patients’ concerns are not perceived as being dismissed. This applies to all specialties, including critical care. Also, “drink more alcohol” should NEVER be a medical recommendation, in my opinion. It was a very important lesson for me, and it is one I will do my best to remember every day of my practice.

Listen to the podcast episode: https://www.healthcaremusings.com/the-freedom-fighters-of-medicine/

The post Can Doctors “Gaslight” Their Patients? appeared first on Medika Life.

Not to take anything away from the Senator’s apparent concern for his constituents’ real, valid frustration with the health system, but is his villain the right one? Is it a fundamental misreading of the facts of the US health ecosystem to believe that there is any one villain in the system at all? The real, underlying reason that the US health system is so fragmented is that the system itself is the problem. And, as it must be, the system will be the source of any viable solution that makes navigating less challenging and more holistically unified.

Stop Blaming Individual Sectors — Look at the Aggregate

High drug prices are just one symptom of a health ecosystem already becoming increasingly fragmented several decades ago. The problem was well-established and recognized when economist Dr. Alain C. Enthoven wrote about it in the American Journal of Managed Care more than a decade ago, positing that inefficient allocation of resources negatively impacted quality, cost of care and medicines, and patient outcomes.

Since then, little has changed. In 2016, FINN Partners released a survey showing that the fragmented health ecosystem was placing an ever-greater burden on patients, the people the system is supposed to protect and serve — and was increasingly failing. Eight years later, the results of this survey will not have changed significantly.

For decades, payers, patients, policymakers, product innovators, and providers turned a blind eye to fragmentation. And while policymakers prefer to spotlight a popular villain — drug cost — the relentless search for villains won’t fix fragmentation. If we attack one piece of the ecosystem rather than look at the problem, we will fail to make meaningful change. While putting pharmaceutical company CEOs under the glare of the Senate HELP spotlight may provide a tremendous election-year photo-op, bipartisan grandstanding is antithetical to addressing the health system’s continued splintering.

If the System Were a Patient with Multi-System Failure, Would We Treat Only One Organ?

We now know beyond a doubt that the health system is fragmented and has a cost impact. It is time to move from this era of fragmentation into the “post-fragmentation” period. Rather than finger-pointing and finding scapegoats, what’s needed is a fuller understanding of how the system works — and fails to work — for the patient. This requires looking at the full picture objectively, without accusation, to understand better how the different players in the system can work together to support the same goal: a health system in which the patient, not the system itself, is the health system’s true beneficiary.

It’s a fact: prescription drug prices in the United States are higher than in other nations, averaging 2.78 times those seen in 33 different countries, according to the February 2024 RAND report. But are pharma companies the sole cause of this patient burden and health-system chaos? Absolutely not: drug costs comprise about 11 percent of the total $4 trillion in US health expenditures. In reality, provider and hospital services total almost half of US health spend (31.4 percent and 20.3 percent respectively).

Fragmentation Adds to Patient Care Burdens and Costs

Fragmentation leads to out-of-control spending across the system. According to a 2018 Commonwealth Fund study, Medicare recipients “with three to four chronic conditions and highly fragmented care are 14 percent more likely to visit the emergency department, and six percent more likely to have a hospital admission.”

If the US health system were a publicly traded corporation, this hemorrhaging of cash would have been decisively stopped years ago. Taken together, the $4 trillion in annual US healthcare costs can be laid on the doorstep of nearly every player in the ecosystem, from insurance companies to PBMs, pharmacies, pharmaceutical companies, government, hospitals, and venture capital, to name a few — even endless consumer demand and neglected preventive care.

Operating with a business-as-usual approach will carry steep costs in money and lives. When the system fails to engage people proactively with heightened risk for heart disease, cancer, diabetes, and other non-communicable illnesses, when it denies patients diagnostic procedures ordered by their physicians, when it shifts patients from working medications to substitute therapies due to a non-medical switch decision, curiously, some parts of the system benefit to the detriment of patients.

These situations shouldn’t be, as the consequences of the current line and the decisions they reward can be dire, leading to rising costs, diminished patient care, and even death. Ultimately, the chaos around care delivery comes from considering patients a necessary fly in the system’s ointment. The patient is not the health system customer. The system is a customer unto itself.

Can We All Focus On Why the System Exists — To Heal Patients?

We recognize the health system’s failings but must also identify its strengths and potential for improvement. This will allow us to reorient our thinking and ask, “Now, what do we do to put the patient back into focus as the ultimate customer and the preferred beneficiary of the system?”

Stanford Physician Ilana Yurkiewicz, an internist, hematologist, and oncologist, in her book Fragmented: A Doctor’s Quest to Piece Together American Health Care, published by W. W. Norton, argues that it’s actually fragmentation that’s the central failure of health care today, resulting in a system that uses more than twice the economic resources other developed nations dedicate toward health and which results in poorer life expectancy outcomes:

“There’s an unspoken assumption when we go to see a doctor: the doctor knows our medical story and is making decisions based on that story. But reality frequently falls short. Medical records vanish when we switch doctors. Critical details of life-saving treatment plans get lost in muddled electronic charts. The doctors we see change according to specialty, hospital shifts, or an insurer’s whims.”

No longer are we debating whether the system is fragmented or not. We must shift our mindsets and drop the mistaken belief that identifying bad players in the ecosystem will fix the problem. With ecosystem fragmentation as the diagnosis, what is the treatment path to better management? This is where “Health System Kinetics” (HSK) enters. HSK fosters collaboration and leverages health information technologies — AI, ChatGPT, GenAI, and LLMs — to create an eco-dynamic that prioritizes people’s well-being and works toward longer, healthier lives.

The Health System is Greater Than Its Sector Parts — Study its Kinetics

Health System Kinetics objectively studies factors and sector-to-sector relationships influencing individual and collective health outcomes. It includes biological, environmental, social, and economic determinants of health. Understanding health system kinetics will allow the health system to evolve for the better, benefiting its stakeholders and addressing gaps and inefficiencies in people’s care by fostering a proactive, positive approach.

Understanding why fragmented care is a system-wide illness is a starting point we passed long ago. Looking at the health ecosystem as an ever-changing aggregate — kinetics — rather than separate sectors at fault is the opportunity to move beyond the present chaos.

Fragmentation goes beyond the left hand, not knowing what the right is doing. Too often, it means that the left hand won’t acknowledge the right hand’s very existence. While rising costs concern everyone, it’s essential to keep our eye on the goal of keeping people healthier at home, out of the hospital, and, if possible, far away from illnesses. To do that, we must address the misalignment of incentives and lack of coordination in the health ecosystem.

Applying Health System Kinetics will allow us to understand better how we can do this to provide better patient care, reduce health professional burnout, and give patients with chronic conditions greater attention. The objective study of the interconnectedness of the parts of the healthc system will promote a better understanding of how these components work together now — and how they can be changed to work better together in the future. Failing to take this approach means we won’t see meaningful change, and that’s not an option.

Do Not Let the Virus Kill its Host — the Health System

We have diagnosed the illness that plagues our health system; it’s a virus called fragmentation. It’s time to examine our biases, behaviors, and business goals. The primary mission is to recognize that we are people — sometimes patients — all seeking to enjoy a healthier life. Suppose fragmentation is the wall that separates us from better access to care. In that case, health professionals in every ecosystem sector can be empowered to pursue their calling with passion and tear down that wall.

Looking for a villain in the health ecosystem, something lawmakers have been doing for the last several election cycles, may be suitable for campaigning but not for progress — not for continued innovation and patient care. Progress can only be achieved when we get past the mindset of the period in which we have been — the period of acknowledging the system is fragmented — and move into the post-fragmentation era, in which we view the system through the lens of health kinetics and eco-dynamics.

When we look at and understand how all parts of the system work together — or fail to –we enter an era in which we no longer debate who’s to blame. Proper understanding will allow us to compromise, adjust our aims, improve our practices, and finally, make changes that remove the health system as its own beneficiary, replacing it with the patient as the system’s customer.

[Special thanks to John Bianchi for his review of this health policy economics article that shifts the conversation from sector-to-sector blame to a forward-looking perspective; to industry friend and mentor John Nosta for encouraging me to put these thoughts into publication and to Dr. Dean and Anne Ornish, pioneers in preventive and consumer empowered health and co-founders of Ornish Lifestyle Medicine.]

The post We Know the Health Ecosystem is Fragmented, Resulting in Rising Costs and Poorer Patient Outcomes, But What Are We Doing About It? appeared first on Medika Life.

No Wild Expectations – A Will to Try Something New

The collaboration between Amazon Medical Services and the 220-site One Medical may signal a near-term business model shift in patient care. In a brief conversation with the companies’ four-person strong chief medical officer team at HLTH 2023, it was evident that senior staff at both companies have been rolling up their sleeves to think through how to leverage their combined strengths to improve people’s access to care. It’s happening.  There were no promises or predictions of what’s ahead.  Yet, the combined leadership team was frank in acknowledging the possibility of making a difference in people’s health.

Amazon and One Medical objective is to team up and make it easier for customers to access its wide range of primary care and pharmacy services. One Medical offers in-office and 24/7 virtual care services, on-site labs, and programs for preventive care, chronic care management, common illnesses, and mental health concerns. Through its app, members can access on-demand video chats, receive “Treat Me Now” assessments for common health concerns, book same- or next-day appointments, direct messages with providers, renew prescriptions, and access their care plans.

Amazon has invested in varied clinical, pharmacy and telehealth services.  Amazon Pharmacy is a digital-first, full-service pharmacy on Amazon.com—essentially, a pharmacy in your pocket. As expected, the warehouse giant carries most prescription medications with the ability to deliver right to customers’ doors – even providing free delivery for Prime. Their pharmacy team is available 24/7 to answer patient questions.

Composite Wisdom with IQ + TQ = EQ Health Offer

Combining Amazon technological and supply chain savvy with the One Medical patient-centric approach, the healthcare industry could witness a business model transformation prioritizing personalized, efficient, and proactive healthcare services. While industry leaders often talk about “patient centricity,” the Amazon Medical Services lead exec made it clear that is where they are heading – a  healthier and better patient experience.

In an exclusive comment to Medika Life, Neil Lindsay, senior vice president Amazon Health Services, said:

“Much of the current health care experience is simply too hard. At Amazon, we believe we can make health care easier by relentlessly applying customer obsession to experiences that deliver  choice, convenience, and continuity of care for people in their pursuit to get and stay healthy.”

Lindsay was integral in building the Amazon consumer brand, shaping branding for the Kindle e-reader and Fire and Echo devices.  He knows the strengths of Amazon consumer marketing and technology strengths.

Leading economist and authority on integrated delivery systems, Dr. Alain C. Enthoven wrote more than a decade ago that the “healthcare system is fragmented, with a misalignment of incentives, or lack of coordination, that spawns inefficient allocation of resources. Fragmentation adversely impacts quality, cost, and outcomes.”

Not much has changed since Dr. Enthoven penned those words; fragmentation complicates every aspect of care. Amazon and One Medical executives know that and are looking at how their combined strengths and readiness to invest in building a better medical mouse trap will make their vision valuable to payers, patients, product innovators and providers.  The two companies sit at the nexus of the ecosystem.

Among the possible advantages lies in integrating Amazon’s innovative technologies into One Medical’s patient-care model, such as augmented intelligence, data analytics, and home automation. Patients could benefit from personalized health recommendations from their medical history, lifestyle, and physician’s advice.

“We believe technology, threaded across health care, can improve the entire experience—reducing the time customers spend seeking care, saving customers money, and supporting clinicians so they can focus on patient care,” adds Amazon’s Lindsey.

Amazon’s voice assistant devices like Alexa could finally find a practical purpose and accelerate communication between patients and their health providers, enabling remote consultations and medication reminders. Amazon supply chain expertise has yet to be fully realized, tapping into the consumer giant’s logistics network potential to streamline the medication and medical supply delivery, ensuring timely access for patients, especially those with chronic conditions. The ability to handle prescription refills and follow-up on diabetes monitoring and therapeutic supplies can reduce urgent hospitalizations.

It’s long been suggested that “the patient is at the center of care.”  That is a distant dream.  Consumerism is at the center – prescribing products that patients may never fill at pharmacies.  No doubt, Amazon knows consumer patterns and markets.  When the partnership moves into high gear, it might enhance the overall patient experience through convenient and comprehensive healthcare services.

“Improving how primary care providers can access the information they need to understand a patient’s full health picture while reducing administrative burden has long been a priority for One Medical. For example, One Medical has already forged relationships with leading health systems across the country to digitally integrate to provide for the seamless and secure flow of information between primary care and specialty care settings to improve the experience of both patients and providers,” shared primary care physician Andrew Diamond, MD, Ph.D., chief medical officer, One Medical.

Making the Consumer Matter

The One Medical patient-focused approach, characterized by longer appointment times and same-day scheduling, could be augmented by Amazon user-friendly interfaces so that patients could easily manage appointments, access test results, and communicate with health providers. A business model centered around patient design and technologies could reduce administrative hassles and waiting times, leading to higher patient satisfaction and better health outcomes. That in itself would be a high bar set for others to follow.

Amazon is savvy about integrating technology into its business platforms. If One Medical can find its way to advance proactive healthcare management through wearable devices and remote monitoring tools, patients could actively track health metrics and invite health professionals to around shifts in their well-being. An approach to real-time data exchange would be a shift from sick care to preventive care, potentially reducing patterns around chronic disease management and unplanned hospitalizations. This might well be the (healthy) version of Reese’s Peanut Butter Cups when it comes to personalized care combined with a tech-based touch.

HLTH Showed its Sector Commitment

“As part of Amazon, we look forward to continuing to innovate on using tech to improve the organization, filtering, and presentation of patient health information for care teams while prioritizing security and privacy. We’d love to reach the point where providers can see a comprehensive summary of a patient’s health history as easily as Amazon customers can see their past purchases on Prime,” added One Medical’s Diamond.

The United States health ecosystem is a modern-day version of the mythological Labyrinth. Like the Cretan maze, it is almost impossible for patients and providers to navigate. Still, Amazon Health Services, now with One Medical as a big piece of its supply chain and tech puzzle, certainly has the resources, patience and self-interest to explore and try to get it right. HLTH was the perfect forum for Amazon Health Services to let the sector know it’s in the game!

While success will take time and effort, expect this e-commerce giant and its significant investment in One Medical to continue to press forward learning until it gets it right.

Amazon Introduces New Health Benefit for Prime Members

Read their news release here: https://www.aboutamazon.com/news/retail/one-medical-amazon-prime-benefit

The post The Amazon and One Medical Combo May Not Disrupt the Health System Now – They Will Champion its Transformation appeared first on Medika Life.

Achievements in science, tech advancements, shifts in health policy, a renewed interest in preventative care, and tackling health disparities can shift how we improve people’s health. Will these topics be front and center at HLTH?  We’ll know more in the days ahead. 

10 Predictions for the HLTH Main Stage

Here are my 10 predictions for health innovation in 2024 that have the potential to transform health – topics that should be woven into the commentary during HLTH mainstage conversations – that can make the most significant impact to improve people’s outcomes, reduce costs, and advance wellness. Let’s see what next weeks social media posts provide that give us indication of the changes ahead.

Prediction 1: AI-Driven Medicine Saves Lives

ChatGPT and AI (augmented intelligence) made their big public splash this year!  However, Microsoft and evangelists such as Tom Lawry and John Nosta have been pointing to AI as a life-sustaining tool in health for years. Surprisingly, “big data and “machine learning didn’t attract the same attention as the newest label – AI!  These technologies enable the development of highly personalized treatment plans based on an individual’s genetic makeup, medical history, and lifestyle and risk factors. AI-driven predictive models will assist health providers in making more accurate diagnoses faster and tailoring treatments for optimal patient outcomes.

Prediction 2: Telemedicine and Virtual Patient Monitoring Go Mainstream

Telemedicine saw unprecedented and “no alternative” growth during the COVID-19 pandemic.  It should continue to see prominence in 2024. Improvements in telehealth infrastructure and regulatory support make virtual consultations with health professionals accessible and efficient. One challenge has been reimbursement for providers compared to in-office visits.  There is a time and place for in-person care and virtual engagement.  Regardless, the urgencies of people in rural and remote communities and preventive care needs make telemedicine and virtual patient monitoring public health priorities.  There is no going back!

Prediction 3: Women’s Health Innovation Prioritized

Women’s health remains under-researched and is barely prioritized by biopharma companies and government-supported research grants. Women comprise half the adult population, but research into women’s health needs is embarrassingly low. The National Institutes of Health directs $42 billion on medical research annually, but only $5 billion of those funds are targeted to women’s health priorities. One global company stands out as a leader – more are needed. In the 1990s, women were more likely to die from their first heart attack compared to men due to gender bias. While those statistics have improved, women still face numerous public policy and care disparities – among the more pressing challenges – reproductive choice. These issues should take center stage and HLTH may be the platform for this long over-due (and urgent) conversation.

Prediction 4: Digital Therapeutics Take Center Stage

Digital therapeutics, including smartphone apps and wearables, will become integral to health intervention and connection. These innovative tools help patients manage chronic conditions, monitor vital signs, and adhere to treatment plans. The gamification of health through digital therapeutics will encourage patient engagement and long-term health outcomes.  Sector leaders, like Click Therapeutics Founder David Klein, are adopting “biopharma” like research models to demonstrate their value to patient care by conducting well-designed clinical trials that show complementary benefits with and with other therapies.  Those enterprises will set the stage for the future of digital therapeutics and redefine the category.

Prediction 5: Health Data Privacy and Security

Despite the hype, consumer-friendly cybersecurity technologies can shift how health data is managed and shared. Patients will have greater control over their health information and records, with the ability to securely share them with health providers, clinical researchers and other stakeholders as needed. Data that cannot be accessed or shared transparency and securely is useless in sustaining and saving lives. Consumers and health professionals need easier ways to protect sensitive health information and streamline data exchange for improved care coordination. EMRs are great if they offer convenient use and application; however, they are too often a jumble of inaccessible information. Security and utility are key! So long (hopefully) fax machine!

Prediction 6: Obesity as a Treatable Disease

Among the most dramatic ways to reduce disease burden and address heart disease, diabetes, respiratory illness, and even some cancers is to take obesity (very) seriously.  It Is not only about weight reduction but understanding that obesity is a domino effect, a multi-system disease. Weill Cornell’s Louis J. Aronne, MD‘s pioneering work recognized early that seeing this only as a “weight problem” underestimates its enormous human health impact. More and more, physicians will need to tap into the expertise of specialists to guide their treatment decisions.  With new medications available, physicians will examine the problem and think about solutions.  However, reducing weight is only part of the clinical response.  Getting it right will save millions of lives and billions in costs.

Prediction 7: Robotics and Automation

Don’t be surprised when robotic technology is increasingly integrated into health systems ORs and patient-care wings. Robots will soon perform set surgical procedures, dispensing medication, and performing patient-care tasks. Watch for Rafael Grossmann, MD, who first used Google Glasses in the OR to push the boundaries on what is possible and needed.  Automation will enhance efficiency, reduce human error, and improve patient safety. Robotic exoskeletons will also aid in rehabilitation and mobility for individuals with physical impairments. But remember the human touch!  While ChatGPT has become a patient favorite in searching out information and robotics will transform the patient experience, people’s confidence in skilled medical professionals remains paramount.

Prediction 8: Mental Health Priorities

There is a long-needed shift toward destigmatizing mental health issues and increasing access to mental health services. AI-powered chatbots and virtual therapists will provide on-demand support, while data analytics can identify at-risk individuals and tailor interventions. Virtual reality therapies will increasingly become a mainstream treatment option for anxiety and PTSD.  Services and upskilling are becoming an investment and professional-development priority.  However, while tech has a place in the process, there is something to be said for developing a personal relationship with a licensed psychologist or licensed clinical social worker skilled in face-to-face therapy. It’s always about caring for people!

Prediction 9: Global Collaboration for the Next Pandemic

The COVID-19 pandemic highlighted the importance of global collaboration in addressing public health emergencies. In 2024, international cooperation and data sharing must be at the forefront of pandemic preparedness. A global surveillance network will provide early warning systems, and rapid vaccine development platforms should be established to respond to emerging infectious diseases quickly.  COVID was a test run, and from a public health information standpoint, the developed nations stumbled.  From disappointment comes learning. Collaboration among public health professionals, policymakers, and medical innovators was paramount to the – even stymied – response. 

Prediction 10: Ethical Considerations for Health Innovation

As health innovation advances in 2024, ethical considerations must take prominence. The long overdue pain revealed during COVID must shift mindsets, behaviors and budgets. We must expect increased scrutiny and priority around data privacy, AI bias, health, and attention to racial and gender disparities.  We must set a path for responsible use of emerging technologies. We must recognize that public policy cannot diminish people’s care options. Ethical frameworks and regulations will be developed to ensure that health innovation benefits all people – and all nations – while respecting access, rights, and values.

A Common Call to Action at HLTH

These 10 predictions are a glimpse into the possibilities of what we might hear from speakers during HLTH. AI-driven personalized medicine, telemedicine and virtual patient monitoring, women’s health, digital therapeutics, cybersecurity, obesity management, robotics, mental health innovation, global collaboration, and ethical considerations should be front and center in the conversation to improve people’s health and well-being.  Life is often referred to “as a game.” It’s not. Health access cannot be roulette wheel spin left to chance. It requires advocacy, policy, planning and empathy. Kindness is a human quality that must be given center stage.

Right now, the people who often need preventive and primary care services face the most significant hurdles.  These predictions are based on one underlying principle – health innovation can only achieve its greatest potential when available to those with the greatest needs.  Hopefully, we’ll hear from more and more speakers stepping to the stages at HLTH that shared call to action.

The post When It Comes to the Future of HLTH – Life Is Not a Las Vegas Roulette Wheel appeared first on Medika Life.

However, I’ve been battling a seemingly endless war with my wisdom teeth. I heard horror stories about other people and their painful teeth, and for a few months now, I have struggled with this excruciating pain. Surprisingly, I also listened to an equal number of stories that ended with, “I had no problem with my wisdom teeth because they grew in perfectly fine.”

Holding on to the hope that my battle would reach a more peaceful conclusion, I prolonged getting my teeth checked. I prayed my story would end with “I had no pain at all.”

This was not the case.

Part One: The Introduction to Pain

The first part of my fight started with minor pain, which worsened over months and evolved into a constant, aching, throbbing sensation. I’ve been trying to find the words to describe this feeling. However, there’s nothing worse than dental pain. It resides in the corner of agony all by itself.

Part Two: The Impossible Solution

You’ve probably figured out how this fight ended—with my wisdom teeth once again winning. The second part of my fight entailed trying to find the perfect over-the-counter medicine to ease my discomfort. There is nothing in this world that can ease these aches. You’re probably listing medications you’re certain would work: Tylenol, Excedrin, Ibuprofen, Motrin, etc. Trust me, I tried them all and without fail, the pain persisted. Even two doses of Motrin combined with two doses of Tylenol every 4 to 6 hours wasn’t enough to give me relief.

Part Three: The Wisdom Teeth Win

The third part of the fight ended up just as you probably predicted— I had to see an orthodontist, who told me that my wisdom teeth were severely impacted and I would need oral surgery to remove them.  Therefore, I was referred to a specialist—an oral surgeon.

Thinking my fight couldn’t get any worse, the surgeon told me that my wisdom teeth were infected, and I was instructed to take oral Penicillin.

That brings me to where I am now. I look back at where I first started – hoping my story would have a joyful ending – and question if there is any way to change the narrative. I’ve shed an endless supply of tears, become accustomed to daily headaches, and returned to my dietary roots: eating baby food—all because of my wisdom teeth.

The Remedy to It All:

As I write about the worst fight of my life and prepare for oral surgery, there are a few things I’ve found that have made my battle a BIT easier:

• Drinking hot liquids: Cold liquids usually made my pain worse. However, tea, coffee, and hot drinks offered my teeth a calming sensation.
• BC Powder: At one point, the pain was so bad that I pulled over to the nearest gas station and stumbled upon this powder and have used it ever since! Applying the powder directly on my teeth and drinking water with the powdered medication helped with my intense pain.
• Getting rest: There were times NOTHING worked, and I had no choice but to sleep. Sleeping in a position where I wasn’t laying on my teeth helped a whole lot!
• Seeking professional help: Yes, I hesitated in getting help from a professional. However, I wouldn’t recommend that you follow my example. It pays to tackle your teeth head-on and immediately, so you won’t end up in a battle similar to mine! 

The post “Going One On One With My Wisdom Teeth” appeared first on Medika Life.

This is the 40th anniversary of the Battle of Sultan Yaacoub. It is also the 40th anniversary of my commitment to advocate for people in urgent need of healing.

I was part of the often-overlooked rescue force called into an overwhelming clash in Lebanon’s Beqaa Valley, where two forces were locked in battle. While Wikipedia, New York Times and Military History Fandom pick apart which army came out on top, I was among the small group of paratroopers who were like ants dwarfed by the tanks that lumbered across the ground and the attack-helicopters and supersonic jets that battled from above. For us, to survive was to win.

Decades later, I vividly remember people screaming for help and rushing to their sides to stop their bleeding or arrange for their evacuation. In the haze of the battle and commitment to the purity of arms code, I was blind to uniform, language and flag.  A broken person – no longer a combatant – became my responsibility. Their life depended on my actions; there was no time to be afraid. Perhaps their need kept my mind clear and my effort focused. Many commanders would cite extensive training as the key to overcoming battlefield terror. We should add that a clear sense of purpose can override panic.  I look back at that day and the months and years of service that would follow and recognize that my mission as a health communicator was forged in that fire. 

In battle, people discover who they are – as soldiers, friends and human beings.  We learn things about ourselves that we didn’t know, things about our ability to think and perform in terrifying situations.  As a paratrooper combat medic, I was trained to sustain and save lives. In the 24 hours from when we entered the bloody valley until a cease-fire was called, my destiny – my purpose and passion for the next 40 years – would be cemented.  I would become a healer.

Health policy strategist Dr. Glenna Crooks captured my memories as a medic caring for friend and foe in those hours in the bloody valley in her Covenants: Inspiring the Soul of Healing. Her book explores a vital theme: healing as a gateway to global peace and prosperity.  She maintains healing is the nemesis of despair and death.  Healers are the warriors pushing back the inevitable. We all must leave this world at some point, yet how we live is in our hands.  We can prevent illness in many cases, and those in the health system can rally to tackle seemingly hopeless situations through intervention and innovation.

Healing is an enduring calling. I do not forget those years in uniform and call upon those memories frequently; they sharpen my feelings of empathy and renew my energy to answer the call to action from people with serious worries undergoing their trials by fire.  I impart accurate information about cancer treatments, heart disease therapies, mental health struggles and the myriad of conditions and illnesses people face so that they can make informed decisions.  I represent the needs of patients, their parents, spouses, children and friends – all dealing with serious, often life-threatening obstacles.  I must remain sensitive to their fears and anxieties, and know that my work impacts their lives.

Years ago, physician and photojournalist Mathew Naythons, who covered the Soviet invasion of Czechoslovakia, and the Vietnam and Yom Kippur Wars, gave me a copy of his amazing photographic history of medicine at war, titled The Face of Mercy, with an inscription: “For Gil: Who has been there, and who understands…” It sits in my office as a reminder that generations of people willingly dedicate their lives, often placing themselves in harm’s way, to help others. It is an aspect of the best in human nature that continues to amaze me as I strive to “understand” needless suffering. 

Throughout history, we have faced armed conflict. This moment in time is no exception. We still witness the struggle of people trying to breathe free. We still see the brave faces of healers working in cities reduced to rubble and beneath the ground in bomb shelters to save lives.  We frequently meet people who face overwhelming diagnoses and press on with their treatments and critical decisions—all heroes and role models who ignite our desire to do more to help.

Since my time as a medic, my energy has not waned, nor has my passion or professional purpose. I am proud to be part of the generations of healers and advocate for people who urgently need care.  My wish is that, when faced with the frustration of dealing with the chaos of our fragmented health ecosystem and struggle to secure access to care for those who have pressing needs, we do not give up hope. 

The sage wrote, “It is not your responsibility to finish the work of perfecting the world, but you are not free to desist from it either.”  Remember that we are all still in the fight and sustaining life is victory.

———-

This article is dedicated to the healers and all seeking to be healed. Through the angst of diagnosis and treatment journey, may they find strength and hope. May the health system address their needs with empathy and compassion – recognizing that these difficult moments are when our humanity is tested.

The post Memories of Life-Threatening Struggle Inspire Life-Saving Action appeared first on Medika Life.

Going with Braces Tightening can be painful to anyone, but multiple methods can help you to ease your pain. Let’s get started and look at the best ways to help you reduce your pain after getting your braces tightened. 

Why Tightening Braces Hurt?

While you are going through orthodontic treatment, your teeth actively keep switching their position, leading to discomfort in the blood flow and pain in your mouth. Usually, new patients feel pain while getting their braces tightened, and most of them stop feeling it after six months of their treatment. 

What Can You Do To Minimize Discomfort?

1. Take an over the counter painkiller or anti-inflammatory

You must check with your doctor before doing this; however, taking painkillers can help you to reduce the pain caused by tightening your braces significantly. You can take the painkillers an hour before entering the dentist for your treatment or after the treatment is done. 

Most commonly used painkillers include acetaminophen (Tylenol), ibuprofen (Advil), and aspirin. Make sure you check the dosage guidelines because overdosing on it can cause harm to your body. 

2. Use an oral anesthetic to reduce discomfort. 

Oral anesthetics come in a gel form, and you can quickly grab them from your nearby pharmacies since they are available widely. Oragel and Anbesol are some of the most used products in this category. Using Oral Anesthetics can help you to heal your pain because they numb any area it comes in contact with, so your teeth and gum won’t feel any pain. 

3. Apply cold to your face and teeth to reduce pain and swelling. 

Using an ice pack on your face and teeth can help you to ease your pain. This is a widely used method, and usually, the results can be seen in an hour after applying an icepack to your face. 

It is recommended that you take a rest and avoid eating warm food immediately once you’ve used the ice pack to heal your pain. 

4. Eat soft foods

Eating soft foods allows you to put less stress on your teeth and hence a lot of dentists recommend eating soft foods after getting your treatment done. Common soft foods include yogurt, soups, smoothies, pudding, and baked or mashed potatoes. Ensure that you follow a soft food diet for at least 3 to 4 days. 

5. Stimulate Blood Flow In Your Gums 

When you have pain in your teeth, it can be hard to chew anything; Chewing helps you stimulate blood flow in your gums, and hence we recommend that you chew a piece of sugarless chewing gum or use a bite wafer to ensure the blood flow remains constant. 

6. Drink Ice Water

Drinking icy chilled water after getting your treatment done can help you feel relaxed, but it will also help cleanse your teeth and braces. The cool liquid will help you to sore areas in your mouth, leading to less pain, and hence drinking ice water is recommended when you are going through pain after tightening your braces. 

When To Contact Your Dentist?

It usually takes several days before patients start feeling relieved from their braces tightening; however, if you think you have an injury or swelling, it is recommended to contact your dentist immediately. 

Conclusion:

Most likely, you’re going to go through some discomfort throughout your orthodontic treatment; however, it’s natural and happens with everyone. In the end, the entire process will be more than worth the temporary sensitivity, and meanwhile, you can use the above methods to ease your pain. 

The post How To Survive When Your Braces Are Tightened? appeared first on Medika Life.

I met Ashley yesterday while hiding in the hallway just outside our room. I had been fighting with August for at least 20 minutes to keep his pulse ox on his toe and oxygen connected to his trach. I was at my limit. I had been crying and needed to step away for a moment. You know the headspace you get when trying to console a newborn at 3 a.m. for the 20th time? That’s where I was. Except I was fighting with a three-year-old cancer and stroke survivor. I was exhausted and defeated. He was relentless.

Ashley was sitting on the ground in the doorway of the room next to us, encouraging her son, Pierce, to take steps in the hallway.

Meeting parents on the oncology floor is an exceptionally weird experience. It feels a little like a college dorm in some ways. Everyone is shuffling around in their sweats and pajamas, bags under their eyes, and usually mumbling something that sounds like, “more coffee.” The whole vibe is strangely familiar but in a backward, twisted kind of way. More like a dorm in The Upside Down from Stranger Things or the nightmare version of déjà vu.

But, Ashley and I exchanged smiles that made space for us to exchange pleasantries.

“How long have you guys been here?” I asked, making small talk.

“About six and a half weeks. You?” she replied.

“Only a week or so this time, but we spent many nights here on this floor a few years ago,” I explained.

I know the darkness that her shirt referenced. I’ve slept in it. I’ve tried to manifest positive outcomes with my tarot cards in it. I’ve been consumed by it. Nearly three years ago, the life that I had poured myself into creating most of my adulthood was obliterated within a few hours. Thankfully, that memory is burning into my mind more like a dream these days than a threat, but I still recognize it when I see it.

“He’s so sweet. How old is he?” I asked.

“He just turned two at the new year. He was diagnosed just a few days before his birthday.”

“Do you mind me asking about his diagnosis?” I asked, nodding to Pierce.

“He has stage four liver cancer. But it has metastasized to his lungs,” she said.

“I am so sorry. Can I give you a hug?” I asked. I could see her vulnerabilities flickering in that moment.

“Yes!” she replied without hesitating. We became instant friends.

As we got to know more about each other, it occurred to me that this was still their first stay in the hospital since finding out the news. The first six weeks. The first six weeks of this new life that only a few people come to know. Where were we during the first six weeks? They are a blur now, but there are things I won’t forget in that time. Those early days stay with you even if you can’t remember them in detail.

I do remember the layout of the room in the trauma ICU. I remember the consultation room we were taken to learn about August’s prognosis. That was the room in the back corner of the floor so no one could hear me scream, at least not clearly. I remember the couch I laid on during his surgery, where my sister rubbed my back and ran her fingers through my hair as I lay curled in a trance.

I remember the neuro recovery room we stayed in after he was stabilized from surgery. I remember meeting August’s oncologist for the first time and being told “he already knew who we were” and that he had been following this case from the moment he was admitted. I remember asking him if trying to continue breastfeeding would give my son a better chance at beating the odds ahead of him.

Ashley is just starting this journey with her son, but I could see the burning flame inside of her. She is still in those first six weeks. Her soul has been lit on fire. She is a mom fighting for her son and demonstrating to him at the same time his capacity to fight as well. She is evolving, in real-time, into a force that will power her family for the long journey ahead. I see myself in her. I was in her shoes nearly three years ago and still am stoking that fire.

You don’t have children and expect them to traverse an obstacle like cancer. You expect scrapes, bruises, maybe broken bones. At baby showers, you joke about “all the trouble your little boy will get into,” but you aren’t suggesting they fight for their life. You expect bullies and heartbreak and lessons in trust. You don’t expect what comes with a cancer diagnosis, like chemo and radiation. Those kinds of things aren’t for children.

Our day eventually blurred into night, which you don’t notice the same way when you’re in the hospital. I swear that time moves differently here. Somewhere in between Twitter searches for updates on the impending world war, the late-winter ice storm, and respiratory treatments, I fell asleep. I woke to muted voices casting shadows on the wall. It was 3 a.m. but something was going on.

I stepped out of our door to see the clinically bright lights on in my new friend’s room. The door was wide open and a team of hospital staff was in the hallway. Somehow, I got a text from Ashley.

“I’m sorry if I’m keeping you up,” she said.

How on Earth did she have the ability to text me while her son was the center of everything in that moment? I should be the least of her worries.

Stunned, I replied, “Omg, no worries at all. Is everything okay? Do you need anything?”

“No, we are headed to the ICU,” she explained.

“I am so sorry, Ashley,” I replied. I know better now than to say anything more in these moments.

“I’m so worn out. How did you do it?” she asked.

I typed out so many responses to that question. This time, for these circumstances, she needed validation and a reminder of self-care before anything. She needed to know she is not alone. She’s allowed to feel scared, tired, and sad. And she’s allowed to take care of herself.

I said, “It is exhausting. You need rest. Will you be able to get some?”

What I didn’t say – but wanted to tell her – is that truthfully, I didn’t “do it.” I did what I had to do to support August and our family, but any sense of accomplishment about what we experienced feels inauthentic; for me at least. The primary accomplishment belongs to August.

The only genuine answer I could give is that I just survived; alongside my son. That was all I could do. And that is enough.

And she will do it too.

The post A Vignette of Life as a Pediatric Cancer Mom appeared first on Medika Life.

This most recent, alarming case, outlined in a major newspaper article, was of a young woman who sought medical care and an accurate diagnosis from 10 physicians over three years. All of them attributed her symptoms to various non-life-threatening disorders that didn’t require a sufficient degree of care.

Most physicians told her it was stress and she should modify her lifestyle. One physician suggested she needed to lose weight, which was the cause of her many symptoms.

Finally, in excruciating pain, she went to a hospital emergency room. The diagnosis and treatment? Ovarian cancer and the removal of a tumor weighing over four lbs. was extracted from her stomach. How did they miss this, and why was she told it was stress, weight, and lifestyle? Obviously, she is not alone in this failure to listen and diagnose a deadly illness.

Aren’t there tests for ovarian cancer? I recall over 20 years ago being asked to write an article for an oncologist at a prestigious hospital (it would be published under his name) for CA-125. I have no idea if he had it published. But the problem is not limited to cancer or ovarian cancer, specifically.

We know that heart attacks in women are a major concern in healthcare. The reason? Women’s symptoms aren’t classic as they are in men. When women reveal their physical distress, it may be viewed as the oh, so biased diagnosis of anxiety.

It’s the same old song; gender bias in medicine. And it has been receiving more attention as physicians publish opinion articles. The “good little girl syndrome” is at work once again. In medicine, it’s exhibited when women feel intimidated in a power situation where they aren’t on equal footing.

The topic isn’t how to deal with medical anxiety but how to appropriately handle medical situations that may entail life and death questions. No longer should we be viewing medical personnel, as Alec Baldwin said in the film, “Malice.”

When questioned in the film about his role as a surgeon in the operating room, Baldwin says, “I am God” in the operating room. Currently, the god aspect of medicine has been addressed and, hopefully, changing with new medical personnel. Bringing attention to this dangerous self-concept should also emphasize attention to diagnosis and inherent bias.

A reversal of communication problems also can be seen when parents with sick children are believed when they should be viewed askance. In some instances, these individuals depend on deceiving medical personnel in diagnosis. When destructive, possibly psychopathic caregivers are in charge, the result may be to circumvent child advocacy, as in the case of Munchausen’s Syndrome by Proxy (MSP).

A recent case made national headlines when a young seven-year-old girl was viewed as suffering from a mysterious, untreatable, and deadly ailment. One of the things she wished for came from the Make a Wish Foundation that granted it.

The little girl’s tragic journey began when she was two-year-old, and her mother took her for treatment. Here, the mother was believed each time, and repeated surgeries were performed. Ultimately, the mother signed her daughter into hospice and requested a DNR form.

Hundreds of thousands of dollars in donations from various charities and Medicare for medical treatments were provided to the mother. According to the symptoms of MSP, the goal is for the guardian/parent to receive attention and be lauded for their continued care for the child. I wrote on MSP in an article for Postgraduate Medicine. The article resulted in my decade of TV appearances.

Although usually limited to children, MSP is also found in men seeking medical care for their wives. The research, however, thus far concentrates on women since they are the main care providers for children and children appear to be the prevalent victims.

Often, the caregiver has a medical background of some type or is knowledgeable about medical procedures and diagnoses. Rather than seek care at one hospital, they may circulate to several, knowing there would be no medical records shared by all of them. The loophole creates an opportunity for deceit and death.

Fortunately, someone blew the whistle as this mother proceeded to take another daughter for “treatment” of a curious ailment. An investigation by a county sheriff’s office led to the mother’s arrest after the death of the first child. Caught, the mother entered a guilty plea resulting in her being sentenced to 16 years in jail. The child’s step-father sued one of the hospitals that provided care for the girl and did receive an award.

Licensing authorities for many professions, including medicine, mental health, barbers, hairdressers, and others, require continuing education to aid in reporting abuse of adults, children, and the elderly and making accurate diagnoses. Training to address bias is also mandatory, but not everywhere.

If I were to suggest a film on caregiving and legal abuse, I’d recommend “I Care a Lot.” It is not a comedy.

The post “Deaf” Physicians’ Failure to Listen to Seriously Ill Patients appeared first on Medika Life.