Category: What’s new?

Our local drinking water

Carmel Water District 2

EWG’s drinking water quality report shows results of tests conducted by the water utility and provided to the Environmental Working Group by the New York Department of Health – Bureau of Public Water Supply Protection, as well as information from the U.S. EPA Enforcement and Compliance History database (ECHO). For the latest quarter assessed by the EPA (January to March 2017), tap water provided by this water utility was in compliance with federal health-based drinking water standards.

WHAT ABOUT LEAD?
WANT TO FILTER THESE CONTAMINANTS OUT?
0
contaminants detected above health guidelines
1
other detected contaminants
Includes chemicals detected under the EPA’s Unregulated Contaminant Monitoring Rule (UCMR 3) program in 2013 to 2015, for which annual utility averages were lower than an EWG-selected health guideline established by a federal or state public health authority.

Bromochloromethane

Bromochloromethane is a tap water disinfection byproduct; it is also used as an intermediate in chemical manufacturing and as a fire extinguishing agent. Disinfection byproducts in drinking water increase the risk of cancer.

STATE
NATIONAL
THIS UTILITY
How your levels compare
0.0164 ppb0.00350 ppb1.33 ppbThe State and National averages were calculated using the averages of the contaminant measurements for each utility in 2010-2015.
ppb = parts per billion.

https://www.ewg.org/tapwater/system.php?pws=NY3903641#.WXsdCsaZPdR

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Knee pain & surgery

An international panel of surgeons and patients has challenged the effectiveness of one of the most common orthopedic procedures and recommended strongly against the use of arthroscopic surgery for patients with degenerative knee problems.

The guidelines, published Wednesday in the journal BMJ, reviewed 13 studies involving nearly 1,700 patients and found the surgery did not provide lasting pain relief or improve function for most of them. Those studies compared the surgery with a variety of options, including physical therapy, exercise and even placebo surgery.

Fewer than 15 percent of patients felt an improvement in pain and function three months after the procedure, and that those effects disappeared after one year, the review found. In addition, the surgery exposed patients to “rare but important harms,” such as infection.

Casey Quinlan, 64, who had the surgery in 2003 and was on the panel issuing the guidelines, said her orthopedist told her the procedure would not only help restore mobility in her knee after a nasty ski accident but also improve her arthritis.

Quinlan, of Richmond, Va., said the procedure did not deliver, since her arthritis remained unchanged. “It was not what I was told to expect,” she says.

In an arthroscopic knee surgery, physicians make several small incisions around the joint and insert a tiny camera that allows them to see inside the knee as well as insert small instruments to correct problems they identify. Often the surgery is performed to remove part of a damaged meniscus, a disc of cartilage that helps cushion the knee.

The panel said meniscal tears “are common, usually incidental findings, and unlikely to be the cause of knee pain, aching or stiffness.”

The panel said the surgery is performed more than 2 million times a year across the globe, and in the United States alone costs more than $3 billion annually.

The panel’s recommendations are counter to guidelines from a number of medical groups. Most of those organizations have recommendations against arthroscopy for patients solely with arthritis that can be seen through an X-ray. But many still promote the procedure for people with ailments such as meniscal tears, which are frequently present in arthritic patients.

The American Academy of Orthopaedic Surgeons does not recommend the treatment for patients with arthritis, said David Jevsevar, chairman of orthopedics at the Dartmouth Geisel School of Medicine and chair of the AAOS Council on Research and Quality. He said the BMJ assessment is in line with current evidence, but he also cautioned that generalizing a variety of randomized trials does not necessarily take into account the circumstances of individual patients.

“Guidelines don’t apply to every patient,” Jevsevar says. “There’s always going to be an exception.”

Reed Siemieniuk, a physician in Ontario, Canada, and the lead author of the panel’s statement, said he understands the frustration some people may have about the guideline — especially those who have seen an improvement with surgery.

The strongest evidence of a procedure’s benefit is a randomized controlled trial, Siemieniuk notes, “Despite those personal experiences that say it might be doing good, the evidence suggests that it might not be doing any good.”

Siemieniuk said that the panel’s reading of the studies suggests that “on average, the pain relief that you’re getting is not going to be important to you at all.”

The BMJ assessment is the latest in a string of studies that have raised concerns about the surgery. The journal also published a study in 2015 by researchers in Denmark showing that arthroscopic repair of the meniscus for middle-aged people was not much better than exercise in relieving pain and carried a risk of rare but debilitating side effects.

The surgery was questioned in 2002 after researchers reported in The New England Journal of Medicine that in a randomized trial of older veterans with osteoarthritis in their knees, arthroscopic surgery was no more effective in treating pain than a placebo surgery in which patients had incisions made but no instruments were inserted into the knee. At least three other studies in that journal since then have also found arthroscopy is not better than sham surgery or physical therapy in relieving arthritis pain in the knees of older adults.

 

http://www.npr.org/sections/health-shots/2017/05/11/527915056/arthroscopic-surgery-doesnt-help-with-arthritis-knee-pain

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Former JAMA editor becomes a pitch man for acupuncture

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by John Weeks, Publisher/Editor of The Integrator Blog News and Reports

The CEO of Aetna Health, Mark Bertolini, had a horrible ski accident that left him in great pain. In his long recovery, he discovered that he couldn’t function well under the adverse effects of the opioids and other medications that regular medicine and insurance companies support. He found relief in yoga, acupuncture, meditation, and the services of a naturopathic doctor. The stories are all too familiar.

Cases like Bertolini’s struck a chord with the outspoken octogenarian and former editor of the Journal of the American Medical Association (JAMA), George Lundberg, MD, pictured. Lundberg was an immensely successful editor of JAMA, whose 17-year term ended in 1999 when he was let go. One reason was, in many estimates, a special issue on complementary and alternative medicine that JAMA published in 1998, much to the dismay of his colleagues. He drew attention to JAMA. and also drew antagonism of those who felt he was diminishing the journal’s reputation.

ssNow, Lundberg works as an editor-at-large for Medscape, sharing his experiences both in audio and print in “Sciatica: A Love Story.”  He describes how he had a return bout with the condition that had bothered him for some time while on a business trip in the Bay Area. The pain required him to bend over at the waist to gain any relief.

“Uninvited, an orthopedist told me bluntly that I probably had foraminal stenosis, needed nerve function measurements, and would probably require back surgery,” he writes.

He’d already learned that pharma did little for him.

“A woman, unknown to me, urged me to have acupuncture because it worked for her sciatica,” he continues.

Soon after, Lundberg put out a query on social media, looking for someone who specialized in acupuncture. The next morning, still fully gripped by pain, he received a response from a graduate of Five Branches University, who had an office in San Jose.

Lundberg describes how he brought in his “acute, excruciatingly painful, lancinating, searing, burning, right buttock, thigh, leg, and foot pain” that he knew did not respond to nonsteroidal anti-inflammatory drugs.

ddd“I met [the acupuncturist] at 9:30 AM, still walking bent forward at a 90 degree angle,” he writes “After 90 minutes of deep massage (including the psoas muscle), multi-needle acupuncture, soft music, and Kinesio Taping, my lower back over a smelly poultice, I got off the table, stood erect and pain free, and met my large family for Mother’s Day brunch. Three days later, I did an all-day visiting professor gig at the University of California, Davis, including presenting grand rounds. After three more days, I gave the commencement address at the University of Alabama School of Medicine, all pain free.”

Lundberg goes on to describe a second incident with acupuncture for his sciatica, which was also successful.

“I walked, bent at 90 degrees, into the same San Jose acupuncturist’s office,” he writes. “Ninety minutes later, after the same quadruple therapy, I stood erect, pain free, and I walked out fine, to drive myself home. That was five days ago. So far, so good. Do I believe this treatment works? Oh yeah! You better believe I do. Does Medicare or my supplemental Blue pay for it? No, but I am working on that. Maybe some insurer will see this column. Stay tuned.”

Survival strategies to help you escape a forest fire

Forest-FireEmergency Situation: While hiking through Kings Canyon National Park in California, you notice the ground crunching audibly underfoot — the result of the state’s severe drought. As you travel up a small rise in the terrain, you begin to smell smoke and hear a loud rushing sound. Then you see it: a line of flame racing through the bone-dry brush not far ahead of you. Suddenly the wind picks up. Embers float your way, and … goodness, gracious, great balls of fire!

What should you do?

Solution: Let’s back up a minute. Part of your pre-hike planning should include assessing risks in the area. Check with local park rangers to learn more about conditions before heading into the wild. Smokey Bear is all about prevention, which is great, but what about surviving forest fires?

Forest fire survival strategies are complex and will differ based on any number of factors: the severity of the fire; your location and proximity to the fire and to roads or other potential escape routes; weather; and the terrain.

In general, forest fires are driven by two factors: wind and terrain. In both cases, it is critical to move upwind (that is, into the wind) when attempting to escape wildfires. You can determine general wind direction by viewing which way the smoke is moving, assuming there’s reasonable visibility. Look high up in the sky, where the smoke direction is less affected by the terrain. You should also travel downhill. This is because the hot air masses created by the fire tend to move up, making higher elevations more prone to ignition.

Once you’ve determined your direction of travel, search for a natural firebreak: an area without combustible material. This may be a road or a clear-cut area of woods, or it may be a boulder field or body of water.

In general, large trees retain more moisture than, say, dry fields, so if you must seek protection in an area without a firebreak, avoid open areas and ones with small, dry scrub brush. Such areas are extremely dangerous during a forest fire. Flames also tend to travel uphill, and running uphill will slow you down anyway.

Can you — or should you even attempt to — outrun a forest fire? Again, wildfires are unpredictable. Researchers have been perplexed by recent California fires with flames that have spread at incredible speed, mostly due to unprecedented levels of drought. The short answer is that a wall of flame can move at 20 mph or faster and easily overtake a runner. Plus, embers might travel in unpredictable directions via updrafts or so-called “chimneys,” igniting new flare-ups ahead of you as you try to outrun the fire. If you must run, try to make it through the leading edge of the fire into an area that has already burned.

In a situation where you cannot escape the flames and cannot make it to a safe location, your best option is to locate a trench or deep gulley. Dig a hole in the side, cover the opening with a tarp or blanket, and then crawl into the hole. Alternatively, dig a trench and lie down in it with your feet facing the direction of the flames, and cover yourself with dirt. Make sure you can breathe, and wait for the fire to travel over you.


Safe Campfire Tips
According to the U.S. Forest Service, people cause nine out of 10 wildfires. Unattended campfires are one of the common causes of wildfires. Other causes include fireworks, sparks from equipment or vehicles, burning leaves or debris or even cigarettes tossed from cars.

In addition to following Leave No Trace guidelines, use these tips to help prevent wildfires when burning a campfire:

  • Do not build a campfire at a site with dry conditions. Check with the local park ranger to see if there is a burn ban.
  • If there is no burn ban, use the designated fire ring or fire pit for your campfire.
  • If there is no designated campfire spot, look for a site away from tents, trees or scrub.
  • Keep your campfire small and under control. Never leave your campfire unattended.
  • Allow the fire to burn completely to ash. Then, to fully extinguish the campfire, pour lots of water and drown all embers. Stir the ashes with a shovel and pour more water atop the ash until all hissing sounds stop. Make sure everything is cold to the touch.

Visit smokeybear.com for more campfire safety tips and to take a pledge to prevent wildfires.

New Rules Would Require Airlines To Refund Baggage Fees For Delayed Luggage

October 19, 20165:14 AM ET

The White House is proposing a new rule that would require airlines to refund the checked baggage fee if luggage is “substantially delayed,” though it does not define “substantially.”

NPR aviation reporter David Schaper says airlines are already required to compensate passengers for lost or damaged luggage. Schaper quotes Transportation Secretary Anthony Foxx arguing that this next step just makes sense: “If you pay the baggage fee and your bags are not returned to you in a timely manner, you’ve essentially paid for a service you’re not getting.”

An airline industry spokesperson says the regulation is unnecessary because many airlines already offer baggage fee refunds on their own and some will even reimburse travelers for the cost of clothes they need to purchase if luggage is substantially delayed. Some airlines don’t charge fees for checking luggage as a way of gaining a competitive advantage.

The Obama administration is announcing additional proposed rules designed to address common passenger complaints about airline service.

One of the targets is travel-booking websites that offer comparison-ticket shopping. Such websites commonly rank airlines higher or lower based on undisclosed payments or other business incentives.

A new rule proposed by the Transportation Department would require such websites to be neutral “or disclose their bias upfront so consumers can truly comparison shop when booking flights,” Schaper reports.

Another focus of the new rulemaking is airlines’ on-time record. “Major airlines are now only required to disclose on-time performance data for the flights they operate,” reports Schaper, “not those of those small regional partners that the big legacy carriers partner with.”

The new rules will require those regional carriers, including Air Wisconsin, Allegiant, Endeavor, Envoy, Mesa, Republic and Shuttle America, to also report their on-time performance data.

The Transportation Department also announced it would investigate a longtime practice by some airlines of preventing various travel websites from showing their fares. Airlines do this to direct traffic to their own web sites where they can upsell passengers on seat assignments and upgrades.

A spokesperson for the industry group Airlines for America said that airlines have the same goal of providing quality service, but improvement is already taking place in the marketplace without more government regulation.

“We’ve said for a long time that we think the airline industry is probably the most regulated deregulated industry you can find, and this is another example of it,” says spokesperson Jean Medina.

The new rules are a “big win” for airline passengers, says Charlie Leocha, president of the advocacy group Travelers United and a member of the Department of Transportation’s consumer advisory committee. But Leocha also criticizes the administration for delaying action on some other proposed rules that he says would better protect consumers.

The travel site TripAdvisor applauded DOT’s move to investigate whether the practice by some airlines of restricting access to fare information is an unfair business practice. In a statement, a spokesperson calls the investigation into the “anti-competitive and anti-consumer practice” a step in the right direction.

But Airlines for America says that forcing airlines to share fare information widely with travel sites “would only benefit those third parties who distribute tickets, not the flying public.”

 

Is the Election Making You Sick?

You’re not alone. One in 6 older Americans feel the same

Is The Election Making You Sick?

Take a break from the 24-hour news cycle. Read just enough to stay informed. — Getty Images

Anxious and stressed? Can’t concentrate at work? Worried and afraid about the future? The solution could be to turn off the news. One of the most contentious, adversarial presidential campaigns in American history is literally making us sick.

More than half of Americans, regardless of their party affiliation, are reporting significant election stress, and it’s particularly affecting older adults, according to the results of the American Psychological Association’s (APA) annual Stress in America survey, announced this month.


“I’ve never seen this level of stress and anxiety over an impending election in my 26 years [of practicing], said Nancy Molitor, a Chicago-area clinical psychologist.

Washington, D.C., psychologist Stephen Holland, director of the Capital Institute of Cognitive Therapy, where 12 clinicians see more than 300 patients a week, told The Atlantic that “probably two-thirds to three-quarters of our patients are mentioning their feelings about the election in session.”

The APA survey found that 52 percent of adults say the election is a very or somewhat significant source of stress. Those age 71 and older are the most anxious (59 percent), followed by millennials (56 percent) and boomers (50 percent).

And “it doesn’t matter whether you’re registered as a Democrat or Republican,” said the APA’s Lynn Bufka, associate executive director for practice research and policy. Across party lines, 55 percent of Democrats and 59 percent of Republicans reported being stressed out by the long, appalling slog to Election Day.

Older Americans reporting high levels of election stress was a surprise, said psychologist Vaile Wright, a member of the APA’s Stress in America team. “Older adults typically report lower stress levels than younger generations, so it is particularly surprising to see the reverse is the case with the election,” she told the Washington Post.

One possibility is that older voters are concerned about the election’s implications for their children and grandchildren, Wright said. “Another is that the issues that are particularly important to older Americans — Social Security, Medicare, prescription costs — aren’t being talked about that much by the candidates.”

It’s the opposite in the workplace, however, where younger employees (ages 18 to 34) were more likely than older ones to report feeling tense and argumentative due to political discussions among coworkers, according to another APA survey, Politics in the Workplace: 2016 Election Season.

More than twice as many men as women said office debates about the election were making them less productive. Men were also more than four times as likely as women (18 percent vs 4 percent) to report having argued about politics with a coworker.



So what can you do, short of severing your internet connection and wearing earplugs 24-7, to manage your election-related stress? Here are some tips from the APA:

*Take a break from the 24-hour news cycle. Read just enough to stay informed. Take time for yourself: Go for a walk, do things you enjoy with friends and family, or read a book.

*Cut back on social media. Nearly 40 percent of adults in the Stress in America survey said political and cultural discussions on social media caused them stress. What’s more, adults who use social media were more likely than those who don’t to say the election is a very or somewhat significant source of stress (54 percent vs 45 percent).

*Avoid getting into discussions about the election if you think they could escalate into a conflict. Be aware of how often you’re discussing the election with friends, family members or coworkers. Find other topics to talk about.

 


*Keep in mind that life will go on, no matter what happens on Nov. 8. Thanks to our political system and the three branches of government, we can expect a significant degree of stability immediately after a major transition in government. Avoid catastrophizing; maintain a balanced perspective.

*Vote. In a democracy a citizen’s voice does matter. By voting, you can be proud that you are taking a proactive step and participating in the election cycle, no matter how stressful it has been. Find balanced information on all candidates and issues on your ballet, not just the presidential race, so you can make informed decisions.

Time to change the 15 minute office visit

Who said that 15 minutes is enough time for a doctor to examine and take care of a patient? According to a Western Colorado radio station, KOOL 107.9 FM, this is roughly the same amount of time men spend on the toilet each day, which could increase depending on what you eat and how much toilet texting you do. Patient care is probably more complex than taking a dump (i.e., you don’t need as much training to poop). So how exactly did 15 minutes become the typical doctor’s visit length, and why isn’t this number being questioned more?

The reason is insurance reimbursement, which dictates a lot of what is done in medicine. Currently, insurance seems to pays hospitals, clinics and doctors only enough to justify 15-minute appointments. How, then, did insurance companies decide that 15 minutes is enough? As this piece by PBS explains, the answer is not completely clear but probably comes from a decision made by Medicare in the year 1992. Yes, 1992 was apparently when it all started. (Are you listening, Marty McFly and Doc Brown, in case you want to use your time machine?) Yes, the fateful decision that led to today’s visit length occurred several years before N*Sync and Google even got started. That year Medicare adopted the following “relative value unit”, or RVU, formula as a standard way to calculate doctors’ fees:

(Work RVU x Geographic Index + Practice Expenses RVU x Geographic Index + Liability Insurance RVU x Geographic Index) x Medicare Conversion Factor

The purpose of this now archaic formula was to reduce the variability in physician fees. Based on this formula, a typical primary care office visit should be 1.3 RVUs, which using the American Medical Association coding guidelines at the time translated to 15 minutes. Medicare then set its reimbursement rules based on this length of time, private insurance companies followed suit, managed care took over in the mid to late 1990′s, N*Sync emerged and then later broke up, Justin Timberlake became a star and medicine was no longer the same. Because of this series of events, nowadays, 15-minute doctor visits have become the norm with no apparent change on the horizon. Great Scott!

Why in Justin Timberlake’s name are we still sticking to a rule from 1992? It seems absurd to have to say this, but times have changed over the past 25 years since that Medicare decision. People actually use the Internet now. Miley Cyrus and Justin Bieber were born. Medicine is also very different. Many new and different treatments, tests, rules and regulations have emerged. Electronic health records began and grew. And the amount of paperwork involved has skyrocketed.

As a result, as indicated in a recently published study in the Annals of Internal Medicine, doctors aren’t even spending the entire 15 minutes talking to and examining patients. The study, led by Christine Sinsky, MD, at the American Medical Association, found that even when in the examination room with patients, doctors were spending only 52.9% of the time talking to or examining the patients and 37.0% doing paperwork. In other words, shrink that 15 minutes to under eight minutes (or the same amount of time women spend sitting on toilets a day, because apparently women are more efficient on the can).

Does eight minutes even make sense? Let’s examine a typical visit and see how you can squeeze everything needed into eight minutes. The visit begins with the doctor opening the door and saying hello. This can probably take under a minute as long as you, as the doctor, don’t shake hands too long and make any social greetings that require a long answer such as “enjoying the weather”, “have trouble finding parking” or “how’s the family”. Also, make sure that the patient understands and speaks English fluently, because any type of miscommunication or translation may require more than a minute. And patients, don’t talk to the doctor, which wastes time. Just say “hello” and smile.

This leaves seven minutes. Note that the patient should be already be fully undressed to save time and because patients just love sitting naked on a cold examining table waiting for the doctor. The next step is asking the patient why he or she is visiting. (As a doctor, make sure that you know the patient’s gender before the visit because figuring this out can take time. If you are a patient, then make sure you tell the doctor immediately that you are a man or a woman or something else. This removes any time-consuming mystery.) With seven minutes left, you as the patient should not take more than two minutes to tell your story, and you as the doctor should be able to understand the entire story within that time. After all, the typical television commercial is about 30 seconds long. Two minutes is like a typical commercial break from a television show. If four companies can get you to buy things in two minutes surely you can tell your whole story. Of course, you don’t have the benefit of paid accompanying actors, graphics and other visuals, and a nice soundtrack. But no one said you can’t utilize these for your doctor’s visit. Just make your story like a GEICO ad.

When telling your story to you doctor, stay concise and to the point. Avoid unnecessary time-consuming things such as saying that the symptoms are hard for you or describing your family or work situation or crying. There’s no crying in baseball or the doctor’s office. Doctors, don’t do anything to establish or strengthen your relationship with the patient. Again this takes valuable time. No small talk. No unnecessary comforting. No additional questions.

Also, patients, don’t mention any weight issues (unless that is the specific reason for your visit) because they take time to address. Pain or opioid medication issues? You can always see multiple different doctors to get enough collective time. Remember we’ve already taken out 7 minutes for the doctor to review the patient’s medical record, ask any questions about items in the record and correct any errors.

This leaves five minutes. Now the doctor has to wash his or her hands. Proper handwashing should take at least 30 seconds of lathering and hand rubbing with soap. Pushing the soap dispenser, turning on and off the faucet, getting a paper towel and drying then takes another 30 seconds. There may be time for you to throw the paper towel away as long there isn’t more than one different trash receptacle (such as trash vs. recycling vs. hazardous materials…darn conservationists). When in doubt, just throw the paper towel on the floor to save time. Patients, you can help the doctor wash his or her hands by pushing on the soap dispenser or maybe bringing your own soap packet.

This leaves four minutes. Time for the doctor to examine the patient. Taking medical equipment out consumes valuable time. One option is to have the patient hold all of the equipment before the doctor walks in the examination room. This will not only save time but strengthen the patient’s muscles and make the patient look like a Christmas tree, which can be very festive during certain times of the year. Of course, this may be a problem for frail patients, but who ever heard of frail patients going to see the doctor? The other option is to not use medical equipment. As a doctor, your finger can serve a tongue depressor, and you can put your eyeball against the patient’s ear.

One problem is the rectal exam. (I know, you’ve never said those words about a rectal exam.) Rectal exams require additional time and are only useful to detect prostate and colon problems such as cancer. Putting on gloves, applying lubrication and checking carefully. If you want the doctor to skip any of these steps to save time, the choice is yours.

This leaves one minute, if the doctor can complete all of the exam in three minutes. In the final minute, the doctor needs to tell you what to do. If the doctor found nothing wrong, great. The doctor can then tell you when your next appointment is within one minute. If the doctor found something wrong, he or she can simply say “that sucks” and quickly tell you what you need to do. If the doctor is unclear about what’s going on then he or she can just say “who knows” and leave the room.

Remember, as the patient, don’t ask questions. Questions take time. The doctor has to listen to you and actually answer. Thus, avoid questions like “what causes this problem” and “what are other options?” Remember, 15 minutes is what you have. And doctors, don’t listen to or answer patient questions. Other patients are waiting.

Time is up, so not much time for goodbyes. Maybe a quick “hasta la vista, baby” will work. Doctors, make sure that you are on your way out while saying goodbye, because the 15 minutes does not account for travel time between patient rooms. Clinics often book doctors back-to-back-to-back-to-back because reimbursement does not account for doctors having to catch their breath, take breaks, make phone calls and, of course, go to the bathroom.

Of course, specific visits may vary from the above-mentioned scenario. An unexpected emergency could make things longer. Also, the length of visit may vary by specialty. In fact, some specialty visits have even less time, such as orthopedic and dermatology visits. The bottom line is there is little time to actually listen or talk to patients and maybe not enough time to carefully examine them. Who, then, is really happy with the 15-minute visit? Wouldn’t doctors want more time to do their work well and get to know the patient? Wouldn’t patients want more time to air their issues and communicate with the doctor? Surveys by the Physicians Foundation and Commonwealth Fund have shown that many doctors are suffering from burnout. As Peter Pronovost, professor and director of the Armstrong Institute for Patient Safety and Quality at the Johns Hopkins School of Medicine, explains in the Wall Street Journal, running on a 15-minutes-per-patient treadmill can contribute to such burnout. Studies such as this one have found that shorter visits can lead to less patient satisfaction. Wouldn’t hospitals and clinics prefer patients and doctors to be more satisfied as long as their bottom line is not affected? Wouldn’t pharmaceutical and medical device companies want more time for patients and doctors to discuss treatment options?

This brings us to insurance companies. Perhaps the thought is that shorter visits will reduce healthcare costs. But is this actually the case? If shorter visit times are hurting the quality of care then maybe ultimately healthcare costs increase. A study published in 2003 in the American Journal of Public Health showed that physicians do not have enough time to provide all the preventive services recommended by the U.S. Preventive Services Task Force (USPSTF). And less preventive care means more disease and higher healthcare costs. Short visit times could also lead to overlooking medical problems and medical errors, leading to later treatment of problems and even more healthcare costs. So, who exactly is benefiting from 15-minute doctor visits?

There is a lack of science supporting the 15-minute limit for a doctor’s visit. Where are the studies? Where is the justification…from today, and not from 1992? The situation is a bit ludicrous (meaning absurd and not the rapper Ludacris, who incidentally wasn’t yet famous back in 1992.) Is everyone in society being hurt by a rule that was arbitrarily set over two decades ago?