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Showing posts with label problem. Show all posts
Showing posts with label problem. Show all posts

Monday, 5 September 2011

The Healthcare Dilemma Simplified

Posted on 15:42 by Unknown
As an otolaryngologist in private practice, I have observed from the sidelines the healthcare crisis that is brewing in our nation, being debated in Congress, and bemoaned by fellow colleagues.

Being a simple man, I see the essence of the healthcare problem being summarized in one sentence:

"How to deliver low-cost, high-quality healthcare cheaply."

Being a simple man, I also realize that this statement is nearly impossible to accomplish for something as complex as healthcare delivery.

It's also a concept engineers have struggled with for way longer than medicine has. It is summarized by a great graphic known as the "Engineering Project Triangle". What is achievable is only where the colors overlap.




Design something quickly and to a high standard, but then it will not be cheap. 

Design something quickly and cheaply, but it will not be of high quality.

Design something with high quality and cheaply, but it will take a long time.

In other words, you can only pick two.

In terms of healthcare, the triangle could be known as the "Healthcare Project Triangle."



Design healthcare that is able to provide quality care at low-cost, than not everyone can have it. It's also known as "rationed" care which is what Canada and Great Britain have to some degree.

Design healthcare that is able to provide quality care to everybody, it will be expensive. This is where our healthcare model is currently situated.

Design healthcare this is able to provide low-cost care to everybody, it will suffer in terms of quality. Some would argue this is the HMO model. It's also what we could consider the kind of healthcare that is provided in free clinics.

In essence, you can't have healthcare with all three characteristics. You can only pick two.

Engineers know that and are probably wondering why doesn't everybody else.

"You can only pick two" is what the great debate is all about. Nobody can decide on which two and there are FANTASTIC arguments for the given two a Senator or presidential candidate will promote.

However, in the end, either quality, quantity, or low cost will suffer no matter which healthcare policy is chosen.

So the great debate has been identified...

The great question is what will be sacrificed?

Because unfortunately, there is no great answer.

Reference:
When Nurses Wear "Do Not Disturb" Signs. Dr. Wes.
Read More
Posted in debate, healthcare, pick, policy, problem, triangle, two | No comments

Monday, 6 June 2011

Sleep Apnea Can Turn Your Child Into a School Bully

Posted on 15:44 by Unknown
Image courtesy of Grant Cochrane / FreeDigitalPhotos.net
This statement is supported by a published study indicating that poor sleep, whatever the cause, can be a factor leading a child to bully or display other aggressive behaviors. Among 341 kids who were evaluated, 23% had conduct problems. Of these kids with conduct issues compared to those without, a significant number had symptoms suggestive of a sleep disorder indicated by sleepiness scoring as well as snoring.
It is already known that the prefrontal cortex governs social behavior which is also influenced by sleep. As such, poor sleep can deleteriously influence the brain leading to behavior problems.

Of course, there are other factors that can contribute to sleep problems as well as bullying... such as an unstable family as well as too much technological stimulation (cell phone, internet, television, etc).

As such, as with most things, more study is needed.

But here's my two cents... Applying some common sense here, ask anybody who has pulled an all-nighter whether they are grouchy the next day and I bet you most will say "of course, no duh"!

Well, here's a study that supports that! (No duh!)

All kidding aside, if a child is having behavior issues, it may behoove the parents to see if obstructive sleep apnea is present which would lead to poor sleep quality. At least for kids, obstructive sleep apnea can be addressed surgically by removing the tonsils and adenoids leading to markedly improved sleep quality (and hopefully improved behavior as well!).

Reference:
Aggressive behavior, bullying, snoring, and sleepiness in schoolchildren. Sleep Med. 2011 May 25. [Epub ahead of print]
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Posted in adenoidectomy, behavior, bullying, disorder, issue, osa, problem, sleep, tonsillectomy | No comments

Monday, 25 April 2011

The Diane Rehm Show on NPR Examines the Human Voice

Posted on 08:26 by Unknown
Diane Rehm who hosts an NPR show of her name, suffers from a voice disorder called Spasmodic Dysphonia. On April 18, 2011, she hosted a show on vocal issues with expert guests addressing what makes a healthy voice. The experts range from physician laryngologist Dr. Nazaneen Grant to voice coaches.

Listen to the show here!
Read More
Posted in diane, healthy, healthy voice, hoarse, npr, problem, raspy, rehm, show, vocal | No comments

Thursday, 21 October 2010

Pediatric ENT Care of Warrenton, Virginia (Fauquier County)

Posted on 05:04 by Unknown
Recently, there has been some confusion regarding whether our office deals with adults only or do we see kids as well... Strangely enough, we also get asked by parents whether our office sees adults when seeing a pediatric patient.

To clear up any confusion, our office does see kids AND adults... starting from birth to the elderly.

Dr. Chang who joined the office in October 2005, was named one of America's Top Physicians by the Consumer's Research Council of America in 2008 as well as a Northern Virginia Top Doctor for 2011 (to be published in February 2011).

Some common problems and procedures for which Dr. Chang sees kids specifically include:

- Tongue Tie Release (starting from ONE DAY OLD!)
- Tonsillectomy
- Adenoidectomy
- Sinus Surgery starting with adolescents
- Ear Tube placement
- Hearing Loss
- Nasal Obstruction
- Nasal Congestion
- Snotty Nose
- Speech Delay
AND many other issues...

Our office has even created videos on a few common pediatric procedures including tonsillectomy, adenoidectomy, earwax removal, ear tubes placement. Watch the video below on tonsillectomy.

Read More
Posted in allergy, best, chronic ear, doctor, ent, jairo, kid, kids, medical, nasal, nose, otolaryngology, pediatric, pediatrician, Physician, problem, sinus, throat, top, torres | No comments
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  • otalgia
  • otc
  • otoacoustic
  • otolaryngology
  • out
  • out-of-pocket
  • outer
  • over
  • over-the-counter
  • overweight
  • oyster
  • oz
  • pa
  • pacemaker
  • packing
  • pageant
  • pain
  • painful
  • paint
  • palate
  • pandas
  • paper
  • papilloma
  • parachute
  • paradoxical vocal cord
  • paralysis
  • paralyzed
  • parathyroid
  • parents
  • participating
  • past
  • patch
  • pathologist
  • pathology
  • patient
  • pattern
  • patulous
  • pbm
  • pediatric
  • pediatrician
  • pellet
  • pen
  • peptide
  • perennial
  • perfect
  • perforation
  • perfume
  • peri
  • perichondrium
  • period
  • peritonsillar
  • permanent
  • permission
  • persistent
  • personal
  • pet
  • ph
  • ph probe
  • pharmacist
  • pharmacy
  • pharyngeal
  • pharyngitis treatment
  • pharyngocele
  • pharynx
  • phd
  • phegm
  • phelgm
  • phelgmy throat
  • phlegm
  • phlegmy
  • phlegmy throat
  • phone
  • Physician
  • pick
  • picking
  • picture
  • pictures
  • piercing
  • piezoelectric
  • pillar
  • pipe
  • pitch
  • PKCzeta
  • placebo
  • plan
  • planet
  • planetree
  • plastic surgery
  • plastics
  • plugs
  • pocket
  • police
  • policy
  • pollen
  • polly hunsberger
  • polonium
  • polyp
  • pons
  • poor
  • popping
  • popular
  • popularity
  • portable
  • portman
  • positive
  • post
  • post-nasal
  • post-nasal drainage
  • posterior
  • pouch
  • power
  • ppo
  • practice
  • predicting
  • prediction
  • prednisone
  • pregnancy
  • pregnant
  • premarin
  • prenatal
  • prescribing
  • prescription
  • prescriptions
  • pressure
  • prick
  • prilosec
  • primer
  • problem
  • problems
  • procedure
  • process
  • professional
  • propel
  • protein kinase
  • provider
  • public
  • publication
  • puck
  • pulsatile
  • pumpkin
  • punishment
  • purchase
  • purulent
  • pus
  • puzzle
  • pylori
  • quickly
  • quickmark
  • r. kelly
  • radiation
  • radio
  • radioactive
  • radioactivity
  • radiological
  • radiology
  • raft
  • ragweed
  • random
  • rapid
  • raspy
  • RAST
  • reaction
  • reader
  • real-time
  • rebound
  • reckitt
  • record
  • recording
  • records
  • recurrent
  • red eyes
  • reduction
  • referral
  • reflux
  • regurgitation
  • rehm
  • removal
  • renovation
  • renovations
  • repair
  • repellant
  • replacement
  • reporter
  • research
  • residency
  • resident
  • resistance
  • response
  • resurface
  • resurfacing
  • review
  • rhinitis
  • rhinoplasty
  • richmond
  • right
  • ringing
  • rinse
  • risk
  • robert
  • robot
  • robotic
  • rock
  • roger
  • roof
  • room
  • rotating
  • routine
  • rubber
  • runny nose
  • rupture
  • ryan
  • safe
  • sale
  • saline
  • saliva
  • salivary stone
  • saltwater
  • santa claus
  • scan
  • scans
  • scar
  • scheduling
  • science
  • scientist
  • SCIT
  • scopolamine
  • scramble
  • scratch
  • screening
  • SD
  • seafood
  • search
  • seasonal
  • seaweed
  • secondhand
  • secure
  • security
  • sedated
  • sedation
  • self-pay
  • sensory
  • sepsis
  • septal
  • septo
  • septoplasty
  • septum
  • sermo
  • service
  • set
  • severe
  • sex
  • shampoo
  • shape
  • shark
  • shenandoah university
  • shop
  • shortness of breath
  • shot
  • shots
  • show
  • shrimp
  • sialadenitis
  • sialendoscopy
  • sialoadenitis
  • sickness
  • side
  • side effect
  • silent
  • silver nitrate
  • singer
  • singing
  • singing cat
  • singulair
  • singultus
  • sinuneb
  • sinuplasty
  • sinus
  • sinus fracture
  • sinus infection
  • sinus lift
  • sinus surgery
  • sinusitis
  • skating
  • skin
  • skin cancer
  • skull
  • sleep
  • sleep disorder
  • SLIT
  • sluder
  • small
  • smartphone
  • smell
  • smoke
  • smoking
  • sms
  • sneeze
  • sneezing
  • snore
  • snoring
  • snot
  • snotty nose
  • social
  • social media
  • social networking
  • soda
  • sodium
  • soft
  • song
  • sore
  • sore throat
  • sour
  • spa
  • spam
  • spanish
  • spasmodic
  • spasmodic dypshonia
  • spasmodic dysphonia
  • spasms
  • special
  • specialist
  • speech
  • speech therapy
  • spinal
  • spinning
  • spit
  • splints
  • split tube
  • spray
  • spur
  • ssnhl
  • staph
  • starvation
  • stat
  • station
  • stem
  • stereoisomer
  • sterile
  • steroid
  • steroids
  • sticky
  • stink
  • stone
  • stones
  • stops
  • storybooks
  • strange
  • strep
  • strep throat
  • stridor
  • strobe
  • stroboscopy
  • stroke
  • stuck
  • stud
  • student
  • study
  • stuffed animals
  • stuttering
  • sublingual
  • submandibular
  • submaxillary
  • sudden
  • sudden hearing loss
  • sun
  • sunblock
  • sunscreen
  • sunshine
  • superbill
  • superbowl
  • superbug
  • support
  • surgeon
  • surgery
  • surgical
  • survey
  • suture
  • swallow
  • swallowing
  • swelling
  • sword
  • symbicort
  • symphony
  • symptom
  • symptoms
  • syndrome
  • T-tube
  • tablet
  • talk
  • talking
  • tall
  • target
  • taste
  • tea
  • teacher
  • technology
  • teen
  • teenager
  • teeth
  • television
  • temperature
  • terrorism
  • terrorist
  • test
  • testing
  • tests
  • text messaging
  • the doctors
  • the onion
  • theory
  • therapy
  • thick
  • throat
  • throat cancer
  • throat clearing
  • throat-clearing
  • thrombosis
  • thrombus
  • throwing
  • thyroid
  • thyroidectomy
  • tia
  • tic
  • tic cough
  • tick
  • tilt
  • time
  • times
  • tinnitus
  • tiny
  • Tionne
  • TLC
  • TMJ
  • tobacco
  • TOCPM
  • today
  • tongue
  • tonsil
  • tonsil stones
  • tonsillectomy
  • tonsilliits
  • tonsillitis
  • tonsilloliths
  • tonsillotomy
  • tonsilolith
  • tonsiloliths
  • tony
  • tooth
  • tooth pain
  • top
  • topical
  • TORD
  • torres
  • tors
  • torticollis
  • tour
  • toxin
  • toyota
  • trach
  • tracheostomy
  • training
  • trans
  • translation
  • transmedics
  • transmission
  • transplant
  • transplantation
  • transportation
  • trauma
  • treating
  • treatment
  • tremor
  • trend
  • triangle
  • trombone
  • trouble
  • tube
  • tubes
  • tucci
  • tumor
  • turbinate coblation
  • turbinate hypertrophy
  • turbinate reduction
  • turning
  • tutorial
  • TV
  • tween
  • tweet
  • twitching
  • twitter
  • two
  • tylenol
  • tympanic
  • type
  • ulcer
  • ulpa
  • ulrich
  • ultrasound
  • unable
  • unclog
  • under
  • uninsured
  • united kingdom
  • university
  • Update
  • upper
  • upper respiratory infection
  • uppp
  • urgent
  • URI
  • urine
  • urticaria
  • usa
  • USA today
  • uva
  • uvula
  • uvulectomy
  • uvulopalatopharyngoplasty
  • vaccination
  • vaccine
  • vagal neuropathy
  • vascular
  • vasomotor
  • vasomotor rhinnitis
  • vcd
  • ventilation
  • versus
  • vertigo
  • ves
  • vessel
  • viagra
  • vibration
  • video
  • viral
  • virginia
  • virus
  • viruses
  • vit d
  • vitamin
  • vitamin A
  • vitamin d
  • vivosonic
  • vlog
  • vocal
  • vocal cord
  • vocal cord dysfunction
  • vocal cord paralysis
  • vocal cord paresis
  • vocal cords
  • vocal process
  • voice
  • voice therapy
  • voicebox
  • voicelift
  • volume
  • vomit
  • vs
  • wait
  • waiting
  • wall
  • wall street journal
  • warm
  • warrenton
  • washes
  • washington
  • washington dc
  • washington post
  • water
  • watkins
  • wax
  • wearable
  • web
  • web 2.0
  • webapp
  • Website
  • Website Update
  • wedge
  • weight gain
  • whale
  • what to do
  • wheezing
  • where
  • whisperer
  • whispering
  • white
  • who
  • whooping
  • wierd
  • wifi
  • will.i.am
  • wind
  • windows 7
  • winter
  • wire
  • wireless
  • withdrawal
  • without
  • woman
  • word
  • world
  • world voice day
  • world's
  • worlds
  • wound center
  • wp
  • wrestling
  • wrong
  • wsj
  • x-ray
  • xeomin
  • xray
  • xylitol
  • xyzal
  • youtube
  • zenker's
  • zenkers
  • zeta
  • zicam
  • zinc
  • zyrtec

Blog Archive

  • ▼  2011 (190)
    • ▼  September (26)
      • Cat with Two Faces (Literally)
      • Cigarettes Contain Radioactive Polonium
      • Not All Spinning Motions Cause Dizziness
      • HIPAA Allows for Regular Email Communication Betwe...
      • MRI Scans CAN Cause Vertigo
      • Oral Exam Using a Finger
      • United Kingdom Ends $17 Billion Electronic Medical...
      • New Webpage on Vocal Cord Granuloma
      • Singer John Mayer Diagnosed with Vocal Cord Granuloma
      • Tongue Acrobatics
      • World's Longest Human Tongue
      • Another Rock Singer With Injured Voice
      • World Record Large Ears
      • Keychain Emergency Airway Device (Video)
      • Smoker's Kids Have More Ear Infections
      • 100 Years of Style and Dance
      • Carbon Dioxide Helps with Nasal Allergies
      • Intranasal Treatment for Clogged Ears
      • Best Ballpoint Pen for Emergency Cricothyroidotomy?
      • Beating Heart in a Box
      • The Healthcare Dilemma Simplified
      • Man Chokes to Death During Air Flight... Preventable?
      • Best Medication for Dizziness
      • Surgery Without Wires
      • Movie Sets are Dangerous to Ears!
      • Hearing Loss Can Can Accelerate Brain Volume Loss
    • ►  August (22)
    • ►  July (20)
    • ►  June (15)
    • ►  May (10)
    • ►  April (18)
    • ►  March (12)
    • ►  February (33)
    • ►  January (34)
  • ►  2010 (267)
    • ►  December (23)
    • ►  November (18)
    • ►  October (32)
    • ►  September (30)
    • ►  August (35)
    • ►  July (16)
    • ►  June (27)
    • ►  May (22)
    • ►  April (27)
    • ►  March (11)
    • ►  February (13)
    • ►  January (13)
  • ►  2009 (43)
    • ►  December (11)
    • ►  November (13)
    • ►  October (19)
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