Written by yvonnethornton on October 20th, 2011
We’ve all been told how important it is to eat well in order to stay healthy. Now, new research shows that what you eat when you’re pregnant can be as important for your baby as it is for you.
A study published in the Archives of Pediatrics and Adolescent Medicine shows that when mothers-to-be ate healthful foods, such as those that make up the so-called Mediterranean diet, their babies had fewer birth defects such as cleft palates and neural tube defects.
The Mediterranean diet focuses on vegetables, beans, fruits, grains and fish, and is lower in meat, dairy and “empty” carbs.
Before you panic if you’re reading this while gorging on burgers and fries, no, your baby isn’t going to be born with birth defects just because you’re taking a vacation from your diet. The birth defects researchers looked at in the study are quite rare to begin with. It’s just that they are rarer still among women who eat well.
But the study does hint at something we know: your baby’s development depends, in part, on the nutrients you consume. So, give your little one a head-start on a good future. You’ll be doing a favor for both of you.
– Yvonne S. Thornton, MD, MPH
Posted in Pregnancy, Women's health issues, Women's health news, Your newborn baby | No Responses »
Tags: babies, baby, birth defects, Childbirth & delivery, healthy newborn baby, infant, infants, Mediterranean diet, newborn, Pregnancy, pregnancy study
Written by yvonnethornton on October 4th, 2011
Many women are too embarrassed to talk to their doctors about urinary incontinence—which means that they may be suffering needlessly for a common complaint that often has an easy fix.
You’d probably be surprised to learn that about half of all adult women share this problem.
What’s behind urinary incontinence? There are several possibilities, including certain medications, but the two most common culprits are the loss of pelvic floor muscle tone, causing stress incontinence (urine escapes during activities such as exercise, laughing, or coughing), and over-active bladder (you feel the need to “go” more often than normal).
Stress incontinence can often be successfully treated with pelvic floor strengthening techniques called Kegel exercises. These exercises are remarkably simple to do, once you have the hang of it, and you can do them anywhere: sitting in traffic, watching TV, even at your desk.
If incontinence is brought on by an over-active bladder, different re-training exercises, including biofeedback and behavioral therapy, may be helpful. And there are several medicines that your doctor may prescribe, depending on the underlying causes.
What’s most important to know is that help is available, and not just in the Depends aisle of your pharmacy. Remember that you’re not alone in dealing with incontinence. Chances are good that about half of the women you know are dealing with some form of this disorder.
Don’t let embarrassment keep you from discussing this all-too-common issue with your doctor.
– Yvonne S. Thornton, MD, MPH
Posted in General health news, Women's health issues | 1 Response »
Tags: help for incontinence, Kegel exercises, Urinary incontinence
Written by yvonnethornton on August 16th, 2011
For parents-to-be, impatient to know whether to paint the nursery blue or pink, a simple test can provide answers as early as seven weeks into the pregnancy. These tests have been available for some time but weren’t widely used in the U.S., because their accuracy wasn’t known. Now, The New York Times reports, a new study in The Journal of the American Medical Association, has “found that carefully conducted tests could determine sex with accuracy of 95 percent at 7 weeks to 99 percent at 20 weeks.”
But is it really necessary to know your baby’s sex that early? For some parents, it can be. The Times reports that European doctors routinely use such tests to:
… help expectant parents whose offspring are at risk for rare gender-linked disorders determine whether they need invasive and costly genetic testing. For example, Duchenne muscular dystrophy affects boys, but if the fetus is not the at-risk sex, such tests are unnecessary.
But the big downside, and one that concerns me greatly as a doctor and a mother, is that some cultures have such a bias against baby girls that the wide availability of such testing will result in ever more otherwise healthy female fetuses being aborted.
Several companies do not sell tests in China or India, where boys are prized over girls and fetuses found to be female have been aborted. While sex selection is not considered a widespread objective in the United States, companies say that occasionally customers expressed that interest, and have been denied the test. A recent study of third pregnancies in the journal Prenatal Diagnosis found that in some Asian-American groups, more boys than girls are born in ratios that are “strongly suggesting prenatal sex selection,” the authors said.
At least one company, Consumer Genetics, which sells the Pink or Blue test, requires customers to sign a waiver saying they are not using the test for that purpose. “We don’t want this technology to be used as a method of gender selection,” said the company’s executive vice president, Terry Carmichael.
Cultural preferences won’t be deterred by a signature on a form, but at least, it’s a start. At some point, all cultures will learn to value both genders equally. Until then, a test that holds promise for some, can be a terrible incentive for the ultimate act of bias against females in others.
– Yvonne S. Thornton, MD, MPH
Posted in Childbirth & delivery, Pregnancy, Women's health issues, Women's health news | No Responses »
Tags: babies, bias against female babies, Fetal testing, infants, Pregnancy
Written by yvonnethornton on August 3rd, 2011
In keeping with the Institute of Medicine’s recommendations that free birth control be made available to all under their insurance policies, a new rule from the White House mandates birth control coverage without co-pays or deductibles. The new rules also cover domestic violence screening and breastfeeding assistance without co-pays or deductibles.
Starting Aug. 1, 2012, new health insurance plans will be required to cover women’s preventive care without charging a co-pay or deductible. The new guidelines require health insurers to provide FDA-approved birth control, including emergency contraception such as the morning-after pill, HIV screenings, and well-women visits, among other services.
The guidelines also include an amendment that allows religious institutions that offer insurance to their employees the choice of whether or not to cover contraception services.
– Yvonne S. Thornton, MD, MPH
Posted in Contraception (birth control), General health news, Health care policy, Women's health issues, Women's health news | No Responses »
Tags: birth control pills, contraception, Free birth control, new regulations for women's health care, no co-pays
Written by yvonnethornton on July 22nd, 2011
When you’re on a strict budget, out-of-pocket costs can convince a woman to forego birth control. But getting pregnant is a much more expensive proposition and comes with a lifelong commitment — one that many women are neither emotionally or financially ready to make.
The new health care law requires the Department of Health and Human Services to create a list of health services that new health insurance plans must provide without deductibles or co-pays. And the National Academy of Sciences’ Institute of Medicine (IOM) has prepared a report recommending that birth control be on that list.
…the Guttmacher Institute estimates that 98 percent of sexually active women will use contraception at some point during their reproductive years, and that cost concerns are frequently cited as a reason for inconsistent use or use of a less then optimal method.
In fact, Guttmacher said in testimony submitted to the IoM earlier this year, “Women citing cost concerns were twice as likely as other women to rely on condoms or less effective methods like withdrawal or periodic abstinence.”
Along with the recommendations concerning birth control, the IOM recommended a number of other preventive care services for women be made available without deductibles or co-pays:
…annual “well-woman” visits; screening of pregnant women for gestational diabetes; screening for sexually transmitted diseases, including HIV; more support for breast-feeding mothers; and counseling and screening for possible domestic violence.
I urge HHS Secretary Sibelius to accept the IOM recommendations. Women’s health issues have taken a backseat for too long.
– Yvonne S. Thornton, MD, MPH
Posted in Contraception (birth control), Health care policy, Women's health issues, Women's health news | 1 Response »
Tags: birth control, birth control pills, co-payments, contraceptive, contraceptives, deductibles, Dr. Yvonne Thornton, Institute of Medicine, IUD, women's health
Written by yvonnethornton on July 13th, 2011
Ask anyone, if she could change one thing about her doctor, what would it be?
I’d bet that most would say that they wish their doctors spent more time really listening, really communicating, instead of rushing in and out of the exam room. Too many otherwise excellent doctors fail in the communications department. They act like they have more important things to do than set aside time for a relaxed heart-to-heart with a patient about her concerns. Arrogance isn’t an occupational hazard, but over a long career in medicine, I’ve met too many physicians with this counter-productive attribute.
I’ve always taken the time to listen to my patients, even if it meant that I didn’t get home by dinner or, when the kids were little, by their bedtime. But, to my mind, that’s a big part of what it means to be a good doctor.
At long last, it looks like medical schools are taking notice that a lack of people skills can be a real problem, and doing something about it. The New York Times reports that medical schools are evaluating prospective medical students’ social skills through a series of “mini-interviews” along with their grades and test scores, and taking all into consideration when deciding who to admit to medical school:
The new process has enormous consequences not only for the lives of the applicants but, its backers hope, also for the entire health care system. It is called the multiple mini interview, or M.M.I., and its use is spreading. At least eight medical schools in the United States — including those at Stanford, the University of California, Los Angeles, and the University of Cincinnati — and 13 in Canada are using it.
…Virginia Tech Carilion administrators said they created questions that assessed how well candidates think on their feet and how willing they are to work in teams. The most important part of the interviews are often not candidates’ initial responses — there are no right or wrong answers — but how well they respond when someone disagrees with them, something that happens when working in teams.
Candidates who jump to improper conclusions, fail to listen or are
overly opinionated fare poorly because such behavior undermines teams. Those who respond appropriately to the emotional tenor of the interviewer or ask for more information do well in the new admissions process because such tendencies are helpful not only with colleagues but also with patients.
Medical schools have the capacity to train only a fraction of the students who want to become doctors. Those who are turned down often have test scores and grades that are about as good as those who get in.
A process that focuses on the whole person, not just numbers on a page, will ensure that those limited opportunities at medical schools are offered to people who will become the best doctors possible.
I applaud this new focus and hope that the same sort of screening is applied when evaluating residents, as well.
– Yvonne S. Thornton, MD, MPH
Posted in General health news, Health care policy | No Responses »
Tags: better doctors, doctors' people skills, limited medical school admission opportunities, medical students
Written by yvonnethornton on June 24th, 2011
As anyone who has read either of my two memoirs knows, I’ve worked long hours as a ob-gyn/maternal-fetal medicine specialist, throughout my career. While it’s been a challenge, at times, and I’ve had to juggle like crazy to be the kind of mother my children could always count on, it was the life I signed up for.
I don’t regret my career choices. Becoming a doctor is as much a calling as a profession.
So, when I read an op-ed by a woman anesthesiologist, which criticizes a recent trend among women doctors to think of medicine as a part-time career, it struck a chord.
This section, in particular, offers food for thought:
Since 2005 the part-time physician workforce has expanded by 62 percent, according to recent survey data from the American Medical Group Association, with nearly 4 in 10 female doctors between the ages of 35 and 44 reporting in 2010 that they worked part time.
This may seem like a personal decision, but it has serious consequences for patients and the public.
Medical education is supported by federal and state tax money both at the university level — student tuition doesn’t come close to covering the schools’ costs — and at the teaching hospitals where residents are trained. So if doctors aren’t making full use of their training, taxpayers are losing their investment. With a growing shortage of doctors in America, we can no longer afford to continue training doctors who don’t spend their careers in the full-time practice of medicine.
… The Association of American Medical Colleges estimates that, 15 years from now, with the ranks of insured patients expanding, we will face a shortage of up to 150,000 doctors.
When you look at training in the medical profession as a scarce resource, provided to a small number of people, in whose hands others place their lives, you can see that it isn’t the kind of career choice you make lightly. It’s a commitment. And those who don’t feel the need to fully commit, who think of it as a profession in which they can dabble, do a disservice to the patients who need them, as well as to those who would have committed fully to the profession, if only they could have gotten into medical school.
In our do-your-own-thing society, this might seem like a harsh, even an unfair judgment. But medicine isn’t practiced for the benefit of the practitioner. It’s a service to our fellow men and women. And as long as there are so few of us that some people have long waits for needed care, those who choose this profession must be willing to be there when they’re needed. And if they can’t? There are plenty of other professions with lesser requirements.
– Yvonne S. Thornton, MD, MPH
Posted in General health news, Health care policy, Something To Prove: A Daughter’s Journey to Fulfill a Father’s Legacy, The Ditchdigger's Daughters, Women's health issues, Women's health news | No Responses »
Tags: doctor shortages, medical school, Medicine must be a full time commitment, part-time doctors
Written by yvonnethornton on June 22nd, 2011
The story of James Verone, who lost his health insurance when he lost his job with Coca Cola, epitomizes the dysfunction in our country’s health care system, until now. Health care reform would have given him access to insurance by 2014. He would have qualified for Medicare in 2017. But he can’t wait — he needs health care today. Because he has a growth on his chest today. And with no other way of getting a doctor to diagnose him and treat him, he decided his only chance was to get sent to prison, where health care is free.
But how would this lifelong law-abiding citizen find his way to prison?
He decided to politely rob a bank – just for a dollar – and ask the teller to call the police:
James Verone … limped into a bank in Gastonia, N.C., this month and handed the teller a note, explaining that this was an unarmed robbery, but she’d better turn over $1 and call the cops. That, he figured, would be enough to get himself arrested and sent to prison for a few years, where he could take advantage of the free medical care.
Just to make sure that no one was confused about his intentions, Mr. Verone made sure to let the teller know that he would be sitting on a couch in the bank, waiting for the police. Before he set out for the bank that morning, he also mailed a letter explaining his scheme to a local newspaper, The Gaston Gazette.
“When you receive this a bank robbery will have been committed by me. This robbery is being committed by me for one dollar,” the letter read. “I am of sound mind but not so much sound body.”
The next time you hear someone you know say that we should repeal health care reform, I hope you’ll share this blog post with that person.
– Yvonne S. Thornton, MD, MPH
Posted in General health news, Health care policy | No Responses »
Tags: health care in America, health care reform, Man robs bank to get medical care
Written by yvonnethornton on June 15th, 2011
One of the big advantages of the Affordable Care Act (a.k.a. the healthcare reform bill) is that millions of Americans who once had no recourse when their insurers turned them down for coverage, now can appeal. Insurance company turns you down for a transplant? Appeal. Says no to a life-saving procedure? Appeal. Insists that you have to pay for something you believe is covered under your policy? Appeal.
And your appeal won’t be decided by the same administrator who turned you down in the first place. Under the new healthcare reform law, health insurance appeals are decided by an independent decision-maker, one who has no financial stake in the outcome.
This provision can be a lifesaver … but only if you know about it and act on it within the 180-day timeframe permitted.
According to Kaiser Healthcare News:
The provision took effect for most plans Jan. 1. But in response to self-insured plans’ concerns about being able to meet some of the requirements, the government said it wouldn’t require the plans to tell members about their external appeals rights until plan years beginning after July 1. Since most plans start their new year in January, that means they won’t have to notify members about their right to external appeals and how to file them until next year.
However, the government isn’t granting enrollees more time to file appeals, said an official at the Department of Health and Human Services, who spoke only on the condition of not being identified. Patients have 180 days from the date of initial denials to file internal appeals to the plan. If the appeals are rejected, they then have another four months to appeal to outside arbiters.
If nobody tells patients about their rights, this provision, in other words, might not be discovered by the people who need it most until it’s too late.
So, I’m urging you to link to this post wherever you can: Facebook, Twitter, Reddit, any and all social networks. Explain the need to be informed. Tell your friends and family: you have a right to appeal. For some, it can be a matter of life and death.
Don’t let the chance slip away.
– Yvonne S. Thornton, MD, MPH
Posted in General health news, Health care policy, Women's health issues, Women's health news | No Responses »
Tags: catch-22 in health insurance appeals process, healthcare reform, Right of health insurance claims appeal
Written by yvonnethornton on June 3rd, 2011
I’m thrilled to report that Something to Prove: A Daughter’s Journey to Fulfill a Father’s Legacy earned the Grand Prize from the judges in “The New York Book Festival,” besting hundreds of rivals in every category for the title.
Although I wish I could be at the ceremony on June 10, 2011, at the Algonquin Hotel, to accept the award, I have a previous commitment. I will be the lead panelist at the “100 Black Men of America Annual Convention,” in San Francisco that day.
My fellow panelists include Terri McMillan, bestselling author of How Stella Got Her Groove Back, and several other books, radio talk show host Shirley Strawberry, and TV personality Star Jones, best-known for her long-running stint on the popular talk show, “The View.”
Although I won’t be there to accept the New York Book Festival Award in person, you can bet I’ll be there in spirit. I am so honored to have been chosen to receive this recognition, and so very, very grateful to the judges who chose Something to Prove over so many other terrific books.
– Yvonne S. Thornton, MD, MPH
Posted in Media appearances, Publishing news, Something To Prove: A Daughter’s Journey to Fulfill a Father’s Legacy, The Ditchdigger's Daughters | No Responses »
Tags: Dr. Yvonne Thornton, Grand Prize winner New York Book Festival, Something To Prove: A Daughter's Journey to Fulfill A Father's Legacy, Star Jones, Terri McMillan, The Ditchdigger's Daughters
