Written by yvonnethornton on February 11th, 2010
The open-backed, modesty-destroying, ugly hospital gown is set for oblivion, at least in the United Kingdom:
To address the shortcomings of the much-abused medical garb, the U.K.’s Department of Health recruited designer Ben de Lisi to give the hospital gown a design overhaul, the BBC reports. De Lisi, who has outfitted stars such as Kate Winslet, came up with a solution that offers more coverage while also including “entrance points” for the necessary medical access.
It’s about time.
Back when I was on the faculty of Cornell in the 1980s, I decided that no woman who visited my Cornell practice would be forced to wear one of those open-backed monstrosities.
They always made a woman feel all exposed. As a woman myself, I was especially sensitive to the indignity of it all.
So I designed a pretty blue poncho with an opening that fit over a woman’s head. It covered everything, and allowed for easy examination.
I’m surprised that more doctors and hospitals haven’t done anything similar but I like the U.K.’s new plan. Here’s hoping the U.S. follows suit.
– Yvonne S. Thornton, MD, MPH
Posted in General health news, Women's health issues, Women's health news | No Responses »
Tags: hospital gowns, redesign
Written by yvonnethornton on January 28th, 2010
Last night, President Obama, in his State of the Union address, reminded us why we need real health care reform.
First, I’ll quote a few of the points the president made and then I’ll explain why it matters to each of us, currently insured or not:
“The approach we’ve taken would protect every American from the worst practices of the insurance industry. It would give small businesses and uninsured Americans a chance to choose an affordable health care plan in a competitive market. It would require every insurance plan to cover preventive care.
“… It would reduce costs and premiums for millions of families and businesses. And according to the Congressional Budget Office – the independent organization that both parties have cited as the official scorekeeper for Congress – our approach would bring down the deficit by as much as $1 trillion over the next two decades.”
When the president spoke of the insurance companies “worst practices” he didn’t elaborate. But it’s those practices that make us all, insured or not, vulnerable, and in need of reform. Too many Americans believe that they have great health insurance – right up to the moment when they get sick and find that their insurance won’t cover their medical bills.
Recently, one of the organizations advocating on behalf of health care reform shared the case histories of numerous people who, although insured, were unable to get their medical bills paid when they got sick. The following few cases are among dozens of similar stories. If we don’t think it can happen to you, you’re wrong. I speak from experience. Although I’m a doctor, when my daughter became ill, her insurance refused to cover all her medical costs and I had to pay tens of thousands out of pocket.
- An AT&T worker from Arkansas was in a coma for three weeks after a 2004 horseback riding accident. She and her husband had to pay more than $200,000 in medical bills because UnitedHealthcare wouldn’t cover her emergency surgery.
- A Realtor from Delaware, has a health care plan that forces her to pay for her cancer care “out of pocket.” She has turned to getting her chemotherapy medication from India in order to afford it.
- A minister from Tennessee has almost $175,000 in medical debt due to his wife’s muscular disorder. The family had health insurance through his wife’s job as an insurance claims adjuster, but the health insurance would only cover 14 days of her 91 days in intensive care.
Don’t let anyone tell you that if you’re insured, you don’t need to support health care reform. As the above cases illustrate, this affects us all. While there is no longer any chance of passing a new bill through the United States Senate, the House can vote for the Senate bill that passed over Christmas eve now and make changes over time. It may be our last chance for reform in a generation. Please call your Congressperson today and remind him or her what’s at stake.
– Yvonne S. Thornton, MD, MPH
Posted in General health news, Women's health issues, Women's health news | 1 Response »
Tags: health care reform, health insurance, healthcare legislation, healthcare reform, pass real healthcare reform, President Obama, State of the Union speech
Written by yvonnethornton on January 21st, 2010
If you’re pregnant or have recently had a baby, you’ve probably heard that breastfeeding is one of the best things you can do for your baby. Other mothers will tell you so. Books extol breastfeeding’s virtues. Even the government gives mothers a nudge in this direction.
But what if your schedule doesn’t make breastfeeding a viable option?
Don’t let anyone make you feel like you’re an inadequate parent if you give your baby a bottle instead. There are no randomized clinical trials that prove the virtues of breast milk over formula feeding. And most working mothers simply don’t have the opportunity to breastfeed in our society, at least not exclusively.
When public lactation stations become the norm, and when most workplaces have specifically designated areas for breastfeeding, then it will make sense for more women to consider the breastfeeding-only option.
Until then, in a society where many women are either single parents or are the primary family breadwinners, exclusive breastfeeding must be seen as an unrealistic – and maybe even a chauvinistic — recommendation.
– Yvonne S. Thornton, MD, MPH
Posted in Women's health issues, Women's health news, Your newborn baby | 2 Responses »
Tags: bottle fed babies, breastfeeding, new mothers, newborns, nursing
Written by yvonnethornton on January 18th, 2010
As we celebrate the birthday of one of America’s greatest African-American leaders, Dr. Martin Luther King, and we take pride in the leadership of our first African-American president, Barack Obama, it’s easy to assume that racial disparities are a thing of the past.
But our infant mortality rates tell us that that’s not so.
According to the Centers for Disease Control (CDC), infant mortality among African-American babies is more than twice that of white babies. Among the other troubling statistics in the CDC report:
- African Americans had 1.8 times the sudden infant death syndrome mortality rate as non-Hispanic whites, in 2005.
- African American mothers were 2.5 times more likely than non-Hispanic white mothers to begin prenatal care in the 3rd trimester, or not receive prenatal care at all.
- The infant mortality rate for African American mothers with over 13 years of education was almost three times that of Non-Hispanic White mothers in 2005.
America is still a country where people of color face discrimination at every turn, even if it’s less overt than it was in our past. Bias limits educational opportunities, employment opportunities, and it even limits the opportunity of pregnant women to get access to good healthcare.
If Dr. King could see us today, I know he’d be pleased at how far we’ve come. But if we haven’t provided our youngest and most vulnerable citizens equality in medical care, we still have a long way to go.
– Yvonne S. Thornton, MD, MPH
Posted in Childbirth & delivery, General health news, Pregnancy, Women's health issues, Your newborn baby | 1 Response »
Tags: African-American babies death rate, babies, health care, infant, infant mortality, infants, newborn, prenatal care, racial bias limits access to healthcare
Written by yvonnethornton on January 12th, 2010
Last June, in the Journal of the National Medical Association, I published the results of clinical trials that showed that it was safe for obese pregnant women who followed a well-balanced diet to gain little or no weight. Prior to my study, the conventional wisdom was that all women, even obese ones, should gain 26 to 35 pounds. That guidance had come from the most august body of ob-gyns in the U.S., The American College of Obstetricians and Gynecologists (ACOG), whose recommendations were based upon what we knew in the 1980s. That was before we fully understood the dangers of obesity in pregnancy. Yet, the guidelines had never been updated.
Being obese during pregnancy greatly increases the risks of preeclampsia, diabetes, stillbirth, and blood clots, among other problems. Gaining more weight if you’re already obese makes complications more likely while limiting weight gain makes them less so.
But until my study was published, obstetricians lacked the evidence that limiting weight gain among pregnant women was safe. The ACOG’s guidance from the 1980s stated that, unless a woman, obese or not, gained at least 26 pounds, the baby in her womb would be at risk of dying.
Right before my study results were published, a government body recommended that obese women gain somewhat less weight: between 11 and 20 pounds. It was a start but still not enough. And most board certified obstetricians would wait for the ACOG to – you’ll excuse the pun – weigh in before they changed their practices.
I’m delighted to say that, in a commentary in the peer-reviewed journal Obstetrics & Gynecology, the ACOG has just come out in favor of limiting weight gain among obese pregnant women. My study, which was quoted in the commentary, appears to have been instrumental in effecting this turnaround.
Now that the ACOG is changing its recommendations, obstetricians are more likely to change how they manage their patients. Fewer women will be told that it’s fine to gain weight during pregnancy if you’re already obese. And that will mean healthier moms and healthier babies.
I’m proud to have played a role in helping to make this happen.
– Yvonne S. Thornton, MD, MPH
Posted in Childbirth & delivery, Pregnancy, Women's health issues, Women's health news, Your newborn baby | 1 Response »
Tags: ACOG, American College of Obstetricians and Gynecologists, babies, baby, Institute of Medicine, Journal of the National Medical Association, new guidelines, weight gain
Written by yvonnethornton on December 24th, 2009
Despite months of bluster and disinformation from those who hope to maintain the status quo, 60 U.S. senators came together this Christmas Eve morning and voted to make health care available to virtually all Americans.
The House had passed its version of health care reform months earlier. Now the two legislative bodies will have to come together and agree to a blended version.
That blended version almost certainly won’t have a public option because it would require 60 votes in the senate to get one. But here’s what we can be assured of getting in any final combination of the two bills:
- Insurance companies will have to cover everyone – you can no longer be turned down due to pre-existing conditions.
- Insurance can’t be snatched away from you via “rescission” when you get sick, i.e., voiding the policy when you need it the most.
- There will be limits on how much more insurers can charge you as you get older.
- Your insurance won’t run out when you need it due to annual or lifetime caps.
- Most lower and middle-income people will get subsidies to help pay for insurance.
For those who say the senate bill doesn’t do enough, remember that getting this passed was a Herculean task. This is just the start of reform. Over the years, our lawmakers can continue to improve the bill, just as they’ve done with Social Security and Medicare. This is a long overdue beginning to regulating the health insurance companies, which have been given carte blanche for so many years.
The Centers for Disease Control recently reported that 58.4 million Americans were uninsured for at least part of the year and almost 32 million had been uninsured for more than a year. The situation will only get worse if we do nothing. As President Obama is fond of saying, we can’t let the perfect be the enemy of the good. This is a good bill. And it’s the best present that the U.S. Senate could give us this holiday season.
Merry Christmas to all.
– Yvonne S. Thornton, MD, MPH
Posted in General health news, Women's health issues, Women's health news | No Responses »
Tags: Centers for Disease Control, health care reform, health insurance, healthcare legislation, healthcare reform, Uninsured Americans
Written by yvonnethornton on December 14th, 2009
When I was a little girl, just beginning to play the saxophone in the all-girl family band that would one day win acclaim as The Thornton Sisters, the big scandal in the music industry was payola. Radio disc jockeys took money under the table in exchange for playing certain records on the air. The practice, equivalent to bribery, was illegal.
I recently learned payola is alive and well – but with a reverse twist, and in a different industry. Major pharmaceutical companies have been paying off generic drug companies in order to keep the generics off the market. So, instead of “pay to play” we have “pay to not play.” Without generic competition, major pharmaceutical companies can – and often do – charge exorbitant prices. It’s estimated that pharmaceutical reverse payola costs us $3.5 billion per year.
Here’s how the scheme works.
Let’s say a major pharmaceutical company manufactures a cholesterol-lowering drug that many doctors prescribe. Because the drug is patented, and the company has spent billions of dollars in research and development for that drug, the pharmaceutical company is then given a “head start” to charge whatever the market will bear in an attempt to recoup its investment and time spent developing the new drug. The downside is that people whose doctors prescribe the drug either must pay the price or go without.
But the effective life of the drug patents on a name brand medicine is from seven to twelve years. After the pharmaceutical company’s patent expires, other drug companies are permitted to manufacture and market identical chemical versions of the drug and cheaper generic versions of the drug become available to those who need it. How much cheaper? At Costco Pharmacy, a month’s supply of the name brand version of a popular tranquilizer costs $146.22. The generic version – which must by law provide the identical medication in identical amounts – costs just $8.32 for a month’s supply.
Obviously, if a drug company can continue to get close to 20 times the money for the same product, it’s going to look for ways to keep out generic competition. Some pharmaceutical companies are paying manufacturers of generic drugs in exchange for the generic manufacturers’ agreement not to market generic versions. A bipartisan effort is underway in the United States senate to make the practice illegal.
Such “reverse payola” could be compromising the health of our families and loved ones. According to a survey of 2,004 adults, done earlier this year by Consumer Reports, because prescription drugs costs are so high, 28 percent did one or more of the following:
- Failed to fill a prescription (16 percent).
- Skipped a dose (16 percent).
- Took an expired medication (11 percent).
- Cut pills in half (10 percent).
- Shared a prescription (4 percent).
About 23 percent said they cut back on groceries in order to afford their prescriptions.
Although brand name medications often are better formulated with better bioavailability and, therefore, are often more effective than generic drugs, patients and physicians should have the option to choose which is the best under specific circumstances. They must weigh the cost of the drug with the intended outcome. However, the practice of “reverse payola” is unconscionable and violates the principles of good medical and pharmaceutical practice.
Generic drugs are far more likely to be affordable – and therefore available – than brand name versions. That’s where you and I come in. We need to contact our senators and congressional representatives and tell them to make such practices illegal. We need to contact our local newspapers, TV stations and other media, and ask why they aren’t covering this story. We must ensure that we and our loved ones can afford the medicines we need in order to stay well.
– Yvonne S. Thornton, MD, MPH
Posted in General health news, Women's health issues | No Responses »
Tags: drug company payola, generic drug manufacturers, generic drugs, healthcare legislation, pharmaceutical company pay-for-delay, prescription
Written by yvonnethornton on December 10th, 2009
Today on Dr. Nancy, I was invited to appear to discuss a controversial issue. A young pregnant woman, whose high school took precautions against injury to her fetus by treating her differently than other girls on her volleyball team, has filed a complaint, claiming discrimination.
On the show, Dr. Nancy and I explained why this isn’t a discriminatory action but an appropriate one that protects the health of mother and fetus. Although some may not think of it this way, volleyball can be a contact sport. A player can get an elbow shoved into her abdomen when someone else reaches for the ball. A player can get pushed down on the court. There is always risk of injury but for most young women, the risk is minimal. Not so with a young pregnant woman. She risks harm to her fetus in the rough and tumble of such competitive sports.
While exercise is good for a pregnant woman’s health, contact sports are not, certainly not when the sorts of things we see happening in games have the potential to injure a fetus.
This isn’t a women’s rights issue. Dr. Nancy and I are both staunch defenders of women’s rights. It’s about keeping a baby and mother safe.
– Yvonne S. Thornton, MD, MPH
Posted in General health news, Media appearances, Pregnancy, Women's health issues, Women's health news | No Responses »
Tags: babies, Dr. Nancy, exercise during pregnancy, pregnancy and sports, Yvonne S. Thornton
Written by yvonnethornton on December 8th, 2009
I still hear from readers who were inspired by my first memoir, The Ditchdigger’s Daughters, although it was originally published almost 15 years ago.
The latest to come to me via email really touched me. It’s from Mr. Fred Belknap, whose lovely words make me think that he appreciates the values that my father instilled in his children in almost the same way I do:
What an example this can be for our children relative to today, in that many think everything should be handed to them and meeting goals and beating the odds is a birth right. It seems your father did a special job to prepare you and your sisters for this world though perhaps his message was questioned at times as a result of his methods. Even though his vision, now a reality through his daughters, speaks to the strength of having a plan and carrying it through.
Thank you for sharing your experiences and I pray the many messages engraved within them are seen by the upcoming generation.
Thank you Mr. Belknap. Your kinds words have made my day, week and month.
And a big thanks to all those who have read The Ditchdigger’s Daughters and taken its lessons to heart. I hope you’ll all continue the journey with me and read Something to Prove, my next memoir, which picks up where The Ditchdigger’s Daughters left off. It’s scheduled to be published by Kaplan Publishing in Fall 2010.
– Yvonne S. Thornton, MD, MPH
Posted in Publishing news, Something to Prove: Memoirs of a Ditchdigger's Daughter, The Ditchdigger's Daughters | No Responses »
Tags: Donald Thornton, letter from a reader, memoir, Something To Prove, The Ditchdigger's Daughters, Yvonne S. Thornton MD
Written by yvonnethornton on December 4th, 2009
The word from the Centers for Disease Control is that women who are pregnant are at high risk from the H1N1 virus, also known as the swine flu.
If you’re pregnant, you need to get vaccinated with both the seasonal and the H1N1 vaccines. It’s the single best way to protect yourself and your baby from the flu. And don’t let the anti-vaccination rumors swirling around the Internet scare you into delaying or avoiding a flu shot. According to the CDC, the seasonal flu vaccine has been administered to millions of women and has not been shown to harm women or their babies. The 2009 H1N1 flu shot is made in the same way and in the same places as the seasonal flu shot. You may receive both flu shots at the same time; however, they should be given at different sites on your body, e.g., left arm and right arm.
Although recent cases of swine flu have been diminishing, influenza epidemics tend to come in waves. So even if there are few new cases of the flu in your area, it may just be a lull and you could get hit by the next wave. Get vaccinated now, if the vaccines are available in your area. Get everyone in your household vaccinated to prevent the disease from spreading among family members. Babies under 6 months of age are too young to get the vaccine so it’s especially important to their health that other members of the household are vaccinated to protect against family members spreading the virus.
Here are some other ways you can protect yourself from the germs all around us.
- Wash your hands often with soap and water. Or use small bottles of alcohol-based hand sanitizer you can carry in your purse.
- If you have flu symptoms, call your doctor immediately. Pregnant women tend to get more serious cases of this flu and it’s important to get treatment. Your doctor can prescribe medicines that will help.
- Don’t assume that, just because you don’t have a fever, you don’t have the flu. This flu doesn’t always cause fever.
- Try to avoid contact with others who appear ill. If someone in your family gets sick, ask your doctor to prescribe medications that may prevent you from getting sick, too, such as Tamiflu® or Relenza®.
- Cover your nose and mouth with a tissue when you cough or sneeze and throw the tissue away immediately. If a tissue isn’t available, sneeze into your sleeve, not your hand.
- Keep your cabinets well stocked with non-perishable foods as well as other basics and medicine that you might need if you got sick.
The CDC warns that if you are pregnant and experience any of the following, you must call 911 immediately:
- Difficulty breathing or shortness of breath
- Pain or pressure in the chest or abdomen
- Sudden dizziness
- Confusion
- Rapid pulse over 100 beats per minute
- Severe or persistent vomiting
- A high fever that is not responding to Tylenol®
- Decreased or no movement of your baby
Just remember, the nasal spray vaccine is not licensed for use by pregnant women because it is a live, attenuated virus. Pregnant women should not receive nasal spray vaccine for either seasonal flu or 2009 H1N1 flu. After delivery, women can receive the nasal spray vaccine, even if they are breastfeeding.
In summary, get vaccinated, practice good hygiene, and call your doctor immediately if you get sick, and you and your baby should come through this flu season just fine.
– Yvonne S. Thornton, MD, MPH
Posted in General health news, Pregnancy, Women's health issues, Women's health news, Your newborn baby | No Responses »
Tags: babies, CDC recommendations swine flu, flu, flu vaccination, flu vaccine, H1N1, newborn, obstetrician, pregnancy and the flu, pregnant women at risk for flu, Swine flu
