An important development in the worldwide treatment and care of HIV-infected individuals was announced earlier this week. Read on to find out what this means for HIV treatment practices moving forward…
“Anyone who understands systems will know immediately that optimizing parts is not a good route to system excellence.…We connect the engine of a Ferrari, the brakes of a Porsche, the suspension of a BMW, the body of a Volvo. What we get, of course, is nothing close to a great car; we get a pile of very expensive junk.” – Chapter 8.
I just finished reading Atul Gawande’s The Checklist Manifesto, which was first published in 2009 and spent some well-deserved time on the New York Times Bestseller List. Written by an attending general surgeon at Brigham & Women’s Hospital in Boston, this book tells the admittedly “unsexy” story of how a simple tool such as a checklist can improve the quality and consistency of outcomes in a wide range of fields: aviation, building construction, venture capital, and (even) medicine. All of these fields are complex systems – involving many moving pieces and players, and an inherent unpredictability of conditions, materials, personnel, and complications. In addition, these arenas assume a certain level of skill and require a high standard of consistency and safety, but errors and complications still plague us. We have reached a point in many fields where the problem isn’t ignorance (we do understand a lot about the world around us) but rather ineptitude (we fail to apply the knowledge that we have consistently and correctly). A checklist can help us improve our “eptitude.”
One of the questions that I am often asked is why I chose to study public health in addition to my medical training. The answer is simple: I believe that the therapeutic relationship can and should exist outside the four walls of the doctor’s office. While medicine and therefore physicians will always be necessary to cure disease, I see problems in the world that must be solved on a structural level — from the environments in which we live and work that promote unhealthy behavior, to the very real disparities in access to and quality of care.
A newly released study demonstrates that approximately one third of Alzheimer’s cases worldwide are attributable to seven modifiable risk factors: depression, physical inactivity, diabetes, midlife hypertension, midlife obesity, smoking, and low educational attainment. The largest proportion of cases was attributed to physical inactivity, which affects more than half of all Americans. Depression, which affects approximately 14.8 million Americans, accounted for approximately one in ten cases of Alzheimer’s disease globally.
These findings highlight the urgent need for more investment in prevention – and specifically in a holistic approach to health promotion, which includes mental health. (more…)
After a long day at the office or the hospital, when I am mentally wiped out, going for a bike ride or lifting weights at the gym is often the last thing that I want to do. I also don’t want to go grocery shopping, make dinner, or plan lunch for the next day. I definitely don’t want to take the time to floss. Happy hour, sitting on the couch and watching Netflix, or trying out a new restaurant with friends sound much more appealing.
This problem is shared by all – we are constantly bombarded with messages and forced to make short-term decisions that may conflict with long-term health goals. Eat healthy, but try the KFC Double Down. Go to the gym, but have you marathon-watched that new season of House of Cards yet?
Living a “healthy” lifestyle – however defined – takes work and energy. (more…)