Millenson in Forbes: How Mayo's "Dr. Google" Deal Disrupts Medicine

In his latest column in Forbes, health care quality consultant Michael Millenson examines the implications of Google joining with the Mayo Clinic to provide consumers with medical information, which he says quietly signals a powerful disruption for all of medicine.

Now when people search their health questions on Google they will get relevant medical facts up front that have been reviewed by teams of doctors including expert clinicians at Mayo Clinic for quality and accuracy.

Millenson writes:

Recommending a Google search “as the first stop for those needing health information,” in the words of a Mayo physician executive, represents a true paradigm change.

But there’s much more going on here than search. From the Fitbit to medicine’s front lines, information technology is forcing a new doctor-patient relationship with new rules for new roles.

If information is power, digitized information is distributed power. While “patient-centered care” has been directed by professionals towards patients, collaborative health – what some call “participatory medicine” or “person-centric care” ­– shifts the perspective from the patient outwards.

Genuine collaborative health will require incorporating information technology into relationships that harmonize both those views

New Study: New Medical Advances Often Not Better, and Sometimes Worse

A study published in the August issue of Mayo Clinic Proceedings reviewed each issue of The New England Journal of Medicine from 2001 through 2010 and found 363 studies examining an established clinical practice. In 146 of them, the currently used drug or procedure was found to be no better, or even worse, than the one previously used. More than 40 percent of established practices studied were found to be ineffective or harmful, 38 percent beneficial, and the remaining 22 percent unknown.

In some instances, doctors routinely refused to give beneficial therapies despite a lack of evidence that they were harmful. Vaccines were unnecessarily withheld from multiple sclerosis patients in the belief that they increased flare-ups; women with lupus were denied oral contraceptives for fear they increased the severity of the disease; and epidural anesthesia was delayed during childbirth on the theory it increased the rate of Caesarean sections. Yet good studies showed that none of these fears was justified.

This evidence has implications for designing employer-sponsored health benefits. Value-based insurance design techniques could be applied to these types of procedures or therapies to discourage their use. Employers should be looking for these types of studies and gain experience in understanding clinical evidence.

What costs more: obesity or smoking?

According to a new study by Mayo Clinic researchers... obesity. Both obesity and smoking contribute to higher individual health costs, but obesity brings more additional spending.

In an article in the Journal of Occupational and Environmental Medicine, March 2012 [subscription required], researchers analyzed data from more than 30,000 Mayo Clinic employees and retirees who had continuous health insurance coverage between 2001 and 2007 to identify the additional health costs of smoking and obesity.

Although both obesity and smoking were associated with additional costs, the researchers found that health costs for obese workers were higher than smokers. The average annual health costs for smokers were $1,275 more than nonsmokers, while obese workers cost $1,850 more than non-obese workers.

Additionally, the cost increased to $5,500 more per year for morbidly obese workers than non-obese workers.