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inferno31




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I no doubt believe there are some corporate interests at work, and it's true hospitals give you normally a month's supply of formula to new mothers. However, there are also classes on breast feeding and lactation experts, not to mention more push from pediatricians to breast feed. I think if more mothers were given time off after their pregnancy you'd see breast feeding rates rise irrespective of the fact they get formula from the hospital. The important corporate interests are about getting them back to work, not pressure from "big formula". If we really want to fight obesity and improve our children's future this is the place to start.

There is a bias between women who breastfeed and those who don't. Being that those who don't often have to return to work and can't afford help at home etc. Having said that most of these studies control for these cofounders and incorporate that into their results. Unfortunately I'm not able to post the full study up. The obesity study was done in Japan though, not in the United States so theres definitely socioeconomic factors at play there.

You have to figure the lack of time off also correlates with the low breast feeding rates in the US.

With studies linking breast feeding to lower Obesity and higher IQ, it isn't just the mothers being screwed but their children as well. It's ridiculously archaic mindset to expect mothers back to work right away, both for them and their children.

inferno31  ·  link  ·  parent  ·  post: How Doctors Die (2011)

    I do think we will see major changes in the next couple of generations in regards to how this is handled.
I hope your right - right now the patient definitely isn't coming out on top. Thanks for the replies! Just started out on this hubski thing, trying to figure it out still.
inferno31  ·  link  ·  parent  ·  post: How Doctors Die (2011)

    I think that physicians are equipped to have these discussions but are discouraged from doing so, especially in the wake of the post healthcare battle "Death Panels" scare that was so pervasive.

That's actually a great point, it's mostly the older physicians I've seen who are uncomfortable having these discussions. The medical-legal landscape scares off many doctors from wanting to have this discussion though, you can see the hazards of it even in the article. It's all about documentation.

    If you are big pharma or a med device company you lobby hard to keep life extending policies in place. More of their products are consumed in the last days, weeks and months of life than the whole rest of life combined. (Okay, I made up that stat, but I would bet it's true). It's all about money, including the money the hospitals and physicians can make. It's not about what is best for the patient.

While this is a pretty cynical view I can see where it's coming from, and the last few years of life account for well over 60-70% of total healthcare expenses. A lot of physicians do want what's best for the person, especially if they've been treating them for years. You can argue the surgeon doing the tracheostomy or placing the G-tube doesn't really care, but more often the primary physician either publicly or privately will voice concerns or hesitation. I really don't think people are adequately informed. You always hear that one story of the doctors wanted to pull the plug but little betsy against all odds survived and now shes an astronaut! People don't like dealing with the harsh realities of end of life care because it's uncomfortable to do so.

inferno31  ·  link  ·  parent  ·  post: How Doctors Die (2011)

There is a huge gap of understanding between what physicians know is "futile" including the success rate of resuscitation and the general publics perception of it. The main two issues I see are:

1. The general public believes resuscitation is far more effective than it actually is. Survival rates are about 10% for out of hospital cardiac arrest and only 20% for in hospital cardiac arrest. But a much a better endpoint is higher brain function and quality of life which is even lower.

2. When someone is given power of attorney and able to make medical decisions for a loved one, there isn't quite enough communication of what this role entails. Most family members see denying resuscitation or intubation as them "killing" their family member, and as such most are obviously reluctant to do so. It's difficult to separate that feeling with the real responsibility which is to act as a stand in for that person and honor their wishes. Ask would they want to continue to live like this, based off everything you know of them? The results are quite different.

The US provides far too much extraordinary care at the end of life, not because it's useful but rather because it's available and physicians aren't equipped for the palliative care discussion that needs to happen. Now why this is the case and how it impacts healthcare costs is another discussion entirely.