Blunders and Wonders: Cancer's Price Tag & Sneaky Sugar

Nick van Terheyden, M.D.
OCTOBER 24, 2018
Hello! I’m Dr. Nick, the Incrementalist, and I’m here today to talk about Blunders and Wonders.

Blunder: Cancer’s Double Blow

This week’s Blunder: Cancer’s double blow. There’s something deeply wrong with a healthcare system that takes a patient recently diagnosed with cancer and kicks them while they’re down. That’s the finding of a recently published study in the American Journal of Medicine. A longitudinal study that looked at data from the Health and Retirement Study from 1998 to 2014, that collects data on people aged 50 and over. They looked at patients’ financial status prior to receiving a cancer diagnosis, and then again at year two and year four for post diagnosis.



With the increasing shift of costs in healthcare to the patient, the impact of cancer diagnosis was debilitating, revealing over 40 percent of people had depleted their life assets, and by year four almost 40 percent had become financially insolvent. In other words, they had gone bankrupt. Over half of all people with cancer experienced house repossession, bankruptcy, loss of independence, and relationship breakdowns. That’s a bleak picture for anyone with a disease that is the second leading cause of death in the United States. The direct medical disease costs in the US run to $80 billion per year.

In this instance, the open sharing of data through open notes and transparency is the path to mitigating this opening up clinical records, costs and research to everyone so they make informed decisions, even if those decisions put everyone in an uncomfortable position.

Cancer is an equal opportunity offender. With some exceptions, it strikes for no reason and with no specific underlying cause or warning. In other words, it’s the random drawing over which we can do little to mitigate and have little control. So current circumstances mean that not only do patients face the devastating news of a diagnosis of a severe disease, but they also must face the financial burden this will place on them and their family.

Wonder: Visual Tools to Help Assess Sugar Consumption

This week’s Wonder: Visual tools to help assess sugar consumption. I know I’m a visual person, and I suspect many of you are too. So the discovery of the Sneaky Sugar website that offers you a visual representation of the amount of sugar in common foodstuffs was a simple but powerful idea.

We have reached an inevitable conclusion on food consumption and sugar: too much sugar is bad for you. What’s the right amount of sugar depends as much on you as it does on what else is in your diet, but the World Health Organization (WHO) recommends a maximum of 25 grams of sugar per person per day. That’s about 11 sugar cubes per day.

The challenge many of us have is consuming less sugar in our diet. When that sugar comes in the form of sugar cubes or granules it’s easy to assess how much we are eating. But when it’s hidden inside everyday products, it can be challenging to understand how much we are putting into our bodies every day. As the site points out, they identify 60 different ways that the nutrition labels on foodstuffs can say sugar.

The site offers you a handy way to educate yourself and identify the hidden sources of sugar that add up to push your total consumption each day past the recommended daily allowance. By way of an example, a handful of your favorite candy probably contains more than your daily allowance, as does your favorite large coffee drink.

Until next time, I’m Dr. Nick, the Incrementalist. Don’t let perfection stand in the way of progress.

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More Blunders and Wonders of the Digital Transformation:
Patient Access & CRISPR
EMR Interfaces and Continuous Blood Pressure Monitors
Unusable EMRs & Smartphone Ultrasounds

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