Conquering Fear

So much to blog about and so little time....
A patient of mine turned me onto the television series Doc Martin years ago, and I wondered why the good doctor never did a repetitive exposure protocol to reduce his blood phobia. 
If anyone out there is not getting medical care or blood draws for good preventive care because they are afraid of needles, there are great ways to help yourself. 
I highly recommend a workbook which a patient of mine introduced me to called 
Mastering Your Fears and Phobias.  
http://www.amazon.com/Mastering-Your-Fears-Phobias-Treatments/dp/0195189183
This book is meant to be used in conjunction with a therapist who is using this book:
Mastering Your Fears and Phobias: Therapist Guide
http://www.amazon.com/Mastering-Your-Fears-Phobias-Treatments-ebook/dp/B00192LYRG
This is the link to the Kindle edition but you can also find it in hard copy from Barnes and Noble and other places online. 
Unlike with most books, I found that the authors' blurb on the cover of the therapists' guide delivered exactly what it said and that the two books together are an extremely effective system. So I will reproduce the blurb on the therapists' guide here:

"Specific Phobia is the most commonly occurring anxiety disorder with approximately 12.5% of the general population reporting at least one specific phobia during their lives. People may fear heights, flying, spiders, blood, water, and any other number of circumscribed objects or situations. Research has shown the most effective treatment for these fears and phobias is an exposure-based, cognitive-behavioral program.  Written by renowned researchers, this Therapist Guide provides you with all the information you need to help your clients ease their anxiety and conquer their fears. Whether they are afraid of dentists, dogs, or driving, you can teach your clients the necessary skills to overcome their phobia in as little as a few weeks. The strategies outlined in this book include exposure exercises and cognitive restructuring techniques. The corresponding Workbook includes blank forms and records for tracking progress and allows the client to extend the therapeutic experience outside of the office. Together, both books form a comprehensive package that has proven to be the most effective and successful treatment available for specific phobia. TreatmentsThatWorkTM represents the gold standard of behavioral healthcare interventions! All programs have been rigorously tested in clinical trials and are backed by years of research A prestigious scientific advisory board, led by series Editor-In-Chief David H. Barlow, reviews and evaluates each intervention to ensure that it meets the highest standard of evidence so you can be confident that you are using the most effective treatment available to date.  Our books are reliable and effective and make it easy for you to provide your clients with the best care available Our corresponding workbooks contain psychoeducational information, forms and worksheets, and homework assignments to keep clients engaged and motivated."
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Unlike other phobias, it is hard for a regular psychotherapist to provide the exposure needed if you are afraid of needles or blood.  Your therapist will need to work with a doctor who can expose you to needles and blood.  Or, like my client did, you can buy your doctor the Therapists' Guide and convince them to help provide you with the needed exposures. Be prepared to spend some money on this as it would not be surprising, given the sorry state of our insurance system, if your insurance plan did not cover the doctor visits needed for this type of treatment. 

So, if you have nothing to fear but fear itself, take heart and buy these books and enlist your doctor in helping you get rid of this disabling phobia which is preventing you from taking care of yourself.

US Worst of 11 Industrialized Nations in Cost-Related Health Care Access Problems

http://www.commonwealthfund.org/~/media/Files/Publications/In%20the%20Literature/2010/Nov/Int%20Survey/PDF_2010_IHP_Survey_Chartpack_FINAL_white_bkgd_111610_ds.pdf

Insurance Companies Invest in Fast Food

Interesting article in American Journal of Public Health (click here for an abstract of the article) describing insurance company investments in fast food companies. The surprise is that this even makes the news. First, is anyone still under the impression that health insurance companies care if you live longer or are healthy? They are basically just claims processing outfits. In fact, the higher health costs and therefore health insurance costs, the more they grow their own organizations, since they pay themselves as a percentage of premium.

Second, I experienced myself as a member of the Board of Trustees and a member of the Fund Management Committee at a health-related nonprofit that most companies are not watching carefully what their financial advisors are investing their money in. Unless an external group makes a fuss about it, even the top leadership of the company may not realize what these investments consist of. Investment and fund management committees tend to be run by finance folks and treasurers, and for these people getting the best return is the most important thing. The meetings are dominated by concern about the financial state of the organization. In the ones I was involve in, they are not paying much attention to the mission of the organization as they make their investments, beyond their basic thought that they can do better with their mission if they make money on their investments.

So this did not come as a surprise to me. An analysis of the investments of endowment at our universities, and investments of endowment by other health related organizations such as health care foundations and medical provider organizations would show exactly the same thing, I am sure.

Of course our government is also ignoring our health in the companies it subsidizes...

Uninsurance

Recently a patient had an dermatology outpatient laser surgery procedure. The procedure was supposedly "preauthorized" by the PPO plan, and all the person's deductibles had already been met for the year, so it would seem that there would be no out of pocket costs besides the copays for the doctors and the facility. Wrong again!!! There was a "laser rental" charge that no one said anything about in advance, which turned out not to be covered by the insurance (why?).

Just another insurance ripoff....please comment if you've experienced anything similar.