NSA Surveillance

NSA Surveillance- Lesson Learnt?

NSA has come under fire for indiscriminately collecting data on Americans. Could others including healthcare industry learn something from this?

I believe that NSA did not set out to break any laws. It did what it did because the technology let it do it so effortlessly.  Many other industries are giving in to similar temptation.  

The clutter of data, while satisfying our voyeuristic instincts, can take industries off their core mission. We must use technology to achieve the goal of doing better for those we serve, but there is a need for setting some rules. Before analyzing any data, we should determine which issue the data will help us with. The next question: how important that issue is given the overall mission of the industry. Otherwise, in this world with advancing information technology, we could be like a kid binging on the newly found stash of Halloween candy. 

Keshav Chander MD

Smart Heart Care

Las Vegas Cardiologist

Palpitations

Should I Be Worried?

The heart is an amazing organ that starts beating a short time after conception, and continues to do so throughout our life- without a break! And it does so without a fuss; most of us are not aware of our heart beat.

Sometimes, we do notice our heart beat, and this could be due to heart beat abnormality.

Whenever you have abnormal heart beat, the following questions should come to mind:

What is causing it?

Can this be life threatening?

What we can do about it?

Keshav Chander, MD

Cardiologist, Las Vegas

No Insurance…

Across the US, almost all who can, have health insurance. According to census report from 2011, 15.7 percent (48.6 million) of the US population did not have health insurance. Nearly half (46%) of adults ages 19 to 64 did not have insurance for the full year or were underinsured and unprotected from high out-of-pocket costs. Many medical professionals as well as uninsured tend to think that emergency room is the only place for medical care for the uninsured. That is a wrong notion. Here are important tips for the uninsured:

1. The law says that all hospitals in the US must treat patients regardless of their ability to pay. It does not say that hospitals cannot later come after you for all you owe them. So you have every reason to try to keep yourself out of the emergency room even……especially if you have no insurance.
2. Be equal partner in your care. If after hearing all pros and cons of a certain test or treatment, you think you do not want to go for it, say so. Thank your doctor for explaining the test/treatment and make your decision clear. Take responsibility for your decision. This is better than walking out of the office keeping everybody guessing. That allays your doctor’s anxiety and concerns, and you will be able to retain a good doctor even if you do not do exactly as she initially proposed.
3. If you end up needing a procedure in the hospital, shop around for a hospital that will be most willing to understand your situation and work with you.
4. Ask your doctor about generic drugs. Shop around to see if any of your prescribed meds or their alternatives are on ‘4 dollar a month’ prescription program that quite a few pharmacies offer.
5. At Smart Heart care, we have a rate list for our cash pay patients. It should just take a quick phone call to our office to know how much a certain service will cost to you. This brings predictability and also helps you manage your finances.

At Smart Heart Care, we do not have ‘no insurance, no service’ policy. We welcome those without health insurance. Just call us at 702 473 5333 to get a clear idea about the cost, so you can plan accordingly. 

Keshav Chander, MD

Cardiologist, Las Vegas. 

 

 

Water, Water, …

There is no dearth of proposed solutions for what ails our healthcare system. The most commonly used term as a part of the solution is ‘quality’. ‘Quality’ to a patient might be the ability to see a doctor that he wants, when he wants. The ‘quality’ to a doctor might be the ability to offer the best possible solution to his patient’s problems. The ‘quality’ to someone else might me the best use of healthcare dollars. The added problem is that the definition of ‘best use of healthcare dollars’ is different depending on which side of the desk you are.

So many proposals without any palatable solution remind me of lines in The Rime of the Ancient Mariner by Coleridge:

Water, water, every where,

And all the boards did shrink;

Water, water, every where,

Nor any drop to drink.

Keshav Chander, MD

Cardiologist

Smart Heart Care, Las Vegas

Thanks

Thanks to VegasDesi for sharing our story

 

 

What is My Risk?

About half a million people die suddenly in the US every year. The commonest cause of sudden death is blockages in heart arteries (coronary artery disease). Many of my patients ask me about their risk of having blocked arteries.

Your risk is a complex interplay of many factors including your age, family history, smoking status, diabetes, hypertension, high cholesterol etc. Click on this National Institute of Health link  to calculate your risk.

Keshav Chander, MD RVT 

Cardiologist, Las Vegas                                                                            

Smart Heart Care

Six Things…

…To Know About The Heart

1. You are never too young to be thinking of your heart.
2. We talk about heart disease, and heart attack comes to mind. In addition to blockage of heart arteries, several other problems can affect this organ. There can be problem with wiring of the heart or problems with heart muscles; there can be shrinkage or leakage of the heart valves or other structural abnormalities.
3. A concern for heart attacks makes us think of heart disease in local terms. We just tend to think of blockages that need fixing. The heart arteries are part of body’s plumbing system that runs from head to toe. Those who have heart attack tend to be at a higher risk for stroke and vice versa. This makes a strong case for thinking of heart disease in systemic rather than local terms. Systemic approach should involve controlling the risk factors for heart disease aggressively.
4. Not too long ago, we used to think that heart artery blockages progress over time (progressing from 50 to 60 to 70 percent and so on), and eventually cause heart attack. Later studies suggested that most of the heart attacks are caused by the arteries that are less than 50% blocked. These are the blockages that can be hard to detect through commonly used tests. This makes a case for proactive approach that should involve controlling risk factors for heart disease like high blood pressure, diabetes, high cholesterol, smoking, physical inactivity etc.
5. Cardiology (study of heart) is a rapidly evolving field. There was a time when people used to think that high blood pressure is an essential part of growing old. There was a time when swollen heart failure patients were treated by blood-letting. Both these approaches have been proven to be flawed over the years. On the other hand, new developments in this field continue to save lives.
6. It is possible to have perfectly normal life after heart problem. Quite often, my patients have told me, “This heart attack was a wakeup call for me. Now I eat right and exercise regularly. I am feeling better than I have felt in a long time”.

My Vegas Move

I came to Saint George July of 2001. Two month later, 9/11 happened. My wife was still about 2000 miles away in New Orleans along with our autistic son. She is an internist and was finishing her medical residency. Those were stressful times. Those times also brought along the opportunity to serve patients in Utah, Nevada and Arizona.

Many of my patients have personally wished me well with this move; some I have seen for years; a few were ‘given’ just months to live ten years ago. Over the years, I also cried alongside few patients’ families, and God did not seem quite fair during those tough times.

During these eleven years, our family made many friends and had many beautiful moments including the birth of our younger son. 

The family needs are necessitating our move to a bigger town. With its glitz and glamour, divine scenery including Red Rock Canyon area right in its backyard, a beautiful international airport, nearby Mount Charleston to cool off during the summers, and Saint George (our wonderful home town for 11 years) a ‘stone’s throw away’, Las Vegas was a no-brainer.

Our Vegas move has been about a year in the making. During this time, I have met some wonderful people with big hearts in Las Vegas. Some a little beaten by the sluggish economy, but ready to dust off and get on.

I will be practicing in beautiful southwestern part of Las Vegas. This area has some of the most beautiful hospitals I have seen. I am gratified to have met some genuinely supportive people in these hospitals. I am looking forward to working with them.

I am looking forward to doing my best to be an asset to the city of Las Vegas. 

The Smart way

American health care system is known for its quality around the world. But there is a need for reining in health care cost.
Are we going to have to gut the best healthcare system in the world for cost containment, or is there a way to provide efficient, compassionate, quality care despite our fiscal challenges? We believe there is a way…the Smart way.