Raw milk? No, thanks

Milk comes from cows who live on picturesque farms and spend their days contentedly grazing in lush pastures while clouds float overhead in a pure blue sky.

Who doesn’t have wholesome images of milk? Perhaps if we could do away with all those artificial processes such as pasteurization, we could drink fresh raw milk straight from the cow and be healthier for it.

This seems to be the thinking of raw-milk enthusiasts who have apparently gained the ear of some Minnesota legislators.

Minnesota Public Radio reported today that three state senators have proposed legalizing most sales of raw milk in Minnesota. The measure would allow unpasteurized milk to be sold directly to consumers with minimal restrictions, meaning they could buy it in a variety of settings such as farmer’s markets and people’s homes. Under current law, raw milk can only be sold at the farm where it was produced.

I’m at a loss to see why we would want to make it easier for consumers to buy a product that comes with clear, documented health risks. People need look no further than Gibbon in southern Minnesota, where raw milk sold at a dairy farm was linked last year to at least eight cases of E. coli, three cases of Campylobacter and four cases of cryptosporidium. Those stricken included a child who developed hemolytic uremic syndrome, which can lead to kidney failure and is sometimes fatal.

This was not an isolated incident. After the state Health Department began investigating the outbreak traced to the Gibbon farm, 47 other reports of illnesses linked to the consumption of raw milk were identifed across the state. Most of them involved children and young adults.

Those in the raw-milk camp believe unpasteurized milk has special health benefits. But a review published a couple of years ago in the Clinical Infectious Diseases journal found no scientific proof to support this. Indeed, the risks clearly outweighed any anecdotal evidence to the contrary.

Don’t just take my word for it. See what the U.S. Centers for Disease Control and Prevention and the U.S. Food and Drug Administration have to say about unpasteurized milk.

For those who think milk producers and consumers should be allowed to decide for themselves whether to take the risk, consider this: Many of those who’ve been sickened by raw milk have been children who aren’t in a position to make an informed decision. Minnesota health officials also are concerned that people may be consuming raw milk without knowing, or without understanding, what they’re getting. On top of this, a rather alarming report this week from the Center for Science in the Public Interest found that raw milk, raw milk cheeses and ground beef appear to be prime carriers of antibiotic-resistant pathogens, with implications for the safety of the entire food system.

If anything, the Minnesota Legislature should be looking at more, rather than less, regulation of raw milk sales.

It’s still early in the session and this issue may end up going nowhere. But it’s baffling that it would even be proposed, in view of the many foodborne disease outbreaks the U.S. has experienced in recent years and increasing public health concerns about food safety.

Wait, there’s more. Legislation also was introduced this week to undo part of the 2007 Freedom to Breathe Act, allowing Minnesotans to smoke in bars once again and expose employees and customers to the hazards of secondhand smoke.

The state may be facing some challenging times, but you’d think we could at least try to maintain the status quo. Instead we appear to be headed for a couple of steps backwards in the quality-of-life department.

It’s starting to look as if the biggest risk to Minnesotans’ health right now is under the roof of the state Capitol.

West Central Tribune file photo

Portion distortion

If you like iced coffee, you’ll soon be able to drink it by the quart. Last week Starbucks announced it’s adding a new size to its array of cold coffees and teas – the 31-ounce Trenta.

OK, so it’s one ounce shy of a full quart. But that’s still a lot of coffee, even for coffee lovers like me. According to the company, the Trenta (the name is Italian for “30″) will be available at all Starbucks locations by early May, just in time for the arrival of warm weather.

What’s interesting about the introduction of the Trenta is that it’s apparently driven primarily by customer demand for larger drinks. Starbucks explains:

We listened to you. You told us on My Starbucks Idea and through your purchases that you love refreshing iced coffee and tea beverages but want them in a larger size. Did you know that over 60% of our iced tea customers currently order our largest size, the 24 oz. Venti?

Now you iced coffee and tea fans can enjoy more refreshment – a Trenta offers seven more ounces than a Venti at a cost of only 50 cents more!

Can you say “Supersize me”?

From Big Gulp drinks to jumbo cookies and oversized pizzas, food portions in the United States are succumbing to the philosophy that more is, well, more. The result has been an increasingly skewed perception of what constitutes a normal portion, or what nutritionists refer to as ”portion distortion.”

To get an idea of how our notions of normal have changed over the years, consider this: Twenty years ago, the typical bagel was 3 inches in diameter. A bagel nowadays has a six-inch girth. Blueberry muffins have almost quintupled in size from 1.5 ounces to 5 ounces. This quiz from the National Heart, Lung and Blood Institute helps illustrate how far out of whack many of us are when it comes to accurately judging portion sizes and calories.

It hasn’t helped that foods are often packaged in ways that blur the difference between servings and portions – a bag of chips, for instance, that contains three servings but looks like one portion. Plates have become larger, distorting the consumer’s sense of what a full plate of normal-sized food servings should be.

The new Trenta, according to Starbucks, is not necessarily loaded with calories. Unsweetened versions of the 31-ounce iced coffee or tea will contain about 90 calories. The sugared versions are 230 calories, or so we’re told. Even so, this is a massive drink that makes the 24-ounce Venti look puny by comparison (which is the whole point, I guess). The National Post of Canada pointed out last week that at 916 milliliters, the Trenta contains the same volume as the average capacity of the adult human stomach.

When food portions continue to expand, and when the marketing emphasis is on “more” and “value,” it’s not hard to see why many people have trouble maintaining a healthy weight. Even when they think they’re making good food choices, their efforts can be undone by oversized portions that simply add up to too many calories.

There are obviously many factors – activity level, for one – that contribute to weight and weight management. But experts agree that portion control is clearly an important one. A few years ago, researchers at the University of Tennessee conducted a study designed to look at whether food packaged as a single serving could help people lose weight. They found that when study participants were given single servings of food for breakfast, they took in fewer calories than a control group that was allowed to have standard servings.

Another study that appeared a couple of years ago in the Appetite journal tracked a group of people who were randomized to receive portion-controlled snacks or standard-size snacks for two weeks. During the first week, the participants who were given calorie-controlled snacks ate less than those in the standard group. In the second week, the participants who had already received the portion-controlled snacks continued to eat less, even though they now had access to standard-size snacks. Among the researchers’ conclusions: “Initial exposure to portion-controlled packages might have increased awareness of portion size such that less was consumed when larger packages were available.”

Here’s more perspective on portion distortion, from a 2008 article in the Journal of the American Board of Family Medicine which identified oversized portions as a key eating behavior contributing to weight gain:

Portion size is closely related to restaurant and fast food consumption; the largest food portions in the United States come from restaurants and fast food establishments. Between 1977 and 1996, portion sizes and energy intake increased in the US population older than 2 years of age when considering home, restaurant and fast food sources. The greater the amount of food presented to people, the more food is consumed.

How can we correct our portion perceptions to something that’s more realistic? Here are some rules of thumb from the NHLBI (the graphic can be downloaded into a handy pocket-sized reference): A cup of salad greens is equivalent to a baseball. One cup of cereal should be the size of a fist. Half a cup of cooked rice or pasta is the same as half a baseball. Three ounces of meat, fish or poultry is the same size as a deck of cards. Two tablespoons of peanut butter are the size of a pingpong ball.

The Weight-Control Information Network of the U.S. Department of Health and Human Services offers several helpful tips:

- Use smaller plates and glasses. That way, when you fill up your plate you won’t be taking as much.

- Avoid eating out of boxes or bags. Instead, measure out an amount equal to one serving and eat from a plate or bowl.

- Eat slowly so your brain has time to get the message that you’re full.

- Buy single-serving prepackaged snacks, or divide snacks from larger bags into single servings.

- When cooking in large batches, freeze leftovers so you won’t be tempted to eat them later.

Some suggestions for dining out:

- Share your meal, order half a portion, or order an appetizer.

- Avoid large beverages.

- Ask for a portion of your meal to be boxed up when it’s served.

Is it really a good value to spend a few more cents for a larger meal? Not always, because you often end up with more food and more calories. Nutritionists suggest either sharing a super-sized meal or, if you’re eating alone, forget about the bargain and order only as much as you need.

Photo: Wikimedia Commons. Logo: Troy Murphy, West Central Tribune

Safer care: What is it going to take?

Dismay? Disappointment? Frustration?

I’m trying to come up with a word that would adequately describe the reaction Minnesotans ought to have to the state’s annual report on adverse events at health care facilities. The Minnesota Department of Health released the 98-page report last week. It lists which of the state’s hospitals, surgery centers and community behavioral hospitals reported a “never” event in 2010.

There are 28 harms that meet the reporting threshold. They range from wrong-site surgery and serious medication errors to patient falls, severe bedsores, injuries caused by medical devices, and abduction or sexual assault involving a patient.

Minnesota was the first in the United States to institute a formal reporting system. The sharing of error rates and the factors that contribute to them has produced a wealth of information to help make care safer.

But in spite of all this, the latest report shows little, if any, improvement. We need to be asking why.

I’ve blogged before about the difficulty of reducing medical errors and adverse events. Health care is complex, and safety seems to be far harder to achieve than anyone ever dreamed. How much of this, though, has to do with the difficulty of the task itself and how much lies within health care culture and an apparent lack of collective will to do better?

To be sure, there are organizations that get it – Rice Memorial Hospital here in Willmar, for one, where the employees chipped in $52,000 last year to the Rice Health Foundation for patient safety projects. It takes commitment to put your money where your mouth is, and it speaks to the value that Rice employees clearly place on providing safe care.

But the fact that many organizations continue to struggle with this suggests that at bottom, there is a disconnect between the concept of “patient safety” and what it actually means in day-to-day care.

One of the recommendations from state officials is rather novel. They are urging health care organizations to share stories about the bad things that sometimes befall patients – in other words, putting a human face on this issue so health care professionals can begin to more clearly understand the real-life consequences when something goes wrong with patient care and, it’s to be hoped, become more engaged in making health care safer.

Well, it’s about time. They can start with my story.

Back in 1995 I developed an aggressive form of non-Hodgkin’s lymphoma and was promptly transferred to an inpatient cancer unit at a Twin Cities hospital. During my first chemotherapy treatment one of the drugs accidentally leaked out of the vein and into the surrounding tissue of my arm. The tissue ultimately was destroyed down to the bone. I had to undergo surgery to remove a chunk of my arm, followed by skin grafting. The scarring is disfiguring and permanent.

This incident cost somewhere between $3,000 and $5,000. Although my health insurance covered it, that isn’t the point.

It took staff, resources, time and energy to deal with this – from the plastic surgeon and the OR team down to the pharmacy, the lab, the surgical supplies and the people who handled the scheduling, billing and claims.

For me personally, it meant additional doctor visits, additional co-pays and daily futzing around with wound cream and bandages. After the surgery my right arm was immobilized in a splint from my elbow to my fingertips. I couldn’t drive, couldn’t work, couldn’t put in my contact lenses. I was forced to take sick leave at a time when I’d already used up a substantial amount of paid time off and couldn’t be sure I wouldn’t have more complications – or worse yet, a cancer recurrence – that would exhaust my sick benefits. The surgery delayed the start of radiation therapy and prolonged the overall time I spent undergoing cancer treatment.

I haven’t even touched on the distress and anxiety this incident caused, nor the apprehension of something else going wrong that hung like a cloud over the entire remainder of my cancer treatment.

Now multiply all of this 100-fold or 1,000-fold for serious injuries that lead to severe or permanent disability or death.

While I believe the vast majority of health care professionals are caring, dedicated individuals who feel badly whenever a patient is harmed, there seems to be an industrywide tolerance of adverse events as the inevitable cost of doing business. There is too much focus on health care’s inability to be perfect and not enough focus on the concrete things that can be done to make adverse events less inevitable. All too often, health providers are unaware of, or underestimate – or perhaps don’t want to know – the physical and emotional price patients must pay when something goes wrong.

Like a stone thrown into a pond, the consequences of medical harm spread outward in a series of ripples, disturbing and altering the universe contained within the patient experience in ways both large and small. It is a burden on patients and families. It is a burden on the system.

Look me in the eye, health care providers, and tell me again why you can’t do better.

Warming up to breakfast

What did you have for breakfast this morning? More to the point, did you even eat breakfast? If you’re like many people, chances are you skipped it altogether, even though this first meal of the day is supposed to be the most important.

It’s hard to get a handle on the number of those who abstain from breakfast. Various studies have tried to pin this down and come up with wildly varying estimates: 4 percent, 5.1 percent, 16 percent. One survey involving mostly poor and rural middle-school students put it at 38 percent.

Once upon a time, skipping breakfast was usually a sign of a poor or low-income household. This no longer seems to be the case as more and more families of all income levels succumb to calorie-counting and time constraints. In fact, breakfast-skipping appears to be on the rise, with many surveys finding a growing number of households where breakfast is consumed as an afterthought or not at all.

Why does breakfast matter? The majority of studies have found numerous benefits for both children and adults. Kids seem to function better in school when they’ve started their day with a good breakfast. Ditto for adults in the workplace. Researchers have noted better memory, concentration and problem-solving, and even higher energy levels among those who routinely eat breakfast compared to those who don’t.

Conversely, a study conducted in Finland noted a link between breakfast habits and overall health, with breakfast-skippers more likely to smoke, drink alcohol and be sedentary. It’s not clear which is cause and which is effect, but I think it’s safe to say that eating breakfast, in and of itself, doesn’t automatically make us healthier. The real issue is that the breakfast habit seems to be one of several markers that indicate overall health. 

An especially intriguing, and often-cited,  study suggests that eating breakfast actually helps you live longer. The Alameda County Study, which started in California back in the 1960s, surveyed nearly 7,000 people in an effort to identify lifestyles that contributed to health and longer life spans. Among the researchers’ conclusions: Eating breakfast was one of the habits consistent with better health and was a predictor of longevity. Men in the study who ate breakfast and didn’t snack appeared to cut their risk of premature death. When the findings for 60- to 94-year-olds were further analyzed, eating breakfast emerged as a positive health factor that was as important as physical activity and avoiding tobacco.

So what’s the physiology behind breakfast? The first meal of the day – breaking one’s fast – helps rev up the metabolism and stabilize blood sugar levels. It also gives the body a jolt of fuel to replenish glycogen stores that deplete during the night.

Breakfast provides an extra daily chance as well for people to consume key nutrients such as calcium, protein and fiber. According to federal statistics, children who participated in the School Breakfast Program increased their intake of calcium and vitamins and were more likely to meet the daily nutrition recommendations for their age group.

With all this evidence, why do so many people continue to skip breakfast? I confess: I used to habitually avoid breakfast. My reasons were the same as most other people’s: didn’t have time, wasn’t hungry, didn’t want the extra calories.

This last excuse – the calorie-counting – seems to be pretty common. It’s also, according to much of the research, based on a fallacy. If you skip breakfast, chances are you’ll be hungry enough to start nibbling on snacks by mid-morning or having a large meal at noon, thus canceling out whatever calories you might have avoided.

The time factor, let’s face it, is very real in many households. I work around it by often preparing breakfast-type foods ahead of time. For instance, I now make my own granola. It can easily be done the night before or on the weekend. Homemade granola is simple to mix up, requiring no fancy culinary equipment or techniques. There are plenty of recipes to be found on the Internet; the one I use most often contains dried cherries and almonds. It’s very good with a couple of spoonfuls of plain yogurt or a splash of almond milk, and best of all, it’s both filling and nutritious.

One of my favorite go-to resources for healthful morning foods is “Sunlight Cafe.” The author, Mollie Katzen, is both a chef and nutrition expert, with many suggestions for turning breakfast into a great-tasting meal. A couple of weekends ago I turned to her book for a recipe for a hot cereal of millet cooked with orange juice and pecans. The grains take half an hour to cook, which sounds lengthy, but once the cereal is in the skillet it only needs to be stirred a couple of times at the 15-minute mark, leaving you free to dry your hair, put on your makeup, feed the cat, fold laundry or whatever.

Most basic cookbooks contain at least a few recipes for breakfast foods. The Internet, aided by Google, can put thousands of breakfast menus and ideas at your fingertips. If you want to keep it simple with a single information source as your Breakfast Central, check out Mr. Breakfast.com, an online place for all things breakfast-related. (Did you know January is National Oatmeal Month? Or that “how to boil an egg” is one of the Mr. Breakfast website’s top search terms?)

If you’ve been following the news, you may have noticed a new study that came out this week in Nutrition Journal. It seems to contradict the widely held belief that eating breakfast can help people control their calorie consumption the rest of the day. The researchers found that when their 380 study participants consumed a large breakfast, they also tended to rack up more daily calories overall. Reading more closely however, the key seems to lie not in the fact they ate breakfast but in what and how much they ate. In other words, calories and portion sizes still matter – but your mother also is still right about the benefits of a nutritious, balanced breakfast.

Image credits: Top: Wikimedia Commons; bottom: HealthBeat photo by Anne Polta; Logo: Troy Murphy, West Central Tribune

The weekly rundown, Jan. 19

Blog highlights from the past week:

Most-read posts: This thing called grief; How to talk like a health care hipster.

Most-read from the archive: Hoarders: Behind closed doors, from Feb. 16, 2010.

Link with the most clicks: HealthLeaders Media.com and its list of the top 11 health care buzzwords for 2011.

Most blog traffic: Tuesday, Jan. 18.

Search term of the week: “barbed wire.”

Linkworthy 3.0

Killer dogs, the physical exam, kiddie meals – what’s not to like about today’s collection of linkworthy tidbits?

Here’s the top question for today: If you’re otherwise healthy, how often should you see your doctor? And how do you know if you’re really getting an adequate physical exam?

As it turns out, neither question has a clear answer. Dr. Lucy Hornstein, who blogs at Musings of a Dinosaur, writes about “The Myth of the ‘Complete’ Physical.” The definition of “complete,” she concludes, can be summed up in two words: “It depends.”

At Kevin MD, guest blogger Dr. Eric Van De Graaf tackles a similar issue: How often to see your doctor when you’re feeling well. My favorite quote: “I don’t know how other doctors do it, but I like to burden healthy-ish patients with as few doctor visits as possible, so I mostly try to set my return appointments for a year.” Thanks, Dr. Van De Graaf; your patients probably appreciate it.

Poor Martha Stewart. She was forced to visit the emergency room last week after Francesca, one of her French bulldogs, bolted into her face, causing her to badly split her lip. The experience, complete with photos, is described on The Martha Blog.

Lest you think this is all rather silly, consider a report that was published a couple of years ago in the Morbidity and Mortality Weekly Review of the U.S. Centers for Disease Control and Prevention. The researchers studied how often people had to visit the emergency room after tripping and falling over their household dog or cat. The number was startling: more than 86,000 a year. Most of these injuries weren’t serious but some victims did end up with broken bones. Does it mean we should all get rid of our companion animals so we can be safer at home? Certainly not, but it gives you pause (or should that be paws?).

Here’s a dismaying development from Tucson, Ariz., scene of last weekend’s tragic mass shooting: Three employees at University Medical Center in Tucson inappropriately snooped into the medical records of some of the shooting victims who were brought to the hospital. All three have been fired, as has a nurse who worked under private contract. For those who think HIPAA is needlessly burdensome, this is a reminder of why the law exists.

Kaiser Health News has been publishing an occasional “First Person” series. The latest installment starts out like this:

The clinic starts at 5 p.m. sharp with a team huddle in the conference room. A black plastic tray of stale bagel halves and crusted cantaloupe sits on the table, remnants of a breakfast meeting, but despite our medical-student hunger, we focus on the task at hand.

Ishani Ganguli, a student at Harvard Medical School, then proceeds to describe what it’s like for students to gain skills in hands-on primary care and why primary care is increasingly becoming an unattractive career option for many doctors in training. It’s a great read.

If you have kids, this last item for you: Yet another study has confirmed what many parents already know – adults tend to have a better diet when they don’t have to take children’s tastes into account. This shouldn’t be surprising. Many kids don’t like what’s supposed to be good for them, and parents often have to resort to chicken nuggets and mac ‘n’ cheese just so their child eats something. To be sure, there are probably other factors at work, such as how snacks and fast food are relentlessly marketed to the younger set. In any case, the blogosphere is having some fun with the reaction to this. I’ll let Cole Petrochko of MedPage Today have the final word here: “Kids eat junk.”

This thing called grief

One of the first things you notice on author and grief counselor Ashley Davis Bush’s page on Facebook are the heartfelt comments from those who have either read her book, “Transcending Loss,” or have somehow found their way to her website.

“My life will never be the same after losing my husband. I know that. But I feel lost. I don’t know where I’m supposed to go from here,” one woman posted.

Someone else wrote, “I feel as though because it’s been almost 9 months that Dan passed away that I am expected to have moved on by now… I hate it.”

Of all the emotions – love, anger, happiness, fear – that are part of the human experience, grief seems to be the one we misunderstand and avoid the most.

Most of us, if we live long enough, will encounter grief in some form or another. It might be the loss of a spouse or child or close friend. Maybe it’s the loss of a job or a home, or the end of a relationship. People can grieve when they lose their health. They grieve when they lose a beloved pet.

Yet despite how universal it is to experience bereavement, most of us are unprepared for what it’s like or how to deal with it. Nor do we always know how to respond respectfully and sympathetically to someone else who is grieving.

It doesn’t help that here in the United States we have a hurry-up culture that often expects people to reach “closure” and move on within a matter of days. Who are we kidding? It doesn’t work that way.

This weekend the Church of St. Mary here in Willmar is hosting a workshop on bereavement. It’s from 9 a.m. to noon Saturday in the parish center and will feature a panel discussion on the emotional, physical and spiritual aspects of bereavement. This event was organized by the bereavement committee of the Catholic Area Faith Community of Jesus Our Living Water, which includes Catholic parishes in Kandiyohi, Lake Lillian, Spicer and Willmar.

Talking about grief and bereavement may not be most people’s idea of a fun way to spend their Saturday morning. But it’s both necessary and worthwhile. Whether you’re dealing with a recent or long-ago loss, want to help someone you know who is grieving, or simply want to learn more, consider attending. The event is free.

Photo: Wikimedia Commons

Contagion

If you’ve ever browsed through old newspapers from the late 19th and early 20th centuries, you can hardly fail to notice how commonplace it was for children to die of infectious diseases that are now considered preventable. I’ve seen stories in the West Central Tribune from the early 1900s that describe families losing two or three children to diphtheria within the span of just a few days.

It’s easy to forget this history. After all, kids no longer get sick – or sometimes die – from measles, polio, mumps or other diseases of childhood, because there are effective vaccines to prevent this. Many of the biggest gains in life expectancy in the 20th century were due to vaccination and the huge accompanying reduction in the number of children who died from preventable disease before they reached adulthood.

What has been happening in California in the past several months is a wake-up call, though, that many of these diseases remain a threat.

In case you missed the story, last year California experienced the worst outbreak of pertussis, or whooping cough, in half a century. By the end of the year, nearly 8,000 cases were confirmed and 10 infants had died. The outbreak led to a new state law requiring booster immunizations for children and adolescents, and prompted a fair amount of soul-searching over how so many young people could become sick with a preventable infectious disease.

Although it would be easy to blame it all on parents’ failure to vaccinate their children, the picture is more complicated than this. Many of the sickest, and most vulnerable, victims were less than 6 months old and therefore too young to safely receive the pertussis vaccine. Even when children are appropriately vaccinated, the protection tends to fade by adolescence or early adulthood unless a booster shot is administered. Many adults skip a pertussis booster altogether, possibly because they don’t know they need it or don’t realize they could transmit the pertussis-causing bacteria to a vulnerable infant.

All of these factors appear to have contributed to last year’s outbreak in California. Another contributing factor: the nature of the whooping cough bacteria, whose frequency tends to wax and wane in three- to five-year cycles.

If you want to know what it’s like to encounter whooping cough, this video from PKIDs gives you the straight story:

Although pertussis and other vaccine-preventable infectious diseases are certainly less common than they used to be, the fact that we don’t see them very often doesn’t mean they’ve been conquered. Microbes are smart creatures who are still very much with us. They’ve learned to adapt and survive. In fact, if I had to name one of the most serious and persistent health threats in the modern-day world, it would be the continuing presence of infectious disease.

If a mother from the early 1900s could travel forward in time and discover that diphtheria, measles and the other diseases that routinely ravaged her family, her friends and her neighbors could be prevented with simple, relatively inexpensive vaccination, how do you think she would react? It argues for contemporary parents to think carefully and have all the facts before they decide to opt out of immunization.

Image courtesy of the National Library of Medicine

How to talk like a health care hipster

If you want to sound cool in the world of health care, forget chillaxin’ with your peeps. HealthLeaders Media has released a list of 11 hot buzzwords in the industry for 2011, and nary a one contains fewer than at least two syllables.

In fact the list is rather nerdy esoteric – but pay attention, because we’ll all be hearing these terms often in upcoming months.

Why does it matter? Because buzzwords mean something, and knowing what they mean can help readers and listeners follow the conversation with a little more comprehension.

Cheryl Clark, who compiled the list, puts “EHR-EMR-HIT interoperability” at the top. She writes:

These acronyms are among the most important to know and understand. The concept is that EHR (electronic health records), EMR (electronic medical records), and HIT (health information technology) use technology to connect providers’ and patients’ data and communication online. EMR and EHR are sometimes used interchangeably but they are distinct.

What else is on the list? “Creative destruction,” which refers to the theory that in order to create a new and better health care system, the old one first needs to be torn down. “Alignment,” or the standardization of equipment, procedures and supply purchases, policies and programs.

Here’s a good one: “respectful crisis management.” What is it? Clark explains:

This term actually represents a growing area of scientific research to find the best management strategies that provide productive responses to a critical healthcare error. Responses that unify the team to acknowledge and mitigate harm and prevent a similar mistake from occurring are the ones to adopt.

Patients might hear the term “teachback” being used more often in their care. It refers to the technique of asking patients to repeat and summarize what the doctor or nurse has told them, to make sure they understand. It’s going to mean more engagement by both patients and providers, Clark writes. “A nod of the head is not okay.”

If I were in charge of the list of buzzwords du jour, I would probably add “accountable care organization”, “comparative effectiveness” and “transformation.” I briefly considered “a culture of [fill in the blank]” but I think the term has become a little too 2010, as has “transparency.”

So there’s the list of important health care words and phrases you’ll need to know for the coming year. If you memorize them and drop them into casual conversation, you might be able to impress your friends and maybe even your health care provider.

Are there other terms you think should belong on the list? Add them to the comment section below.