Free help for North Carolina tobacco users who want to quit

QuitlineNC, the state's toll-free telephone and online support service to help tobacco users quit, is offering free nicotine replacement patches, gum or lozenges to North Carolina residents who sign up for four telephone coaching sessions.

In Mecklenburg County, 146 tobacco users signed up for "quit coaching" last month.

“We want to support the efforts of smokers and other tobacco users who choose to take responsibility for their own health by quitting,” said Dr. Aldona Wos, secretary of the Department of Health and Human Services.

To sign up for the over-the-counter medicine and support, call QuitlineNC, 1-800-QUIT-NOW (1-800-784-8669), or visit www.quitlinenc.com. 

Each enrollee will develop a personalized "quit plan" with a "quit coach." The supply of medication available to each individual varies, depending on insurance coverage, and is available on a first-come, first-served basis.

Future doctors unaware of own obesity bias

Two of five medical students have a bias against obese people and they don't even know it,  according to a study by researchers at Wake Forest Baptist Medical Center in Winston-Salem. The study is published online in the Journal of Academic Medicine. 

“Because anti-fat stigma is so prevalent and a significant barrier to the treatment of obesity, teaching medical students to recognize and mitigate this bias is crucial to improving the care for the two-thirds of American adults who are now overweight or obese,” said Dr. David Miller, associate professor of internal medicine and lead author of the study.

The three-year study included more than 300 third-year medical students from 2008 through 2011. The students were from 25 states and 12 other countries. 

Researchers used a computer program called the Weight Implicit Association Test to measures students’ unconscious preferences for “fat” or “thin” individuals. Students also answered a survey assessing their conscious weight-related preferences. 

Overall, 39 percent of medical students had a moderate-to-strong unconscious anti-fat bias as  compared to 17 percent who had a moderate-to-strong anti-thin bias. Less than 25 percent of students were aware of their biases.

The study didn't specify which teaching strategies are most effective, but to combat prejudice, doctors have to acknowledge its existence, Miller said.

At Wake Forest, all third-year medical students in the family medicine program must complete the online Weight Implicit Association Test and then participate in an in-class discussion of their experience with bias. 

“Bias can affect clinical care and the doctor-patient relationship, and even a patient’s willingness or desire to go see their physician, so it is crucial that we try to deal with any bias during medical school,” Miller said. “Previous research has shown that ... Doctors are more likely to assume that obese individuals won’t follow treatment plans, and they are less likely to respect obese patients than average-weight patients.”

The study was funded by a grant from the National Cancer Institute. Co-authors are Dr. John Spangler, Mara Vitolins, Stephen Davis, Edward Ip, Gail Marion, and Sonia Crandall of Wake Forest.

Cancer patients want to talk with doctors about costs

Researchers at Duke Cancer Institute have found that most cancer patients would like to talk about the cost of care with their doctors, but they often don't because they fear the discussion could compromise the quality of their treatment.

But patients who do bring up the subject of finances believe it helps decrease their costs. 

Researchers surveyed about 300 insured patients treated at Duke and affiliated clinics in rural North Carolina. 

Dr. Yousuf Zafar, assistant professor at Duke and lead author of the study, said 57 percent of participants in the survey said they wanted to talk about treatment costs with their doctors, but only 19 percent actually had that conversation.

“There’s a real disconnect,” Zafar said. “Even people with the highest needs aren’t bringing up costs as part of the decision-making process.”

Some respondents said they were embarrassed to bring up cost. Others didn’t think it was something their doctor could help with or should worry about. Twenty-eight percent said they wanted the best possible care regardless of cost. 

“We found that when patients did talk about costs with their doctors, many felt they gained something from the discussion – that their expenses were reduced,” Zafar said. 

Zafar said this suggests the "perceived barriers to the cost conversation aren't real" and that doctors should have tools to identify patients who need financial help and direct them to appropriate resources.

“With today’s evolving health insurance landscape, cancer treatment-related costs to patients are more important than ever,” Zafar said. “...Knowing that patients want to have these discussions should give us confidence in making this a routine practice.” 

The research will be presented June 3 at the 2013 Annual Meeting of the American Society of Clinical Oncology in Chicago. 

The study was funded by the Duke Cancer Institute Cancer Control Pilot Studies Award, the Duke Clinical Research Institute Comparative Effectiveness Research KM1 Award, and an American Cancer Society Mentored Research Scholar Grant.

New Medicaid billing system may have problems

A state audit has found that the new North Carolina Medicaid billing system, called NCTracks, may not be ready for its scheduled July 1 launch. The program to test the system was "seriously flawed," the audit found.

Here's a link to an article about the audit in our sister newspaper, the News & Observer in Raleigh: http://projects.newsobserver.com/under_the_dome/state_audit_faults_testing_of_new_medicaid_billing_system

Read more here: http://projects.newsobserver.com/under_the_dome/state_audit_faults_testing_of_new_medicaid_billing_system#storylink=cpy

Terrie Hall speaks from experience about the harmful effects of smoking

This week, a 52-year-old Lexington, N.C., grandmother will receive the Surgeon General’s Medallion, one of the highest honors in public health. 

You'll recognize Terrie Hall from the startling anti-smoking commercials she has appeared in as part of the "Tips from Former Smokers" national tobacco education campaign. 

A lifelong smoker, Hall developed mouth cancer and throat cancer that led to surgery to remove her larynx. She has a permanent stoma, or hole in her throat, and a voice prosthesis that must be replaced every few years.

She'll will receive the award in a ceremony Wednesday morning in Washington.

Here's a link to the story I wrote about her last year:

http://www.charlotteobserver.com/2012/05/21/3257516/nc-woman-sends-anti-smoking-message.html