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Summer Safety: Seasonal Risks and Tips · CareTalk: Healthcare. Unfiltered.

• 0:00
  Memorial Day weekend, the official start of summer 2024 is upon us.
• 0:04
  It's my favorite time of year, although as a bald redhead, I really have to be careful in the sun.
• 0:09
  But what should more normal people be thinking about when it comes to summer health and health care?
• 0:18
  you Welcome to Care Talk, America's home for incisive debate about healthcare business and policy.
• 0:26
  I'm David Williams, president of Health Business Group.
• 0:29
  And I'm John Driscoll, senior advisor at Walgreens.
• 0:32
  Everyone deserves healthcare that helps them feel and live their best.
• 0:35
  And that's why TriHealth is breaking down the barriers that stand between patients and living a healthy future.
• 0:41
  With five hospitals and over 140 care sites, TriHealth is making it easier for Cincinnati area residents to stay proactive about their health, get the care they need and be seen, heard.
• 0:51
  and healed.
• 0:52
  To learn more about how TriHealth is transforming care through its groundbreaking population health approach, visit www .trihealth .com.
• 1:01
  So David, let's start with the bad news about the good news.
• 1:05
  I mean, it sounds like you think there are health hazards associated with the warming days, the soft feeling of sun on your cheeks.
• 1:18
  But how does the topic?
• 1:20
  of the sun become a topic of concern for Care Talk.
• 1:24
  Well, John, it does go way back.
• 1:26
  So when I was a not a bald redhead, but just a regular redhead, I remember my mother cut my hair short for camp.
• 1:31
  You know, then I went to camp and was wearing my hat.
• 1:35
  And then somehow my ears were like really hurting after the day.
• 1:39
  And it turned out, you know, back in the day, my ears were usually covered and they were just like burned up.
• 1:44
  So I've always had an awareness of it, John, and it's really an avoidable.
• 1:50
  health risk that people take tis the season for it.
• 1:54
  And I feel duty bound to do some awareness building at a bare minimum.
• 1:59
  But David, you know, a lot of people, you know, there's the public health advice here goes back and forth.
• 2:05
  Some people think you've got to be outside more to get more vitamin D.
• 2:09
  There's vitamin D deficit that kind of can lead to all kinds of negative health effects, including depression.
• 2:15
  And you're now you're coming in and saying, beware of the sun.
• 2:19
  or embrace the sun.
• 2:20
  Like what's your, can you find a line here for us, us healthcare?
• 2:23
  Sure.
• 2:24
  For sure, John.
• 2:25
  So there's one easy one that's like, don't stare at the sun, especially during an eclipse.
• 2:29
  All right.
• 2:30
  And then even not during an eclipse.
• 2:31
  For sure, John, I, like I said, I love the summer.
• 2:34
  I love the sun actually.
• 2:35
  And yeah, you need to get vitamin D from the sun.
• 2:38
  It's good for bone and muscle health for you and for animals too.
• 2:41
  And also the more hours of sunlight, there's less depression.
• 2:44
  You know, in some places where it's really dark during the winter, people have these like sun.
• 2:48
  you know, lamps so they can look at these things to reduce depression.
• 2:52
  And also, you know, you want to go outside and be seen and, you know, wear your new clothes and stuff like that so we can see what's what.
• 3:01
  But when you're doing that, you put yourself at risk, especially somebody who's fair skinned, but even people who are not.
• 3:08
  Yeah, I think it's really important to, you know, skin cancer is one of the fastest growing categories.
• 3:15
  in the US.
• 3:17
  It's the most common form of cancer in the US and not to necessarily a serious clinical outcome, but one in five Americans is likely to develop some form of skin cancer in their lifetimes.
• 3:31
  I mean, that's a lot of people.
• 3:34
  Yeah, I mean, it is and it's reasonably avoidable.
• 3:37
  You know, you see where they're taking the sun seriously is Australia, where there's a lot of fair skinned people that move to a climate.
• 3:44
  which is not conducive to their skin type necessarily.
• 3:48
  And it's a big killer, skin cancer is there, but they've actually taken it seriously and shifted the culture so that people use hats, sunglasses, sunscreen and all that.
• 3:58
  And John, I'd love to see - But David, David, people do that here.
• 4:01
  Like what's different about Australia other than kind of the rugby and the beaches?
• 4:05
  Like, come on, beer is good.
• 4:07
  Like, I think you're basically saying they're doing what we're doing.
• 4:11
  What are they doing differently?
• 4:12
  Well, John, they have hats that are like, you know, much longer that like have tails on them and really actually cover things up as opposed to like a baseball cap from my, you know, from my example.
• 4:22
  So it's just it's so much in their face, so to speak, that they do something about it.
• 4:27
  I do like I always wear my hat, John, and my sunglasses whenever I can find them, although they went missing earlier this week.
• 4:35
  But sunscreen is is an interesting and controversial area, John.
• 4:39
  And I actually learned something about sunscreen.
• 4:41
  in getting ready for the show beyond just you should use it.
• 4:46
  So what did you learn David?
• 4:47
  I mean, please, you know, since so many of us, I mean, the risk of kind of skin cancer, melanoma is increasing.
• 4:56
  It's gone up by about one and a half times from the 70s to now and is again, and still climbing.
• 5:03
  So for those of us at risk, I mean, everybody gets the same advice that you're supposed to slather on the saline tan lotion.
• 5:10
  Aren't all are I think the assumption for most people is that all?
• 5:15
  Sun lotions It are sort of made the same right?
• 5:20
  Yeah, I mean the standard advice John is you get one with a high SPF Sun protection factor and you you put it you reapply it Etc and they always say to use a good amount right like I think they say to use like a grapefruit sized amount to squeeze on something like that But what I did learn John was that while the US sunscreens protect well?
• 5:39
  against UVB rays, which cause sunburn, they are deficient when it comes to ultraviolet A rays.
• 5:48
  And those are the ones where you don't actually see the damage, but it causes longer term damage.
• 5:52
  And when I say deficient, John, I mean they're deficient relative to what is offered in the rest of the world.
• 5:57
  And in particular in Europe, where there's something like 28 chemicals for UVA on the market there that we don't have here.
• 6:05
  So break this down for me a little bit differently.
• 6:07
  You know, you obviously aren't suggesting that we don't avoid the UVBs, the rays that'll create skin damage and burns.
• 6:18
  However, slight or not, that actually start the process, create the basis for the opportunity for skin cancer to develop.
• 6:27
  So if you don't know that something's happening, you can't see it, how do we know it's a problem?
• 6:32
  Yeah.
• 6:33
  It's like one of those things like UVAs.
• 6:35
  It's like radiation.
• 6:35
  How do we know it exists?
• 6:37
  Maybe it doesn't.
• 6:38
  Well, so.
• 6:39
  It could be measured and just because it's not in the visual spectrum doesn't mean that it can't be observed.
• 6:48
  But what happens, John, is that the core problem here, it's really not controversial about UVA causing damage.
• 6:54
  The issue is how sunscreens are regulated.
• 6:58
  And in the US, they're regulated as drugs, over -the -counter drugs, and in Europe, they're regulated as cosmetics.
• 7:06
  And what that means is it's much more expensive to test sunscreen here in the U.S.
• 7:12
  than it is in Europe.
• 7:13
  And it also involves animal testing for drugs.
• 7:17
  Now, in Europe, you've got these companies, these cosmetic companies, and you could say, well, why don't they just send their sunscreens over to the U .S.?
• 7:24
  And the answer is, well, they don't want to develop them as drugs.
• 7:27
  And if they start doing animal testing, which would be required for drugs, then they're going to lose their existing...
• 7:32
  European customers.
• 7:33
  So the critical thing is that sunscreens are considered part of the mandate of the FDA as drugs and sunscreens that are obviously applied and can penetrate to the subdermal layer.
• 7:47
  So they're penetrating your skin and getting to the bloodstream.
• 7:50
  The only good ones are in Europe because they're...
• 7:53
  So I get it.
• 7:54
  To protect our health, we have to go to a place that doesn't test sunscreens for health.
• 8:00
  The good news, John, is that so they...
• 8:02
  So it would make sense if you were starting from scratch.
• 8:05
  It could make sense.
• 8:07
  But in Europe now, a lot of these products have been on the market for decades.
• 8:11
  And I think what would be a good idea is either to change the regulations so they're regulated as cosmetics here, or to be able to take into account the long-term population level data that are actually out there about these drugs.
• 8:24
  And in the near term, while we're talking about policy and so on, I'm thinking of hopping over to Europe, grabbing some sunscreen.
• 8:31
  Bring it back.
• 8:32
  I'll make sure to put it in my check bag so it doesn't get taken away as a liquid or gel.
• 8:38
  Isn't that going to get you in trouble because you'll be bringing something that's an unregulated substance into the country?
• 8:44
  You know what I'll do, John?
• 8:45
  Maybe I'll bring it along with some raw milk cheese or something like that and that'll throw them off the scent and they can go after that.
• 8:51
  I don't know what the rules are about bringing it in.
• 8:53
  I think you could probably bring it in for personal use.
• 8:55
  I'm not going to sell it.
• 8:56
  I'm not going to give you any.
• 8:58
  Well, that's fine.
• 8:59
  But I think we had a probably...
• 9:01
  tighten this part of the conversation up.
• 9:04
  I think the message here is that takes skin cancers growing really fast.
• 9:08
  It's continued to increase even though the sunscreen business has exploded and apply the sunscreen liberally, particularly if you look like David.
• 9:17
  And that's just a requirement.
• 9:21
  And then it sounds like we should be really thinking about opening up the different ways we define sunscreen so that we can capture.
• 9:29
  or grow the product market share of those products that protect against UVA, you know, sunbeam stuff, UVB, sunburn stuff.
• 9:42
  Yeah.
• 9:43
  So David, what else should we be thinking about as the weather has changed?
• 9:46
  OK, well, I'll tell you.
• 9:47
  So one other thing I would be remiss if I didn't mention that my actual favorite solution here is to wear sun protective clothing, which gets out of the issue about sunscreen and having to reapply or even to buy it.
• 9:58
  Right John, so the next thing...
• 10:00
  You dress like the IRC wants women to dress in Iran.
• 10:04
  You just dress, just wrap yourself up.
• 10:06
  I dress to depress John.
• 10:08
  So now in terms of these other behaviors, so I get a little quiz for you John.
• 10:11
  So there's a lot of activities that people do in the summer that are dangerous.
• 10:14
  Boating, swimming, drugs.
• 10:17
  I know not you John, but like risky sex.
• 10:20
  What do you think is the biggest killer in the summer?
• 10:26
  Source some...
• 10:28
  Killer.
• 10:30
  Source of most deaths.
• 10:31
  You got it, John.
• 10:32
  You got it.
• 10:33
  Yeah.
• 10:34
  Car and probably we have to include light truck and SUV in that.
• 10:37
  But yeah, driving, that's still the biggest killer.
• 10:39
  So now these things are related, especially, you know, drugs, alcohol, I won't say sex, but the yeah, you got to be careful out there.
• 10:48
  Now, boating is actually a big danger because there's a lot of people out there that don't know what the hell they're doing.
• 10:52
  And they some of them are under the influence as well.
• 10:56
  They may not be licensed.
• 10:58
  Swimming happens where you've got drowning, where there's an undertow, you're in an unfamiliar area.
• 11:06
  David, this is the spring summer issue.
• 11:09
  Do you really have to like...
• 11:11
  And then there's the possibility of being hit by lightning if you go outside.
• 11:18
  Swimming is one of the great joys of life.
• 11:20
  And you're like, well, there's drowning, there's shark attacks, the orcas have been knocking over.
• 11:26
  boats in the in the Mediterranean.
• 11:28
  I mean, you know, Fisher and I said and Fisher killers like, come on, a little positive here.
• 11:33
  John, get this.
• 11:33
  I know somebody got electrocuted by lightning bolt when they're inside their house.
• 11:37
  It actually came like came in their window and got them.
• 11:40
  You're not you read the room, dude.
• 11:42
  It's time to say something positive about this time of year.
• 11:46
  All right.
• 11:46
  Well, John, certainly it's very healthy to go out and do some swimming and to eat healthy foods.
• 11:54
  Go for a walk, enjoy the sun, and so on, and just be aware of these risky behaviors, and maybe watch other people doing them, and don't do them yourself.
• 12:06
  So, David, what happens if you, how should people, assuming they're over, assuming they disagree with you, and they actually spend a lot of time outside.
• 12:16
  Yeah.
• 12:17
  How do you figure out whether you've actually got skin cancer or melanoma?
• 12:21
  What should people be thinking about?
• 12:24
  Well, you might want to make your appointment with your dermatologist now since it's usually about like a six month wait in order to get that.
• 12:31
  But a lot of it has to do with just really being aware of what can happen with the sun.
• 12:38
  So I always wear a hat and I actually don't love sunscreen as I think I mentioned before.
• 12:42
  And so my dermatologist looks at me and says...
• 12:44
  So that makes you the expert who doesn't care.
• 12:47
  No, no, no.
• 12:48
  You don't want to know what people should do, John.
• 12:50
  I'm just generalizing from my own experience here.
• 12:52
  So...
• 12:52
  So my dermatologist looks at me and says like, it's kind of weird.
• 12:55
  Cause like, you don't have like a lot of sun damage on your head, but somehow your face is kind of messed up, you know?
• 13:01
  And, and it's partly, it's actually like the reflection off the sand and the water.
• 13:07
  and so when COVID came, I actually, I actually do have, I actually was one of the few people that had a mask originally, John, because I actually have a mask, to protect me from the sun.
• 13:17
  I don't wear it that much, but I did happen to have one around.
• 13:19
  Is that what you tell your MAGA neighbors?
• 13:22
  No, I actually, my brother has a mask when he's wearing a mask, but he has a Blue Lives Matter mask and it really confuses people.
• 13:30
  Take that off, you know?
• 13:32
  I don't know if that's good for the son or not.
• 13:36
  But John, so, all right, let's talk about something a little more healthcare related, because I get the idea that you're not comfortable anywhere but behind the desk or in the boardroom.
• 13:45
  Let's talk about the famous July effect, John.
• 13:48
  What is the July effect?
• 13:49
  So we've now...
• 13:51
  There's been way too much time on your son issues.
• 13:54
  Yes, indeed.
• 13:55
  And skin issues.
• 13:56
  But there is a period when the new doctors come on wards and are interacting with patients and start to really roll the dice.
• 14:04
  And there's a fear that there's a theory that you're rolling the dice, taking a greater risk by joining, by engaging in the health care system in the middle of the summer, that with so many young doctors just going from books to people, in July that you might, if you have the option, push your doctor visits if you think you're going to end up in the hospital a little farther out so that you don't end up with a complex problem and an uncomplex doctor.
• 14:35
  I guess the thing, John, is when, you know, like, the new doctors come in and they pick up some piece of equipment and say, what's this?
• 14:39
  You know, and start banging it around or whatever.
• 14:42
  But, you know, this is I agree.
• 14:44
  It's a conventional wisdom, especially among the, you know, the wise group that's exposed to health care to say, like, you don't want to go to the hospital in July.
• 14:51
  Now that's true because I don't want to go to the hospital ever.
• 14:54
  But I heard some interesting thoughts and maybe data even in the other direction, John, the other day, which is that July is reasonably safe because it's also the time of heightened vigilance because all the doctors who are doing the training, the attending physicians are aware of this July effect.
• 15:13
  They don't want to say like, what's this?
• 15:14
  Put that down.
• 15:16
  Whereas they actually, maybe June.
• 15:18
  is the wrong time to go because there's more complacent to that point.
• 15:21
  So let's start.
• 15:23
  Let's remind people that, you know, the hospital is one of the fastest growing risks of death just visiting the hospital in America.
• 15:29
  Yeah.
• 15:29
  That you want to avoid those doctors in the hospital as much as possible and that young doctors start a lot of young doctors start their practices right then.
• 15:38
  But I think, you know, you won't always have a choice.
• 15:42
  What should you do, David, if you're in the hospital and you're it's during these transitional periods and you're worried about the doctor.
• 15:48
  What should a patient do?
• 15:51
  Well, I'm no expert, John, as you know, but that's never stopped me in the past.
• 15:55
  So my solution, actually, I call it BYOMD.
• 15:59
  So if you need to go to the hospital, bring a friend, preferably a physician with you, because nobody knows what's going on in the hospital and particularly the people that are that are trying to run it because they've got so many things that are going on.
• 16:13
  and you need somebody to keep an eye out for you.
• 16:16
  And you're not going to be at your best when you're in your gown and you're sedated and you're sick.
• 16:21
  And so you really actually need to have somebody.
• 16:23
  And if it's not a physician, and I'm completely serious about that, I try to bring a physician friend if I have to go to the hospital, then bring the next best thing.
• 16:31
  Another person who is in the healthcare world, preferably clinician, if not then on the more administrative business side like you or me, or at least somebody who's good at advocating.
• 16:42
  Not everybody's going to be related to your point to as many doctors as you are.
• 16:47
  Yeah.
• 16:48
  Or have either doctors in their ecosystem or doctors who are friends.
• 16:53
  But I think your point about if you happen to hit the hospital, bring an advocate, someone you trust to be with you because it is really hard as you're dealing with either a small catastrophe or a large one that threatens your health enough that you go to the hospital to consume, absorb, and navigate.
• 17:11
  what's a really complicated system.
• 17:13
  So always, if you can, bring a friend and ideally one of David's doctors.
• 17:19
  John, the other thing, of course, you know, you can have injury in the hospital.
• 17:22
  You can also have an injury from your insurance when you get out and get the bill.
• 17:25
  And this is actually one of those things where people don't always consider it when they're traveling.
• 17:30
  You know, as part of summer vacation, it's like, you know, yeah, vacation was great, except, you know, I broke my leg or I ended up in the hospital and guess whose insurance doesn't cover that.
• 17:39
  So.
• 17:39
  That's also something to consider, especially if you have, let's say, an HMO or if you're out of the country, you might want to consider travel insurance.
• 17:48
  David, with all of this bad news about the good news of summer and sun, I think we ought to wrap it.
• 17:55
  Otherwise, we're just going down.
• 17:56
  We've gone from cancer to the catastrophe of going to a hospital with untrained doctors, potentially, to your concerns that people have holes in their insurances they may or may not have, but your point about coverage.
• 18:10
  Let's make sure people also know this is a time to enjoy, take time and reflect with their families, sensibly spend time outdoors and avoid you for dinner conversations about summer.
• 18:21
  Yeah, that's fair enough, John.
• 18:22
  Well, I got a last question for you on the lighter side.
• 18:25
  If you like ice cream or if you tolerate it, what's your favorite flavor that you're looking forward to for the summer?
• 18:30
  mint chip.
• 18:31
  I love mint chip.
• 18:33
  Regular mint chip, coffee mint chip, chocolate mint chip.
• 18:35
  That's my favorite.
• 18:36
  That's my go -to.
• 18:37
  What about you?
• 18:38
  I love all kinds of ice cream pretty much, but I like the black raspberry.
• 18:42
  It's probably my go -to.
• 18:43
  All right.
• 18:43
  Well, okay.
• 18:45
  Fair enough.
• 18:45
  We'll do a little meld and we'll have a black raspberry mint chip, which wouldn't shock me if they have that.
• 18:51
  Well, that's it for yet another episode of Care Talk.
• 18:53
  We've been talking about going into our favorite season, although maybe a little less favorite after we aware of all the dangers now.
• 18:59
  That's the summer.
• 19:00
  I'm David Williams, president of Health Business Group.
• 19:03
  And I'm John Driscoll, the senior advisor at Walgreens.
• 19:05
  If you like what you heard or you didn't, particularly if you didn't like what you heard.
• 19:08
  David said, you should still subscribe on your favorite service.