Physicians, Business, Professional and Information Technology Communities
Networking to Restore Accountability in HealthCare & Medical Practice
Tuesday, December 21, 2004
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FAREWELL TO 2004: We wish all of you a very Merry Twelve Days of Christmas or Happy Holidays as your beliefs may be.
LIVES AT RISK - The Definitive Work on
Single-Payer National Health Insurance Around the World by
John C Goodman, PhD, Gerald R Musgrave, PhD and Devon M Herrick, PhD.
To read a brief review, go to http://www.healthcarecom.net/JGLivesAtRisk.htm;
to order your copy, go to http://www.ncpa.org/pub/lives_risk.htm.
MedicalTuesday refers to the meetings that were traditionally held on Tuesday evenings where physicians met with their colleagues and the interested business and professional communities to discuss the medical and health care issues of the day. As major changes occurred in health care delivery during the past several decades, the need for physicians to meet with the business and professional communities became even more important. However, proponents of third-party or single-payer health care felt these meetings were counter productive and they essentially disappeared. Rationing, a common component of government medicine throughout the world, was introduced into the United States with Health Maintenance Organizations (HMOs), under the illusion that this was free enterprise. Instead, the consumers (patients) lost all control of their personal and private health-care decision making, the reverse of what was needed to control health care costs and improve quality of care.
We welcome you to the reestablishment of these MedicalTuesday interchanges now occurring on the world wide web currently reaching into twenty-one countries and your own desktop. If this newsletter has been forwarded to you or you have not been on our email list, please go to www.MedicalTuesday.net and subscribe to continue to receive these free messages on alternate MedicalTuesdays. At this site you can also subscribe to the companion quarterly newsletter, HealthPlanUSA, designed to make HealthCare more affordable for all Americans. Please forward this message to your friends. If you were referred in error or do not wish to receive these messages, we have made it easier for you to unsubscribe simply by clicking the Remove Link below and entering your email address above.
In This Issue:
1. Quest for a Quality Medical Education
2. Will Humans Download Their Minds into Computers Someday?
3. Jury Verdict for Dr Bill Hurwitz: Guilty
4. This Week’s Review of Corporate Socialized Medicine - Write E-Scripts or Else
5. Medical Gluttony: Two Cardiac Evaluations a Month Apart
6. Medical Myths: Medicalization BENEFITS Society
7. Overheard in the Consultation Room - International News
8. The MedicalTuesday Recommendations for Restoring Accountability in Medical Practice, HealthCare and Government
The increasing problem in the United States, which has been the pattern in most of the world for nearly a century, is that politicians, bureaucrats and health care administrators who have little comprehension of what we do in our profession have the temerity to tell us, even force us, to manage patients in a way that may not be in their best interest. This forces us to practice inferior medicine while still holding us to the highest standard. Thus, every medical decision can make us guilty of malpractice (not following the best practice) or of breaking the law (not following some legalistic guideline). The medical felons may indeed be the doctors with the highest ethical standards who put the patient's welfare ahead of the bureaucrats legal arm. The rest of the world's medical profession (i.e. the Russian doctor we referred to some issues back) has long recognized that medical bureaucrats are medically illiterates. But they have the force of law which ultimately can injure patients, prosecute doctors, and lower the level and standard of health care.
When so many laws are passed that no one can observe
all of them, then you have a nation of lawbreakers.
You can then get conviction after conviction for total servitude. - Ayn Rand
Well, help may be on the way. Chip Walter, in the current issue of Scientific American, tells about Hans Moravec, the Carnegie Mellon scientist who predicted that someday we would routinely download our minds into robots. So when word got around that Moravec, who built his first robot at age 10 out of tin cans, batteries, a motor and lights, had founded an honest-to-goodness robotics firm, more than a few eyebrows were raised. This 56-year-old Austrian scientist also predicted that exponential advances in computing power would cause the human race to invent itself out of a job, developing the robots to supplant us as the planet's most adept and adaptive species? Somehow, creating a company seemed uncharacteristically pragmatic.
But Moravec doesn't see it that way. He says that he didn't start Seegrid Corporation because he was backing off his predictions. He founded the company because he was planning to help fulfill them. "It was time," he says, "the computing power is here." Moravec should know. He has been pushing the envelope on robotics theory and experimentation for the past 35 years, first as the graduate student at Stanford who created the "Stanford Cart," the first mobile robot capable of seeing and autonomously navigating the world around it, and later as a central force in Carnegie Mellon's vaunted Robotics Institute. His iconoclastic theories and inventive work in machine vision have both shocked his colleagues and jump-started research; Seegrid is just the next logical step, he says.
Read the exciting story in the January 2005 issue or go to http://www.sciam.com/issue.cfm.
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"At the end of today, the jury in United States v. Dr. Hurwitz announced that it had reached a decision on most counts but was still undecided on a few. In an unusual move, the judge arranged for the jurors to announce their partial verdict and to continue deliberating tomorrow on the few unresolved counts.
"The jury then declared Dr. Hurwitz guilty on the conspiracy counts, which constituted the vast majority of the case. The jury acquitted Dr. Hurwitz on a handful of counts relating to causing bodily harm.
"In a move that shocked even a seasoned Washington Post reporter in attendance, the prosecutor then demanded that Dr. Hurwitz be shackled and hauled to jail immediately. The judge agreed and he was taken away, perhaps for the rest of his life."
Dr Hurwitz, in my estimation, was a harmless physician and not given to hurting anyone. I'm glad the jury acquitted him on most of the bodily harm charges. He, as most physicians, could have been given the same courtesy as O J Simpson (charged with a double murder) who was asked on a Tuesday to report on Friday. But the prosecuting federal attorney and judge couldn't wait for the entire deliberations to conclude and immediately shackled him and led him to prison, as if he was a dangerous man. How can those attorneys and judge sleep at night?
Of the dozens of emails I received in the first 24 hours, I felt the editor of the AAPS journal gave a sound prediction: "I believe this verdict will effectively sentence most, if not all, patients who have a history of addiction (either to street drugs or prescription drugs) and who suffer chronic pain to a life of pain. I can't imagine any physician willing to risk life in prison to treat such patients who have chronic pain.
"Making an 'example' of someone and 'show trials' are a very effective means of control. Stalin used to take live chickens and pluck them of their feathers in front of crowds of people. This cruel display was extremely effective in getting the message across about who was in charge and what might happen if one dared to fall out of favor."
From a dermatologist: "Bill Hurwitz has done more in one day to alleviate human suffering and make this a better world than Federal Prosecutors Gene Rossi and Paul J. McNulty have done in their whole lives. I'd be willing to bet my life on this. He's now been snatched from his wonderful wife and not just two, but four, children; the two youngest are adopted Haitian orphans, and it was heartbreaking to hear Kettia ask what might happen to him when I saw them in DC around Thanksgiving. [Kettia is the younger of his adopted orphaned Haitian daughters, whom he taught to speak English fluently, helped with her home work, taught her to play the violin, and was able to converse with her in French.] Invisible dropping out by physicians happens, but it is information-poor. A better idea would be to explicitly and publicly address and re-address the issue, and not shut up. Like the crows who set up an infernal shrieking if one of their own is hassled.
"What we need to do now is make an effort to get President Bush to pardon Dr. Hurwitz (for something he is not guilty of doing ), and ceaselessly agitate for either getting the DEA out of medical practice or totally decriminalizing drugs. Siobhan Reynolds, the head of the Pain Relief Network, PRN, has been a very articulate spokeswoman, and deserves our support." See http://www.doctordeluca.com for a copy of her letter to Karen Tandy, the head of DEA.
Yes, doctors will soon give up their narcotic license and pain practice and eventually refuse treating any government Medicare or Medicaid patients. As usual, the government's assault on medicine, although it hurts doctors, does the greatest harm to our patients–citizens, whose freedoms the government should be protecting.
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4. This Week’s Review of Corporate Socialized
Medicine - Write E-Scripts or Else
Last week, I received a memo from one of the HMOs for which I see patients. I was told that if I didn't write more e-scripts between now and the end of December, I might lose the 10 percent that was withheld from my payments for seeing patients this past quarter because of non-compliance.
This is not electronic efficiency because they are not fully on line. It is forcing a certain practice behavior because of some bureaucrat or administrator deciding how doctors should function. Until e-scripts are part of a total package, blending in with an electronic medical record, they significantly increases prescription writing time by interrupting patient care in order to access the website and enter patient, insurance, and pharmacy data that would already be there if they had an electronic medical record.
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5. Medical Gluttony: Two Cardiac Evaluations a Month
I recently saw a patient in follow-up evaluation who I thought might have a significant cardiac problem. I obtained a cardiac consultation that resulted in a stress echocardiogram, among other tests. I was informed that he was unhappy with the cardiologist and subsequently went to a neighboring hospital system and had similar tests run. I asked why he felt the need to duplicate such expensive tests?
He replied, "Expensive tests? Why they didn't cost me a thing."
When patients are shielded from the cost of their care, there is no limit to excessive costs. What is sometimes not appreciated by bureaucrats and those who write laws is the result of managed care attempting to control costs, but at the same time allowing a 100 percent increase. In patient- or consumer-directed health care, even a shared 10 percent of the cost would have stopped this 100 percent increase in its tracts.
Government is not the solution to our problems,
government is the problem.
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6. Medical Myths: Medicalization BENEFITS Society
Madeleine Pelner Cosman, PhD, JD, Esq, in her upcoming book Who Owns Your Body, gives Nine Myths of American Medicine. See October 26, 2004, for Myth One; November 9, 2004, for Myth Two; November 30, 2004, for Myth Three; and December 7, 2004, for Myth Four. (www.MedicalTuesday.net)
Myth 5: Medicalizing Select Social Hazards BENEFITS Society
All collectivized medical patients in the same group get the same treatments no matter what each individual truly needs. One size fits all. Collectivizing patients has ominous consequences in public health law and practice. This chapter reviews the three interrelated phenomena of Congressional and public health experts’’ demands
for medicalizing select social hazards
for creating single standard medicine
for eliminating health disparities (differences in medical access, care, and outcomes)
Medicalization is the process of studying, paying for, and directly intervening in a volitional social action by calling it a disease. In public health lingo, drug addiction, obesity, teenage pregnancy, and ghetto violence are epidemics we must be inoculated against to avoid contagion. Medical effects are clumped together with volitional causes. Volitional acts such as using heroin and methamphetamines are disconnected from medical consequences. Physicians diagnose, prognose, and treat select social dilemmas as if they are contagious diseases or accidental injuries. Treating social dilemmas as disease is fund-worthy. Treating social dilemmas as disease also vastly expands the ranks of Medicaid beneficiaries. Medicalizing is said to benefit patients, compassionately honoring their humanity without blame and without stigma.
Single standard medical care for all Americans is said to be necessary for democratic fairness, for eliminating health disparities, and for fiscal necessity. Medical single standardists forget that America has no single standard for any commodity or any asset. Americans do not eat one standard of American food, requiring everyone daily to swallow McDonald's hamburgers or Chicken Chop Suey. Americans do not wear one standard uniform with all people clothed in same jacket style plus routine jewelry ration. Americans do not live in single standard 800-square-foot houses. Yet few people are protesting single standard medicine.
In Congress and in public health programs there is ominous convergence among medicalizing of select social hazards, creating single standard medicine, and eliminating health disparities. Two recent examples are mental health legislation and public health anti-terrorism guidelines. Mental health provisions of the failed Clinton American Health Security Act (many parts of which now are enacted in the Health Insurance Portability and Accountability Act and other sections are written into laws currently awaiting Congress’s approval) yoke the mentally ill suffering from depression, schizophrenia, and autism, with drug addicts. Mental illness is half of the routine medical law phrase Mental Health and Substance Abuse. This yoking unjustly adds to burdens of mental illness the heavy freight of addicts’’ criminality to support drug habits and places the two groups in competition for the same limited funds.
Even terrorism is medicalized. One month after the September 11th terrorist atrocities, the American Public Health Association (APHA) met in Atlanta and publicized its 12 Guiding Principles for a Public Health Response to Terrorism. Americans expecting their public health guardians to recommend new vaccines and antidotes to biological, chemical, and nuclear warfare, to set standards for disaster preparations and city evacuations, and to propose safety measures for integrity of America’s water, food, medicine, and fuel supplies discovered instead that APHA’s #1 guiding principle is: to address poverty, social injustice, and health disparities that may contribute to the development of terrorism.
APHA’s stated mission is "equity in health status for all" in a "healthy global society" where everyone has "right" to medicine and even a "right" to health. What rights? Whose responsibility? Who decides what for whom? Who pays? Health defense of the nation and the health of each citizen depend on bold, clear answers to those questions and to the sentinel question: Who owns your body?
Truth 5: Medicalizing Detrimentally CONFUSES Medical Effects with Social Causes and HARMS Patients
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7. Overheard in the Consultation Room -
It's been said that one gains a great perception of global politics in a taxi. However, doctors hear the gambit of stories in their consultation room. Last month, a Persian man came in for a complete medical evaluation. During the medical interview, we determined that his asthma was well controlled and his other medical problems were stable. During the physical exam, in that relatively quiescent interlude between the ophthalmologic exam and the prostate exam, he elaborated on why he left Iran at age 17, having spent a few months in the military service. Only 20 percent of the citizens have guns and they are the military and government personnel. Anyone who speaks against the regime is shot dead instantly. He developed an aversion to this part of his job classification. Since Iran’s military was using nerve gas, he and his buddy feigned confusion secondary to the gas exposure and were discharged. They came to this country. He obtained a college degree, set up a successful business, and made his first million within a few years. He characterized the Iranian government as maniacal and one which needed to be toppled or at least prevented from developing "the bomb." He had hopes that the U.S. or U.K. would bomb the nuclear facilities in his homeland. He said if Iran ever got "the bomb," the world would no longer be safe.
Asked if that would precipitate retaliation, he said that would be impossible. Before the revolution, pilots had destroyed the computer surveillance system in the 80 F-16 jets that Carter sold Iran. Hence, they cannot retaliate with guidance-compromised aircraft.
All in a day’s work practicing medicine. Yes, some days in addition to the taxi driver and the hair dresser, also my doctor knows.
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8. MedicalTuesday Supports These Efforts of the Medical and Professional Community in Restoring Accountability in Medical Practice, HeathCare and Government
• PATMOS EmergiClinic - where Robert Berry, MD, an emergency physician and internist, provides prompt care for many of the injuries and illnesses treated in Emergency Rooms at a fraction of the usual emergency room fees. He is able to do this because he accepts no third-party payments. Be sure to read his article on how the Robert Wood Johnson Foundation is using "Cover the Uninsured" as a ruse to promote single-payer HeathCare by government mandate. Read the whole article "Health Coverage Does Not Equal Health Care" at http://www.emergiclinic.com. Read Dr Berry’s response to Physician’s Support of Single-Payer Health Care or Socialism at http://www.delmeyer.net/hmc2004.htm#by%20Robert%20Berry.
• Dr Vern Cherewatenko concerning success in restoring private-based medical practice which has grown internationally through the SimpleCare model network, http://www.simplecare.com. Any patient or provider may become a member of SimpleCare. A number of brochures are available on line about a practice that is becoming increasingly popular. There have been a number of news networks and press reports. For the AP article: on April 27, 2004, go to http://apnews.myway.com/article/20040404/D81O7R7O0.html.
• Dr David MacDonald started Liberty Health Group, http://www.LibertyHealthGroup.com, to assist physicians in controlling their own medical benefit costs for their staff and patients. There is extensive data available for your study. Dr Dave is available to speak to your group on a consultative basis.
• John and Alieta Eck, MDs, for their first-century solution to twenty-first century needs. With 46 million people in this country uninsured, we need an innovative solution apart from the place of employment, and apart from the government. Caring for the sick is in the best tradition of the Church, which should be in the best position to meet the physical, emotional and spiritual needs of the community. Please visit them at http://www.zhcenter.org and check out their history, mission statement, newsletter, and a host of other information. For their article “Are you really insured?” go to http://www.healthplanusa.net/AE-AreYouReallyInsured.htm.
• Madeleine Pelner Cosman, JD, PhD, Esq, has made important efforts in restoring accountability in health care. Please read her bio, some of her articles that highlight the government’s efforts in criminalizing medicine and the introduction to her new book, Who Owns Your Body, at http://www.healthplanusa.net/MPCosman.htm. See section 6 above. For other OpEd articles that are important to the practice of medicine and health care in general, click on her name at http://www.healthcarecom.net/OpEd.htm
• David J Gibson, MD, Consulting Partner of Illumination Medical, Inc. at http://www.illuminationmedical.com/, has made important contributions to the free Medical MarketPlace in speeches and writings. His series of articles in Sacramento Medicine can be found at http://www.ssvms.org. Dr Gibson edited the March/April historical issue. To read his "Lessons from the Past," go to http://www.ssvms.org/articles/0403gibson.asp. For additional articles such as Health Care Inflation see http://www.healthplanusa.net/DGHealthCareInflation.htm.
• Dr Richard B Willner, President, Center Peer Review Justice Inc, reports his latest success story and the secret of helping doctors keep their medical license. On a daily basis, doctors are reviewed, are suspended, lose their medical licenses and go to jail on trumped-up charges. These "extra"-legal services are necessary services that your lawyer does not offer. Stay current with a wealth of information including numerous actual cases at http://www.peerreview.org. “The Center for Peer Review Justice now has a Joint Venture Partner so we can offer Headhunting for those MDs who have been DataBanked and cannot find a new job. This is a fee-based service where the fee is paid by both the doctor and facility.”
• Semmelweis Society International, Verner S. Waite MD, FACS, Founder; Henry Butler MD, FACS, President; Ralph Bard MD, JD, Vice President; W. Hinnant MD, JD, Secretary-Treasurer; is named after Ignaz Philipp Semmelweis, MD (1818-1865), an obstetrician who has been hailed as the savior of mothers. To see some horror stories of atrocities against physicians and how organized medicine still treats this problem, please go to http://www.semmelweissociety.net. To read the article that Dr Waite wrote at my request for Sacramento Medicine when I was editor in 1994, see http://www.delmeyer.net/HMCPeer.htm#by%20Verner%20Waite%20and%20Robert%20Walker. To see Attorney Sharon Kime’s response, as well as the California Medical Board response, see http://www.delmeyer.net/HMCPeerRev.htm Scroll down to read some very interesting letters to the editor from the Medical Board of California, from a member of the MBC, and from Deane Hillsman, MD.
• Dennis Gabos, MD, President of the Society for the Education of Physicians and Patients (SEPP), http://www.sepp.net, for making efforts in Protecting, Preserving, and Promoting the Rights, Freedoms and Responsibilities of Patients and Health Care Professionals, with a special page for our colleagues in nursing. Several free newsletters are available. Be part of protecting and preserving what is right with American HeathCare–physicians, nurses, pharmacists, psychologists, all health professionals and all concerned individuals are urged to join.
• Robert J Cihak, MD, former president of the AAPS, and Michael Arnold Glueck, M.D, write an informative Medicine Men column that is at NewsMax. Please log on to review the last five weeks topics or click on archives to see the last two years topics at http://www.newsmax.com/pundits/Medicine_Men.shtml. This week, read what happens when the Drug Enforcement Agency (DEA) decides it doesn't like the way some doctor is practicing, or the Food and Drug Administration (FDA) places bureaucratic business-as-usual over patient welfare. http://www.newsmax.com/archives/articles/2004/12/14/160714.shtml
• The Association of American Physicians & Surgeons (http://www.AAPSonline.org), The Voice for Private Physicians Since 1943, representing physicians in their struggles against bureaucratic medicine, loss of medical privacy, and intrusion by the government into the personal and confidential relationship between patients and their physicians. Be sure to click on News of the Day which this week is on the Hurwitz' conviction. The government used (bought?) a number of Dr Hurwitz’ patients, who had once begged Dr. Hurwitz for pain relief, to testified against him in return for a reduction in their own sentences for trafficking. (Purchased testimony?) The “AAPS News,” written by Jane Orient, MD, and archived on this site, provides valuable information on a monthly basis. Scroll further to the official organ, the Journal of American Physicians and Surgeons, with Larry Huntoon, MD, PhD, a neurologist in New York, as the Editor-in-Chief. There are a number of important articles that can be accessed from the Table of Contents page of the current issue. Be sure to read the important and relevant scientific articles “Association Between MMR Vaccination and Autism in Denmark” and “The Shaken Baby Syndrome”
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Stay Tuned to the MedicalTuesday.Network and Have
Your Friends Do the Same
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Read the latest medical news of the day at http://www.healthplanusa.net/MedicalNews.htm which will also lead you to the headlines for the past month.
If you would like to participate in this informational campaign on behalf of your patients or the HeathCare community, please send your resume to Personnel@MedicalTuesday.net.
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Del Meyer, MD, CEO & Founder
6620 Coyle Avenue, Ste 122, Carmichael, CA 95608
Words of Wisdom
George Bernard Shaw: A government which robs Peter to pay Paul can always depend on the support of Paul.
Frederic Bastiat: Government is the great fiction, through which everybody endeavors to live at the expense of everybody else.
Edward Langley, Artist 1928-1995: What this country needs are more unemployed politicians.
Review some recent postings below.
Voices of Medicine: To read a review of the first issue of Sacramento Medicine in 1950, go to http://www.ssvms.org/articles/0403vom.asp remembering that the first 132 years are no longer available. To read this years series of my column, the "Voices of Medicine," go to http://healthcarecom.net/vom2004.htm.
Charles B Clark, MD: A Piece of the Pie: What are we going to tell those bright-eyed little boys and girls who are going to be the doctors of tomorrow? When there isn’t anything left for them, are we going to tell them we didn’t fight because the changes were inevitable anyway? What are we going to say when they ask us why we laid down and died when things got a little tough? Are we going to feel good about ourselves when we tell them it’s all right because we got a piece of the pie? Read Dr Clark at http://www.healthcarecom.net/CBCPieceofPie.htm. Also be sure to read his most recent posting Feeding the Monster at http://www.healthcarecom.net/CBCFeedingMonster.htm.
Madeleine Pelner Cosman, JD, PhD, Esq: The chapter summaries of her latest book to be published early next year are now available at http://www.healthplanusa.net/MC-WhoOwnsYourBodyIntro.htm.
Ada P Kahn, PhD: Foreword to "Encyclopedia of Work-Related Injuries, Illnesses and Health Issues". Dr Kahn came to Sacramento in February and I joined her on a Channel 31 interview about her book. I was privileged to write the foreword which we’ve posted at http://www.delmeyer.net/MedInfo2004.htm To purchase the book, go to http://www.factsonfile.com/ and type in KAHN under search.
Henry Chang, MD: WEIGHT LOST FOREVER - The Five Second Guide to Permanent Weight Loss suggest daily weights to stem the weight loss before it becomes a problem and, if it does, how to take it off and keep it off. Congratulations to Dr Chang for winning the Sacramento Publishers and Authors 2004 award for “Best Health Book of the Year.” Read our review at http://www.healthcarecom.net/bkrev_WeightLostForever.htm.
Tammy Bruce: The Death of Right and Wrong (Understanding the difference between the right and the left on our culture and values.) http://www.townhall.com/bookclub/bruce.html. Reviewed by Courtney Rosenbladt
An Alzheimer's Story: To read a touching story by a nurse about her Alzheimer's patient, go to http://www.delmeyer.net/MedInfo2003.htm.
An Entrepreneur's Story: AriadneCapital (http://www.AriadneCapital.com) provided the initial funding for MedicalTuesday and the Global Trademarking. Julie Meyer, the CEO, has a clear vision in her mind of the world that she wants to live in, and it's considerably different from how it looks now. If you're an entrepreneurial woman, or if you lost hope or are having difficulty envisioning success, (if you'll forgive a little nepotism), the following article may be of interest to you. http://observer.guardian.co.uk/business/story/0,6903,1237363,00.html.
On This Date in History - December 21
Forefathers Day: The Pilgrims landed at Plymouth on this date in 1620. Although we may all have different forefathers, the late Whitney M Young, Jr, reminded us, "We may have come over on different ships, but we're all in the same boat now."
On this date in 1937, Walt Disney premiered a new animated cartoon feature picture called Snow White and the Seven Dwarfs. Although originated by the brothers Grimm, it was Disney that gave the seven dwarfs individual names or personalities: Doc, Happy, Grumpy, Sneezy, Sleepy, Bashful and Dopey, a cartoon profile of humanity. Dopey never talked–which may have made him, in the long run, less dopey than the others.
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