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NEWSLETTER

Community For Better Health Care

Vol X, No 8, July 26, 2011

 

In This Issue:  REV with Gibson reflect Med

1.      Featured Article: Tourette’s syndrome

2.      In the News: Our world is a much wilder place than it looks

3.      International Medicine: Government’s Health Spending Crises

4.      Medicare: Who Has Power to Stop a Rogue President?

5.      Medical Gluttony: Government Gluttony: Insurmountable Debts

6.      Medical Myths: It’s Safe to be a WhistleBlower? By James J. Murtagh, M.D.

7.      Overheard: If it weren’t for Republicans in the House, I’d spend another $800 Billion

8.      Voices of Medicine: Deal With the Patient, NOT the Computer

9.      The Bookshelf: The Immortal Life of Henrietta Lacks, by Rebecca Skloot

10.  Hippocrates & His Kin: Can you really go without Health Insurance?

11.  Related Organizations: Restoring Accountability in Medical Practice and Society

Words of Wisdom, Recent Postings, In Memoriam . . .

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Always remember that Chancellor Otto von Bismarck, the father of socialized medicine in Germany, recognized in 1861 that a government gained loyalty by making its citizens dependent on the state by social insurance. Thus socialized medicine, or any single payer initiative, was born for the benefit of the state and of a contemptuous disregard for people’s welfare.

Thus we must also remember that ObamaCare has nothing to do with appropriate healthcare; it was similarly projected to gain loyalty by making American citizens dependent on the government and eliminating their choice and chance in improving their welfare or quality of healthcare. Socialists know that once people are enslaved, freedom seems too risky to pursue.

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1.      Featured Article: Tourette’s syndrome                                                                                      

Treating Tourette's | Scientific American Magazine | by Sonya Collins | June 2011

Tourette’s syndrome is most pronounced in children. The physical and vocal tics, which can alienate kids from peers, are difficult to treat. First-line drugs are limited in their efficacy, whereas more effective antipsychotics have many potential long-term side effects, including weight gain and movement disorders. Investigators may be moving closer to a new treatment option involving drugs that already exist. Read more . . .

Last year researchers identified a new gene mutation associated with the disorder. Known mutations have only explained a small number of Tourette’s cases, so the investigators, led by Matthew State, co-director of the Yale Neurogenetics Program, studied a rare family in which the father and his eight children all had Tourette’s. In these family members, the gene involved in the production of histamine in the brain was shorter than normal, generating lower levels of the compound, which is involved in inflammatory response. State believes these lower levels can cause tics, and he is looking for this and further histamine-related mutations in other people with Tourette’s.

Now scientists have found parallels between this family and histamine-deficient mice, which furthers the connec­tion to Tourette’s. Most indi­viduals with Tourette’s have low prepulse inhibition, meaning that they are more easily startled or distracted than the average person, says Christopher Pittenger, direc­tor of the Yale OCD Research Clinic. In May he was to present new data to the Society of Biological Psychiatry that both this family and mice missing the histamine gene had low prepulse inhibition and tics. Other experiments have shown that histamine-boosting drugs decrease ticlike behaviors in mice.

Histamine is known for contributing to allergic reac­tions and keeping us awake at night, which is why anti­histamines are available over the counter. But it is also a neurotransmitter found throughout the brain, includ­ing in a region associated with Tourette’s.

The findings suggest an alternative to antipsychotics, which reduce tics by blocking dopamine. As dopamine lev­els drop, histamine levels rise. Increasing histamine directly, without blocking dopamine, may work as well and avoid many of the side effects of antipsychotics. “Other people with Tourette’s may have other changes in their hista­mine system, so it’s quite pos­sible that a histamine-boost­ing drug may have benefits, but it’s still very early,” says Kevin McNaught, vice presi­dent for medical and scientif­ic programs at the New York–based Tourette Syn­drome Association.

Drugs that increase hista­mine are already being tested to treat other neurological conditions, as well as atten­tion-deficit hyperactivity dis­order, which is often found in people with Tourette’s. —Sonya Collins

Read the entire article with illustrations in Scientific American – Subscription required . . .
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2.      In the News:  Our world is a much wilder place than it looks.

A new study estimates that Earth has almost 8.8 million species, but we've only discovered about a quarter of them. And some of yet-to-be-seen ones could be in our own backyards, scientists say.

So far, only 1.9 million species have been found. Recent discoveries have been small and weird: a psychedelic frogfish, a lizard the size of a dime and even a blind hairy mini-lobster at the bottom of the ocean. Read more . . .

"We are really fairly ignorant of the complexity and colorfulness of this amazing planet," said the study's co-author, Boris Worm, a biology professor at Canada's Dalhousie University. "We need to expose more people to those wonders. It really makes you feel differently about this place we inhabit." . . .

There are potential benefits from these undiscovered species, which need to be found before they disappear from the planet, said famed Harvard biologist Edward O. Wilson, who was not part of this study. Some of modern medicine comes from unusual plants and animals.

"We won't know the benefits to humanity [from these species], which potentially are enormous," the Pulitzer Prize-winning Mr. Wilson said. "If we're going to advance medical science, we need to know what's in the environment." . . .

Mr. Worm and Camilo Mora of the University of Hawaii used complex mathematical models and the pace of discoveries of not only species, but of higher classifications such as family to come up with their estimate.

Their study, published Tuesday in the online journal PLoS Biology, a publication of the Public Library of Science, estimated the number of species at nearly 8.8 million.

Of those species, 6.5 million would be on land and 2.2 million in the ocean, which is a priority for the scientists doing the work since they are part of the Census of Marine Life, an international group of scientists trying to record all the life in the ocean.

The research estimates that animals rule with 7.8 million species, followed by fungi with 611,000 and plants with just shy of 300,000 species. . .

Of the 1.9 million species found thus far, only about 1.2 million have been listed in the fledgling online Encyclopedia of Life, a massive international effort to chronicle every species that involves biologists, including Mr. Wilson.                                                                                          

If the 8.8 million estimate is correct, "those are brutal numbers," said Encyclopedia of Life executive director Erick Mata. "We could spend the next 400 or 500 years trying to document the species that actually inhabit our planet."                                                                           Associated Press

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3.      International Medicine: Bureaucrats don’t understand and can’t micromanagement healthcare

Government’s Health Spending Crises by Mark Rovere

Provincial governments across Canada are facing a serious crisis in public finances as government health spending is growing at unsustainable rates. The most recent data indicate that in nearly every province, health costs continue to follow their long-term trends of growing much faster than government revenues. At the same time, patients are facing shortages of medical resources and declining access to necessary medical care (Barua et al., 2010). Unless provincial governments are willing to deviate from the status quo and acknowledge that the current means of financing medical services in Canada is not working, Canadians will continue to pay more for health care services while getting less in return. Read more . . .

According to Canada’s Medicare Bubble: Is Government Health Spending Sustainable without Userbased Funding?, our annual study that measures the sustainability of provincial government health spending,1 total government spending on health grew at an average annual rate of 7.5% across all provinces over the period 2000/2001 to 2009/2010. During the same time, total available provincial revenue from all sources, including federal transfers, grew at an average annual rate of 5.7%; while the economy, measured by gross domestic product (GDP), grew by only 5.2% (figure 1). By definition, government health spending is deemed unsustainable when it grows faster on average than total revenue. Thus, the most recent data show that averaged across the provinces (over the most recent ten-year period), provincial health expenditures have been growing at unsustainable rates as they have grown faster than revenues and the economy.

If these trends continue, provincial governments will be allocating the bulk of their revenues to pay for health care, taking money away from other important government services. Critically, this is not a recent problem, it is systemic. Government spending on health has grown faster on average than GDP over the entire history of Medicare. The result is that total government health expenditures accounted for 8.4% of GDP in 2009 up from 5.4% of GDP in 1975 (Canadian Institute for Health Information, 2010). . .

More money is not a solution

Allocating more money to provincial health care has not resulted in increased access to, or the availability of, medical services and resources, thus is not a solution to the problem. For example, despite significant increases in health spending across Canada, the most recent data show that wait times for access to medical services have increased in every province over the ten-year period (Barua et al., 2010). In 2010, patients waited approximately 18.2 weeks from the time they obtained a referral from a general practitioner to the time they received treatment from a specialist. This means that Canadians waited 96% longer for elective surgery in 2010 than they did in 1993, when wait times were 9.3 weeks.

In addition, research shows that in comparison to its international counterparts, Canada lags behind many developed nations in the size of its medical technology inventory (for instance the number of CT and MRI machines per population) and the availability of medical resources such as physicians and nurses, even though it is one of the most expensive universal-access health care systems in the world (Esmail, 2008; Skinner and Rovere, 2010a). At the same time, provincial publicly funded drug programs are increasingly covering only a small percentage of new medicines. As of December 31st, 2009, only 20.3% of new drugs approved by Health Canada as safe and effective in 2008 had actually been approved for reimbursement by the provinces (Skinner and Rovere, 2010b).

Rationing access to health services has the effect of slowing growth in government health spending in the short term. However, the rationing of health goods and services cannot continue indefinitely without increasing medical risks for patients. Unfortunately, under the current financing model, policy makers do not have many tools at their disposal—cutting medical services or increasing taxes are the only two options. With that in mind, it is absurd to suggest that governments can sustain the health system indefinitely by raising taxes. Not only is this political suicide, but rising taxes discourages economic growth and reduces the long-term potential revenue base for governments (Karabegović et al., 2004). . .

Read the entire article at the Fraser Institute . . .
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Canadian Medicare does not give timely access to healthcare, it only gives access to a waiting list.
Government micromanagement makes the waiting list longer.
Can’t bureaucrats ever take a hint?

--Canadian Supreme Court Decision 2005 SCC 35, [2005] 1 S.C.R. 791

http://scc.lexum.umontreal.ca/en/2005/2005scc35/2005scc35.html

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4.      Medicare: Who Has Power to Stop a Rogue President?

WHISTLEBLOWER MAGAZINE: STATES OF REBELLION

How legislators and governors nationwide are challenging a rogue president

Posted: April 05, 2011, © 2011 WorldNetDaily

While millions of outraged Americans protest what they see as a lawless and power-mad Obama administration, many wonder how much clout individuals can really have in reining in a wildly out-of-control government.

But suppose, in addition to citizens with little power beyond their vote, those standing up to the federal government were named Virginia, Texas, Arizona, Utah, Wyoming, New Hampshire, Tennessee, Montana, Maine, South Dakota – and many more? Read More . . .

Incredibly, though under-reported by the establishment press, that's exactly what is happening right now, as the April issue of Whistleblower documents in-depth, in "STATES OF REBELLION: How legislators and governors nationwide are openly challenging a rogue president."

A wide-ranging rebellion is indeed under way – by a large majority of states – against what they claim are intolerable and blatantly unconstitutional encroachments by the federal government. And they are seriously intent on declaring such unconstitutional laws null and void in their state.

Here's how Thomas E. Woods Jr., author of the bestselling book, "Nullification: How to resist federal tyranny in the 21st century," succinctly lays out the issue in the April Whistleblower:

Nullification begins with the axiomatic point that a federal law that violates the Constitution is no law at all. It is void and of no effect. Nullification simply pushes this uncontroversial point a step further: If a law is unconstitutional and therefore void and of no effect, it is up to the states, the parties to the federal compact, to declare it so and thus refuse to enforce it. It would be foolish and vain to wait for the federal government or a branch thereof to condemn its own law. Nullification provides a shield between the people of a state and an unconstitutional law from the federal government.

Take Obamacare: Most people know the GOP-led House of Representatives repealed it (though the Democrat-controlled Senate almost certainly will not, nor will Obama ever sign it). And many also know 27 states are challenging Obamacare in court. But what few understand is that at least 11 states are attempting to legislatively nullify Obamacare within their borders. So far, an act to nullify the entire federal health-care law has become state law in Montana and Idaho, has been approved by one house in North Dakota, and introduced in eight other states – New Hampshire, Maine, Oregon, Nebraska, Texas, Wyoming, South Dakota and Oklahoma.


·  "Did Jefferson foresee Obama's deficit – and the solution?" by Fergus Hodgson, who notes the third president wanted an anti-debt constitutional amendment – and may yet get his wish

·  "Barack Hussein Alinsky" by Patrick J. Buchanan, who says the big battle shaping up is between the "organizer in chief" and the governors of the 50 states – with America hanging in the balance

·  "Leadership requires actual leadership" by Herman Cain, who shows that America's governors, not Obama, are showing the nation how to "win the future"

"There's so much bad news these days," said Whistleblower Editor David Kupelian, "that it's great to be able to report this crucial and encouraging trend. America is made up of 50 sovereign states – something largely forgotten in this age of seemingly all-powerful federal government. And what a great thing it is to see state after state actually standing up to the Obama administration and saying, in effect, 'Don't tread on me!'"

Read more in WND . . .
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 Government is not the solution to our problems, government is the problem.

- Ronald Reagan

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5.      Medical Gluttony: Government Gluttony: Insurmountable Debts

Explaining Our Debt Problem

 Recently, Standard & Poor’s downgraded the United States because of our budget problems. But the figures are awfully hard to comprehend:

  • U.S. Tax revenue: $2,170,000,000,000
  • Federal budget: $3,820,000,000,000
  • New debt: $1,650,000,000,000
  • National debt: $14,271,000,000,000
  • Recent budget cut: $38,500,000,000

To make it easier, let’s remove 8 zeros and pretend it’s a household budget:
Read more to see how much wool has been used to cover the taxpayer’s eyes . . .

  • Annual family income: $21,700
  • Money the family spent: $38,200
  • New debt added onto the credit card: $16,500
  • Outstanding balance on the credit card: $142,710
  • Total budget cuts: $385

Now that’s putting Obama’s budget cuts in perspective.

This is courtesy of the Heartland Institute.
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Medical Gluttony thrives in Government and Health Insurance Programs.

Gluttony Disappears with Appropriate Deductibles and Co-payments on Every Service.

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6.      Medical Myths: It’s Safe to be a WhistleBlower? Not unless we have a law to make it safe!

5th Annual Whistleblower Conference in Washington By James J. Murtagh, M.D.
(Ed. Note: Dr. James Murtagh is co-chair of this Caucus)

International Association of Whistleblower invites all Citizens of Conscience to Caucus Sept 18, 2010:
A CONFERENCE FOR CONSCIENCE

WASHINGTON, DC - This September 18, the whistleblowers and persons of conscience will hold the fifth annual gathering on Capitol Hill, focused on signature issues of Judicial Accountability, Medical Integrity and expanding education and awareness of whistleblower issues, particularly in light of consideration of the preventable disasters that have beset the United States. Advocates from around the country to meet in the Nation's Capitol and encourage their lawmakers to pass the protection for whistleblowers.

As the Nation's budget crisis continues to grow, lawmakers must be encouraged to look towards the activities of corporate and federal whistleblowers in assuring proper spending.
Read more . . .

Registration and details at
http://internationalwhistleblower.org/

Dear Scoop Readers and Writers,

Scoop has been crucial to the public interest, and in exposing matters of critical interest to the nation. Now, all of us are having a National Meeting to press our agenda to Congress. OEN has consistently pursued the public interest and whistleblower rights. We have a once in a lifetime opportunity to make our voices heard, and to meet and make the public aware of the crisis in rights.

 We Need Every Single OEN reader and writer to attend. Please send this invitation everywhere. We need all interested citizens. Please examine: http://internationalwhistleblower.org/

The IAW is non-political, and non-aligned. The IAW seeks to provide a forum for citizens of conscience to meet, network, and seek new relationships and mentoring in the struggle to bring integrity to America.

Now is the time for all public minded and enlightened citizens to band together. The International Association of Whistleblower Caucus will be held in Washington, DC, on Sunday Sept 18:

Included in the IAW Caucus are many signature panels and events:
1.    A ceremony to Honor Absent Heroes; a "empty chair" panel will represent four outstanding       whistleblowers that cannot attend the meeting because they are in prison or are deceased:
a)    Martin Salazar, former Dept. of Energy employee
b)    Bradley Birkenfeld, former UBS banker
c)    Mordechai Vanunu, former Israeli nuclear technician
d)   Karen Silkwood, Kerr-McGee technician (deceased)

Other absent heroes will also be honored in a roll call of those lost while serving the nation's interests.

2.   Atlanta Whistleblowers will discuss the alarming problems in Georgia including the eruptions of scandals in schools, hospitals and courts. Dr. Helen Salisbury and her colleagues will ask: "Can the Patient Quality Care Project Bring Integrity back to Medicine?"

3.  Medical Whistleblowers will report on need for improvements at the nation's for-profit hospital chains.

4.   A special session will be provided by OpEdNew's own Rob Kall and Joan Brunwasser and Tapping the Power of Media "How can we use the power of story, and new internet media, to promote social justice?

More events can be seen on the IAW website. Whistleblowers from all walks of life are welcomed. Membership is being enlarged. The IAW will also host social events and book signings. Every single person attending will have the opportunity to have their story recorded for You-tube.  This event is "of, by and for the whistleblower."

We encourage all 264 organizations and corporations that signed the Whistleblower letter to join us! We are already bonded by a shared principle that "whistleblower protection is a foundation for any change in which the public can believe. It does not matter whether the issue is economic recovery, prescription drug safety, environmental protection, infrastructure spending, national health insurance, or foreign policy."

For More Information, see http://internationalwhistleblower.org/

Please register at: http://makeitsafecampaign.org/news/?page_id=2154)

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Medical Myths Originate When Someone Blows the Whistle

Myths Disappear When Courts Pay Appropriate Attention to the Whistle Blower

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7.      Overheard in the Medical Staff Lounge: If it weren’t for Republicans in the House, I’d spend another $800 Billion

Mr. Rosen: Mr. Obama said he would be able to spend another $trillion if it weren’t for the Republicans in the House.

Dr. Milton: Do we have a lunatic in the White House?

Dr. Sam: I think we do. But a very smart one.

Dr. Rosen: I think he will be another Bismarck who introduced Socialized medicine in Germany after visiting France.

Dr. Edwards: It’s going to be a tough battle to save our country, the nation and its people.

Dr. Milton: It’s not only tough but critical. Just look at Germany and France, once they got used to socialized medicine and the interminable waits and poor care, it wasn’t politically possible to reverse the trend.

Dr. Rosen: Those countries have been downtrodden with inferior medicine for more than 150 years. The UK with only 60 years of enslavement has difficulty finding any physician that remembers the good days of private medicine. It sounds too risky for them to pursue.

Dr. Milton: If you think Physicians can’t remember their more responsible days, certainly the politicians in their House of Commons wouldn’t recall that much history.

Dr. Edwards: We’ll have to pull this one out of the fire to save our nation.

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The Staff Lounge Is Where Unfiltered Medical Opinions Are Heard.

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8.      Voices of Medicine: A Review of Local and Regional Medical Journals

Deal With the Patient, NOT the Computer by STEPHEN KAMELGARN, M.D.

From the Humboldt-Del Norte Medical Society

I’ve made no bones about my reticence to fully embrace electronic medical records (EMR). While they do offer the advantage(s) of easy to read notes, well organized charts and tons of reminders to keep us on our toes with the P4P people and the US Preventative Health Task Force recommendations,

I’ve found them to be klunky, user unfriendly, and designed for billers. I realize that we’re in the early stages of EMR, and, as time goes on, many of these issues will be resolved. However, there are philosophical questions that don’t loan themselves so easily to the technological quick fix. Read more . . .

When I wrote of EMR back in 2008 (“EMR: a meditation” The Bulletin; Oct. 2008), I stated, “But, as much as a computer may seem to be an inanimate lump of circuit boards and plastic, computer technology is not merely a passive recipient for our sophisticated software. In a weird Newtonian way, it pushes back at us and exerts all kinds of unintended subjective effects on the user.” This feeling was recently confirmed when I read an article in the New York Times by Abraham Verghese, M.D., where he writes of his experience as a patient in the ER, among other aspects of computer technology in medicine (“Treat the Patient, Not the CT Scan” NY Times Feb 26, 2011).

He notes that we now have the computer technology to really help us in our diagnostics, and treatments since the computers can rapidly scan data bases far more extensively than any human can hope to achieve, and make almost as many abstruse connections; witness the recent success of Watson in handily defeating two Jeopardy champions several weeks ago. The designers of Watson have stated that their next goal is to aid in medical diagnoses and treatments.

However, not all is perfect, and there is a downside. Dr Verghese writes: “But the complaints I hear from patients, family and friends are never about the dearth of technology but about its excesses. My own experience as a patient in an emergency room in another city helped me see this. My nurse would come in periodically to visit the computer work station in my cubicle, her back to me while she clicked and scrolled away. Over her shoulder she said, ‘On a scale of one to five how is your ...?’

“The electronic record of my three-hour stay would have looked perfect, showing close monitoring, even though to me as a patient it lacked a human dimension. I don’t fault the nurse, because in my hospital, despite my best intentions, I too am spending too much time in front of the computer: the story of my patient’s many past admissions, the details of surgeries undergone, every consultant’s opinion, every drug given over every encounter, thousands of blood tests and so many CT scans, M.R.I.’s and ultrasound images reside in there.

“This computer record creates what I call an “iPatient” — and this iPatient threatens to become the real focus of our attention, while the real patient in the bed often feels neglected, a mere placeholder for the virtual record.” (Italics mine)

Now, be honest, how many of you that use EMR have fallen into the same trap that Dr Verghese outlined here? I’m raising my hand; despite my best intentions I know that  I spend far too much time clicking mouse buttons, entering text and just eyeballing that damn computer screen rather than interacting face-to-face with the person sitting in the room with me. We can’t help it.

Humans seem to be hard-wired to respond to novelty, and the flashing images on a computer screen, popping up all over the place, are far more novel than looking at a poorly lit patient from the same camera angle. There have been many, many studies (usually using “starving” undergraduates, who need the money, as test subjects) that seem to indicate that we are biologically programmed to respond to the screen rather than a person just sitting and talking—no matter how important it is to pay full attention to that person. Despite our hubris, none of us is truly capable of multi-tasking, and one task will necessarily suffer when we’re paying attention to something else. Witness the law prohibiting talking on a cell phone while driving. Even if, while clicking all over the screen we can fully imbibe the patient’s story we’re still missing something important: ritual.

An interaction with a patient is a ritual, and it is this ritual that is part of the healing process. Multiple studies have shown that patients derive more satisfaction from their visit and do better when the doctor actually lays hands on them. Obtaining a history and talking with the patient is part of this same ritual.

Patients feel that you’re really listening to their concerns when you shove the monitor aside and look them in the face. The way it’s set up now is that the computer robs us of this interaction, and the ritual gets short-circuited. Not only are we missing part of their story, we’re also missing an opportunity to indulge in a bit of healing and treating.

Most of what we do doesn’t require extensive searches of data bases or googling the latest treatments, or even buzzing through a million old labs or reports. But we must engage in human to human rituals with every patient visit, and this provides the basis for healing to occur.

www.sonic.net/~medsoc/images/bulletins/2011%20-%204%20APRIL%20EXCERPTS.pdf

By looking at the computer while interviewing, we miss a lot of clinically important body language also.

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VOM Is an Insider's View of What Doctors are Thinking, Saying and Writing about.

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9.      Book Review: Life After Death By Jeff Sugarman, MD, Sonoma Medicine

CURRENT BOOKS The Immortal Life of Henrietta Lacks, by Rebecca Skloot, 384 pages, Crown, $26.

 “HeLa cells , the first human immortalized cells. They were removed from the cervix of Henrietta Lacks several months before her death in 1951. Lacks was a poor, uneducated African-American woman from a tobacco farming family in Clover, Virginia. . .

The origins of HeLa cells (whose name is an acronym for Henrietta Lacks), the events leading to their worldwide dissemination, and the scientific controversies surrounding them are described in detail by Skloot. She adroitly delves into the moral and ethical ramifications of human tissue research, the thorny issues of ownership, and the process of informed consent. . . Read more . . .

During the 1940s and early 1950s, Dr. George Gey, head of tissue culture research at Johns Hopkins, tried to culture human cells without any success. In 1951, without Henrietta’s consent, Gey received cell samples from a tumor on her cervix. Instead of dying within a few days, as all Gey’s prior samples had done, Henrietta’s cells started growing easily in culture, and they eventually made Gey famous. HeLa cells were shipped to hundreds and then thousands of laboratories, bought and sold, and grown by the trillions. They played a key role in the development of polio vaccine and helped launch the field of virology—all without the knowledge or consent of the Lacks family.

HeLa cells were so amazingly productive and hearty that they threatened to derail the nascent field of cell culture biology by insidiously contaminating hundreds of other cell lines. Researchers had thought they were studying liver or kidney cells, but it turned out their cultures were contaminated with HeLa cells, calling into question the validity of many of their findings. 

Woven into the fabric of the story of HeLa is the history of Henrietta Lacks, whose name was often published incorrectly as Helen Lane or Helen Larson. As Skloot explains, uncovering information about Henrietta was not a straightforward process. The key to unlocking her story was her daughter Deborah, who emerges as the central character of the book.

Uneducated, and at first wary and reluctant to open up to Skloot, Deborah eventually learns to trust her. Over many years Deborah shares more history about her mother, her family and ultimately Henrietta’s hospital records. Skloot takes Deborah with her on field research expeditions, providing Deborah with important information about her mother and the cells. The climax occurs in 2001, when Dr. Christoph Lengauer, a Johns Hopkins researcher, shows Deborah and Skloot the HeLa cells firsthand. He apologizes for the way the hospital and its researchers had kept the family in the dark about the use of Henrietta’s cells. This incident is the seminal event in Deborah’s journey to find her mother and is captured beautifully on the page. . .

. . . Skloot artfully moves from the science of HeLa and cell biology, to the personal stories and tragedies of Henrietta, Deborah and the Lacks family.

One of Skloot’s most provocative explorations is of the intersection between scientists and the vulnerable population with whom they crossed paths. The latter were mostly poor and uneducated, and in many cases were manipulated and not provided important information about the tissue samples they donated to the scientists. Scientific advances, and in some cases patents and significant monetary windfalls, were gained from the use of their tissues. . .  

In my own experience as a clinical investigator, I have often found myself annoyed at the countless forms, attestations and paperwork involved to protect the interests of the research subjects, thinking that they did not really apply to me or my work. Henrietta’s story has reminded me that advances in scientific knowledge often outpace our ability to parse out the ethical issues that emerge from the research process. These forms, while seemingly onerous, serve an important purpose, one that I now see more clearly.

Dr. Sugarman, a Santa Rosa pediatric dermatologist, is president of SCMA.
Email: pediderm@yahoo.com

This brought back memories of my medical student research of growing HeLa cells in mice abdomen.

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The Book Review Section Is an Insider’s View of What Doctors are Reading about.

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10.  Hippocrates & His Kin: Can you really go without Health Insurance?

Going without BC or KP

Ms. Rebecca was working but had no health insurance coverage from her job. She tried Kaiser Permanente, which was $800 a month. She then tried Blue Cross at $700 a month. She felt she couldn’t afford BC either so she dropped that policy also. She continues to come in twice a year since she’s on narcotics for Degenerative Disc Disease. This costs her about $700 a year. She states she obtains the identical care she had from her previous $700 a month insurance premiums. She figures that these costs should not increase for many years. She thinks that she will be stable for two decades with her major problem an old back injury. During the next 20 years she will save $150,000 in insurance premiums. 

What if she has a heart attack or a stroke or requires major surgery? She states she would just quit work and go on welfare and let Medicaid pay for it.

What an amazing health care net we have in these United States.
Better than socialized medicine where so many options are denied

Read more . . .


From the Fresno-Madeira Medical Society Meeting of April 2011: Presentation by two lawyers.

Federal Healthcare Reform has created a host of payment reforms and authorizes the Medicare program to contract with Accountable Care Organizations (ACOs) to improve quality and reduce cost through more coordinated healthcare systems. This presentation will provide information on how independent physicians can create systems and negotiate collectively in order to succeed in this new era of health reform.

Instead of negotiating for advantage over your colleagues, how about letting each practice compete with every other practice in the open Medical MarketPlace so that costs will drop to their lowest level?

Medical Competition will always control costs better than Lawyer’s Negotiations.
It will also be more transparent & fairer
.


Deprofessionalization of the Medical Profession Kern County Medical Society – April 2011

Daniel Grabski, a psychiatrist . . . at Kern Medical Center . . . described our current times where there is a rise of dysfunction and drastic change. There is amalgamation of corporation with physician groups eating up smaller groups. These changes can lead to anxiety and depression. There has been a deprofessionalization of medicine and a depreciation of our medical profession. These changes can result in substance abuse, depression and career burnout. Some physicians may lose their medical license or even their life! These dysfunctional responses can dramatically affect the physician’s life, their practice and their families.

Instead of Physician Psychotherapy to accept this intrusion, why not just let Physicians be Doctors?
Patients don’t like what government intrusion has made us!

Physicians: Rise up and become Professionals Again!

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Hippocrates and His Kin / Hippocrates Modern Colleagues
The Challenges of Yesteryear, Yesterday, Today & Tomorrow

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11.  Professionals Restoring Accountability in Medical Practice, Government and Society:

                      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. To read the rest of the story, go to 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 www.healthplanusa.net/AE-AreYouReallyInsured.htm.

                      Medi-Share Medi-Share is based on the biblical principles of caring for and sharing in one another's burdens (as outlined in Galatians 6:2). And as such, adhering to biblical principles of health and lifestyle are important requirements for membership in Medi-Share. This is not insurance. Read more . . .

                      PATMOS EmergiClinic - where Robert Berry, MD, an emergency physician and internist, practices. To read his story and the background for naming his clinic PATMOS EmergiClinic - the island where John was exiled and an acronym for "payment at time of service," go to www.patmosemergiclinic.com/ To read more on Dr Berry, please click on the various topics at his website. To review How to Start a Third-Party Free Medical Practice . . .

                      PRIVATE NEUROLOGY is a Third-Party-Free Practice in Derby, NY with Larry Huntoon, MD, PhD, FANN. (http://home.earthlink.net/~doctorlrhuntoon/) Dr Huntoon does not allow any HMO or government interference in your medical care. "Since I am not forced to use CPT codes and ICD-9 codes (coding numbers required on claim forms) in our practice, I have been able to keep our fee structure very simple." I have no interest in "playing games" so as to "run up the bill." My goal is to provide competent, compassionate, ethical care at a price that patients can afford. I also believe in an honest day's pay for an honest day's work. Please Note that PAYMENT IS EXPECTED AT THE TIME OF SERVICE. Private Neurology also guarantees that medical records in our office are kept totally private and confidential - in accordance with the Oath of Hippocrates. Since I am a non-covered entity under HIPAA, your medical records are safe from the increased risk of disclosure under HIPAA law. 

                      FIRM: Freedom and Individual Rights in Medicine, Lin Zinser, JD, Founder, www.westandfirm.org, researches and studies the work of scholars and policy experts in the areas of health care, law, philosophy, and economics to inform and to foster public debate on the causes and potential solutions of rising costs of health care and health insurance. Read Lin Zinser’s view on today’s health care problem:  In today’s proposals for sweeping changes in the field of medicine, the term “socialized medicine” is never used. Instead we hear demands for “universal,” “mandatory,” “singlepayer,” and/or “comprehensive” systems. These demands aim to force one healthcare plan (sometimes with options) onto all Americans; it is a plan under which all medical services are paid for, and thus controlled, by government agencies. Sometimes, proponents call this “nationalized financing” or “nationalized health insurance.” In a more honest day, it was called socialized medicine.

                      To read the rest of this section, please go to www.medicaltuesday.net/org.asp.

                      Michael J. Harris, MD - www.northernurology.com - an active member in the American Urological Association, Association of American Physicians and Surgeons, Societe' Internationale D'Urologie, has an active cash'n carry practice in urology in Traverse City, Michigan. He has no contracts, no Medicare, Medicaid, no HIPAA, just patient care. Dr Harris is nationally recognized for his medical care system reform initiatives. To understand that Medical Bureaucrats and Administrators are basically Medical Illiterates telling the experts how to practice medicine, be sure to savor his article on "Administrativectomy: The Cure For Toxic Bureaucratosis."

                      Dr Vern Cherewatenko concerning success in restoring private-based medical practice which has grown internationally through the SimpleCare model network. Dr Vern calls his practice PIFATOS – Pay In Full At Time Of Service, the "Cash-Based Revolution." The patient pays in full before leaving. Because doctor charges are anywhere from 25–50 percent inflated due to administrative costs caused by the health insurance industry, you'll be paying drastically reduced rates for your medical expenses. In conjunction with a regular catastrophic health insurance policy to cover extremely costly procedures, PIFATOS can save the average healthy adult and/or family up to $5000/year! To read the rest of the story, go to www.simplecare.com. 

                      Dr David MacDonald started Liberty Health Group. To compare the traditional health insurance model with the Liberty high-deductible model, go to www.libertyhealthgroup.com/Liberty_Solutions.htm. There is extensive data available for your study. Dr Dave is available to speak to your group on a consultative basis.

                      David J Gibson, MD, Consulting Partner of Illumination Medical, Inc. has made important contributions to the free Medical MarketPlace in speeches and writings. His series of articles in Sacramento Medicine can be found at www.ssvms.org. To read his "Lessons from the Past," go to www.ssvms.org/articles/0403gibson.asp. For additional articles, such as the cost of Single Payer, go to www.healthplanusa.net/DGSinglePayer.htm; for Health Care Inflation, go to www.healthplanusa.net/DGHealthCareInflation.htm.

                      Dr Richard B Willner, President, Center Peer Review Justice Inc, states: We are a group of healthcare doctors -- physicians, podiatrists, dentists, osteopaths -- who have experienced and/or witnessed the tragedy of the perversion of medical peer review by malice and bad faith. We have seen the statutory immunity, which is provided to our "peers" for the purposes of quality assurance and credentialing, used as cover to allow those "peers" to ruin careers and reputations to further their own, usually monetary agenda of destroying the competition. We are dedicated to the exposure, conviction, and sanction of any and all doctors, and affiliated hospitals, HMOs, medical boards, and other such institutions, who would use peer review as a weapon to unfairly destroy other professionals. Read the rest of the story, as well as a wealth of information, at www.peerreview.org.

                      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. He noted maternal mortality of 25-30 percent in the obstetrical clinic in Vienna. He also noted that the first division of the clinic run by medical students had a death rate 2-3 times as high as the second division run by midwives. He also noticed that medical students came from the dissecting room to the maternity ward. He ordered the students to wash their hands in a solution of chlorinated lime before each examination. The maternal mortality dropped, and by 1848, no women died in childbirth in his division. He lost his appointment the following year and was unable to obtain a teaching appointment. Although ahead of his peers, he was not accepted by them. When Dr Verner Waite received similar treatment from a hospital, he organized the Semmelweis Society with his own funds using Dr Semmelweis as a model: To read the article he wrote at my request for Sacramento Medicine when I was editor in 1994, see www.delmeyer.net/HMCPeerRev.htm. To see Attorney Sharon Kime's response, as well as the California Medical Board response, see 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.

To view some horror stories of atrocities against physicians and how organized medicine still treats this problem, please go to www.semmelweissociety.net.

                      Dennis Gabos, MD, President of the Society for the Education of Physicians and Patients (SEPP), is making efforts in Protecting, Preserving, and Promoting the Rights, Freedoms and Responsibilities of Patients and Health Care Professionals. For more information, go to www.sepp.net.

                      Robert J Cihak, MD, former president of the AAPS, and Michael Arnold Glueck, M.D, who wrote an informative Medicine Men column at NewsMax, have now retired. Please log on to review the archives. He now has a new column with Richard Dolinar, MD, worth reading at www.thenewstribune.com/opinion/othervoices/story/835508.html.

                      The Association of American Physicians & Surgeons (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 read News of the Day in Perspective: Surgery Center of Oklahoma City Blog. Don't miss the "AAPS News," written by Jane Orient, MD, and archived on this site which provides valuable information on a monthly basis. Browse the archives of their 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.


The AAPS California Chapter is an unincorporated association made up of members. The Goal of the AAPS California Chapter is to carry on the activities of the Association of American Physicians and Surgeons (AAPS) on a statewide basis. This is accomplished by having meetings and providing communications that support the medical professional needs and interests of independent physicians in private practice. To join the AAPS California Chapter, all you need to do is join national AAPS and be a physician licensed to practice in the State of California. There is no additional cost or fee to be a member of the AAPS California State Chapter.
Go to California Chapter Web Page . . .

Bottom line: "We are the best deal Physicians can get from a statewide physician based organization!"


PA-AAPS is the Pennsylvania Chapter of the Association of American Physicians and Surgeons (AAPS), a non-partisan professional association of physicians in all types of practices and specialties across the country. Since 1943, AAPS has been dedicated to the highest ethical standards of the Oath of Hippocrates and to preserving the sanctity of the patient-physician relationship and the practice of private medicine. We welcome all physicians (M.D. and D.O.) as members. Podiatrists, dentists, chiropractors and other medical professionals are welcome to join as professional associate members. Staff members and the public are welcome as associate members. Medical students are welcome to join free of charge.

Our motto, "omnia pro aegroto" means "all for the patient."


Words of Wisdom

Our country is the best country on this planet.

I am fed up with politicians trashing our country when it is the best country on this planet. Recession is worse in every other industrial nation than it is in ours. And yet with the willing complicity of much of the media, our country is mean-mouthed day in and day out until a lie begins to sound like the truth. –Paul Harvey, 1918- News commentator, author, and columnist.

The Census Bureau, based on a single statistic, has declared that 30 million Americans fall below the poverty threshold of $13,942 for a family of four. But the Bureau’s statisticians ignore the fact that 40 percent of those people own their own homes . . . That their average home is a three-bedroom house with a garage, porch and patio . . . More than half of the poor live in homes or apartments with twice as much living space as the average Japanese, four times more than the average Russian. –Paul Harvey 1918- We are ‘Names,’ not ‘Numbers,’ Sept 11, 1992.

Some Recent Postings

In The July 12 Issue:


1.      Featured Article: Cancer Testing? There’s an App for That

2.      In the News: An Economic Time Bomb

3.      International Medicine: The Road to Privatization is a hard and bumpy journey

4.      Medicare: Medicaid Efficiency is Poor Health Care and Extremely Costly

5.      Medical Gluttony: Hospital measures the home BP and Weight every week

6.      Medical Myths: Patients should be allowed to do their own medical testing to save money

7.      Overheard in the Medical Staff Lounge: Should Physicians become more political?

8.      Voices of Medicine: Drug Expiration Dates: Part III

9.      The Bookshelf: "Harry Potter and the Deathly Hallows" by J K Rowling

10.  Hippocrates & His Kin: Do We Really Need to Spend More on Schools?

11.  Related Organizations: Restoring Accountability in HealthCare, Government and Society

Words of Wisdom, Recent Postings, In Memoriam . . .

In Memoriam

Betty Bloomer Ford, an outspoken First Lady, died on July 8th, aged 93

From The Economist print edition | Jul 21st 2011

ALL her life, Betty Ford loved to dance. At ten she was gliding round to the waltz and the foxtrot at social-dancing classes in Grand Rapids, Michigan. As a young woman, she was taught by Martha Graham and danced in her troupe at Carnegie Hall. (Later she persuaded her husband, Gerald R., to give Martha a medal; if you kept on at a man long enough, he would agree to anything.) In the White House she tried out disco steps, and shimmied to the Bump at dinner-dances. But if you tried to teach her an arabesque or a jetée, she turned into the worst ballet dancer who ever came down the road. She couldn’t bear to be constrained like that. She was, as she put it once, a booby who only wanted to soar.

Of course, she could be proper too. In her brief stint as First Lady, from August 1974 to January 1977, she was always immaculately turned out. She wore white gloves (“these mitts”) whenever she had to do so. But, much as she adored clothes—the room-long rack at her house in Virginia had fallen off the wall, she had so many—all the ladylike public behaviour could be a bit of a strain. So too could the split-second scheduling, when she liked to linger in bed in the mornings till 9.30 or so, putting on her makeup in her own good time. It sometimes happened that she had to greet the public from the balcony with her nightgown tucked up under her coat. “Hi, Betty!” they would shout back.

On Jerry’s inauguration day she kept quiet, because she had taken advice from her Living Bible that morning to “put a muzzle on your mouth”. But she made it clear that she didn’t intend to change the candid habits of a lifetime just because she was in the White House. Jerry and she were going to keep their sleeping arrangements (not really a double bed, just twins that swung out from one headboard, but the fuss was the same), in which they would have sex “as often as possible!” The flag she had made for her limousine featured a pair of voluminous calico knickers on a blue satin ground, because her maiden name was Bloomer. On “60 Minutes” in 1975, her bouffant hair perfect and her warm smile ever ready, she declared that smoking marijuana was like “having a first beer” and that she wouldn’t be surprised if her 18-year-old daughter Susan had an affair. Jerry said: “Honey, you just lost me 20m votes.” Her own ratings soared.

She had no preparation for the White House. When Spiro Agnew resigned the vice-presidency in 1973 Jerry became Veep; when Richard Nixon resigned the next year, he was suddenly president. There was no election. She felt terrified, but ended up enjoying it. She had never known what she was in for since she had met Jerry, the big, blond, handsome football hero who walked beside her at their wedding in 1948 in awful dusty brown shoes that didn’t match his suit. He had seemed such a relief after Bill, her first husband, who sold furniture and was an alcoholic. But Jerry too had a secret vice, and that was politics.

He was elected to Congress the year they got married, and they stayed in Washington for 28 years. For more than half that time he was away from home while she raised Mike, Jack, Steve and Susan, tripping over bags of marbles and toy trucks, burying pet alligators, visiting the emergency room, measuring out her life in Pablum spoons. She was a den mother for cub scouts and taught Sunday School, but by 1965 she couldn’t be Bionic Woman any more. A psychiatrist told her she had to believe she was important again.

She went to him for almost two years, and openly admitted it later. Why not get help if you needed it? It was the same when breast cancer struck her as First Lady. She spoke “breast” aloud and “cancer” aloud, had a mastectomy and urged others to do the same. Why, she told the world, she could even wear her evening clothes. When she became addicted to pills for neck pain and, over martini-filled years, started drinking too much, she publicly booked into a clinic to recover, sharing a room with three other women, and then in 1982 founded the Betty Ford Centre for addiction in Rancho Mirage, California. There she would tell patients: “Hi, I’m Betty. I’m an addict and an alcoholic.”

That secondary feeling

Her impulse to speak out shockingly and usefully extended into politics, too. Though she tried not to get in Jerry’s way, she realised that First Ladies had power to make waves. . . She had spent so much of her life feeling secondary (though to a man she adored) that she burned to undo the laws that hemmed women in.

She was only an ordinary woman, she liked to say. She’d worked in a department store, had an unlucky marriage, could only make scalloped potato out of a box, never got a college degree. But she was caught up in extraordinary times. And when they ended—as she blissfully contemplated getting both life and husband back, as they packed up to leave the White House—she took just a moment to climb on the Cabinet table, so beautifully set, and dance.

Read the entire obituary at The Economist – Subscription required.

On This Date in History - July 26

On this date in 1908, the FBI was established. It was established by an Attorney General named Charles J. Bonaparte and did not acquire its Napoleonic complex until some years later. We can credit the FBI with assuming an important role in modernizing the science and methods of crime prevention, crime detection and law enforcement.

On this date in 1947, the Department of Defense was established under the Armed Forces Unification Act. It signaled the recognition that, in an era of the totality of war, there had to be one combined overall military command.

After Leonard and Thelma Spinrad

* * * * *

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Announcing The 1st Annual World Health Care Congress Latin America, October, 2011 in
São Paulo, Brazil

The World Health Care Congress (WHCC) convenes the most prestigious forum of global health industry executives and public policy makers. Building on the 8th annual event in the United States, the 7th annual event in Europe and the inaugural Middle East event, we are pleased to announce the 1st Annual World Health Care Congress - Latin America to be held in October, 2011 in São Paulo, Brazil.

This prominent international forum is the only conference in which over 500 leaders from all regions of Latin America will convene to address access, quality and cost issues, including Latin American health ministers, government officials, hospital/health system executives, insurance executives, health technology innovators, pharmaceutical, medical device, and supplier executives.

World Health Care Congress Latin America will address escalating challenges such as improving access to quality care, financing and insurance models for health care, driving innovation in health IT, promoting evidence-based medicine and clinical best practices. World Health Care Congress Latin America will feature a series of plenary keynotes, invitational executive Summits, in-depth working group sessions on emerging issues, as well as substantial business development and networking opportunities.

For more information on the World Health Care Congress Latin America . . .

For information on the 9th Annual World Health Care Congress on April 16-18, 2012 . . .