|
MEDICAL TUESDAY . NET |
NEWSLETTER |
|
Community For Better Health Care |
Vol X, No 4,
May 24, 2011 |
In This Issue:
1.
Featured Article:
The History of
Memorial Day
2.
In
the News: How
Brains Bounce Back from Physical Damage
3.
International Medicine: Cancer survival
rates in Europe and the United States
4.
Medicare: Robbing Peter to pay
Paul doesn’t help Peter or Medicare!
5.
Medical Gluttony:
“It Didn’t Cost Me
Anything. I’m on MediCal!”
6.
Medical Myths: It Didn’t Cost
Anything!”
7.
Overheard in the Medical Staff Lounge: Is Texas
Governor Perry Presidential?
8.
Voices
of Medicine: Concierge Medicine
Practice
9.
The Bookshelf: The Rising Tide: The danger in failing to recognize the
storms
10.
Hippocrates
& His Kin: A Short History
of Political Suicide
11.
Related Organizations: Restoring Accountability in Medical Practice and Society
Words of Wisdom,
Recent Postings, In Memoriam . . .
* * * * *
Next week is
Memorial Day
America, the
Beautiful
O beautiful for
pilgrim feet, whose stern impassioned stress
A thoroughfare for freedom beat across the wilderness!
America! America! God mend thine ev’ry flaw,
Confirm thy soul in self-control, thy liberty in law!
* * * * *
1.
Featured
Article: The
History of Memorial Day
History
The first known observance of a Memorial
Day-type observance was in Charleston,
South Carolina in
1865; freedmen (freed enslaved Africans) commemorated and celebrated at the
Washington Race Course, today the location of Hampton Park,
and each year thereafter. African Americans founded what was then called
"Decoration Day," now referred to as Memorial Day, at the graveyard
of 257 Union soldiers and labeled the gravesite "Martyrs of the Race
Course", on May 1, 1865.
In a recent lecture, David Blight, Class of 1954 Professor of
American History at Yale University, told the story of the first Memorial Day:
"During the last months of the
[American Civil] war the Confederate Army turned the Washington race course [in
Charleston, South Carolina] into an open air prison. And in that open air
prison in the in-field of the horse track about 260 odd Union soldiers had died
of disease and exposure. And they were buried in un-marked graves behind the
grandstand of the race track. And by the way, there was no more important and
symbolic site in low country planter slave holding life than their race track.
The black folks of Charleston got organized. They knew about all this. They
went to the site. They reinterred the buried men. They couldn’t mark them with
names. They didn’t have any names. Then they made them proper graves. They
built a fence around the cemetery. And over an archway they painted the
inscription: “Martyrs of the Race Course.” And then on May 1, 1865 they held a
parade of 10,000 people on the race track led by 3,000 black children carrying
arms full of roses singing John Brown’s Body. As many as could fit got into the
gravesite: Five black preachers read from scripture; A children’s choir sang
the national anthem; America the Beautiful, and several spirituals. And then
they broke from that and did what essentially you or I do on Memorial Day: They
ran races, listened to speeches, the troops marched back and forth, and they
held picnics. This was the first Memorial Day. African-Americans invented
Memorial Day in Charleston, South Carolina. What you have there is black
Americans recently freed from slavery announcing to the world with their
flowers, their feet, and their songs what the War had been about. What they
basically were creating was the Independence Day of a Second American
Revolution.”
In the North
The friendship between General John
Murray, a distinguished citizen of Waterloo, New
York, and General John A. Logan, who helped bring attention to
the event nationwide, was likely a factor in the holiday's growth. On May 5,
1868, in his capacity as commander-in-chief of the Grand Army of
the Republic – the organization for Northern Civil War
veterans – Logan issued a proclamation that "Decoration Day"
should be observed nationwide. It
was observed for the first time on May 30 of the same year; the date was chosen
because it was not the anniversary of a battle.
There were events in 183 cemeteries in 27
states in 1868, and 336 in 1869. The northern states quickly adopted the
holiday; Michigan made "Decoration Day" an official state holiday in
1871 and by 1890 every northern state followed suit. The ceremonies were
sponsored by the Women's Relief Corps, which had 100,000 members. By 1870, the
remains of nearly 300,000 Union dead had been buried in 73 national cemeteries,
located mostly in the South, near the battlefields. The most famous are Gettysburg
National Cemetery in
Pennsylvania and Arlington
National Cemetery, near Washington.
The Memorial Day speech became an occasion
for Veterans, Politicians and Ministers to commemorate the War – and at
first to rehash the atrocities of the enemy. They mixed religion and
celebratory nationalism and provided a means for the people to make sense of
their history in terms of sacrifice for a better nation, one closer to God.
People of all religious beliefs joined together, and the point was often made
that the German and Irish soldiers had become true Americans in the
"baptism of blood" on the battlefield. By the end of the 1870s the
rancor was gone and the speeches praised the brave soldiers both Blue and Gray.
By the 1950s, the theme was American exceptionalism and duty to uphold freedom
in the world.
Ironton, Ohio, lays claim to the nation's
oldest continuously running Memorial Day parade. Its first parade was held May
5, 1868, and the town has held it every year since.
In the South
In Charleston,
South Carolina, in 1865, freedmen (freed -enslaved Africans)
celebrated at the Washington Race Course, today the location of Hampton Park.
The site had been used as a temporary Confederate prison camp for captured
Union soldiers in 1865, as well as a mass grave for Union soldiers who died
there. Immediately after the cessation of hostilities, freedmen exhumed the
bodies from the mass grave and reinterred them in individual graves. They built
a fence around the graveyard with an entry arch and declared it a Union graveyard.
On May 1, 1865, a crowd of up to 10,000, mainly black residents, including 2800
children, proceeded to the location for events that included sermons, singing,
and a picnic on the grounds, thereby creating the first Decoration Day-type
celebration.
Beginning in 1866, the Southern states had
their own Memorial Days, ranging from April 26 to mid-June. The birthday of
Confederate President Jefferson Davis,
June 3, became a state holiday in 10 states by 1916. Across the South,
associations were founded after the War to establish and care for permanent
cemeteries for Confederate soldiers, organize commemorative ceremonies and
sponsor impressive monuments as a permanent way of remembering the Confederate
cause and tradition. Women provided the leadership in these associations,
paving the way to establish themselves as capable of public leadership.
The earliest Confederate Memorial Day
celebrations were simple, somber occasions for veterans and their families to
honor the day and attend to local cemeteries. Around 1890, there was a shift
from this consolatory emphasis on honoring specific soldiers to public
commemoration of the Confederate cause. Changes in the ceremony's hymns and
speeches reflect an evolution of the ritual into a symbol of cultural renewal
and conservatism in the South. By 1913, however, the theme of American
nationalism shared equal time with the Lost Cause.
Columbus, Mississippi,
at its Decoration Day on April 25, 1866, commemorated both the Union and
Confederate casualties buried in its cemetery.
At Gettysburg
The ceremonies and Memorial Day address at
Gettysburg National Park were nationally famous, starting in 1868. In July
1913, veterans of the United States and Confederate armies gathered in
Gettysburg to commemorate the fifty-year anniversary of one of the Civil War's
bloodiest and most famous battle. The four-day "Blue-Gray Reunion"
featured parades, reenactments, and speeches from a host of dignitaries,
including President Woodrow Wilson, the first Southerner in the White House since
the War. Congressman James Heflin of Alabama was
given the honor of the main address. Heflin was a noted orator; two of his
best-known speeches were an endorsement of the Lincoln Memorial and his call to make Mother's Day a
holiday, but his choice as Memorial Day speaker was met with criticism. He was
opposed for his racism, but his speech was moderate, stressing national unity
and goodwill, and the newspapers, including those who opposed his invitation to
speak, praised him. . .
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the entire article . . .
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* * * * *
2.
In the
News: How Brains Bounce Back from
Physical Damage
After a traumatic injury,
neurons that govern memory can regenerate.
| Scientific American | May
20, 2011 |
For most of the past century the
scientific consensus held that the adult human brain did not produce any new
neurons. Researchers overturned that theory in the 1990s, but what role new
neurons played in the adult human brain remained a mystery. Recent work now suggests
that one role may be to help the brain recover from traumatic brain injury.
Cory Blaiss, then at the
University of Texas Southwestern Medical Center, and her colleagues genetically
engineered mice such that the researchers could selectively turn neurogenesis
on or off in a brain region called the hippocampus, a ribbon of tissue located
under the neocortex that is important for learning and memory. They then
administered blunt-force trauma to the brain and compared the performance of
brain-injured mice that could produce new neurons to brain-injured mice that
could not. They sent each mouse through a water maze that required it to find a
platform obscured beneath the surface of murky water. The researchers found
that after injury only mice with intact neurogenesis could develop an efficient
strategy to find the hidden platform, a skill that is known to rely on spatial
learning and memory. They concluded that without neurogenesis in the
hippocampus, the recovery of cognitive functions after brain injury was significantly
impaired.
The finding may lead to much
needed therapeutic techniques. Deficits in learning and memory are nearly
universal after a traumatic brain injury. The ability to stimulate more robust
neurogenesis could lead to faster healing times or perhaps even more complete
recovery of cognitive functions, a potentially life-changing prospect for the
millions of people who suffer from traumatic brain injury every year. . .
Read the entire article in Scientific American, subscription required . . .
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* * * * *
3.
International
Medicine: Cancer
survival rates in Europe and the United States
During this presidential election season, candidates
are urging Americans to radically overhaul our “broken” health care system.
Before accepting the premise that the system is broken, consider the impressive
evidence from the largest ever international study of cancer survival rates.
The data show that cancer patients live longer in the United States than
anywhere else on the globe.
Overall Cancer Survival
Rates. According to the survey of cancer survival rates in Europe and the
United States, published recently in Lancet Oncology :
·
American women
have a 63 percent chance of living at least five years after a cancer
diagnosis, compared to 56 percent for European women.
·
American men have
a five-year survival rate of 66 percent — compared to only 47 percent for
European men.
·
Among European
countries, only Sweden has an overall survival rate for men of more than 60
percent.
·
For women, only
three European countries (Sweden, Belgium and Switzerland) have an overall
survival rate of more than 60 percent.
These figures reflect the care available to all
Americans, not just those with private health coverage. Great Britain,
known for its 50-year-old government-run, universal health care system, fares
worse than the European average: British men have a five-year survival
rate of only 45 percent; women, only 53 percent.
Survival Rates for Specific Cancers. U.S. survival rates are higher than the average
in Europe for 13 of 16 types of cancer reported in Lancet Oncology, confirming
the results of previous studies. As Figure II shows:
·
Of cancers that
affect primarily men, the survival rate among Americans for bladder cancer is
15 percentage points higher than the European average; for prostate cancer, it
is 28 percentage points higher.
·
Of cancers that
affect women only, the survival rate among Americans for uterine cancer is
about 5 percentage points higher than the European average; for breast cancer,
it is 14 percentage points higher.
·
The United States
has survival rates of 90 percent or higher for five cancers (skin melanoma,
breast, prostate, thyroid and testicular), but there is only one cancer for
which the European survival rate reaches 90 percent (testicular).
Furthermore, the Lancet Oncology study found that lung
cancer patients in the United States have the best chance of surviving five
years — about 16 percent — whereas patients in Great Britain have only an 8
percent chance, which is lower than the European average of 11 percent.
Results for Canada. Canada's system of national health insurance is
often cited as a model for the United States. But an analysis of 2001 to
2003 data by June O'Neill, former director of the Congressional Budget Office,
and economist David O'Neill, found that overall cancer survival rates are
higher in the United States than in Canada: . . .
Early Diagnosis. It is often claimed that people have better
access to preventive screenings in universal health care systems. But
despite the large number of uninsured, cancer patients in the United States are
most likely to be screened regularly, and once diagnosed, have the fastest
access to treatment. For example, a Commonwealth Fund report showed that
women in the United States were more likely to get a PAP test for cervical
cancer every two years than women in Australia, Canada, New Zealand and Great
Britain, where health insurance is guaranteed by the government.
·
In the United
States, 85 percent of women aged 25 to 64 years have regular PAP smears,
compared with 58 percent in Great Britain.
·
The same is true
for mammograms; in the United States, 84 percent of women aged 50 to 64 years
get them regularly — a higher percentage than in Australia, Canada or New
Zealand, and far higher than the 63 percent of British women.
Access to Treatments and Drugs. Early diagnosis is important, but survival
also depends on getting effective treatment quickly. However, long waits
for treatment are “common devices used to restrict access to care in countries
with universal health insurance,” according to a report in Health Affairs. The British National Health Service has set a
target for reducing waits to no more than 18 weeks between the time their
general practitioner refers them to a specialist and they actually begin
treatment. A study by the Royal College of Radiologists showed that such
long waits are typical, and 13 percent of patients who need radiation never get
it due to shortages of equipment and staff.
Another reason for the higher cancer survival rates in
the United States is that Americans can get new, effective drugs long before
they are available in most other countries. A report in the Annals of
Oncology by two Swedish scientists found:
·
Cancer
patients have the most access to 67 new drugs in France, the United States,
Switzerland and Austria.
·
Erlotinib,
a new lung cancer therapy, was 10 times more likely to be prescribed for a
patient in the United States than in Europe.
One of the report's authors, Nils Wilking, from the
Karolinska Institute in Stockholm, explained that nearly half the improvement
in survival rates in the United States in the 1990s was due to “the
introduction of new oncology drugs,” and he urged other countries to make new
drugs available faster.
Conclusion. International comparisons establish that the most
important factors in cancer survival are early diagnosis, time to treatment and
access to the most effective drugs. Some uninsured cancer patients in the
United States encounter problems with timely treatment and access, but a far
larger proportion of cancer patients in Europe face these troubles. No
country on the globe does as good a job overall as the United States. Thus, the U.S. government should focus on
ensuring that all cancer patients receive timely care, rather than radically
overhauling the current system.
NCPA Brief Analyses | Health
| No 596
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NHS &
Canadian Medicare do not give timely access to healthcare, only access to a
waiting list.
Waiting lists
can be fatal in Cancer Care
* * * * *
4.
Medicare: Robbing Peter to pay
Paul doesn’t help Peter or Medicare!
Obama’s IPAB Board Will Control
Medicare Decisions by Betsy McCaughey
A toxic political strategy is spreading across the land, one that
involves Medicare. It threatens to bamboozle voters and allow the 2012 election
to turn on a lie.
Democrats are making the obscenely false claim that they will
"save Medicare as we've known it." On Wednesday, Democrats used this
deceptive strategy to take the special election in the 26th congressional
district in western New York. Sadly, this corrupt strategy is likely to be
repeated. Voters need to know the facts.
The truth is, the Obama health law, passed by Democrats last year,
already eviscerated Medicare — though seniors won't feel the effects for some
time. And the reform plan Democrats are attacking — Rep. Paul Ryan's vision —
would undo much of the damage to Medicare while charting a new course to ensure
the program doesn't run out of money.
The Obama health law cut future funding
for Medicare by $575 billion over the next decade and used $410 billion of that
money to expand eligibility for Medicaid. It’s like robbing Peter to pay Paul,
only it’s robbing Grandma to benefit Medicaid recipients.
The nation needs to spend less on
government programs, and entitlement reform is key. The best way to reform
entitlements is not to start new ones. Don't miss the point here. The Obama
health law is redistributing the wealth — taking money out of Medicare to
create new entitlements and millions more government dependents. Seniors are
being forced to sacrifice to pay for this.
According to projections from the Obama
administration’s actuaries, Medicare will spend $14,731 per senior in 2019,
instead of $16,162 if the health law had not passed. That’s less care for
seniors.
Such cuts might be justifiable if the
“savings” extended the financial life of Medicare. Mr. Obama and Health and
Human Services Secretary Kathleen Sebelius frequently make that false claim.
But in truth, the Obama health law raids Medicare, leaving less money to take
care of the next generation of retirees.
So what can that next generation, retiring
a decade from now, count on? The Obama health law puts those decision in the
hands of an unelected board called the Independent Payment Advisory Board,
IPAB, a cost-cutting panel.
The board is a radical departure from
Medicare as we’ve known it. Congress cedes nearly all control of Medicare
spending on the rationale that budgeting decisions should be shielded from
outraged seniors and political pressures.
On April 13, the president reiterated that
the board would decide what care is “unnecessary” for seniors, and that he
would like to see IPAB’s unprecedented powers increased.
Even the Congressional Budget Office
cautioned that as the nation’s debt crisis worsens, benefits will be put on the
board’s chopping block. IPAB is drawing fire from AARP and Democratic Rep. Pete
Stark (California).
Last week, President Obama indicated that
he would like to reduce the deficit by taking an additional $200 billion from
Medicare over the next decade. That would be IPAB’s job too.
Ryan's plan, passed by the Republican
majority in the House of Representatives, was distorted into a scare machine to
intimidate voters in the western New York race. The truth is, seniors would be
safer under the Ryan plan than under Medicare Obama style. . .
Let's hope voters examine the plain facts
because one thing is clear — Obama and the Democratic Party are not saving
Medicare “as we know it.”
Read more: Obama's IPAB Board Will Control Medicare Decisions
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Government is not the solution to our
problems, government is the problem.
- Ronald Reagan
* * * * *
5.
Medical
Gluttony: “It
Didn’t Cost Me Anything. I’m on MediCal!”
Mary, a 33-year-old lady,
stated that she went to the Emergency Room twice last month. When asked, “Why?”
she said, “Well I had two emergencies.” When asked what did they find wrong
with her? She replied that she had pulled a muscle in her chest. But they did
dozens of tests including CT scans and MRI and she was pleased to find out that
everything else was just fine.
When asked whether she
thought the rather large expenditure in tests was justified, she replied, “It
didn’t cost me anything. I’m on MediCal.”
And so the Medical Gluttony
continues. Someone else, the taxpayers in this case, picked up the tab. The
patient felt no pain. The patient felt no responsibility. The patient was
unable to understand the costs. She furthermore did not understand these costs
as unnecessary for her health. Thus gluttonous behavior becomes the norm in the
absence of any responsibility.
Patients will never
understand the costs and thus be able to contain costs unless they have a
percentage co-payment. This is the single most important item in health care
reform—patient responsibility through a percentage share of cost. Even if only
ten percent. Someone in that family will help her figure it out. And that
someone who is paying her ten percent will make sure s/he never will have to
pay another 10 percent. Even if its only 10 percent of the basic ER charge of
$600 if no testing is done. In this case, more than $9,000 worth of testing was
done. Since a pulled muscle will never show up on the $9,000 of sophisticated
tests, it was a diagnosis that could have been rendered at the very beginning
sans tests. The entire visit was pure medical gluttony.
This is always understood by
responsible Americans. Even the socialist should understand it. However, the
socialist has a predicament if the patient ever became responsible. How could
he ever control the patient as a political pawn if the patient became
responsible for his gluttonous behavior?
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Medical Gluttony thrives in Government and Health Insurance Programs.
Gluttony Disappears with Appropriate Deductibles and Co-payments on
Every Service.
* * * * *
6.
Medical
Myths: “It Didn’t
Cost Anything!”
Sarah, a 43-year-old lady,
came in for her second visit and announced that she went to the Emergency Room
since seen last month. When asked, “Why?” she glared “Well I had an emergency
last week.” When asked what did they
find wrong with her? She replied that they had found a tender breastbone in her
chest. But they did dozens of tests including CT scans and MRI and she was
pleased to find out that everything else was just fine.
When asked whether she
thought the rather large expenditure in tests was justified, she replied, “It
didn’t cost me anything. I’m on
MediCal.”
And so the Medical Myth
continues. Someone else, the taxpayers in this case, picked up the tab. The
patient felt no pain. The patient felt no responsibility. The patient was
unable to understand the costs.
And patients will never
understand the costs and thus be able to contain costs unless they have a
percentage co-payment. This is the single most important item in health care
reform—patient responsibility through a percentage share of cost. Even if only
ten percent. Someone in that family will help her figure it out. And that
someone who is paying her ten percent will make sure s/he never will have to
pay another 10 percent. Even if its only 10 percent of the basic ER charge of
$600 if no testing is done. Since costochondritis will never show up on the
$9,000 of sophisticated tests, it was a diagnosis that could have been rendered
at the very beginning sans tests.
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Medical Myths Originate When Someone Else Pays The Medical Bills.
Myths Disappear When Patients Pay Appropriate Deductibles and
Co-Payments on Every Service.
* * * * *
7.
Overheard
in the Medical Staff Lounge: Is Texas
Governor Perry Presidential?
Dr. Rosen: During the past month, we
have pilloried Gingrich and Romney. Meanwhile the Governor of Texas may have
joined the race after the most powerful person on the candidate’s team, his
wife, told him the next election was so crucial, that he has to run.
Dr. Edwards: That would be a breath of fresh air.
Dr. Milton: I would have to agree with that. He looks so
presidential.
Dr. Dave: I
think he also looks very Reaganesque.
Dr. Dave: He looks like someone who will make all the Generals
of the World take notice if he became the Commander-in-Chief of the USA.
Dr. Sam: I think he looks like the first Constitutionalist that
could win and also save our country from going backwards 200+ years in one
administration.
Dr. Kaleb: I think he would also gain the respect of the
Mid-East.
Dr. Rosen: Do you think he could straighten out the 20 Arab
States?
Dr. Dave: Yes, I think he would make them tremble.
Dr. Ruth: What about the downtrodden women in the Middle East?
Dr. Dave: He could be a great boon to women’s rights. Can you
imagine a Texan’s reaction if his wife couldn’t drive his car in Saudi?
Dr. Rosen: Such things will come about gradually; but it will
take a sledgehammer to drive the initial point home, such as a woman heading a
motorcade.
Dr. Kaleb: I think the women would come out of their huts and
out from behind their burqas.
Dr. Rosen: There’s a ground swell of women in France, New South
Wales and other Muslim enclaves in states the world
over where if they refuse to remove their veils for police, they will face
jail.
Dr.
Kaleb: That will really
add momentum to the movement.
Dr.
Rosen: I think we’d begin
to see a lot of good things happening if we had a strong leader restoring
freedom in the world’s greatest democracy.
Dr.
Milton: Let’s just hope
that Governor Perry will run. Anybody have a lead into his wife’s circle who
could provide more influence?
Dr.
Edwards: I think Governor
Perry could be the third greatest president right along with George Washington
and Abraham Lincoln.
Dr.
Michelle: I’m already
feeling more optimistic about our future.
Dr.
Milton: Paul Johnson, the
British Columnist in Forbes, stated recently in his monthly column that America
is crying for strong leadership.
Dr.
Edwards: I think Governor
Perry could answer that cry.
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The Staff Lounge Is Where Unfiltered Medical Opinions Are Heard.
* * * * *
8.
Voices of
Medicine: A Review of Local and Regional Practice Experiences
Thomas W. LaGrelius MD, FAAFPAs a concierge doctor in Torrance, CA and past president of AAPP, as well as a good friend of Dr. Martin Schulman, I certainly enjoyed reading your May 11 San Diego Union Tribune article on concierge medicine. One of my patients brought it in for me today. It was excellent. Thank you. We are seeing almost daily examples of such positive reporting on our mode of practice. See link:http://signonsandiego.printthis.clickability.comA couple things you should know that were not touched on in the article. As well as saving lives and improving care, concierge medicine is saving money and increasing the access to primary care doctors, not the other way around as some of its critics claim. Here's how. Our patients have been shown in studies done for example by Qliance in Seattle and MDVIP in Florida to consume 4-8 times as much primary care doctor time, but to visit the ERs 65% less, see consultant physicians 50% less, be hospitalized 25% less, have 35% fewer hospital days and consume 50-95% less prescription drugs. These latter are very costly medical services compared to concierge primary care. The minor cost of having a concierge doctor is therefore proven to be many times offset by the savings at the secondary care level. Many former critics of concierge medicine, who are often as concerned about cost savings as they are about quality of care, are therefore now starting to ask how we can do this for everyone!As to increased access, I for example am 68 years old, but I come from a long line of Swedes who stay well and can work till they are 90. I plan to practice till I am at least 80. I could easily afford to retire and would have done so already had I not converted my practice to concierge in 2005-6. I care for about 600 patients in a very detailed manner. Most are geriatric, since I am a geriatrician, and they have more complex, difficult problems than average as do the patients of most concierge doctors. Concierge medicine is thus preserving senior doctors like me in practice for decades longer, caring for the sickest members of our society. This would be impossible in the insurance based "hamster wheel" style we used to practice. If you come to an AAPP meeting (the next one is in New York in October) you will find happy doctors, a rarity in the rest of the profession where doctors are leaving practice in their 50s and doing anything they can to get out of clinical medicine. Thus concierge medicine is INCREASING access to primary care while the insurance system we are escaping from is drastically cutting that access. It is the insurance based system of primary care the critics should be attacking since primary care is not an insurable event, but a low cost relationship easily destroyed by third party interference and price fixing.Furthermore, until a few years ago 50% of medical students entered a primary care pathway after medical school. In recent years that percentage has fallen to 8%. I give talks occasionally (I'd love to give more) at medical schools to students who want to do primary care but believe it is impossible to do so in the current insurance based system that forces them to see too many patients and never do hospital care, degrading them to little more than triage nurses. Seeing what concierge doctors do inspires them and for the first time in years they have hope. This year there has been a slight up-tic in students entering primary care pathways. This also is INCREASING access to primary care. We hope as the model advances that this small up-tic becomes a flood. . . Thomas W. LaGrelius MD, FAAFPDiplomate of the American Board of Family Practice and Geriatric MedicineSkypark Preferred Family Care, a Concierge primary care medical practiceTorrance, CA 90505shttp://www.skyparkpfc.comPresident, Los Angeles County Medical Association Southwest DistrictChair Emeritus, Founder and VP, INDOC http://www.indoc.com 310-214-9921Director, Past Board Chair and Past President, AAPP the national concierge doctors professional society http://www.aapp.org 877-746-7301Director, Secretary and Past President, SBIP http://www.sbipmedicalgroup.com 310-534-8805
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VOM
Is an Insider's View of What Doctors are Thinking, Saying and Writing about.
* * * * *
9.
Book
Review: The Rising Tide: The danger in failing to recognize the
storms
Turning the Tide By Charles F. Stanley
In His Own Words
Over the years,
I have been privileged to see and walk along some of the most magnificent
beaches in the world. Not long ago, I was at a Hawaiian seashore known for its
tremendous waves—ones worthy of surfing excursions—and I was acutely aware of
the rise and fall of the tides.
On several
occasions in the past, this particular coastline has had waves that rose more
than twenty feet high. A man at the hotel called those times “an extreme
surfer’s paradise.”
While the
unfurling and crashing of breakers of that magnitude may excite avid surfers,
the rest of us may be frightened by such an overpowering crush of
water—fantastic to look at, perhaps, but only from a distance.
As I gazed out
at the ocean, knowing the potential danger for great waves, my thoughts turned
to the painful reality of the tsunami that crashed into Southeast Asia in 2004.
The devastation in terms of lives and property loss was enormous.
I then began to
think about the riptides that can periodically make a beach too dangerous for
swimming. Although these tides can be identified by lifeguards and experts as
they watch from elevated perches, they are not as easily recognized by
beachgoers on the shore or those already in the water. Once an innocent swimmer
has been caught in the clutches of such a powerful current, escape is extremely
difficult. Rescue is often perilous for those who seek to help. Death is
frequently the result.
I considered
the rising floodwaters that have devastated many areas in our nation. We live
in an age where it is not at all unusual to hear a newscaster report, “Nothing
of this magnitude has ever been experienced here before.”
I asked myself,
What makes tides go from beautiful to dangerous? What causes the sea to
swell and produce a wave that washes away beaches and cities? What creates
those waves?
The answer in
many cases is storms.
Some of the
squalls pound on the surface of the waters, while others occur far away,
causing a ripple effect throughout the ocean.
Some tempests
involve fierce winds, and others, a seemingly endless amount of heavy rain.
Regardless of
how these whirlwinds and downpours occur or where
they originate, they cause seismic shifts in the waters—and the tides rise with
immensely destructive power.
These
observations of nature started me thinking about the issues that I will discuss
in this book—tempests which occur in our nation and also in our personal lives.
These storms don’t necessarily have anything to do with the weather. They are
situations in our lives that devastate us just like a category five hurricane
that ravages a coastal village. They may arise due to our finances, a broken
relationship, a lost job, a crippling illness, or any number of distressing
circumstances. The dark, threatening clouds roll in—large, turbulent, and
overwhelming. They destroy our peace and security, and we cannot escape their
fury. We don’t know what to do or where to go,
I am convinced
that our country is facing just such a storm. We are experiencing a
destructive, man-made tide, that is deteriorating our country at a frightening
pace. And as an American citizen, father, grandfather, and preacher of the
Word, I feel the responsibility to speak up about the issues in our country and
in our personal lives that require our attention and intercession as believers.
The storms of
life cause tides to mount up—even to the point of overwhelming us with tragedy,
turmoil, and deeply-rooted fears.
We experience
catastrophic times not just natural, everyday problems, but also man-made
disasters. Sadly, if we don’t come to grip with our crises and learn how to
manage effectively through them, we will continue to find ourselves in
increasingly desperate times.
Just as our
personal tempests can devastate our lives if we do not respond to them
correctly, cataclysmic storms can drastically affect our nation as well. So
after my experience on that Hawaiian beach, I sat down to make a list of the
storms our country is currently undergoing. I came up
with twenty concerns that I truly believe warrant prayer and godly
action….
This book introduction in the
author’s own words is found at . . .
Visit www.intouch.org/turningthetide
for more
information and free tools.
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The
Book Review Section Is an Insider’s View of What Doctors are Reading about.
* * * * *
10. Hippocrates & His Kin: A Short History
of Political Suicide
SNAP hasn’t put a dent in poverty or hunger
Nearly 21 million households
are now reliant on the Department of Agriculture’s Supplemental Nutrition
Assistance Program (SNAP).
The program cost taxpayers
over $68 billion last year, twice as much as in 2007, and accounts for 67
percent of the USDA’s total budget, compared to 26 percent in 1980. . .
Critics complain that SNAP
hasn’t put a dent in poverty or hunger while taking away funds from other
efforts that should be the main focus of the USDA, specifically agricultural
programs, according to ABC News.
Has anyone heard of a federal program outside
of the Military and State Dept that works?
A
Short History of Political Suicide – John Steele Gordon, WSJ, Thurs June 9,
2011
As the late historian
Stephen Ambrose once explained on PBS’s “NewsHour” about the Clinton-Lewinsky
scandal, “God created man with a penis and a brain and gave him only enough
blood to run one at a time.”
With the Weiner’s Sex Pictures sent over the
Internet, why haven’t we come across his Wiener yet?
Question: When will patients be concerned about spending $8K to $10K in the
Emergency Room, finding nothing, and feeling good about it?
Answer: When they will have a 20% co-payment on ER costs and finally figure out
the $1600 or $2000 co-pay out of their own pocket will make the expense of $8K
to $10K of taxpayers money seem like real theft? Or Fraud? Or Embezzlement of
taxpayers or premium payers’ money for personal benefit?
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Hippocrates
and His Kin / Hippocrates Modern Colleagues
The Challenges of Yesteryear, Yesterday, Today & Tomorrow
* * * * *
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.
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.
ReflectiveMedical Information Systems (RMIS), delivering information that empowers
patients, is a new venture by Dr. Gibson, and his research group which will go
far in making health care costs transparent. This site provides access to information related to medical costs as an
informational and educational service to users of the website. This site
contains general information regarding the historical, estimates, actual and
Medicare range of amounts paid to providers and billed by providers to treat
the procedures listed. These amounts were calculated based on actual claims
paid. These amounts are not estimates of costs that may be incurred in the
future. Although national or regional representations and estimates may be
displayed, data from certain areas may not be included. You may want to follow this development at www.ReflectiveMedical.com.
Congratulations to Dr. Gibson and staff for being at the cutting edge of
healthcare reform with transparency.
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: ?. Don't miss
the "AAPS News," written by Jane Orient, MD, and archived on
this site which provides valuable information on a monthly basis. This month,
be sure to read ? . 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 by Gertrude Himmelfarb (1922-
Professor emeritus of history at the Graduate School of the City
University of New York, a fellow of the British Academy, the Royal Historical
Society, the American Philosophical Society, and the American Academy of Arts
and Science. A prolific author in the history of ideas.
With the rise of
communism and Nazism, many liberals, normally inclined to a moderate,
pluralistic, pragmatic view of liberty, were persuaded that the only security
against an absolutistic regime was an absolute principle of liberty. . .
Against absolute despotism the only adequate response seemed to be absolute
liberty.
This was—and still
is—the psychological basis of the “slippery slope” argument. . . This is the
argument used by liberals in support of government subsidies for such “art” as
the photograph of a crucifix submerged in urine. . . Yet the same liberals who advocate the
largest freedom for artists (including the freedom to be subsidized) also tend
to support in the name of the same freedom, the strictest separation of church
and state—with the curious result that the photograph of a crucifix immersed in
urine can be exhibited in a public school, but a crucifix not immersed in urine
cannot be exhibited. On Looking into
the Abyss, 1994
Some Recent
Postings
In The May 10 Issue: