|
MEDICAL TUESDAY . |
NEWSLETTER |
|
Community For Better Health Care |
Vol X, No 24, Mar
27, 2012 |
In This Issue:
1.
Featured Article:
Politicized clinical
medicine spins down to a zero sum budget reality.
2.
In
the News: How California's Colleges
Indoctrinate Students
3.
International Medicine: Why does
politics always interfere with health care?
4.
Medicare: Sutter Health
estimates they will lose $2 billion in Medicare Reimbursements
5.
Medical Gluttony:
Cruel and Unusual
Punishment
6.
Medical Myths: The Myths of Solar
Energy
7.
Overheard in the Medical Lounge: Are we any
further along in the November elections?
8.
Voices
of Medicine: Hard Truths About
Life & Death Choices in My Own Family
9.
The Bookshelf: The Righteous Mind – Why
Good People are Divided by Politics and Religion
10.
Hippocrates
& His Kin: Inconvenient
Truths
11.
Related Organizations: Restoring
Accountability in Medical Practice and Society
Words of Wisdom,
Recent Postings, In Memoriam, Today in History . . .
* * * * *
Congratulations to Dr. David
Gibson, writer of our featured article last week for making the first and
second listing on the Google search engine for his topic: The Affordable Care Act will not survive
November 6, 2012 for two weeks running at this time.
* * * * *
1.
Featured
Article: Politicized clinical medicine spins down to
a zero sum budget reality.
David
Gibson, MD, Director,
Clearway Health Solutions
I believe you will find the following discussion along
with the attached to be informative. It is an internal discussion
relating to the promised efficacy of EMRs. Another PPACA shibboleth is
exposed. Medical homes, ASOs, Medicare Acute Care Episodes (ACE) will
soon follow. Read
more . . .
At the risk of
sounding like a curmudgeon, which I am, the conclusions from this study far
under-state the magnitude of the problem being created. Here are my
observations:
1.
Clinical medicine falls far short of its stated goal to be empiricist based
applied science. Time after time we have witnessed untested fads
relating to diagnostic and therapeutic modalities unleashed into the clinical
environment. Over time, these “cutting-edge” modalities have been found
to not only misappropriate limited funding but in many instances lead to injury
of the patient.
2.
We are now awash in unproven, expensive assumptions relating to
projected improvement in clinical outcomes that have been proven to be
unfounded (see attached). Here is reality - population application of
screening tests and early diagnosis primarily drives inflation rather than
improving outcomes. Screening the apparently healthy potentially
saves a few lives (although the National Cancer Institute couldn’t find any
evidence for this in its recent large studies of prostate and
ovarian cancer screening). The truth is, the fastest way to get heart
disease, autism, glaucoma, diabetes, vascular problems, osteoporosis or cancer
... is to be screened for it. In other words, the problem is over diagnosis and
overtreatment.
3.
The use of the clinical environment for political purposes is appalling. The
Democrats sold PPACA as a cost saving initiative. One of the major
underpinnings of that absurd predicate involved electronic medical record
deployment. Now, after passage and early deployment of EMRs, the reality
is apparent - Physicians’ access to computerized imaging results was associated with a
40–70 percent greater likelihood of an imaging test being ordered (see
attached). The remaining shibboleths within the PPACA sales mantra –
medical homes, accountable care organizations, evidence based medicine (with
untested evidence), and on, and on, and on - will all over the short period
likely prove to be wrong as well. Unfortunately, rather than go back and
reassess these black pearls, the deployed entitlement is un-correctable.
4.
Furthermore,
there is no empiric evidence that EMRs improve clinical outcomes for patients. In fact, EMRs reduce
the reliability of information transfer among practicing physicians. How?
Macros. The primary purpose for EMRs is not to improve care but
improve documentation, particularly for reimbursement up-coding. Macros
are easily inserted into the clinical record and document the components
required for an up-coded CPT. Unfortunately, when this occurs, all other
physicians having access to the record recognize the macro and discount the
clinical reliability of the information. The result, lengthy clinic notes
with discounted reliability.
5.
EMRs do not improve efficiency. The reality on the ground is that
these clinically deployed information systems do not communicate with each
other. Thus, the doctor’s EMR does not communicate with the
hospital. The hospital’s EMR does not communicate with other hospitals.
Etc., etc., etc. (see attached).
Politicized clinical medicine, like all other
entitlement benefits, inevitably spins down to a zero sum budget reality.
Larding up the delivery system with accumulated untested fads inevitably leads
to rationing access to effective therapy. As a curmudgeon, I find all of
this to be profoundly depressing.
David J. Gibson, M.D. Director, Clearway
Health Solutions
916.993.3162 v / 916.359.4267 f / davidjgibson@reflectivemedical.com
Digital Records May Not Cut Health Costs, Study Cautions
By STEVE LOHR
Published: March 5, 2012
Computerized patient records are unlikely to
cut health care costs and may actually encourage doctors to order expensive
tests more often, a study published on Monday concludes.
Industry experts have said that
electronic health records could generate huge savings — as much as $80 billion
a year, according to a RAND Corporation estimate. The promise of cost savings
has been a major justification for billions of dollars in federal spending to
encourage doctors to embrace digital health records.
A new study found that doctors
with computerized records are more likely to order tests. The study is another
piece of evidence, among many, in the debate surrounding electronic health
records. But that debate is really about the best way to adopt the technology,
and at what pace -- not whether moving from the paper records to the computer
age makes sense.
Read More at the NY Times March 06, 2012
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* * * * *
2.
In the News: How California's
Colleges Indoctrinate Students
A new report on the
UC system documents the plague of politicized classrooms. The problem is
national in scope.
OPINION | WSJ | March 30, 2012,
The
politicization of higher education by activist professors and compliant
university administrators deprives students of the opportunity to acquire
knowledge and refine their minds. It also erodes the nation's civic cohesion
and its ability to preserve the institutions that undergird democracy in
America. Read more . . .
So argues
"A Crisis of Competence: The Corrupting Effect of Political Activism in
the University of California," a new report by the California Association
of Scholars, a division of the National Association of Scholars (NAS). The
report is addressed to the Regents of the University of California, which has
ultimate responsibility for governing the UC system, but the pathologies it
diagnoses prevail throughout the country.
The analysis
begins from a nonpolitical fact: Numerous studies of both the UC system and of
higher education nationwide demonstrate that students who graduate from college
are increasingly ignorant of history and literature. They are unfamiliar with
the principles of American constitutional government. And they are bereft of
the skills necessary to comprehend serious books and effectively marshal
evidence and argument in written work.
This decline
in the quality of education coincides with a profound transformation of the
college curriculum. None of the nine general campuses in the UC system requires
students to study the history and institutions of the United States. None
requires students to study Western civilization, and on seven of the nine UC
campuses, including Berkeley, a survey course in Western civilization is not
even offered. In several English departments one can graduate without taking a
course in Shakespeare. In many political science departments majors need not
take a course in American politics.
Moreover, the
evidence suggests that the hollowing of the curriculum stems from too many
professors' preference for promoting a partisan political agenda. . .
While
political affiliation alone need not carry classroom implications, the
overwhelmingly left-leaning faculty openly declare the inculcation of
progressive political ideas their pedagogical priority. As "A Crisis of
Competence" notes, "a recent study by UCLA's prestigious Higher
Education Research Institute found that more faculty now believe that they
should teach their students to be agents of social change than believe that it
is important to teach them the classics of Western civilization." . . .
Even the
august American Association of University Professors—which in 1915 and 1940
published classic statements explaining that the aim of academic freedom was
not to indoctrinate but to equip students to think for themselves—has sided
with the politicized professoriate. . .
In California,
this is more than a failure of their duty as educators. It is also a violation
of the law. Article IX, Section 9, of the California state constitution
provides that "The university shall be entirely independent of all
political or sectarian influence and kept free therefrom."
It is
incumbent upon the UC Board of Regents, not to mention the governing bodies of
other institutions of higher education across the country, to begin the long
and arduous work of depoliticizing our universities and renewing liberal
education.
Mr. Berkowitz is a
senior fellow at Stanford University's Hoover Institution and a member of the
National Association of Scholars board of directors. "A Crisis of
Competence" is posted at www.nas.org/images/documents/A_Crisis_of_Competence.pdf.
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* * * * *
3.
International
Medicine: Why does
politics always interfere with health care?
The
Health Secretary, Andrew Lansley’s bill to reform the NHS was heavily
criticised in the Commons
Medical
professionals must now be allowed to look after the sick . . . without
political interference.
Now make the NHS work
The debate in
the Commons yesterday that preceded the final parliamentary stages of the
ill-starred Health and Social Care Bill was the shape of things to come.
Labour’s spokesman, Andy Burnham, said that the NHS was being “broken apart
after 63 years”. Opposition MPs queued up to tell how their sick constituents
were filled with foreboding about their future care. To call this a caricature
of the Coalition’s health reforms is pointless, because the Government has only
itself to blame for giving Labour the opportunity to misrepresent them in this
way. Many of the changes – including greater competition and private sector
involvement in the NHS – could have been carried forward on the basis of
legislation passed by the last government.
Read
more . . .
This has been an
object lesson in how not to reform a venerated public service that needs an
overhaul, but whose talismanic quality gives it the untouchability of a sacred
cow. By introducing legislation when, arguably, none was needed – and certainly
was never expected – the Government has allowed the NHS yet again to be kicked
around like a political football. Once David Cameron and Nick Clegg had
resolved to proceed with the Bill there was no going back. But they have
squandered so much political capital in getting it through Parliament that
other social reforms will be harder to achieve.
We would like to
think that doctors, nurses and other health workers will now be allowed to get
on with the job of looking after the sick and infirm, free from political
interference and bickering. Judging by the way Labour conducted yesterday’s
debate, this is a forlorn hope. The test now is whether the NHS will be better
or worse. If better, Labour will owe ministers an apology for their
scaremongering; if worse, then the Tories and Lib Dems will pay a heavy
electoral price. . .
http://www.telegraph.co.uk/comment/telegraph-view/9155682/Now-make-the-NHS-work.html
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If Government
HealthCare has the Untouchability of a Sacred Cow,
Can it ever
be reformed?
* * * * *
4.
Medicare: Sutter Health
estimates they will lose $2 billion in Medicare Reimbursements
Sutter revenue up, profits down
By Darrell Smith | dvsmith@sacbee.com |
Mar. 24, 2012 | Page 6B
Sacramento-based
Sutter Health saw total income fall in 2011 by more than $240 million compared
to 2010, the health network reported Friday. Read more . . . .
Total income was $634
million in 2011, down from $878 million in 2010. Revenues were $9.1 billion, up
from $8.8 billion in 2010.
Sutter Health
President and CEO Pat Fry said there were a variety of reasons that income was
down. He cited state-mandated earthquake retrofit requirements, investments in
electronic health records
and other technologies, and continued reductions in federal Medicare payments and the
amounts health plans and employers pay.
"At the same time
the needs of our communities are growing, meeting our financial goals is
becoming more difficult," Fry said in a statement.
Sutter Health
officials estimate that the health network will lose $2 billion in Medicare
reimbursements over the next 10 years under new health care rules.
Meanwhile, the network
expects to spend more than $2.5 billion on earthquake-safety projects at five
of its hospitals in the Bay Area
and Sacramento; and an additional $1.8 billion on projects at its San Francisco
hospitals.
Capital spending on
electronic health records
and other technologies added up to nearly $900 million in 2011. . .
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Government is not the solution to our
problems, government is the problem.
- Ronald Reagan
* * * * *
5.
Medical Gluttony:
Cruel and Unusual
Punishment
Mark Steyn writing March 30 in the Orange County
Register:
"What happened
to the Eighth Amendment?" sighed Justice Scalia the other day. That's the
bit about cruel and unusual punishment. "You really want us to go through
these 2,700 pages? Or do you expect us to give this function to our law
clerks?" Read
more . . .
He was making
a narrow argument about "severability"—about whether the court could
junk the "individual mandate" but pick and choose what bits of
Obamacare to keep. Yet he was unintentionally making a far more basic point: A
2,700-page law is not a "law" by any civilized understanding of the
term. Law rests on the principle of equality before it. When a bill is 2,700
pages, there's no equality: Instead, there's a hierarchy of privilege
microregulated by an unelected, unaccountable, unconstrained, unknown and
unnumbered bureaucracy. It's not just that the legislators who legislate it
don't know what's in it, nor that the citizens on the receiving end can ever
hope to understand it, but that even the nation's most eminent judges
acknowledge that it is beyond individual human comprehension. A 2,700-page law
is, by definition, an affront to self-government.
If the
Supreme Court really wished to perform a service, it would declare that
henceforth no law can be longer than, say, 27
pages . . .
California’s $500 million boondoggle--
Court Case Management System - CCMS
The plug has
been pulled on one of the biggest boondoggles in California history—the effort
to build a $2 Billion computer system linking the state’s 58 county courts. It
never worked, and some say it was doomed from the start. . .
Faced with mounting criticism from judges and legislators, the state Judicial
council finally voted Tuesday to kill the out-of-control program. But not
before spending more than $500 million trying to launce it. –Matier & Ross,
SF Chronicle, CCMS.
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Medical Gluttony thrives in Government Programs.
Gluttony disappears with private responsibility on every program.
* * * * *
6.
Myths: The Myths of Solar
Energy
Notable & Quotable, WSJ, FEBRUARY 17, 2012
Bjørn Lomborg on the failure of
Germany's solar-power subsidies
Germany once prided itself on being the
"photovoltaic world champion," doling out generous subsidies—totaling
more than $130 billion, according to research from Germany's Ruhr University—to
citizens to invest in solar energy. But now the German government is vowing to
cut the subsidies sooner than planned, and to phase out support over the next
five years. What went wrong? Read more . . .
There is a
fundamental problem with subsidizing inefficient green technology: it is
affordable only if it is done in tiny, tokenistic amounts. Using the government's
generous subsidies, Germans installed 7.5 gigawatts of photovoltaic (PV)
capacity last year, more than double what the government had deemed
"acceptable." It is estimated that this increase alone will lead to a
$260 hike in the average consumer's annual power bill.
According to
Der Spiegel, even members of Chancellor Angela Merkel's staff are now
describing the policy as a massive money pit. Philipp Rösler, Germany's
minister of economics and technology, has called the spiraling solar subsidies
a "threat to the economy." . . .
Solar power
is at least four times more costly than energy produced by fossil fuels. It
also has the distinct disadvantage of not working at night, when much
electricity is consumed.
In the words of the German Association of
Physicists, "solar energy cannot replace any additional power
plants." On short, overcast winter days, Germany's 1.1 million solar-power
systems can generate no electricity at all. The country is then forced to
import considerable amounts of electricity from nuclear power plants in France
and the Czech Republic. When the sun failed to shine last winter, one emergency
back-up plan powered up an Austrian oil-fired plant to fill the supply gap.
http://online.wsj.com/article/SB10001424052970204880404577229730508494946.html?KEYWORDS=notable++quotable
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Myths Originate When Someone Else Pays The Bills.
Myths Disappear When Industry makes the first payment on every Service.
* * * * *
7.
Overheard
in the Medical Staff Lounge: Are we any
further along in the November elections?
Dr. Rosen: Well, are
we in the final form for the November Elections?
Dr. Edwards: It’s not the
way some of us would have hoped. Although, I think we all have to agree that
Santorum, with his high moralistic point of view came further than any of us
expected.
Dr. Milton: But was he
effective in defining the course of the elections? Will the Republicans now
take the high road? Will Romney take the high road?
Dr. Rosen: We still
haven’t heard Mitt Romney admit that his Massachusetts health plan, or “Obama Light,”
was a mistake. Until he does that, I don’t think we can trust him. Read more . . .
Dr. Dave: You’re
right, Rosen, until he does that I won’t vote for him.
Dr. Paul: That’s
fine with me. We Obama light fans will take all the support we can get. The
less opposition support from the Conservatives, the better our chances of
keeping Obama and Obama Care.
Dr. Ruth: So this
week, Rosen, you’re indicating you might change your mind if Romney changes his
tune when last week you said it wouldn’t make any difference.
Dr. Rosen: But it’s a
different orchestra now. The horn section has one and possibly two less
players. At this point in time, not voting will give Obama a greater majority.
Dr. Michelle: Although, he’s
playing the woman’s card like he played the black card in the last election. I
think there is a great difference, especially for us professional women.
Dr. Ruth: Just like
I don’t think the Democrats can put all the Blacks in the liberal soup, they
certainly can’t put us women into that down trodden class.
Dr. Paul: Don’t
you think it’s the Republicans that are putting all women into their survival
mode?
Dr. Michelle: Women are not
in a survival mode at this time because of any politician. We will come out
best with freedom to choose our profession, our jobs, and our children. No one will
be able to take that choice away from us by playing the religious card either.
Dr. Ruth: As a
Catholic, the absence of birth control pills has no effect on any professional
woman. We don’t need to put that minimal cost on the taxpayer’s or rate holder’s
responsibility because of lack of coverage. If President Obama thinks he can
sway us with a $25 cost for BC pills, then he doesn’t understand the first
element of health care coverage: individual responsibility.
Dr. Dave: Of course
we already knew he doesn’t understand health care, much less how to pay for it.
Dr. Rosen: Romney didn’t
even understand one department, the Emergency Department, which he tried to fix
in Massachusetts. But he hasn’t and he can’t. This just indicates his standard
response to a question is, “Just tell me the problem and I’ll fix it,” is not
reality.
Dr. Milton: Until he
admits that Massachusetts was a mistake and he has learned from it, I will not
vote for him. Otherwise, he’s as bad as Obama.
Dr. Edwards: I’ll second
that motion.
Dr. Dave: I agree.
And he better do it fast, otherwise we’ll know that his apology was not
serious.
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The Staff Lounge Is Where Unfiltered Medical Opinions Are Heard.
* * * * *
8.
Voices of
Medicine: A Review of Regional Medical Journals
Sonoma Medicine | Volume
63, Number 2 | Spring 2012
|
TESTIMONIAL: Hard Truths About
Life & Death Choices in My Own Family |
By Thelma Escobar
This is Angel. He is now 8 years old, and he is a very happy child. Now
please look at this picture and imagine that this is your own child, nephew,
cousin, niece, grandchild, or a child you know and love. You will do anything
to keep this child healthy, safe and happy. See Angel’s Photo:
This is my story. Read more . . .
When Angel turned 3 years old, he started to gain weight. I took him to
the doctor for his check-up. The doctor told me the weight was not a problem
because Angel was growing and he was going to catch up on it and not to worry.
Two years went by. Angel was now 5 years old. He weighed 120 pounds and
his weight was going up and up. I changed doctors. This time the doctor paid
attention to the weight gain. He suggested we eat more fruits and vegetables in
our diet, and he referred me to the weight assessment clinic at the UCSF
Benioff Children’s Hospital in San Francisco. It took me 2 years from the time
of that referral to get my first visit in 2010.
On the day of our first appointment, Angel was not allowed to eat
anything before the appointment. We drove to San Francisco. We sat in the
waiting room talking and thinking about what the doctor was going to say to us.
The clinic staff talked to us about foods that are rich in fiber and how to eat
small portions 5 times a day and to eat lots of fruits and vegetables and to
drink lots of water. Then we went to the lab, where they did blood tests on
Angel. After that we moved to a big gymnasium with many other children, where
the staff played games like soccer, basketball, rope jumping, and other games
that kept the children moving around, sweating a lot and breathing fast. Staff
told us that getting exercise doesn’t take more than 20 minutes, two to four
times a day and that this was important.
Then we were finally called in to see Dr. Robert Lustig, a pediatric
endocrinologist. He asked us about our daily life, what foods did we eat at
home, how many times did we eat out, what did we drink. I answered that we eat
fruits, vegetables, rice, beans, tortillas; that we drink apple juice and
orange juice and that I add water to the juice as recommended by WIC to make it
less sweet.
The doctor then asked how many times a week I cook at home and eat out.
I said I cook 2 to 3 times a week and I buy fast food 2 to 3 times a week for
dinner with soda. On weekends we have family gatherings and we eat cookies and
cakes and other foods.
The doctor then looked at me and said, “I have the results of the blood
test; your son’s pancreas is making too much insulin. This is called acanthosis. He is very close to being a type-2
diabetic.”
He waited for that information to register in me, then he asked, “Do
you want that for him? If you continue feeding Angel as you have done, and
allow him to drink juice and sodas and eat fast food and junk food, then he is
going to gain more weight and get lots of respiratory infections and get sicker
every year.”
Then the doctor said, “By the age of 25 or 26, he will be dead.” . . .
“If you want to get help from
the clinic,” he continued, “you must agree to change. If you choose not to make
the changes and continue your lifestyle, don’t come back.” . . .
I am pleased to be able to share my story with you, the story about my
son Angel, and how he is fighting with his weight and how hard it is for him to
say no to all the unhealthy foods that are around him. But we are making
progress, and I am working with him and the people around him to help him make
the life-and-death choices the doctor spoke to us about, the healthy choices
for a long life.
Ms.
Escobar is a health advisor for Healthier Children, a nonprofit organization in
Marin County. She presented this testimonial at the Latino Health Forum in
Santa Rosa last October.
Email: Thelma_E@yahoo.com
Read the rest of this heart rending story on Sonoma Medicine,
Steve Osborn, Editor.
Sonoma Medicine recently won a first-place award in a publications
competition sponsored by the Northern California chapters of the Society for
Technical Communication, the world’s largest organization of technical writers
and designers. Beating out dozens of entries from Autodesk, Oracle and other
high-tech giants, the magazine earned high praise from the judges, who noted
that it “provides a great read in any medical waiting room,” and that it has “a
professional yet friendly feel.”
On the strength of its first-place award, the magazine
has been entered into the international STC competition, to be held in Chicago
in May.
Congratulations
to Steve Osborn.
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VOM
Is an Insider's View of What Doctors are Thinking, Saying and Writing about.
* * * * *
9.
Book
Review: The Righteous
Mind – Why Good People are Divided by Politics and Religion
By Jonathan Haidt
BOOKSHELF
| WSJ
| March 18, 2012 | Conflicting Moralities | By GARY ROSEN
The work of Jonathan
Haidt often infuriates his fellow liberals. A professor of psychology at the
University of Virginia, he has focused in recent years on trying to understand
the range and variety of our moral intuitions, especially as they relate to the
most polarizing issues of the day. What he sees across the dividing line of
American politics is a battle of unequals: Republicans who "understand
moral psychology" arrayed against Democrats who "don't." Read more . . .
Mr. Haidt is not simply
parroting the familiar charge that the party of Lee Atwater and Karl Rove is
more adept at the dark arts of political manipulation. He means something far
more shocking to liberal sensibilities: that conservatives possess "a
broader set of moral tastes" and are able, in appealing to the public, to
tap a richer moral lexicon.
But don't mistake
"The Righteous Mind" for yet another guide to how liberals can revive
their rhetoric and electoral appeal. Mr. Haidt is not a partisan with an
agenda. He is a social scientist who appreciates America's tribalism, our
"groupishness." He worries, though, that our divisions are hardening
into mutual incomprehension and dysfunction. His practical aim is modest: not
to bridge the divide between left and right, atheist and believer, cosmopolite
and patriot, but to make Americans, in all their diversity, more intelligible
to one another.
Mr. Haidt describes at
length the fascinating research that he and his colleagues have carried out
through a website called YourMorals.org. The site asks visitors to state their
political and religious preferences and then poses a range of questions meant
to elicit a moral response. Participants might be asked, for example, if they
agree or disagree with such statements as: "One of the worst things a
person can do is to hurt a defenseless animal"; or, "It is more
important to be a team player than to express oneself"; or, "In the
teenage years, parental advice should be heeded."
More than 130,000
subjects (as of 2011) have provided answers, which have been categorized
according to the "moral foundations" that Mr. Haidt and his
collaborators consider the best candidates for "universal cognitive
modules"—that is, the intuitive ideas that all cultures draw upon for
their ethical norms. These moral foundations fall under six broad headings:
care, fairness, liberty, loyalty, authority and sanctity. . .
He recognizes that his
"functionalist" account of morality and religion will leave many
people cold. It does not get us very far in figuring out how, precisely, we
should live. But it does provide a way to accept and understand the moral
pluralism in the world around us—and to do so without surrendering to simple
relativism.
Mr. Haidt's approach has
the added virtue of encouraging a degree of humility in righteous, partisan
minds of every stripe. Even as our rival moralities "bind" us
together, he concludes, we should be aware that they "blind" us too.
Mr. Rosen is the editor of the
Journal's Review section, which appears every weekend.
A version of this article appeared March 19, 2012, on page A15 in some U.S.
editions of The Wall Street Journal, with the headline: Conflicting
Moralities.
This
book review is found at the WSJ – Subscription required. . .
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The
Book Review Section Is an Insider’s View of What Doctors are Reading about.
* * * * *
10. Hippocrates & His Kin: Inconvenient
Truths
An
inconvenient truth for the advocates of higher taxes on America’s rich Read more . . .
While income distribution has become a source of protest and political
debate, any analysis of taxes paid in high tax- and- spend countries shows that
the U.S. has the most progressive income tax system in the world. An
inconvenient truth for the advocates of higher taxes on America’s rich is that
big governments in developed countries are funded not by taxing the rich more
than the U.S. does but by taxing everybody else more. –Phil Gramm and Steve McMillin, WSJ
Declarations
Obama
increasingly comes across as devious and dishonest. What is happening is that
the president is coming across more and more . . . as an operator who’s not
operating in good faith. –Peggy Noonan
To read more HHK
. . .
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read more HMC . . .
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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. 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
•
•
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."
•
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,
•
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.
•
Robert J Cihak, MD, of the Discovery Institute, former president of
the AAPS, wrote an informative Medicine
Men column at NewsMax along with Michael
Arnold Glueck, MD. He now has a new column with Richard Dolinar, MD, worth reading which can be accessed 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. 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 o
f 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,
Recent Postings, In Memoriam, Today in History . . .
Words of Wisdom
Good Humor
and Good Medicine
Hilarity and good humor, a breezy cheerfulness...help
enormously both in the study and in the practice of medicine. To many of a
sombre and sour disposition it is hard to maintain good spirits amid the trials
and tribulations of the day, and yet it is an unpardonable mistake to go about
among patients with a long face." –Sir William Osler, Aequanimitas,
1889
Smile
Let us always meet each
other with a smile—for the smile is the beginning of love. –Mother Teresa
Ancestors
People will not look
forward to posterity who never look backward to their ancestors. –Edmund Burke,
1790.
Some Recent
Postings
In The Last Issue: