MEDICAL TUESDAY .
Community For Better Health Care
Vol X, No 24, Mar 27, 2012
In This Issue:
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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.
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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
916.993.3162 v / 916.359.4267 f / firstname.lastname@example.org
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
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 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. . .
If Government HealthCare has the Untouchability of a Sacred Cow,
Can it ever be reformed?
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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.
Government is not the solution to our problems, government is the problem.
- Ronald Reagan
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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.
Medical Gluttony thrives in Government Programs.
Gluttony disappears with private responsibility on every program.
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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." . . .
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.
Myths Originate When Someone Else Pays The Bills.
Myths Disappear When Industry makes the first payment on every Service.
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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.
The Staff Lounge Is Where Unfiltered Medical Opinions Are Heard.
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Sonoma Medicine | Volume 63, Number 2 | Spring 2012
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.
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.
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.
VOM Is an Insider's View of What Doctors are Thinking, Saying and Writing about.
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By Jonathan Haidt
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.
The Book Review Section Is an Insider’s View of What Doctors are Reading about.
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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
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
and His Kin / Hippocrates Modern Colleagues
The Challenges of Yesteryear, Yesterday, Today & Tomorrow
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• 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.
Richard B Willner,
• 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
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
Let us always meet each other with a smile—for the smile is the beginning of love. –Mother Teresa
People will not look forward to posterity who never look backward to their ancestors. –Edmund Burke, 1790.
Some Recent Postings
In The Last Issue:
The Economist | from the print edition | Mar 24th 2012
DURING his nine decades, Ivan Demjanjuk had several identities. “John” was the longest-lasting. Burly, blue-eyed and with no English, he had fetched up in America in 1952 and eventually made his way to Cleveland, where he worked as a diesel-engine mechanic at the Ford factory in Brook Park. He was there for 30 years. In 1958, to mark his American citizenship, he changed his name to John.
At weekends, a handy man with a spanner, he would get under the hood of neighbours’ cars and mend children’s bikes. His ranch-style house in Seven Hills sat on half an acre, where he proudly grew tomatoes and zucchini. On Sundays he went, with Vera and the three children Lydia, Irene and John junior, to St Vladimir Ukrainian Orthodox Cathedral. He kept himself to himself, worked hard, and never made trouble for anyone.
From 1977 to 1993, however, he became Ivan the Terrible, who had roamed the concentration camp at Treblinka in Poland with a whip, or a sword, in his big mechanic’s hands. As the naked Jews ran shivering from the trains to the gas chambers he would slash off an ear, rip open a belly, or flog them til they fell. He drilled the anus of one man with an auger, and shoved the face of another hard into barbed wire. An expert on engines, he had operated the diesels that pumped out carbon monoxide to kill 870,000 people.
At his trial in Israel—only the second war-crimes trial held there, after Eichmann’s—several witnesses from Treblinka recognised John as Ivan: strong, boss-like, with his cold blue eyes. Under suspicion of being the monster, he had already lost his American citizenship and spent seven years in jail in Jerusalem. In 1988 the Israeli judge, “unequivocally” sure of who he was, sentenced him to hang. He heard from his cell the carpenters building the gallows.
Yet he was not that brutal Ivan, he insisted. He had never been at Treblinka. He could not kill anyone, could not even kill a chicken; he had always had to ask his wife to do it. On the contrary, he was a victim himself. Just a poor farm lad from Vinnytsia in Ukraine . . .
The narrative was rocky, but one part, perhaps, was true. KGB documents, turned up by his Jewish lawyer when the Soviet archives fell open after 1991, seemed to prove that he was not Ivan the Terrible, whose surname had been different, and who had been shot in 1943. John was reprieved and sent back to Cleveland, to a street festooned with yellow ribbons by his Ukrainian friends. Yet he was not declared innocent, and his old life could never be resumed as before. He kept the house blinds drawn so as not to see the Jewish protesters circling silently outside. . .
In 2011, after a fresh trial by a German court, he was convicted on 27,900 counts of being an accessory to murder. He was given a five-year sentence at which, lying on a stretcher in court, he moaned in apparent pain from hips or gout or kidney stones, the victim of vicious Germans, Soviets and now judges—John the Scapegoat, as it seemed to him.
No specific crime at Sobibor was pinned on him. Simply being there, then, and not resisting, was enough. He was hungry, perhaps (“I would have given my soul for a loaf of bread”). Scared, perhaps. But not unwilling to play his small, helpful, handy part in genocide.
On This Date in History – March 27
On this date in 1899, Marconi sent radio signals across the English Channel. In the past century we have made it possible to communicate quickly with masses of people all over the world. This was a giant step towards worldwide radio and television transmissions available today.
On this date in 1794, Washington signed the act to build a U. S. Navy. Although, the United States was born as a seafaring nation, and its naval victories began with the American Revolution, we had no Navy to speak of until this date when President George Washing, an old Army man himself, signed the Act of Congress designed to get a Navy built.
On this date in 1845, William Roentgen was born in Lennep, Germany. This opened up the door to peer inside the Human Body as well as to peer inside our luggage.
After Leonard and Thelma Spinrad
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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, any single payer initiative, Social Security was born for the benefit of the state and of a contemptuous disregard for people’s welfare.
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.