Well, I was correct but I’m sorry I was! The Healthcare Summit was a complete waste of time and C-Span broadcast resources. The only thing that I got from it was that the Democrats told everyone that they were going to pass the current bill no matter who opposes it!

As for me I’m sick on my stomach! You can read the details somewhere else (if you have the time to waste and the stomach for it)!  bjmdjd

Material modifications since posting: none

Healthcare Reform · healthcare summit

If you look on the right side bar of this page you will see under my blogroll a blog that I titled “Interesting Doctor’s Blog.” Dr. Toni Brayer has outdone herself in a blog she posted 2/3/10 entitled “Beleagred Health Care Providers.” I liked it so much that I’m posting it here in its entirety. Enjoy! bjmdjd
I went to my physical therapist yesterday for knee treatment and we talked about the fact that Blue Cross is cutting their reimbursement to the point that the cost of providing care will not even be covered. All I could do was lament with him and listen. One insurer even told him (the owner of the business) to just “make the sessions shorter and don’t give as much care.” As if that is how it works…”You get little money..so just do a little”.

Clearly the insurance intermediaries, who never actually see a patient or deliver any care, haven’t got a clue how this whole health thing works. They are happy with mediocre doctors that cut time and care. Those doctors (and physical therapists) run mills, but the insurance companies are happy with them. Quality and quantity of time are not rewarded, and in fact are punished in the health care environment we have.

He asked me if Primary care had any problems like that. I felt like screaming “Aren’t you reading my blog?”. Or more to the point…why doesn’t the entire population know that access to a primary care physician will become as rare as swimming with dolphins. It will depend upon how much money you have to buy concierge/retainer medicine. Where you live will play a role. If your community has a large multispecialty clinic like Kaiser or Sutter Palo Alto Medical Group, you may have access.

Doctors in training are flooding away from general Internal Medicine, Pediatrics and Family Medicine in droves. Only 2% of medical students plan to go into primary care. It used to be over 50%. A recent Jim Lerher report discussed the reasons. We’ve been talking, talking, talking about it for years but things have only gotten worse, not better.

The whole premise of health care reform ensures that everyone has access to good quality care. Every nation that provides good, quality access has a strong primary care base that is the foundation. Primary care is valued by the government, the payers, the population and even by the physicians.

We have it all backward. It is time to revamp the system from the bottom up. Frankly I don’t care if we get one more multimillion dollar robot to assist in a rare surgical procedure or one more new ” next generation” imaging scanner until we can rationalize how we pay for care.

We have not yet begun the hard work to bring costs under control because there are too many pigs at the trough. One of my favorite teachers (you know who you are, Ed) said “you can’t clear the swamp until you get the pigs out of the way”.

We have a lot of pigs to move aside so more people can get to the water.

Blue Cross Blue Shield · health and wellbeing · Healthcare Reform · primary care doctor shortage

I’ve read a couple of studies recently that reminded me about something very important that I have never mentioned in this blog. Are supplements and so called “natural” medications safe? The answer? They may be and they may not be. That really helps.

The real problem is that many people feel that any medication that can be purchased without a prescription and is called a supplement or “natural” is completely safe. This is absolutely untrue!

I feel that the main problem with many supplements is that no well designed and reliable studies have been done to determine the effectiveness and possible harmful side effects and drug interactions of these medications. They are not regulated by any governing agency. Even though the Food and Drug Administration does occasionally make a mistake when evaluating prescription medications, they have absolutely no control over the manufacture or distribution of these supplement medications.

Another problem with supplements or “natural” medications is that the correct dosages are not really known and with no regulation you really don’t know how much of the medicine you are actually getting in the manufacturers formulation. Maybe it says 500 mg but is it really? Who knows?

The bottom line…be very careful with the use of supplements and “natural” medicines. Many people complain about the cost of healthcare but they gladly purchase these expensive medicines with out of pocket money when they don’t even know if they are helping or hurting them. Because of possible prescription drug interactions you should always inform your doctor of any of these medications that you are taking.

Be very careful with anything that you put in your body.  bjmdjd

Material modifications since posting: none

are supplements safe · Food and Drug Administration · health · healthcare · natural medicines · supplements · wellness

I will be the first to admit that I really don’t care for Oprah or her show. Everyone says, “But Bob, she does such good things with her money!” Yes…and there’s always a camera there to record it. I grew up being taught if you do something good for somebody and you tell it doesn’t count.

But I’ve got to give kudos to Oprah! On her show today the topic was on the dangers of talking on a cell phone or texting while you’re driving. While many folks want to jump up and down and say it’s their right to do both if they want to and it’s not the governments place to pass any laws that govern it. You may feel that way but you can’t actually deny that both are dangerous. How many of us have looked up and been driving in the wrong lane or at least drifting over the center line?

They presented a study which showed that talking on the phone while driving increases your chance of having an accident x4, the same as having a blood alcohol of 0.8 which is legally drunk. Texting while driving increases your chances x8!! No distinction was made between a regular cell phone and a hands free unit with one person stating it’s not what you do with your hands but your head.

I may not be a fan of Oprah but I am a fan of most anything that improves public health. Click on the following link to sign Oprah’s pledge not to talk on your cell phone or text while driving. Regardless of how you feel about the governments intrusion into our lives it might be worth taking a close look at this topic until drivers can use some common sense.   bjmdjd   (D3M5R2CWAJDZ)

http://www.oprah.com/questionaire/ipledge.html?id=4

Material modifications since posting: none

government intrusion into our lives · health · healthcare · Oprah Winfrey · public health policy · talking on a cell phone while driving · texting while driving

Just a short note today. I just read an article about lawmakers wanting to forbid gifts and free meals between drug companies and doctors. Are you kidding me? Politicians fly all over the world and get who knows what from various lobbying groups all of the time. They are actually brash enough to admit in public that they think there is a problem with drug companies buying an office staff a pizza and giving them free plastic ink pens and sticky notes? Healthcare reform should worry you if that’s a major concern of our elected leaders!  bjmdjd

Material modifications since posting: none

drug companies · drug company and doctor financial relationships · health · Healthcare Reform · political lobbying groups

While I said that I would try to keep politics out of this blog as much as possible, sometimes it can’t be helped. It’s a real shame that the healthcare conference committee will be held in private. Never mind that during the campaign President Obama promised that it would all be done in public and broadcast over C Span. By doing it behind closed doors the public will not be privy to all of the vile democratic wheeling and dealing that will take place to get their version of reform passed as the final bill. At least as much of it as possible. It would really be interesting to actually see how abortion and the public option fair during  negotiations. It’s no wonder that several democrats have already said that they won’t run for reelection. The winds of change they are a blowin’. The only thing that will save dems up for reelection this year is if the economy turns around and folks forget about the rape called healthcare reform that is about to take place. The first time in history that a bill this important didn’t pass without bipartisan support. I wonder why?  bjmdjd

Material modifications since posting: none

C Span · health · healthcare conference committee · Healthcare Reform

All I hear is how once we have everyone covered by some form of health insurance there will be this big improvement in access to care. Have you tried to get an appointment with a primary care physician lately? It’s hard enough if you have a doctor and nearly impossible if you don’t. What this shows is that there is a drastic shortage of family physicians and internists. What happens from a numbers standpoint if 46 million people suddenly have coverage and feel that they can go to the doctor? Who is going to see these people? The system can’t support the number of patients that it is trying to see now. The only good thing that I can see coming out of this is that the emergency rooms and ER physicians who are absolutely swamped will finally be getting paid something for the patient care they are providing. When I worked in the ER back in the mid 1990′s our physicians group had a collection rate of 40%. How many businesses do you know that could operate on a 40% collection rate? I have heard nothing in Washington about how to increase the number of primary care physicians. They are trying to replace as many as possible with physician assistants and nurse practitioners.These providers can take care of many simple patient problems and don’t cost near as much in salary as a physician while they can generate almost as much income. But as most everyone realizes there is no replacement for a physician’s education. If there were, physicians training would last a couple of years like that of these mid level providers. It takes 4 years of medical school and at least 3 years of residency training (after 3 – 4 years of college) to produce a new family physician or internist. Add to that the disrespect that primary care gets in the training programs and from other providers, the salary disparity with other specialties, the burdensome reams of paper work, and the long hours.There is not much incentive to go into primary care. I have a friend whose daughter just graduated from pharmacy school (5 years TOTAL training) and she started at a higher salary than a family physician friend of  mine makes after 15 years in practice! Yeah, all doctors are getting rich! If you are uninsured and think healthcare reform will mean that you will have your own doctor, think again!  bjmdjd

Material modifications since posting: none

access to care · family physicians · internists · primary care physicians · universal care