Now, I don’t want to judge Senator John McCain’s motivations, but how can you not support legislation that requires an insurance who covers Viagra to also cover birth control pills? Can some one explain this to me? The best part of this was John McCain’s response to a reporter’s question.
Now, before everyone gets all teary eyed, I can think of no other profession that has had 20 years of salary cuts. My father made more money in 1979 as a family practitioner than the average family doctor makes today. This whole system is crazy. Ever wonder why M.D.’s are hurried and upset?
I support the AMA on this issue. I have called my Senators. We’ll see if it will do any good.
The honest truth is that our government has tried to balance the national budget on the backs of physicians for over 20 years. Since physicians are not unified and they don’t have an effective lobby, lawmakers have found it easy to crank back on payments and reimbursement for years.
———-
From New York Times:
Congress returns to work this week with Medicare high on the agenda and Senate Republicans under pressure after a barrage of radio and television advertisements blamed them for a 10.6 percent cut in payments to doctors who care for millions of older Americans.
The advertisements, by the American Medical Association, urge Senate Republicans to reverse themselves and help pass legislation to fend off the cut.
How to pay doctors through the federal health insurance program is an issue that lawmakers are forced to confront every year because of what is widely agreed to be an outdated reimbursement formula. But the dispute, which showcases the continued potency of health care issues, has reached a new level of urgency this year. Some doctors are reassessing their participation in the program and powerful interests on all sides are in a lobbying frenzy. (more… )
Melissa Harris Lacewell is a scholar and friend. I haven’t seen or heard from her in while. She has been out on sick leave. She has penned her first article since since her surgery. Her article is a tribute to her uterus. It is both funny and thoughtful.
———
After a four-year battle with uterine fibroids, I am finally surrendering. Last Monday, I checked into N.Y. Presbyterian Hospital and underwent a hysterectomy. I am 34 years old.
I fought back with hormones and holistic treatments. I have had second and third opinions in Chicago, Philadelphia and New York. I’ve seen black doctors and white, male and female. I have had every test, read every book and gotten advice from everyone I know. In the end, I made the difficult decision to bid farewell to my uterus.
It is a tough goodbye. I really like my uterus. I don’t have personal relationships with all of my internal organs, but this one was special. She protected and carried my lovely daughter for nine months. She was with me every step of the way in a 12-hour, natural delivery. My uterus and I did not take so much as a Tylenol while birthing that seven-pound baby. We are very proud of ourselves.
My path to this surgery has had some pretty bizarre moments. There was deafening fear the first time my doctor said “oncologist.” The room went silent, and I missed the next five minutes of what my GYN said to me. I had to ask her to repeat everything when my hearing returned.
There were ludicrous situations like my three-hour appearance on CNN American Morning. I was losing so much blood that I sat on set and sent a text to my best friend: “If u dont c me after commercial call 911. I might pass out in ladies room.” [Read more →]
I will have a very long post on health care very soon but I need to do more research. This isn’t just going to be one of those off the cuff kind of posts. It is clear to me that we need to do something. I’m not sure that McCain or Obama have all of the pieces to the large puzzle that is health care.
Here’s Elizabeth Edwards talking about what we need:
The right-wing talking heads have been whispering to American Jews that they can’t trust Senator Barack Obama. “Barack Obama doesn’t really support Israel,” they say. They have taken Obama’s statement on speaking with our enemies to mean that Obama would speak with Hamas, although he has never said that. Well, today Obama was in Boca Raton, Florida where tried to put all of these fears to rest. Obama promised an “unshakable commitment” to Israel. He was also hoping that his presidency can repair some of the damage in African-American and Jewish-American relationship. These problems date back to Jesse Jackson’s ill thought out statements over 25 years ago.
Finally, although it has been rumored for months, tomorrow is the day that Senator John McCain is suppose to release his medical records. Back in 2000, McCain was diagnosed with Malignant Melanoma of the face and arm. Were these two separate lesions? Was one lesion a primary and the other a secondary or metastatic lesion? The implications are significant. In 1993, McCain had a melanoma removed from his shoulder.
Now, I’m not a cancer surgeon, but I am a surgeon. In 2000, McCain had a return or recurrence of his cancer. If I’m not mistaken, metastatic melanoma can not be cured only treated. In my book, this would make him an extreme risk as a president.
We have been waiting for Senator Ted Kennedy’s doctors to tell us something. The Boston Globe has a very nice story that sums up the fact that we still know nothing.
The most common cause of seizures in the elderly would be tumor, alcohol withdrawal, stroke, and arteriovenous malformations (AVM). This is not a complete list, but it is what I can remember from my days in medical school.
I would like to go on TV and get paid for saying nothing, like the M.D. in this clip.
Senator Kennedy, 76 years-old and very overweight, was airlifted to Massachusetts General Hospital. As far as I can tell, no one really has a handle on what is going on. The news media is reporting that he has symptoms of a stroke.
I pray for his speedy recovery.
Update from the Boston Globe:
Doctors believe that Senator Edward M. Kennedy of Massachusetts suffered a seizure at his home in Hyannis Port this morning, then a second seizure as he was being transported by helicopter from Cape Cod Hospital to Massachusetts General Hospital in Boston, according to an official briefed on the situation.
His condition was unclear early this afternoon, as a special police security detail gathered at Mass. General. Kennedy family members were called this morning and told to rush to Boston, according to sources.
Update II Statement from Senator Kennedy’s office:
“It appears that Senator Kennedy experienced a seizure this morning,” a statement released by his office in Washington said. “He is undergoing a battery of tests at Massachusetts General Hospital to determine the cause of the seizure. Senator Kennedy is resting comfortably, and it is unlikely we will know anything more for the next 48 hours.”
All I can say this that this statement isn’t exactly accurate. They should know something by now. Kennedy has been at the hospital for over two hours. I guarantee that he has had blood work and a CT scan of his head, at the very least. Also, since Kennedy was recently diagnosed with a narrowing of his carotid artery but no surgery was recommended, I would guess that a test has been performed on that artery to see if the disease has progressed.
Senator John Edwards states in a passionate speak from Grand Rapids, Michigan that “The reason that I’m here tonight is because the Democratic voters in America have made their choice and so have I.”
He went on, “This election is about taking down those walls of the past so that we can see what’s possible.”
Nothing can really stop Senator Barack Obama now.
As I have mentioned before, Senator John McCain will drop the topic of his military service or experience of being held captive by the Vietnamese into any conversation so that he can get the advantage. He was on “This Week” today and talking about health care. I colored the important parts in red.
STEPHANOPOULOS: What’s wrong with government — what’s wrong with government-run health care?
MCCAIN: And we continue to have these debates — what’s wrong with it? Go to Canada. Go to England and you can find out what’s wrong with it. Governments don’t make the right decisions. Families make the right decisions.
STEPHANOPOULOS: One of the points Mrs. Edwards made in the Wall Street Journal, she said that your whole life, you had government health care. You were the son of a Naval officer, a Naval officer, now a member of Congress. And her point is, why shouldn’t every American be able to get the kind of health care that members of Congress get or members of the military get?
MCCAIN: It’s a cheap shot, but I did have a period of time where I didn’t have very good government health care. I had it from another government. (LAUGHTER) So, look, I know what it’s like in America not to have health care. We know that Americans are hurting there as well. We’ve got to make health care affordable and available. The difference, again, between myself and the Democrats, and with all due respect, Mrs. Edwards, I want the families to make the choices. They want the government to make the choices. That’s a fundamental difference, and we will continue to debate that issue.
It is a skill that you have to watch. McCain is great at it. There is no need to mention that he was a prisoner of war in a conversation about American health care. The point is that he never just answers the question. It isn’t about choice, it’s about accessibility. He has it and we don’t. Why aren’t we good enough for his health care plan? Or is this an elitist thing?
Here’s the video:
The Wal-Mart story getting more play since Keith Olbermann first talked about in his Worst Person in the World segment.
———
From CNN.com:
Debbie Shank breaks down in tears every time she’s told that her 18-year-old son, Jeremy, was killed in Iraq.
The 52-year-old mother of three attended her son’s funeral, but she continues to ask how he’s doing. When her family reminds her that he’s dead, she weeps as if hearing the news for the first time.
Shank suffered severe brain damage after a traffic accident nearly eight years ago that robbed her of much of her short-term memory and left her in a wheelchair and living in a nursing home. (more…)
No matter what happens in the next month or two, one thing is clear: President Bill Clinton was soo much better than Bush.
President Clinton explains Hillary’s healthcare plan.
More Later.
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Re-Posted
I thought that would introduce a new segment to Where’s the Outrage - medical ethics.
A 20 year old female presents to the ER. She complains of feeling like somebody is trying to get into her head. The patient looks scared and anxious. Her eyes are darting back and forth. Her speech is pressured and rapid. You are the ER physician. You run a battery of tests and conclude that the patient may be a danger to herself. You ask her if she will be willing to come in the hospital for some treatment that you think will help her. She agrees. As soon as you walk out of the room, the patient is seen by the charge nurse trying to leave.
What should you, as the ER physician, do?
I couldn’t help myself. When I saw the article, I knew that I had to post it. Unfortunately, reading the article will not made you a better lover or more attractive to the opposite sex. It will just make you a little more knowledgeable about the physiology of sex.
——-
From LAT:
AS they seek to document and demystify one of life’s great thrills, scientists have run across some real head-scratchers.
How, for example, can they explain the fact that some men and women who are paralyzed and numb below the waist are able to have orgasms?
How to explain the “orgasmic auras” that can descend at the onset of epileptic seizures — sensations so pleasurable they prompt some patients to refuse antiseizure medication? (more…)
Michael Moore was on Larry King Live. They discussed the presidential race and health care. This is a pretty good interview.
I listen to a lot of progressive talk radio but it has gotten retarded lately. The same points are poorly made over and over again by callers. On the Stephanie Miller Show, some lady had called in to repeat a point that she made a couple of days earlier. Hillary Clinton has more foreign policy experience. That was her point. I wanted to say - How? As First Lady? Please, can we agree being First Lady isn’t the same as being president? Can we agree that Nancy Reagan was a very involved First Lady but I don’t think that we want her to run for President. Can we also agree that Hillary Clinton has the experience of a Senator? That isn’t nothing but it isn’t the same as being president either.
On the other hand, can we agree that Barack Obama isn’t perfect? He has made mistakes. He was talking about a bill that he passed on some nuclear leak but the bill didn’t pass. Another woman caller on the Mike Malloy show mentioned that. It is still stuck in the bowels of Congress. Obama had an excellent opportunity to say something meaningful in New Orleans yesterday. He really didn’t. He broke out the same old schtick. Personally, I wish he would have pledged more help and more support but he didn’t.
If you like Hillary Clinton than that’s fine. I’m cool with that. I think that she would made a good president. I just think that she isn’t a uniting character. I don’t think that the politics of the 90’s are going to be as effective now. The country has moved so far to the right that triangulation will leave us way over on the right side of issues. I think that we need someone who has embraced the liberal/progressive banner. I think that we need someone who will give us goosebumps. Finally, I want someone who hasn’t been a big supporter of the war. I need someone who could see that this was a mistake from the start.
I guess that my point is there is too much finger pointing and hair splitting. We have 2 good candidates. Use any method you wish to chose who you think will better represent you and your issues. You can read all of their positions on-line then have a mystic tell you who to vote for. Do what you do but don’t try to say that this one isn’t qualified?
The New York Times reports that relatively small amounts of bluefin tuna sushi consumption can leave you with a lot of mercury in your body. The same may well apply to other types of sushi as well.
All we ever hear about are the downsides of mercury.
What about the basic fairness of hearing about what is good and positive about mercury?
The seafood industry needs to fight back. ( Don’t worry though–They are fighting back. And yes, if you look at the web page, you’ll find that pregnant women should indeed eat fish. Here is the list of groups that say it is okay. )
Here is a little bit about mercury from the excellent Nature’s Building Blocks–An A-Z Guide To The Elements by John Emsley—
It has been known for over 30 years that type II Diabetes Mellitus was associated with obesity. It has also been shown that folks who lose weight through exercise can decrease or eliminate their insulin requirements. I heard a presentation over 10 years ago by Walter Pories, former Chairman of Surgery at East Carolina University School of Medicine, that obesity surgery decreased and eliminated in some patients the need for insulin. It was a great presentation.
Now, I read some else has done this exact same study and the study has made it into the lay press. AP has picked up the study. There are now several studies which all show the same result and it makes sense. In morbidly obese patients losing weight is a good thing.
Let me add a disclaimer - I’m a surgeon. I don’t do this operation. No operation is without risk. The risks and benefits of this procedure need to be weighted with your surgeon.
———–
From AP:
A new study gives the strongest evidence yet that obesity surgery can cure diabetes.
Patients who had surgery to reduce the size of their stomachs were five times more likely to see their diabetes disappear over the next two years than were patients who had standard diabetes care, according to Australian researchers. (more…)
A recent New York Times story reported that many people die in hospitals from cardiac arrest because hospital personnel do not reach them in time. And, also, because they are black and/or poor.
From the story—
In nearly a third of cases of sudden cardiac arrest in the hospital, the staff takes too long to respond, increasing the risk of brain damage and death, a new study finds.
In the real world, doctors and nurses do not always run fast enough. Expert guidelines say the shock should be given within two minutes after the heart stops, but the study found that it took longer in 30 percent of the cases.
The consequences were striking. When the defibrillation was delayed, only 22.2 percent of patients survived long enough to be discharged from the hospital, as opposed to 39.3 percent when the shock was given on time.
The study, being published Thursday in The New England Journal Of Medicine is the largest ever to look at what happened to patients with “shockable” abnormalities in heart rhythm, and to correlate their outcomes with the time it took to deliver the needed shock.
Delays were more likely in patients whose hearts stopped at night or on the weekend, who were admitted for noncardiac illnesses, in hospitals with fewer than 250 beds and in units without heart monitors.
Being black also increased the odds of a delay, but the researchers said this finding probably reflected the quality of hospitals in areas where most blacks live and are treated, rather than a decision by medical workers to drag their feet because of a patient’s race.
Why can’t we wash our hands more often?
National Handwashing Awareness Week, which runs from December 2 through December 8, 2007, is a chance to renew our commitment to handwashing.
Here are some tips on good handwashing—
There’s a right way to wash your hands. A splash of water and a drop or two of soap won’t do the trick. Follow these simple steps to keep your hands clean:
The most surprising question was about doctors and their decreasing income. Average Americans, as a rule, aren’t that sympathetic with doctors but, it is true that doctors have had a decreasing income for some time. To our government, decreasing Medicare and Medicaid expenditures meant decreasing reimbursement to physicians and hospitals. This has been the standard practice for over 2 decades. A solo family practitioner could make between $150 - $200,000 in the early 1980’s. Now, a solo family doc makes about $156,000 per year. No change. That’s a problem. Then, add in tuition costs for college and medical school. Many of physicians are graduating medical school owing between $100,000 - $250,000. During residency, some loan institutions will allow you to defer payments but, the interest continues to build so you owe even more.
The cost of care is one of the things that really chaps Americans. Just driving by a hospital can cost thousands. Many Americans incorrectly assume that doctors are the major cost in medicine. In a recent study on clinic AIDS patients at the University of Alabama at Birmingham, the costs that most people associated with medicine (physician and nursing costs) added up to less than two percent of the patients yearly cost of treatment. Sixty percent of the costs were in medication expenses. Sixty percent!!!
Anyway, the answers that I heard were very interesting. John Edwards is 100% correct that we are going to have … already having a severe nursing shortage. Beds are currently closed at hospitals around the country because there aren’t enough nurses.
Biden’s answer was great. Dodd’s answer was okay. Edwards was great but, he didn’t really answer the question. Clinton really didn’t say anything except that her plan answers something. Obama’s answer is good but not complete (unclear how you can give a complete answer in 30 seconds). Kucinich’s answer for universal Medicare will probably not help doctors but will increase access to health care for many Americans. Governor Richardson’s proposal will not increase reimbursement for physicians and I’m not sure how it will attract more physicians. In my opinion, Senator Biden’s answer was the most complete.
Errington C. Thompson, MD, is a surgeon, scholar, fulltime sports fan and part-time political activist. He is active in a number of community projects and initiatives. Through medicine, he strives to improve the physical health of all he treats...
