Archive for the 'Politics and Medicine' Category

Tax Rebates: Maybe Health Insurance Should Pay Attention!

[Note to my regular readers… starting today, I am beginning my migration to my new blog site:

will get you there. You’ll find most of the post here, but you’ll need to finish it at the new site — so — why not link to it right now? Oh — and don’t forget to change your feed address. New posts will no longer be found here after February 1, 2008]

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So hubby and I are excited about this tax rebate thing… looks like we fit in that middle class group that will get $1200 back from the federal government.

We reflected on the rebate for a few moments, and the thoughts by legislators and the president alike — why they voted “yes.” I share their thoughts with you:

  1. The economy is a mess. We need to make people spend more money to improve it.
  2. If we GIVE them money, they will have more to spend.
  3. We want voters to re-elect us in November , and if we give them money, they will like us and vote for us.

So here’s little old me, wondering the following:

  1. Mr. President and Ms/Mr Legislator — excuse me — but wasn’t that my money to begin with? I sent you a WHOLE lot more than that last year, and I’ll be sending you a WHOLE lot more this year. I don’t believe you are “giving” me anything!
  2. And one other question — where did all this extra money come from that you have to give back to me? All I hear about is the escalating costs of the war in Iraq and the hole that has put in the federal budget. So who exactly are you taking money away from so you can give it back to me?

Those thought processes would be enough to share in today’s post….but…. why stop now?

I got to thinking that health insurers should begin to take a page from the federal government’s book…

Find this entire post at my new blogsite: www.EveryPatientsAdvocate.com/blog

MRSA: Patients Ignored, Left to Die

(Find an update to this post: MRSA, Victimization and Shooting the Messenger)

In the past two days, I have heard three stories, all related to MRSA and other hospital acquired staph infections, and all relating to heinous — even (in my not-so-humble-opinion) criminal acts on the parts of healthcare providers or politicos.

One story came from a colleague who visited a woman in the hospital. The woman contracted an infection after surgery almost a year ago. She is still in the hospital, on life support, not because of the surgery, but because the infection has just consumed her.

This post has been moved. Link here to find it in its new location.

Overcoming the Doctor-Patient War of Words

I seem to have hit a nerve with my post about Dr. Steve Cole’s editorial published a few days ago. Dr. Cole asserted that the reason healthcare costs are going up is because doctors have learned to milk the system in ways related to how they order tests, prescribe meds and other tasks which allow them to use billing codes that get reimbursed by insurance at a higher rate.

Wow! Here are a few of the post outcomes:

  • My blog hits doubled.
  • The number of comments to the post doubled over my highest day previously.
  • Several doctors — those who commented and those who emailed — were ready to shoot the messengers — both Dr. Cole and me!
  • Some doctors agreed with Dr. Cole.
  • Some doctors vehemently disagreed.
  • And patients — always the ones who find themselves at the bottom of the totem pole, once again feel victimized by the whole sorry situation, regardless of how it came about or how it’s being handled.

As your friendly — and peace loving — Every Patient’s Advocate — let me raise a few points and clarifications:

There are many reasons the costs of healthcare are increasing. Dr. Cole offered one set of reasons but certainly not all of them. Others include the wish for private insurance to profit more and more, the too-high costs of drugs, the bad habits of patients which require more care to “fix” them (like smoking, obesity and others), the increasing healthcare costs of an aging baby boomer population, the fact that people are living longer, meaning they need higher priced care longer, the higher costs of advanced technology, and others. One commenter to the blog (justordinaryjoe) took a stab at this master list and did a good job at it.

What truly upsets me — UPSETS ME — is that somehow this translates to a them-vs-us discussion. Doctors VERSUS patients or patients VERSUS doctors. We’ve lost the “and” — and that, to me, is frightening and dangerous. This is not about a conflict. But it is about a loss of trust.

But a patient’s loss of trust in his/her doctor is not the trust that should be lost. The patient AND the doctor should be focusing their lack of trust on the very system that has created it. That’s what is broken — the system of healthcare in America. And it won’t be doctors or patients who can fix it, even though it’s doctors and patients who pay the highest price.

Recognizing that it’s the system — and not the doctors and patients — then we patients must work harder to collaborate with our doctors, and doctors must work harder to collaborate — and respect — patients. Here are some of the ways that can happen:

1. Respect for TIME: Time is money. And the respect for time is one of the biggest violations.

Doctors — PLEASE respect the time of your patients. Give them your 100 percent attention during those brief six or eight minutes you will see them. And don’t make them wait in waiting rooms for more than 10 minutes. After 10 minutes, it is a violation of your patient’s time.

And patients — PLEASE respect your doctor’s time. He can’t make a living (and yes, I’m serious about that) if you impose on his time for more than you deserve. Granted, you are hiring him to do a job for you. But you aren’t paying him out of your pocket — and you just can’t have ALL the time you want — so be concise, be specific, ask targeted questions and move on.

2. Respect for KNOWLEDGE

Doctors — you don’t have a corner on all the knowledge. Please respect that patients know their own bodies better than you do. Don’t try to fit their square problems into your round holes. Understand that the internet does yield ideas for them and be willing to discuss them, even if they seem ludicrous to you.

Patients — your doctor spent up to 12 years gaining the medical education needed to accurately diagnose and treat you. Don’t think that by spending an hour or two on the internet, or by talking to other people, that you can trump that education. Ask for help in translating new information you learn… and do so with….
3. Respect for the COLLABORATIVE PROCESS: Getting to WELL is not one sided.
Doctors — please don’t jump to conclusions. Doctors must work WITH their patients — not AT them. And never EVER (well, OK, hardly ever) tell any patient that a malady is all in her head! (see RESPECT below.)

And Patients — make sure you participate collaboratively, too. Ask questions that allow you to assess possibilities, ask more questions, and arrive at a decision WITH your doctor, not just because your doctor tells you that it’s the “best” answer for you. YOU are the only person who can determine the best answer for you.

4. Respect for DECISION-MAKING

Patients — YOU are the people with the responsibility for making decisions about your own bodies (and, in terms of advanced directives, your own demise.) You need to step up to that plate to do so. Don’t just default to what the doctor recommends. Ask instead for a good review of ALL your treatment options, the pros and cons of each, and then make as objective a decision possible based on that input.

Doctors — don’t abbreviate the list of options you give a patient just because you think others aren’t good options. (And a message to many — don’t try to tell me that doesn’t happen, because even if you don’t do it, you know it happens with your colleagues.)

5. Respect for…. RESPECT

Doctors — working with a patient does not allow you to judge him or her. I wish I had a nickel for every time a patient has said, “The doctor just laughed at me.” or “I was so insulted!” A patient comes to you for help and counsel — not for your judgment. You need to treat that patient respectfully.

Patients — and I’m serious about this — the only time you need to respect your doctor is if that doctor deserves respect. If your doctor laughs at you or insults you, or in some way makes you feel like less than the respect-deserving person you are — say something! And if you can’t muster the ability to say something, then send them a report card and tell them. And — if necessary — find yourself another doctor.

And the bottom line is:
Doctors: please make sure your patients understand and experience the respect they deserve. For most of you, this is a daily occurrence. But we all know that for many, it’s not even on their radar.

Patients: stop expecting your doctors to be gods who can overcome a broken system to help you get the medical attention you need. For most doctors are truly doing the best they can. And it’s up to you to weed out the ones who aren’t — and walk away.

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Kickbacks: Doctors, Pharma, Insurance and Surprise! Patients Caught in the Middle

See if you can get your arms around the following conundrum, which is typical of our dysfunctional American Healthcare System — only this time with a twist. We’ll begin with point-of-view:

Consumers (that’s us patients!): When we need a prescription drug to improve our health, we want the best drug for what ails us, at the lowest price possible. We also want affordable health insurance, with fair co-pays for those drugs.

Physicians: When it comes time to prescribing a drug for a patient, the doctor wants to be sure it’s the right drug with the best chance of improving the patient’s health. Further, the physician is also on the constant lookout for ways to increase his/her income. They are offered money, support and/or other incentives from pharma manufacturers on a constant basis, but this practice has become a real point of contention because it creates a conflict of interest. Now, for many, a possible new income stream has been offered by insurance companies (see below.)

Pharma companies: Are interested in maximizing income. Period. And they will do whatever they can to protect that interest. Their real allegiance is to their stockholders who may also be any of the players mentioned here. The great majority of their income is derived from branded/innovator drugs and they take a huge hit when their patents run out and they begin to compete against generics. They look for ways to reward doctors for prescribing and using their drugs.

Insurance companies: Are interested in maximizing income. Period. And they will do whatever they can to protect that interest. Even the not-for-profits want to maximize their income so they can pay out bigger bonuses to their top people. They are constantly on the lookout for ways to reduce their costs so their profits are larger. When they can get doctors to switch patients to generic drugs, (or when they can get patients to ask their doctors about the possibility) then they can save costs.

Some background:

Read the rest of this post at its new location:

http://www.trishatorrey.com/2007/11/26/kickbacks-doctors-pharma-insurance-and-surprise-patients-caught-in-the-middle/

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Thank a Veteran for Your Medical Care

Yesterday for my radio show I had the pleasure and honor of interviewing a doctor who spent 25 years in the Navy, retired in 2005, and now serves a civilian population at University Hospital in Syracuse, NY with the skills he learned and developed while in the Navy.

A fitting program for Veteran’s Day 2007, don’t you think?

Dr. Ross Moquin retired as a commander, and served during both Iraq Wars, as a spinal and neuro surgeon. The stories he told were a mix of service to soldiers, and humanitarian efforts, too. We contrasted wartime medical care from World War II with how soldiers are cared for today — and what struck me more powerfully than any other message was how tuned in the military physicians are to the needs of the soldiers. For example, understanding that the sooner they see their loved ones, the more quickly they will recover, or at least get stronger.

Of interest to you, my reader, may be the fact that there are procedures and treatments being developed in military hospitals that are then translated to a civilian population. Dr. Moquin gave three examples. One is telemedicine — the idea that a doctor in one location, can walk a doctor through a procedure in another location by using video. Telemedicine isn’t new, but it’s being continually refined, partially in collaboration with the military.

A second area of work is for those who suffer from traumatic brain injuries — like American soldiers who are injured by IEDs (roadside bombs, improvised explosive devices). If a soldier is injured in the head, his/her skull is removed, all the repair work is done, and then once the brain is healed and the swelling goes down – up to a year later – a new skull is fabricated from some special material and only then is it replaced on the soldier’s head. Sounds fabulous — and like science fiction to me!

A third area of work is perhaps the biggest, because it’s more about a culture change and communications. Whereas western medicine in general has always separated spinal surgery and neuro surgery (two distinctly different disciplines even though those two body systems are so closely related.) Now Dr. Moquin tells us that he and others on his team, while in Germany and at Walter Reed Hospital, were working together. There is an organization state-side that is promoting this collaboration called One Spine. All of this can only be of major benefit to us patients.

I hope you will take a moment today — Veteran’s Day — or any other day you may find this blog post — to thank a veteran. Their work to protect our freedom is incredibly important, and today we’ve learned more about how that work reaps benefits in other ways, too.

Here’s the thanking I’m doing today: Among those veterans, I thank my husbandairforce1.gif Butch. Before I met him, he spent 20+ years in the Air Force, living all over the world, protecting those of us going about our business on American soil…. an unsung hero to most, but certainly one of the biggest heroes to me. AND my dad, Richard, who very proudly served in the Army Air Corp, in Japan, as World War II was coming to a close, my favorite among the members of the “greatest generation.”

By the way — you can listen to the interview with Dr. Moquin — it lasts about 24 minutes — I think you’ll enjoy it. 

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A Lemon Law for Medical Consumers?

From Hannah Montana to drive-by shootings, there is plenty of interesting news in Cincinnati, Ohio today.  But to me, your friendly patient advocate, an even more fascinating topic was reported in Cincinnati’s news this week:  the possibility of a lemon law for medical consumers.

To me, it’s one of those “now why didn’t I think of that?” ideas!

A woman named Betsey Exline gets the credit here.  Last spring she went for a routine colonoscopy, which was botched, and she ended up with emergency surgery and a stay in the hospital for eight days. 

Nine doctors, the emergency surgeons and the hospital then billed her for the insult.  Can you say “unmitigated gall?”

Should she sue?  She could, although lawsuit cost estimates range into five figures and she’s not getting any younger.

Instead, this very wise woman took a very different approach.  Bless her heart, she’s not looking to make money from this error which she will suffer from for the rest of her life.  She just wants someone to pay her bills.  She just wants someone to recognize that it should not be her responsibility, or her insurance company’s responsibility, to pay for the errors caused by others.

Hello?  Duh!  That just makes so much sense!

So Betsey contacted her local Ohio state representative and is now pursuing the introduction of legislation that would, in effect, force those who caused the errors to pay for the errors — but not through the courts.  Instead the legislation will create a consumer protection process for medical errors. Those who caused the errors will be required to cover the costs that result from their errors.

And if it becomes law?  The doctors win because it will cut down on lawsuits.  The insurance companies win because it will cut down on lawsuits, too.  And the patients win — at least to the extent they won’t have to pay those unfair bills.

(And who will stand in the way?  Of course, those lawyers who handle medical error victim lawsuits.  but that’s another blog post for another day.)

Wish I was in Cincinnati, Betsey.  I’d find you — just to shake your hand.  You’re a fixer of the first order.

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Hospital Infection Prevention Week

The first line of defense against hospital infections is clean hands.

Seems simple, right? Yet millions of Americans are infected in hospitals every year. 100,000 Americans die from them.

Read that carefully — yes — 100,000 Americans go to the hospital because they are sick, or they need surgery. They die — NOT because they were sick or needed surgery — but because they got infected.

And the great majority would NOT have died if hospital employees — from doctors to nurses to the guy who brings in the meal trays — had simply washed and sanitized their hands.

I would write a LOOONG blog post about this — but instead, I’m going to let Consumers Union tell you about it. Then I’ll invite you to join their campaign to stop the spread of these infections.

If you’d like to see what I’ve written in the past about hospital acquired infections, you can do so here.

Save a life — yours, a loved one’s or a stranger’s.  Learn about these infections. Do your part to keep them at bay.

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. . .This Blog Has Moved!. . .

Where did everything go?

Not far.
We just relocated, that's all.

You can find every post and comment from this blog
-- and plenty more --
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Every Patient's Advocate Blog.

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EveryPatientsAdvocate.com/blog

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