Archive for the 'TV' Category

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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Cancer and Bravery: Those Strong TV Women

I remember hearing in 1976 about Betty Rollin, a TV reporter who had written a book about her experience with breast cancer called, First, You Cry.

I was in my 20s, and a new mom. In fact, my daughter Becca turns 31 today and I remember watching book-tour type interviews with Ms. Rollin as I rocked Becca to sleep. (Happy Birthday, Becca!)

Then 8-10 or so years ago we heard about Katie Couric’s husband — dead at 40 something of colon cancer. So what does Katie do? She has a colonoscopy with TV cameras rolling so others will see that it’s not so bad — but it certainly does so much good.

Fast forward all these years — and news in the past few months about both Robin Roberts, ABC’s Good Morning America host, and now Hoda Kotbe from NBC — breast cancer, and sharing their stories to help other women.

How powerful! These four brave, strong women, sharing their experiences so others can learn, and eventually, be saved from the horrors that later stages of cancer can bring.  They share the medical, the emotional and everything in between.   And there are others, people in the limelight who use their own experiences to help others.

I feel a bit of a kinship. My disease may not have turned out to be cancer, but my reaction has been the same. To share, in hopes that others won’t suffer.

The strength of women astounds me sometimes. It’s patientude for sure. I’m proud to be counted among the strong ones.

And my very best thoughts and wishes go out to Robin, Hoda, and all you women who are out there, today, using your incredible strength to carry you through the emotions and treatment, while you hold the hands of others who must follow in your footsteps.

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How Doctors DON’T Think: Groopman on the Today Show

My physician-guru, Dr. Jerome Groopman, was on the Today Show this morning to highlight some of the excellent points he made in his book, How Doctors Think. (My editorial opinion — it’s a must-read for anyone who is having trouble getting diagnosed correctly.)

But I’m beginning to swerve from my usual train of thought surrounding how most doctors think. Whereas I’ve always taken it to a next step to help patients help themselves — I’m taking a bit of a detour today.

Groopman’s background information about the way doctors arrive at diagnoses must be understood by patients:

  1. Doctors make snap judgments about their patients. For example, a doctor will ascribe any symptom a woman over age 50 has to menopause. Or if a patient is diabetic, the doctor will assume any subsequent health problems are related to diabetes.
  2. Doctors always go with their first impressions — and they form them within the first 18 seconds of seeing the patient — which also means they not only don’t listen to anything the patient says after those first 18 seconds, but also means that they try to fit any additional symptoms the patient might recognized into their first impression.
  3. Doctors are not taught to think in med school. They are taught to answer quickly — which means — they don’t think outside the box, because that takes too long.

So the bottom line is that smart patients will bring doctors up short on all this by asking “what else can it be?” or questioning their doctors about symptoms that don’t seem to fit into a profile for their diagnoses.

And I absolutely agree with that bottom line — I’ve agreed with it many times before.

However — I’m also beginning to think a bit differently about this conundrum, too. Whereas I am all about the patient taking responsibility, and I think all patients should be actively participating in their diagnosing and treatment decisions — at what point do we just say, “Whoa!! Hold on!! That may be how doctors think — but they are thinking wrong!”

Groopman stated that 15 to 20% of all diagnoses are incorrect, and that half those patients are then harmed by that misdiagnosis.

Think about it this way: that means that, on average, if you have been to the doctor 10 times, then YOU WERE MISDIAGNOSED TWICE!

Patients themselves can’t make up for that deficit. In addition to patients taking responsibility for participation, I think we need to throw some of the onus back on doctors, too. We can’t simply accept that they don’t do their jobs correctly, we must begin making them responsible for getting it right.

So whereas I usually provide a bottom line to patients, today I’m going to do that for doctors:

  • Doctors, stop interrupting us.
  • Doctors, begin thinking outside stereotypes and profiles.
  • Doctors, stop trying to fit our symptoms into your own little boxes and start building the right boxes to fit them into.

(OK — I can’t help myself here…..)

And patients — start making doctors do all of the above!

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Oprah Takes on Health Insurance

Oprah took on healthcare, insurance and the lack thereof today. While I think she did an astounding job of moving the discussion forward, I think a major point was missed — and needs to be pointed out.

Joining Oprah were Michael Moore, the director and producer of Sicko, Karen Ignagni who is the top lobbyist for the association of health care insurers, and Uwe Reinhardt, a health economist. The debate was heated, hit many of the important points, and during the hour, Oprah asked several times, “What do we believe?”

Believe? Here’s how it was posed: “Do we believe the child of a gas station attendant and the child of a CEO deserve the same access to healthcare?”

How many answers can there be? Of COURSE that child should have the same access!

.. but guess what… they don’t.

This is not new to anyone. And then, of course, the question about the 47 million Americans who don’t have health insurance is imposed…. but then — Joe Average American retreats to this thought process, “well, at least I’m insured and my family is insured, and I’m only one person anyway, and there’s nothing I can do about it, because I am only one person.”

Here’s the point that was missing — The great majority of Americans think like Joe Average American — and that thinking is flawed! Joe Average American — you have missed the point! Joe — you have coverage that isn’t going to cover what you think it is! You have coverage that will pay far less than you think it will, despite the fact that it has already cost you hundreds if not a thousand dollars a month just to have that coverage to begin with!

Yes — Lisa Ling showed the stories of three people who had insurance, yet were denied care. Those are huge, and sad, stories.

But that’s not what I’m talking about. I’m talking about those people who need help with normal, every day care. Their child breaks a leg? It costs them hundreds or thousands of dollars in addition to their insurance coverage. Find out you’ve got allergies? It will be declared a pre-existing condition and it won’t be covered. You’ve got GERD? Even though your health is covered, you prescriptions may not be — it will cost you an additional $300 or $400 per year for the drug you need.

Michael Moore and Oprah reiterated a number of times that they don’t understand why anyone should profit from healthcare. And I do differ with them on that, at least to a degree. I think that profitability is a great motivator for innovation, and it’s profit that drives good research, new discoveries and treatments, and eventually, advanced care.

But I don’t believe that’s true for insurance. Profitability should not be allowed when it comes to human lives.

For those who have insurance and who think they have decent insurance (even though they are usually wrong) …. be advised that you are likely clueless about how little coverage you really have. Be advised that your healthcare dollar won’t go nearly so far as you think it will. And be advised that the health insurance lobby owns too many legislators who will make sure that doesn’t change anytime soon.

I don’t know how Karen Ignagni sleeps at night. Honestly. I’ve seen spin doctors, but hers spins only a much more tangled web.

And those tangles are costing more lives every day.


Find more commentary on Sicko here.

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Dr. Pausch on Life – and PTSD

(A Note: I’ve actually started this post a few times, but then I have to grab another tissue, wipe away my tears, and start again…. this is the face of post traumatic stress…. so bear with me, please….)

At least a dozen people have sent me links to what ABC called “A Lecture of a Lifetime.”

Some background: Dr. Randy Pausch, a computer science professor at Carnegie Mellon University, has been diagnosed with pancreatic cancer and has only a few months to live. He has proof of his disease in the images of the tumors in his pancreas. Of course, it was important for me to see those — because his prognosis is the same one I received — just a few months to live.

Diane Sawyer did a wonderful interview with Dr. Pausch on Good Morning America yesterday, which you can see here.

Or you can watch the entire lecture here. I am not able to do that. I just can’t. That’s the post traumatic stress.

The big difference, of course, is that I learned my diagnosis was wrong. I was told I had just a few months to live (life turns 180 degrees) and then figured out that I wasn’t go to die at all — at least not then (another 180 degrees, back to where I started.) Listening to Dr. Pausch just brings up all those old fears and feelings and — melt down time.

I hope you will take at least the 8-9 minutes to hear what Dr. Pausch has to say in the Sawyer interview. It is brilliantly simple, and simply brilliant.

In many ways, having had the same prognosis-related experience, I count myself as one of the lucky ones. NOT because I was misdiagnosed and learned I was really just fine, but because like Dr. Pausch, I was given the rare opportunity to examine my own life, assess what I did and didn’t like about it, and make the changes needed to be all I want to be.

YOU can make your own luck in this way. If you are one of those fortunate people who can learn from other’s experiences, then listen to Dr. Pausch, and follow his suggestions.

One of them is a long-time favorite of mine: Luck is the point at which preparation meets opportunity. Be prepared for the opportunities in your life. Keep an eye open for them. Take advantage of them. Substitute “someday” for today.

Remember — everything, EVERYTHING, happens for a reason. You are reading this post for a reason.

God bless you and your family, Randy Pausch. You have made a difference in this world you will leave behind.

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Thanks to CNN for sharing my story

Three years ago tomorrow, I learned I wasn’t going to die — at least not before Christmas.

September 20, 2004 was the day I learned I didn’t have cancer afterall — despite 10 weeks of insistence on the part of a handful of doctors and two pathology labs that I had a strange and aggressive lymphoma and would die within months if I didn’t undergo chemo.

The significance of September 20 was that it was the day I received conclusive results from the National Institutes of Health — no cancer, no death sentence, we’ve-just-handed-you-back-your-life.

And in those three years, I’ve changed my life and my career to help others help themselves find their best medical outcomes. That’s why I’m Every Patient’s Advocate.

You can read my entire story here. Or, for the sake of time (because I’m soooo long winded in my version!), you can read Elizabeth Cohen’s and Jennifer Pifer’s version, published today in the Empowered Patient column on the CNN website.

I’ve been a fan of Ms. Cohen’s column since its inception just a few months ago. Why? Because it’s not just a column with a story. It’s a column that compels with a story, and follows with real tools. This column outlines some of the ways you can determine whether you’ve been misdiagnosed.

The Empowered Patient column is a great fit with my blamers and fixers concept. Ms. Cohen is a fixer, and because her audience is so widespread, many will find help among her words.

I’ve taken advantage of the link from CNN to my website to provide additional information about determining misdiagnosis. There will be a second Empowered Patient column next week that helps readers learn what steps to take to confirm a misdiagnosis.

If you’d like updates, or alerts to the second column, please sign up on my email notification list, and I’ll keep you in the loop.

Thanks Elizabeth and Jennifer. You can’t imagine how validating it is to see my work appear on such a grand platform.

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Stossel, 20/20, Bait & Switch, Naivete

Did you watch John Stossel’s take on the future of health care on 20/20 Friday night? If you’re not sure what I’m talking about, you’ll want to link to ABC’s review of the show here.

If you watched it, and you’re curious about my opinions, here they are:

First — can you say “bait and switch?” I’m not sure why the promos for the show all focused on Michael Moore taking people to Cuba (which is all about universal healthcare), but the “fixes” Stossel offered on the show focused on just a portion of our American citizens who have health insurance already? Did I miss something?

OK — as for what WAS in the program:

One point Stossel made was that since we (and our employers) pay insurance companies, and insurance companies then pay doctors, then we patients do not tie the cost of services to the services themselves. He used a metaphor of “grocery insurance.” If we paid insurance companies for our groceries, then when we went to the supermarket, we’d just keep pulling groceries off the shelf and walking out with them, even if we didn’t need them, because we wouldn’t pay for them directly.

(Hmm…. let’s see….. I’ll take a shot of penicillin, an EKG, a few vicodin samples and a blood test, please…. ??)

Actually — I agree with him. Being a step away from actually paying cash for medical services does keep us in the dark, and it does have an effect. It brings to mind the man who told me may moons ago that his health care was free!

Stossel’s next point was that profit and competition make for better health care. Were it not for the possibility of making profits, we would not have the innovation in this country that results in drugs that cure us or improve our symptoms, or devices that do the same, etc.

I agree with that point (in part), too. I’ve said before — I’m a business owner, and have been a business owner for eight years. I “get” the capitalist basis for business, and I embrace it.

But I’m most definitely uncomfortable with Stossel’s conclusion — if that’s what it was. His conclusion seems to be that capitalism provides all the answers, and if we begin using Health Savings Accounts, so that we control our own health spending, then we’ll bring the healthcare system dysfunction under control.

A quick primer on HSAs: you and/or your employer put money into an account that you can draw from when you need healthcare. Your insurance premiums themselves are less, and the difference goes into the HSA. When you need to see the doctor for one of the “basics”, then you draw from the HSA instead of from insurance.

So, John — do you really think using HSAs can “fix” the American Healthcare system?

If he does, then it’s a horribly naive answer. Seriously. It doesn’t take into account any problems beyond the basics, and as we all know, it’s not the basics that are the problem to begin with. Sniffly nose? Maybe I go to the doctor and maybe I don’t. If I have to hand over cash? Then probably I won’t. So for that kind of scenario — yup — I agree. Being responsible for our own spending is a great idea.

But what happens when I find a lump? It doesn’t hurt — do I go to the doctor? I don’t have enough cash left in my HSA. Do I get it checked? Does the stress of worry make me even sicker? There are a million scenarios when an HSA just won’t work.

Or, like in my case. How does that fix the problem of a doctor who recommends a treatment simply so he can make more money? That’s capitalism at it’s best! “Trisha, you need chemo or you’ll be dead in six months.” Bull-pooky.

Further — what about those folks who don’t have insurance to begin with? There’s no employer supplying insurance, and there’s certainly no HSA. In Stossel’s scenario — there’s still no fix for the uninsured.

And what about the catastrophic problems we have? We still need insurance, right? So, does the cost of insurance continue to rise PLUS we need to have an HSA that may or may not have enough money in it when we need to see the doctor?

I still believe the answers lie in the middle. I think that a shift to the system that continues to embrace the good of the private, profitable sides of medical care, but still supplies the basics to those who need it, without a profit basis, is possible.

Social security and medicare both “work”. Granted, at the moment they are underfunded and we need to be more vigilant — but their foundations are fair and good. Neither one subtracts from the idea of separate retirement savings accounts, nor additional private insurance. We have public schools and we have private schools. We have public libraries and retail book stores. We have public parks and private country clubs. We have so many examples of where the public and private have combined to serve our needs — and I believe it can be done for healthcare, too.

One approach — read Dr. Rich Fogoros’ book. It works in theory — why can’t we give it a try?

There are no cut and dried, black and white answers. And there’s no room for naive stabs at an answer. They just fuel the fire and detract from real answer seeking.

So, John Stossel — the next time you want to do a healthcare story on TV? Forget the bait and switch. To suggest to your audience that you’re going to prove Michael Moore wrong about universal care, and then to present only one corner of the debate suggesting it’s an overall solution can only be detrimental.  If that’s the only part you understand, then you have a very long way to go.

I hope neither you nor your loved ones are ever faced with the realities of American healthcare dysfunction.  Believe me,  you’ll be singing a much different tune.  Either that, or you’ll sing it in a very different key.

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