Laying EMR, Texting, Driving to Rest. Start Tomorrow

Guest post from Greg N Korneluk:

The government boogeyman is not forcing us to text, and drive at the same time.  We are the ones making the conscious choice to enter data into the EMR in the examination room while interacting with our patients. So why do so many of us do it?

On the surface it seems intuitive.  We are all good multitaskers. While listening to the same old story, why not update the record. No harm done. While we are at is, how about looking at our incoming messages and emails. It will get us home sooner.  Multi-tasking saves time – right? As it turns out many of us are mistaken about multitasking.

Don’t let them destroy the passion of why you became a doctor.

Dr. Craviotto on The Purity of Medical Learning, Contentment and Satisfaction:

Words could never adequately explain my passion or love for our medical profession and what I do. What we do.

I absolutely loved my medical school experience. Don’t get me wrong: It was damn hard, grueling and challenging. But I loved the commitment, passion, dedication and energy of my medical school fellow students. We bonded together. We endured. We persevered. We learned. Anatomy. Physiology. Pathology. Clinical rotations. On call. Tired, spent and challenged. But I loved it. I gave up my 20’s and 30’s but oh what I gained. To see all of my medical students and residents passionately learn, tirelessly apply themselves, dedicate their lives to their patients and learn the art of medicine, the skills of doctoring through the lows, the highs and yes the tears well that is the stuff that bonds us together. They can never take that from me or you or us.

What we have is eternal. A passion to heal, a desire to learn, a humility that is born out of striving to heal another human being but occasionally failing. Patients will always die, complications ensue and disease destroys the human body. But we press on always optimistic, always looking for a cure, committed to our patients and striving to do our best for our patients.

They can never take that away from us. You are all my heroes. I love you for your ideals and your dedication. Here is the challenge. Don’t let them destroy the passion of why you became a doctor. That’s my prayer for our medical profession. Bless you all.

Dan Craviotto

We Need to Become Joyous Warriors

Richard Armstrong, MD writes in response to Dr. Kris Held’s guest post:

Kris, Yes, but I must also add something which we discussed in Colorado to what I believe is simply a factual observation. The circumstances we are currently living have been very long in the making. Those who favor “government run and planned” medical care are running up against a very harsh reality.the economics of their plans don’t work.there is a fundamental math issue which they tend to gloss over and ignore, but just witness the Vermont attempts. Even Governor Shumlin had to finally admit, although he waited for his re-election, that in the final analysis they couldn’t do it.duh.it is no surprise to us.

A True Holiday Gift

Thank you to Pediatrician Marion Mass, MD for supplying a timely holiday post for IP4PI:

Let’s talk charity.  True charity is that which is given willingly and freely.  Physicians are in the unique position to give such a valuable commodity, many do give of their time, but could the government make it easier for them?  And if they did, would there be any beneficial side effects?

Since 1990, Medicaid spending, jointly run by federal and state governments, has increased roughly five times.  Most state budgets have approximately 30-35% of their budget chewed up by this program designed to give medical care to the poor.  Helpful charts can be found at: https://www.washingtonpost.com/blogs/ezra-klein/wp/2012/07/17/the-state-of-medicaid-in-charts/

Enter Dr. Alieta Eck, M.D. who founded the Zarephath Health Center in New Jersey with her physician husband, John Eck.  Zarephath is a local free clinic serving 300-400 patients per month, and doing so at a fraction of the cost that it would take the same patients to receive care under the government plan. 

We Must be the Paradigm Shift and Mount an Innovative Goliath Offense

Guest Post from Kris Held, MD

After spending the last 7 years treading water naively and optimistically waiting for things to be repealed and fixed and after countless trips to DC and across the country trying to cry from the wilderness of the practice of medicine from the trenches with many of you and our organizations, I am convinced this is beyond repair and will never be repealed by those in power.

The Philosophy of the architects of the current system we are floundering in is the antithesis of Hippocratic medicine and in fact works to undermine and dismantle it. Just take innovation- look at Ezekiel Emanuel’s own words on this- he believes innovation is too expensive and the taxes in Obamacare reflect this opinion. He also is an ethicist whose roots stem from his area of expertise which is dying with dignity and systems of rationing like the complete lives system.

Wake up ABOG, you are tearing the House of Medicine apart to protect MOC

Guest Post from Howard C. Mandel, MD

On February 10, 2012 Medical Economics published my letter: Why don’t lawyers have to be recertified?

As an obstetrician/gynecologist who finished my residency in 1985, I earned a 10-year certificate when taking my boards. If I had graduated in 1984, I would have been certified for life. The American Board of Obstetrics and Gynecology (ABOG) requires a two-part exam. The first part is written, and the second is a 3-hour oral examination, part of which is based on the entire list of all the physician’s hospitalized patients plus representative outpatient visits. I passed and was recertified 10 years later. In 2001, my specialty board modified the certificate to be valid for 6 years.

Does This Benefit the Patient?

Via Forbes (hat tip Suja Amir, MPA):

Two important questions should be asked whenever any new healthcare regulatory measures are proposed:

1. How do they benefit the patient?
2. How do they help physicians help their patients?

If the answer is that they don’t, then they should be scrapped.

“Can I get an AMEN!,” adds Suja.

http://www.forbes.com/sites/physiciansfoundation/2015/12/02/are-patients-really-benefitting/1/

Access to surgery with clear cost, convenience, and choice

Guest post from Arnon Krongrad, MD, CEO of Allevion creator of Surgeo.com.

Suppose you have a uric acid stone in your ureter. This can be treated with endoscopic surgery or oral medication. The former requires anesthesia and acts quickly. The latter requires no anesthesia and acts slowly. One treatment may be better for if you need quick resolution or to avoid anesthesia. Choice matters to you as you take care of your health. This is a real issue as choice contracts and cost goes up.

It’s not enough to have choices. You also have to know, compare, and gain access to these choices. And this is where the complexities for patients so often seem to arise. This is why surgeons – supported by their associated facilities and be they in solo practice, group practice, or academic practice – are working together to develop a market of surgery packages that expands choice and simplifies access. The premise is that every patient deserves quality, convenience, and choice. The quality comes from peer credentialed surgeons. The simplicity comes from how they are delivered. Here is how it works:

Ayn Rand’s speech against socialized medicine in 1963; 100% relevance today.

https://ari.aynrand.org/issues/government-and-business/health-care/How-not-to-fight-socialized-medicine

VA to vets, “Delay, deny, wait till they die”

Craig M. Wax: VA to Vets, “Delay,
deny, wait till they die.” – The Washington Times

As a physician, I have the privilege of knowing and helping thousands of individuals. One patient in particular stands out as a victim of government’s malignant ineptitude. He is an affable, hard working 71-year-old male, who is a veteran of the Vietnam War. There was no Veterans Day parade for him but scorn and disdain, given the antiwar sentiment at the time.
He returned with severe post-traumatic stress disorder (PTSD), sleep apnea, hypertension and multiple other issues. He married, had children and has worked just about every day in industry until his retirement. His medical conditions grew worse and worse, as his PTSD was not diagnosed till age 69.

The Veterans Administration (VA) has done little to recognize, admit responsibility, and take care of the medical consequences of the political military work our brothers and sisters performed abroad. He has fought the VA to recognize his PTSD, medical and hearing disability for years. It took three years, for instance, just to get a partial disability rating, despite his years of psychological counseling for severe PTSD. This patient revealed during an office visit that veterans share the impression that the VA’s true motto is, “Delay, deny, wait till they die.”

We all have heard of the VA scandals including the one that documents the deaths of over 300,000 vets while on the medical waiting lists to be seen. And to compound insult with further injury, VA employees were financially rewarded to take dying vets off the waiting list to make the waiting times appear shorter (http://www.cnn.com/2015/09/02/politics/va-inspector-general-report/index.html). And still, Washington government bureaucrats still rave about how “great” VA healthcare and its electronic health record’s (EHR) are every day.

When will we as independent, individual citizens, stand up for those who have fought for our rights and sovereignty? When will we stand up against the bloated federal bureaucracy in Washington DC and demand that administrative ranks be thinned, budgets be balanced, and our debt paid down instead of given away as political presents to politicians’ cronies in exchange for votes and contributions to fill their campaign coffers?

Let’s not model our healthcare system after the VAs death by administration. Similar failure for patients is what ACA/Obamacare, Medicare, Medicaid and other government malignant ineptitude programs will ultimately lead to. Let’s reestablish the free market in healthcare for individual insurance and private individualized care. Individual citizens should be empowered to make their own decisions about what care to obtain and how to obtain it guided by each individual’s value system.

Government burdensome red-tape regulations have only raised costs and complicated care administration and delivery since the federal government first intervened during World War II with tax-deductible employer-sponsored insurance, again in 1965 for Medicare and Medicaid, and again in 2010 with ACA/Obamacare. Free market competition will again create innovation, effectiveness and lowest cost of care. 

CRAIG M. WAX: VA to vets: 

Delay, deny, wait till they die

http://m.washingtontimes.com/news/2015/dec/1/craig-m-wax-va-vets-delay-deny-hope-they-die/