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Notes_14

 

 

Containment of injured patients.

doctors working for drug companies have as their goal producing results that will convince the FDA to approve the drug...
........"Confessions of a Medical Heretic".....Dr. Robert Mendelsohn

 

 

 

 

 

 

Medical Statistics

Assume that there is a disease that effects only people over 60 years old. It is studied in a community in which people live to be 75 years old. People who don't go to doctors regularly tend not to get diagnosed until they are in their 70s. People who do go to doctors regularly get diagnosed in their 60s. When people are diagnosed with it in their 60s, they are put through a regimen of treatments and therapies that are expensive and time-consuming and have nasty long-term side effects, but the 5-year survival rate is 100%, because they all live to be 75.

The people who do not go to doctors regularly and do not discover they have the disease until they are in their 70s do not endure the expensive and debilitating treatments and suffer no long-term side effects. But the 5-year survival rate of that group is 0% because they all live to be only 75.

The conclusion of the people earning livings by diagnosing this condition is that more early diagnosis is good - screening should be universal. Everyone should be required to be checked for it early, because when it is diagnosed early enough there is a 100% survival rate.

The conclusion of the people earning livings by treating it is that it is a 100% effective life-saving treatment. That everyone who is diagnosed with it should pay for and endure the expensive and debilitating treatments is believed by them to be a no-brainer.

Too bad patients are not allowed to read the experiences of other patients, amass data, and avoid bad medicine.

If you think things don't work this way, you probably work in medicine, and that's why things work this way.

 

 

 

 

 

 

 

 

 

 

 

 

 

According to yet another an article about liability limitations, this time in the NEMJ about malpractice suits:

Legitimate grievances that received no compensation occurred more frequently than did payment for frivolous claims.

Portraits of a malpractice system that is stricken with frivolous litigation are overblown.

"Claims, Errors, and Compensation Payments in Medical Malpractice Litigation"
by David M. Studdert, LL.B., Sc.D., M.P.H., Michelle M. Mello, J.D., Ph.D., M.Phil., Atul A. Gawande, M.D., M.P.H., Tejal K. Gandhi, M.D., M.P.H., Allen Kachalia, M.D., J.D., Catherine Yoon, M.S., Ann Louise Puopolo, B.S.N., R.N., and Troyen A. Brennan, M.D., J.D., M.P.H.
New England Medical Journal, Volume 354:2024-2033, May 11, 2006, Number 19

 

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The head of the Institute for Healthcare Improvement
Dr. Donald Berwick is a professor of health care policy at Harvard. He heads the Institute of Healthcare Improvement, a nonprofit consulting firm. He was quoted in the New York Times on Tuesday, December 22, 2009 in an article by Milt Freudenheim called, "Tool in Cystic Fibrosis Fight: A Registry."

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ADR
Incidence of Adverse Drug Reactions in Hospitalized Patients

A Meta-analysis of Prospective Studies

by Jason Lazarou, MSc; Bruce H. Pomeranz, MD, PhD; Paul N. Corey, PhD
JAMA. 1998;279:1200-1205
http://jama.ama-assn.org/cgi/content/full/279/15/1200

 

 

 

 

 

 

 

 

 

 

The Caduceus
In Roman iconography, the caduceus was often depicted being carried in the left hand of the Greek god Hermes, the messenger of the gods, guide of the dead and protector of merchants, gamblers, liars and thieves. It was confused with the traditional medical symbol, the rod of Asclepius, which has only a single snake and no wings. The rod of Asclepius is an ancient Greek symbol associated with healing the sick through medicine.

Some scholars suggested that the symbol once represented a worm wrapped around a rod. Parasitic worms were common in ancient times and were extracted from beneath the skin by winding them slowly around a stick. Physicians may have advertised this service by posting a sign depicting a worm on a rod. The worm was mistaken for a snake in the Middle Ages.

Does this mean that the very symbol of their profession is an error?

Copies and pasted from:
http://doctorblue.wordpress.com/2008/12/30/blog-overview-replace-the-caduceus/

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Canadian Health Care

"The Supreme Court of Canada declared in June 2005 that the government health care monopoly in Quebec is a violation of basic human rights."

This is a July 8, 2007 piece by Sally Pipes in The New York Daily News that challenges Michael Moore’s “Sicko” movie assertions.

In “Sicko,” Michael Moore uses a clip of my appearance earlier this year on “The O’Reilly Factor” to introduce a segment on the glories of Canadian health care. I am a new American, but I grew up and worked for many years in Canada. And I know the health care system of my native country much more intimately than does Moore. There’s a good reason why my former countrymen with the money to do so either use the services of a booming industry of illegal private clinics, or come to America to take advantage of the health care that Moore denounces.

Government-run health care in Canada inevitably resolves into a dehumanizing system of triage, where the weak and the elderly are hastened to their fates by actuarial calculation. Having fought the Canadian health care bureaucracy on behalf of my ailing mother just two years ago – she was too old, and too sick, to merit the highest quality care in the government’s eyes – I can honestly say that Moore’s preferred health care system is something I wouldn’t wish on him.

In 1999, my uncle was diagnosed with non-Hodgkin’s lymphoma. If he’d lived in America, the miracle drug Rituxan might have saved him. But Rituxan wasn’t approved for use in Canada, and he lost his battle with cancer.

But don’t take my word for it: Even the Toronto Star agrees that Moore’s endorsement of Canadian health care is overwrought and factually challenged. And the Star is considered a left-wing newspaper, even by Canadian standards.

Just last month, the Star’s Peter Howell reported from the Cannes Film Festival that Mr. Moore became irate when Canadian reporters challenged his portrayal of their national health care system. “You Canadians! You used to be so funny!” exclaimed an exasperated Moore, “You gave us all our best comedians. When did you turn so dark?”

Moore further claimed that the infamously long waiting lists in Canada are merely a reflection of the fact that Canadians have a longer life expectancy than Americans, and that the sterling system is swamped by too many Canadians who live too long.

Canada’s media know better. In 2006, the average wait time from seeing a primary care doctor to getting treatment by a specialist was more than four months. Out of a population of 32 million, there are about 3.2 million Canadians trying to get a primary care doctor. Today, according to the OECD, Canada ranks 24th out of 28 major industrialized countries in doctors per thousand people.

Unfortunately, Moore is more concerned with promoting an anti-free-market agenda than getting his facts straight. “The problem,” said Moore recently, “isn’t just [the insurance companies], or the Hospital Corporation and the Frist family – it’s the system! They can’t make a profit unless they deny care! Unless they deny claims! Our laws state very clearly that they have a legal fiduciary responsibility to maximize profits for the shareholders … the only way they can turn the big profit is to not pay out the money, to not provide the care!”
Profit, according to the filmmaker-activist, has no place in health care – period.

Moore ignores the fact that 85% of hospital beds in the U.S. are in nonprofit hospitals, and almost half of us with private plans get our insurance from nonprofit providers. Moreover, Kaiser Permanente, which Moore demonizes, is also a nonprofit.

What’s really amazing is that even the intended beneficiaries of Moore’s propagandizing don’t support his claims. The Supreme Court of Canada declared in June 2005 that the government health care monopoly in Quebec is a violation of basic human rights.

Moore put me, fleetingly, into “Sicko” as an example of an American who doesn’t understand the Canadian health care system. He couldn’t be more wrong. I’ve personally endured the creeping disaster of Canadian health care. Most unlike him, I’m willing to tell the truth about it.


http://www.americanconservativedaily.com/2007/07/moore-lies-about-healthcare/

 

 

 

 

 

 

 

 

 

Semmelweis Society
Quote from founder is at this link:
http://medicalboardreform.tribe.net/thread/6d2e9303-36a5-43dc-b161-887b827e397a

 

 

(On this site the quote is on the links page under Semmelweis.)

 

 

 

 

 

 

 

 

 

 

 

 

 

Discussions about how to fix health care:

I’ve been in the discussion when I was the only one in the group who wasn’t a physician or nurse. I’ve been in the discussion when all the others were relatives of victims, but not victims themselves. I’ve been in the discussion with victims with fresh injuries and old injuries, small ones and life ruining ones, intentional and unintentional ones. For as much as can be understood about the ocean by looking at one drop of water, it is rare for any of these people to see much beyond their own reflection on the surface of that drop of water.

 

 

 

Holy Cross nursing assistant charged with sex attack on patient
http://latimesblogs.latimes.com/lanow/2012/09/providence-holy-cross-hospital-sex-attack.html

 

 

 

 

 

 

 

 

"Historically, what we've seen with the consolidation in the health care industry is that prices go up, but quality does not improve."

- Jeffrey Perro, an assistant director in the F.T.C.'s Bureau of Competition. Quoted in the New York Times, Saturday, December 1, 2012, pg A17.

His quote was in response to a executive at St. Luke's Hospital in Boise defending raising prices after consolidation eliminated competition saying that prices had been raised only to reflect market value and that this would lead in the long term to lower overall costs as fewer unnecessary work was done.

Never believe a person in a white smock talking about money.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I lost track of where these thought were to be put:

While the patient still is at the scene of the injury, health care begins the unconscious and habitual managing of its own perceptions. It records nothing about the adverse event to make sure nothing is discoverable and follows routines that make sure nothing is accurately remembered. The person who caused the injury even is considered "the second victim" and all worry is about protecting that person. No one asks the patient if he or she is all right. Everyone wonders only about how to protect themselves and their colleagues and their institution. Honest information is forgotten. Misinformation fills in the holes. A received view emerges that no one in medicine questions. This goes on even in communities where liability limitations have made any lawsuits impossible. This state of affairs continually is blamed on the litigiousness of our society. Those who think that have accepted the self-serving rationalizations of the medical profession.

 

Sunshine and openness can deprive bad actors of the secrecy required to get away with acting badly. In medicine there are virtually no people who believe themselves to be bad, no matter how bad they may be, but they do believe that sunshine could cause them to be "perceived" as bad. They are willing to cover up any and all information, even from their own view, no matter how many patients might suffer and/or die, rather than allow the possibility of some health care professional being perceived as less good than they perceive themselves to be. When they cannot see the facts themselves, all people in medicine can be perceived to be better than the facts would make them appear.

 

 

 

 

 

 

 

 

 

 

By whitewashing history, it continually distorts the public policy debate.
  -- Michael Millenson: The Silence