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Showing posts from May, 2016

Memorial Day 2016 - We Remember

I am in coffee shops several times per week.  I prefer independent establishments with atmosphere and authenticity.  For that reason, it is rare to spot me in a retail coffee outlet whose HQ is in Seattle, Washington.  This past week, as I was carrying my cafĂ© mocha to my table, I spied some board games stacked up on a table.  On top was the game pictured below. This brought back warm memories of playing this game as a young kid.  It recalled the wholesome and beautiful childhood that my parents gave me.  Millennials might not appreciate the raw and fierce competition of games such as Candyland, Chinese checkers or Trouble, which has caused a huge void in their lives.  Looking back and remembering gives meaning to our lives.  We remember a song, a joke, a celebration, a concert, a speech and relationships.  Isn’t it amazing how hearing a song from years ago captures a mood? This weekend, we remember and ponder something of infinite meaning and importance.  We remembe

Measuring Physician Quality - Bully or Just Plain Bull

Patients are amazing creatures.   The current breed is hyperinformed on medical information and has an ever expanding reservoir of physician data to trove through.  I’m not just referring to physician reviews on Angie’s list.  Soon, the public will be encouraged to review our success and failure rates with respect to medical treatments, how much cash the drug companies grease us with, all disciplinary actions, comparison with peers, complication rates, medical malpractice entanglements and how much Medicare reimbursement we have received. There will be published quality benchmarks on physicians so that the public can see how their physicians scored on these various quality measurements.  I have opined throughout this blog that I feel that these measurements are tantamount to taurine excrement.   Sadly, reimbursement will be tied to these results with physicians who don’t rate high enough having some of their income confiscated.  Physicians who don’t make the grade may game the syst

Medical Insurance Companies: Heroes or Villains?

Physicians are expected to be hostile to insurance companies.  Indeed, a prior Whistleblower post directed arrows in their direction.  They are an easy target, often vilified for their greed and perceived indifference toward those they insure.  Ask most of us if we think insurance companies favor profits over patients, and most of us will respond that profits prevail. Insurance companies are businesses, not charitable undertakings.  Sure, we all like free stuff.  Or, if it’s not free, we prefer that someone else pays for it.  We are outraged at the costs of chemotherapy, hepatitis C treatment and biologic treatments such as Humira and Remicade, leaving aside the zillions of dollars it takes to research, develop, manufacture, market and monitor innovative new drugs.  We want to drive a Cadillac, but only pay for a Chevy. We want to pay for this... ...and drive this. No person, business or organization is wrong all of the time.  Consider the following practices. 

Should the FDA Approve Experimental Treatment for Severe Diseases?

I’ve never had the pain and agony of having a kid who is truly sick.  Broken bones and minor surgeries don’t count.  Even one of my kid’s bout with malaria doesn’t rate, as this illness was easily cured. Parents of kids with chronic illnesses would sacrifice anything to help their kids get better or to suffer less.  In the news recently is a conflict between families of kids with Duchenne muscular dystrophy and the Food and Drug Administration (FDA).  A very small study of an experimental drug called eteplirsen suggested some benefit.   Understandably, the families want the FDA to grant approval so that their kids and others could have access to this drug that will fight a dreadful disease that is fatal.  Families argue that these kids have nothing to lose and can’t wait another 5 years waiting for more definite evidence of efficacy to emerge.  The FDA is legally required to approve drugs that are safe and effective.  Obviously, the definitions of safe and effective are subjec

Should Women Who Seek Illegal Abortions be Punished?

Every four years, abortion gets more press and attention as the candidates compete for electoral support.  My own position on this issue is not relevant for the points I offer here.  We all know that candidates massage their position on abortion and on other issues in an attempt to maximize their voter support.  It’s fun to watch them thread the needle as they dance and pirouette for us.  They are performers who can be as flexible as the amazing acrobats on Cirque du Soleil.  The emphasis, if not the content of their message, changes depending upon the audience.  Al Gore was ridiculed when he sported a more southern accent when he was campaigning below the Mason-Dixon line.  Donald Trump was clearly unprepared for the abortion question when he rhetorically collapsed during a typically vigorous and frenetic interview with MSNBC’s Chris Matthews.  Of course, you don’t really have to prepare on an issue if you already have a principled position.  You can just tell the truth.  Tr