I’m furious and disgusted about how the corporate pursuit of short-term profit, unrestrained by ethics or social needs or long-term consequences, is controlling our healthcare.
The dark underside of corporate wealth is the condition of the workers who create the corporation’s success. Working in the jobs the rich create, there are multitudes who work just as long and hard and don’t get rich. They labor in dangerous and dirty jobs for endless hours, under far worse conditions. Often they barely get paid while some C-suite guy running the corporation committing these abuses gets millions in bonuses.
And all those rich people with all their advantages aren’t even nice:
Instead of looking up to rich people as “self-made” heroes, I know they are actually just lucky when all their skills and preparation meet an opportunity they can take advantage of. Without that luck, they’d just be “commoners” like the rest of us.
Opioid Prescriptions Without Medical Basis– by Gigen Mammoser – Sept 2018
A new study has found that, in a startling number of visits to a physician between 2006 and 2015 when an opioid was prescribed — nearly 30 percent — there was no recorded indication for pain.
The study, published this month in the Annals of Internal Medicine, highlights a potential administrative problem among physicians who prescribe opioids, and a need for better documentation practices
What did the study find?
In the study, opioids were found to be prescribed in 31,943 visits, of which only 5 percent documented a cancer-related pain diagnosis. Continue reading
Automating clinical decisions with predictive analytics – Twitter discussion from Terri A Lewis, PhD @tal7291
This is Dr. Lewis’ take on how Appriss is using the electronic health record (EHR) of pain patients to automatically calculate an “opioid risk score” and guide the doctor to prescribe less and/or add a naloxone prescription. (see EHR tool to assess patient risks for opioid abuse)
This kind of automated standardization flies in the face of the supposed intention to individualize treatments. Unfortunately, such personalized care is expensive, while standardization is cheap.
Allow me to point out the obvious. Med records are far too inconsistent, messy, wrong, incomplete for this to be a valid, reliable tool upon which to make clinical decisions that involve predictive analytics. JUST SAY NO. Continue reading
Impact of prior authorization on patients and physicians – Don McCanne MD – Mar 2018
Prior authorization is unique to our dysfunctional health care financing system here in the United States.
It is the requirement that permission be obtained from private insurers to provide certain procedures and services or to prescribe certain medications for the patients. What is its purpose?
Our health care system should be designed to benefit patients.
What a quaint notion! I doubt there’s anyone left who believes healthcare is “designed to benefit patients” when so much money is involved. The corporations that have sprung up to dominate healthcare are created and designed to make money for shareholders. Continue reading
MedWatch Voluntary Reporting Form – for reporting adverse drug effects to the FDA
Perhaps the FDA doesn’t know how ineffective “alternative” non-opioid drugs are for pain because no one has told them. You can download a form from this site (link above) to report your experiences.
Use the MedWatch form to report adverse events that you observe or suspect for human medical products,including
- serious drug side effects,
- product use/medication error,
- product quality problems, and
- therapeutic failures
It’s this last category that presents our opportunity for action. We could report the “therapeutic failures” and awful side-effects of non-opioid medicaitons like Lyrica, gabapentin, or antidepressants for pain. Continue reading
Evidence-Based Medicine: Common Misconceptions, Barriers, and Practical Solutions – JAY SIWEK, MD, Georgetown University Medical Center, Washington – Sep 2018
More than 25 years have passed since the term evidence-based medicine (EBM) was introduced into the medical literature. Its original definition has been expanded to include not only the quality of the evidence, but also the two key players applying the available evidence—namely the clinician and patient.
A current working definition is: the integration of the best available evidence with clinical expertise and the individual patient’s values, preferences, and unique circumstances.
EBM is not dogmatic, “cookbook ” medicine.
Oh really? But that’s exactly how it’s being used. Continue reading
When Did Guidelines Become Holy Writ? – Med Page Today – by Milton Packer MD – October 17, 2018
During a recent conference, I listened to the speaker opine on a controversial topic. His talk started and ended with slides that copied the text of guidelines issued by several national organizations and societies. When the guideline slides appeared, he dutifully read out their recommendations with reverence.
When the conference ended, I asked the speaker why he had placed so much emphasis on the guidelines. (Below is a paraphrase of our discussion.)
Him: Well, they’re the guidelines! They represent the right and wrong way to do things.
People Can Die From Giving Up the Fight – 25-Sep-2018 – Source Newsroom: University of Portsmouth
We had a neighbor downstairs, a single woman who retired and then, within a few years, lost all interest in life. She never left her townhouse anymore, but she always acted almost normally when social workers visited. On the rare occasions someone would see her it was clear that she was losing a lot of weight.
She had no relatives nearby and it turned out that she had no friends either. She refused to see a doctor or be hospitalized, so there was nothing anyone could do (which I think is exactly what she wanted). She was eventually found dead, lying neatly and perfectly dressed on her bed.
People can die simply because they’ve given up, life has beaten them and they feel defeat is inescapable, according to new research. Continue reading
Professional Societies Should Abstain From Authorship of Guidelines and Disease Definition Statements – John P.A. Ioannidis – Oct 2018
Guidelines and other statements from professional societies have become increasingly influential. These documents shape how disease should be prevented and treated and what should come within the remit of medical care.
Changes in definition of illness can easily increase overnight by millions the number of people who deserve specialist care. This has been seen repeatedly in conditions as diverse as hypertension, diabetes mellitus, composite cardiovascular risk, depression, rheumatoid arthritis, or gastroesophageal reflux.
Similarly, changes in prevention or treatment options may escalate overnight the required cost of care by billions of dollars.
For example, if we accept PROP’s argument that we’re all addicted to our “heroin pills”, we’d all suddenly need “addiction-recovery programs/clinics/residential treatment centers/resorts” for our “substance abuse” instead of “chronic pain”. Continue reading
The CDC Is Publishing Unreliable Data On Gun Injuries. People Are Using It Anyway. | FiveThirtyEight – Oct. 4, 2018 – By Sean Campbell, Daniel Nass and Mai Nguyen
For journalists, researchers and the general public, the Centers for Disease Control and Prevention serves as an authoritative source of information about Americans’ health, including estimates of how many people are killed or injured by guns.
This shows the CDC is using corrupted numbers to serve its own purposes and pushing a desired agenda, whether it be for gun control, flu shots, or opoids. See my previous post, The CDC’s Math Doesn’t Add Up: Exaggerating Death Toll, for how the flu numbers were exaggerated.
I have now found two instances where the CDC has been caught inflating numbers to promote its desired conclusions (we must all get flu shots, we must have stricter gun control). So I believe we can assume the prescription opioid death numbers have been equally corrupted to promote the agenda that we must restrict prescription opioids because they are supposedly feeding the “opioid crisis”. Continue reading