Tag Archives: money

Toilers in the Vineyard and Leadership Behind the Curtain

Toilers in the Vineyard and Leadership From Behind the Curtain – By Henry Buchwald, MD, PhD – Dec 2017

Practicing surgeons, as well as surgical teachers, researchers, analysts and thinkers, are toilers in the vineyard of service and progress, in an effort to do good in a chaotic world.

We workers

  • respect life and strive to preserve it.
  • abhor disease and fight against it.
  • are positive agents in a troubled society.

This description of what “doctoring” used to be, brings back fond memories of finding such a doctor, even more than once. We worked together, the doctors and I, I with expertise in my own body and they with expertise in what could go wrong.  Continue reading

The Doctor–Patient Relationship, Defined by Language

The Doctor–Patient Relationship, as Defined by Language by Henry Buchwald, MD, PhD – Sep 2019

A lexicon or thesaurus of ambiguous, euphemistic language is probably required to understand the Orwellian (George Orwell, born Erick Arthur Blair; author of “1984,” published 1949) “Newspeak” that is engulfing our profession.

The administocracy (see below) of health care has introduced many new terms into our medical vocabulary, and as Orwell fully appreciated, words are transformative precursors of reality.

You’re not in pain, you’re just “experiencing discomfort”. Continue reading

AI used to increase medical billing

AI-based product aims to help providers identify missed charges | Health Data Management – By Joseph Goedert – Sep 2019

It’s always interesting to look at a subject from a different point of view because it gives a more complete picture. I found this article in a publication called “Health Data Management”, which is focused on the health data and computing aspect of healthcare and has nothing to do with medical care.

This article predictably uses the generic functional term “provider” for doctors and nurses, a standardized and interchangeable version of the real people actually practicing medicine.

This is a hint of what we can expect in the future of healthcare after AI systems are embedded in every facet of our care: standardized “providers” will follow standard algorithms to diagnose and treat “standard” patients, who are all assumed to be the mythical “average human”. Continue reading

Health Insurance Industry Interfering with Pain Mgmt

The Role of the Health Insurance Industry in Perpetuating Suboptimal Pain Management – Mar 2011

The author concludes that the outlook for chronic pain sufferers is not particularly bright, until such time that a not-for-profit single-payer system replaces the current treatment/reimbursement paradigm.


Unlike pain practitioners, health care insurers in the United States are not expected to function according to a system of medical ethics.

Rather, they are permitted to function under the business “ethic” of cost-containment and profitability.

This capitalist principle is a problem for all social services because they serve a sector of society that often cannot pay; either their jobs don’t pay enough or they are too disabled to work.  Continue reading

Generic Drugs Are Poisoning Us

A New Book Argues That Generic Drugs Are Poisoning Us – New York Times  – By David Dobbs – May 13, 2019

This is a review of a recently published book exposing the seamy side of the “profit above all else” generic drug industry:

The Inside Story of the Generic Drug Boom
By Katherine Eban

I’ve always been suspicious of generic drugs because I’ve noticed that my body sometimes reacts slightly differently to a new batch, and often reacts very differently to a switch from brand-name medications to generic. This book validates my concerns and even adds new ones.  Continue reading

The Opioid Crisis Is About More Than Corporate Greed

The Opioid Crisis Is About More Than Corporate Greed – By Zachary Siegel Jul 2019

Nearly every step of the pharmaceutical supply chain is implicated in the soaring death rate.

But the companies claim to have been acting legally and in compliance with federal regulators like the Drug Enforcement Administration (DEA).

Was it all, technically, legal?  

Of course, it was legal; pharmaceutical companies are enjoying their legal scheme of profiteering and wouldn’t do anything to endanger that privilege.
Continue reading

Corporate Law Creates Sociopaths

The Most Important Problem in the World – Medium by James Gamble – Mar 2019

The most important problem in the world is a reasonable sounding provision of the corporate law that governs most major U.S. companies.

The rule: corporate management and Boards of directors are obligated by law to make decisions that maximize the economic value of the company.

This is how you end up with absurdities like this: 400% price hike for drugs is ‘moral requirement’. It’s frightening to be at the mercy of such ruthless entities making our health unaffordable, yet this is what corporations were created to do.  Continue reading

Can we trust generic drugs?

Opinion | Americans Need Generic Drugs. But Can They Trust Them? – NY Times – By  May 2019

Technicians used initial hidden tests to get preliminary results, which then guided them as they tinkered with the test settings.

Then they retested in the plant’s official system to get the desired results showing that the drugs fell within specifications. Those drugs with altered test results could then be released to patients.

During his 27 months in India, of the 38 drug plants he inspected, Mr. Baker found fraudulent or deceptive data in 29 of them.    Continue reading

Rein In ‘Sociopaths’ in the Boardroom

Ex-Corporate Lawyer’s Idea: Rein In ‘Sociopaths’ in the Boardroom – NY Times – By Andrew Ross Sorkin – July 2019

This “reformed” lawyer points out a fundamental flaw of our capitalist system that is responsible for increasing income inequality (rich getting richer, poor getting poorer), dysfunctional government (gridlock), and social decay (deaths of despair).

These troubles stem from a particular aspect of corporate law, and he proposes a relatively simple solution to change how corporations operate.

Jamie Gamble, a retired corporate lawyer, has had an epiphany in recent years: The executives who hired him and that his firm sought to protect, he said, “are legally obligated to act like sociopaths.”   Continue reading

Diagnosis Codes Index – Opioid related disorders

Diagnosis Codes Index – Opioid related disorders (F11)

In the new ICD-10 system for medical billing codes, there’s a specific code for anything and everything to do with opioids. There’s even a code for “opioid use, unspecified, uncomplicated, which seems to indicate that any “use” of opioids is a medical problem in itself. 

We can see how “the medical system” is organized by looking at how healthcare services are billed. Looking at the hierarchy of categories in this billing scheme, we can discover how they see us, pain patients, using opioids.

The problems start at the top level: our “code” is listed under the category of “Mental disorders”:

Mental and behavioural disorders (F00–F99)    Continue reading