1. Thank You For The Stories
2. Anecdotal
3. Placebo Journal Update
4. Gorback’s Thoughts by Michael Gorback MD
5. Great News!
6. Nobody Is Listening
7. Joke of the Week
8. Ridiculous TV Reporting of the Month
9. Make Mine Fake
10. AMA Spoof….Again
11. Not All The Same
12. Making Money By Seeing Your Doctor
13. You Think Those Drug Dinners Were Bad?
14. Feedback About The Placebo Gazette

1.  Thank You For The Stories

In a recent mass email I asked for story submissions to receive a free subscription to the Placebo Journal.  Boy, did you people respond!  I have received a ton of stories and I am still in the process of reading through them all.  I received stories from everybody’s perspective.  Most were great.  A few were over-the-top.  A couple of them were interesting but not funny enough to make it in.  I truly appreciate your efforts and want to ask you to continue to send your humorous medical tales to the following section of our website:

http://placebojournal.com/submitstory3.asp

Unfortunately, we do NOT print all of them.  Some just don’t make the cut.  Others get pushed back an issue or two.  Don’t be discouraged if yours doesn’t make it.  Please understand, however, that I only alert those who get published that they will be getting a free subscription.  I don’t have the time or manpower to alert everyone whose submission is not yet used.  For that I am sorry. 

2. Anecdotal

Who needs proof when you have a great story?  Phil Galewitz did a piece in the USA Today about “healing touch”. These are thirty minute sessions where nurses guide their hands along a patient’s body parts.  Sometimes their hands are a few inches above the patient.  Sometimes their hands lightly touch the patient.  More than 100 U.S. hospitals have started offering this service.  Sounds great, right?  I am sure it can’t hurt.  Inherently, I believe that we are made up of an energy force so maybe it can be manipulated or adjusted.  Here’s the problem:  no clinical trials have shown it does anything.  In other words, there is no proof it works.

Does that it mean it should be stopped?  Who knows?  However, in an era where evidence based medicine is changing everything we do as physicians, shouldn’t nurses be held to the same standard?  This is not a knock on the nursing profession, either.  You just can go around making claims on anecdotal evidence.  For example, a buddy of mine swears by the “healing touch” he receives in a Vietnamese nail salon shop he frequents on a regular basis.  Until it was raided by the police, I could have sworn it was doing wonders for his depression.  For even more proof, now that his “healers” have been deported, his depression is even worse.  Where is the USA Today when you need them to do a story on this medical phenomenon?

You can talk about this story at our blog:

http://placebojournal.blogspot.com/

 3. Placebo Journal Update 

For many reasons, some out of our control, the October issue was delayed this year.  We are hoping to remedy this for our December issue. I can tell you that we are almost done and it is looking great.  There is a lot of improvement in the quality of the color.  Wait until you see it.

This issue includes:

• Exhumera: the second hand drug delivery system to use any way you want.
• The Path to Boredom Pathology Conference
• Smoker Repellant System
• And much, much more!

Don’t miss out.  You have until Nov 30^th to get in on this issue.  Click below to find your smile again.

SUBSCRIBE

4. Gorback’s Thoughts by Michael Gorback MD

We have all had discussions about the subtle (and not so subtle) ways the insurance companies try to erode our status. One of the methods - very effective I might add - is to downgrade us from physicians to the generic "health care provider". This is not just a matter of convenience; it is well known that if you change the nomenclature you can change the perception. This is not solely an external phenomenon. The people that the term refers to will internalize the label too.

Have you ever heard a hospital administrator talk about patients as "customers" or "clients", or talk about "customer satisfaction"? Is this a Wal-Mart? Have you ever heard someone talk about "health care consumers"? What happened to "patients" and "sick people"?

Look at the abortion battle. On one side you have "pro-life" and on the other side, not "anti-life", but "pro-choice". Nobody seems to be against anything. Handicapped people are "differently abled", deaf people are "hearing-impaired", and so on. Change the terminology and you change the perception. Shakespeare was wrong: A rose by any other name wouldn't smell as sweet. If you chopped up some weeds and put them in a bottle labeled "Garden Weeds" no one would buy it, but if you call it "Wild Endive" or "Lion's Tooth" suddenly it's medicine worth $20 a bottle.

I have decided to stop being a generic health care provider and go back to being a doctor. Whenever I am presented with forms to fill out now, I cross out "health care provider" and write in "doctor" or "physician". If someone refers to me as a health care provider I interrupt them and correct them. The hospital might have customers but I still have patients. Maybe I'm just pissing in the wind but maybe if enough of us do it someone will get the message. You don't have to put up with this degradation.

5. Great News!

Did you hear that the UnitedHealth Group Inc. posted a 15% rise in third-quarter profit?  Even though there was an enrollment decline, they accomplished this task by what the WSJ calls “putting profitability before revenue growth”.   In other words, it was all in their efficiency.  And we all know what efficiency as a euphemism means.  In other news, doctors are getting paid less by managed care companies and patients are paying more.  The Chief Executive, Stephen Hemsley, told investors that “we strengthened our discipline in pricing to costs across the commercial-benefits even at the cost of membership growth”.  What the hell does that mean?  It means a big bonus for Stephie!

6. Nobody Is Listening

An analysis of 6,446 U.S. adults showed that only a very small amount of those with diabetes were meeting at least three out of five American Diabetes Association dietary recommendations.  Not more than 26% were meeting the recommended physical activity guidelines.  The study did not evaluate what the obstacles to following these recommendations were but my guess it has to be their doctor’s fault.  That is why physicians should be penalized in the future when more and more Physician Profiling (P4P) programs are put in place. 

In a related story, adult obesity is o the rise in 31 states according to a study form Trust for America’s Health.  Even better, no state had a drop in their obesity rate.  We are eating ourselves to death on one hand and then calling for free medical care on the other Whopper Special Sauce stained hand.  Who is to blame for this obesity epidemic? It has to be the doctors.   Putting responsibility into the patient’s hands is too politically incorrect to think otherwise.

7. Maria’s Media Spotlight by Maria Simbra MD

October is a month of psuedo sweeps and a time of pre-bona fide-November-sweeps. 

Here were my assignments.

10/02/07         "Study: Patients, Doctors Use Email to Communicate"

10/05/07         "Study: Stress at Work Increases Risk of Depression"

10/08/07         "Hospital Debuts Umbilical Cord Blood Service"

10/09/07         "Study: Unhealthy Relationships Could Kill You"

10/09/07         "Eating Right Can Improve Your Vision"

10/10/07         "Salmonella Fear Halts ConAgra Pot Pie Sales"

10/29/07         "Study: Daylight Saving Time Affects Body Clock"

To see these reports, go to KDKA.com, click on the word "Video" at the top of the large box (top right), open the drop down menu and click on "Health," look for the headlines mentioned above.  They're organized by date, the most recent reports up top.

Duh.  Stress and depression.  Toxic relationships and heart disease.  Sometimes these things are intuitive, but then a study comes out to support it.  The mass applicability makes it prime fodder for the evening news.

Biased sources.  Beware reporters and consumers of the mass media.  The public relations machinery will try to feed you numbers that make it sound like a novel practice is or will be more common than we can firmly establish at the present.

The list is a bit shorter this month for a couple of reasons: 1) I was away in Maui in the middle of the month celebrating my 10th wedding anniversary (aaawww),

2) Some days I was out shooting reports for the November sweeps, and for that reason, was not assigned to be on air.  But you'll just have to wait until my next entry to hear all the sensational, scary, spectacular stories that make sweeps was it is.

8. Go, Ari, Go

A recent WSJ piece by Dr. Ari Brown truly was wonderful.  Ari is a friend of mine from Texas.   She is a pediatrician and has written some great baby books that I highly recommend.  Her editorial commented on Jenny McCarthy and her misguided attempt to use her celebrity status to claim how vaccines cause autism.  Dr. Brown respectfully, but scientifically, picked apart McCarthy’s accusations.  She obviously read McCarthy’s book and pointed out inconsistencies that make McCarthy seem foolish.   Though we all feel for patients who have autistic children it doesn’t mean we should let this get in the way of the facts.  Celebrities need to do what they do best.  I believe McCarthy’s best days were when she was farting on the MTV show Singled Out.  If you want celebrities to be the mouthpiece for every important decision that goes on in this crazy world, go watch Team America: World Police and you will truly get a laugh.  Here is one of the lines that I love:

“As actors, it is our responsibility to read the newspapers and then say what we read on television like it's our own opinion.”

9. Bacharach's Beliefs By Ted Bacharach MD, Retired

Healthcare for All???

All of the politicians are talking healthcare for all. The idea certainly has appeal for most people. Unfortunately all people are not alike; they differ in many ways. Some have multiple illnesses for which they need help, others are hardly ever sick and avoid medical care. The sicker patients are not always the ones that fill our offices; there are some people however who are constant visitors. The severity of their illnesses is not necessarily the determining factor. Some patients have been limited to some extent by the roadblocks applied by the insurance companies or financial reasons. If people were like machines it would probably be possible to apply a system more easily. Unfortunately the human variations make it difficult to provide all with a similar level of care. The patient with constant complaints frequently usurps the physicians time and the sick patient has difficulty getting an appointment. In retrospect, unfortunately I have too much ‘retro’; fee for service was really a pretty good system. A system that allows patients to see a physician any time they think they might like to would certainly clog up all offices making most people wait for their needed care.

I believe that most of the cost of medical care is generated by hospitals, laboratories and pharmaceuticals. I suggest that all restrictions, reports, authorizations be taken out of the primary care physician’s office. This would allow the patient to have free choice and be responsible for paying for his or her office visits. The relationship between patient and physician would be improved. More physicians would be attracted to family practice if the limitations, restrictions, authorizations and so on were removed. They would not be diverted into cosmetology, plastic surgery or other specialty where they are truly independent. The specialist’s services would be covered by third party remuneration as would hospital, laboratory and medication costs. Patients unable to pay for primary care would be offered free clinics. In many situations at least some of these patients would be seen by a primary care physician for less than his usual fee. In the days of fee for service many of us saw patients for nothing except the satisfaction we derived from being able to provide this service. The fee for primary service might also result in a decline in the need for expensive emergency room care.

Unfortunately, there never has been nor will there ever be a system where everyone gets the same level of care. This should not be a deterrent preventing us from making sure that all people are afforded medical care.