- RSS
- No Respect For Chronic Lyme Gives Lawyers A Win
- Placebo Journal Update
- There Be Fraud In Them Thar Hills
- Look Who Is Going Ethical?
- Who Needs Evidence When Malaria Is All You Need?
- Joke of the Week
- Ridiculous Study of the Month
- Bacharach’s Beliefs by Ted Bacharach MD, retired
- Fortifido
- Sign This To Get Your Relative Into The Nursing Home
- Let The Wars Begin
- As The Money Goes, So Goes Treatment Options
- Feedback About The Placebo Gazette
1. RSS
The online world is continuing to change and we at the Placebo Journal are embarrassed to admit that we are slow to keep up with it. It is not that we are stupid. Okay, maybe a little but there is also the fact after jumping on the bandwagons of other things in the past (ex. Duract, Trovan, Vioxx, etc.), I am now a slow adopter to many new ideas.
Completing the Placebo Journal is a task in itself. Adding to that the efforts needed for the Placebo Gazette, Placebo Television and Placebo Journal Blog and you have a recipe for disaster. Oh, did I mention I am a full-time family physician and coach of a Babe Ruth league baseball team?
As weird as this may sound, I am not looking for your pity. I just wanted to give you a background on where we are at. Also, what we are hearing for the future is that companies need to keep their blogs alive and well. To be honest, I have had trouble wrapping my head around the blog because I never understood its place. What I am being told is that I should at some point morph this e-newsletter into the blog and let readers use an RSS feed to have it sent to them. If you go to our blog, you will see on top a way to “subscribe” to the posts so they are sent directly to you. That would include anything added from this e-newsletter as well as daily updates. Please look into it and give me your opinion about my ideas of “morphing” the Gazette into the Blog.
If you go to www.google.com/reader, you will be able to collect feeds from anyone who has RSS content. It will just come to you.
2. No Respect For Chronic Lyme Gives Lawyers A Win
There are places for lawyers in the healthcare system. As hard as that is for me to write, it is true. What happened recently in Connecticut, however, is not one of them and it should scare us all.
Before I go on, let me give you some background. Lyme disease is a medical condition. It is treated with less then a month of antibiotics. Chronic Lyme disease is an amalgam of symptoms that is not supported by any evidence. It is eerily similar to its sister “designer diseases” chronic fatigue syndrome and fibromyalgia.
The cult groups behind Chronic Lyme want to validate their beliefs and also want the insurance companies to pay for much longer periods of antibiotics. As much as I hate insurance companies (I think my history speaks for itself), I agree with their denials in these cases. The fact that they would just pass the cost on to other customers should make everyone sit up and take notice.
Now for the rest of the story. Connecticut Attorney General Richard Blumenthal was bullied by these Chronic Lyme groups to open an antitrust investigation against the Infectious Diseases Society of America because he felt the panel excluded some opinions and evidence that may have supported the long term antibiotic treatment theory. Was there any new evidence or study that came out recently to instigate this threat of lawsuit? Of course not. Instead Blumenthal makes the comment that his investigation for the 2006 guidelines included experts who got consulting fees, research grants, and stock ownership from drug companies and other companies that have a stake in the treatment of Chronic Lyme disease.
Does that make any sense to you? Wouldn’t drug companies want to sell more antibiotics? That is how they make their money. If so, then these so-called tainted experts would have pushed for the guidelines to be more favorable for the cult of Chronic Lyme. The fact is they didn’t. If you read the AP article you will see how the giddy gurus of this designer disease are ecstatic that the IDSA is going to take a look at their guidelines again. I think it is a horrible thing for any lawyer to pressure our esteemed medical groups to change their positions by using the threat of lawsuits. It poisons our best thinkers to make “defensive guidelines” not unlike doctors in the field who practice “defensive medicine”.
Check out our discussion about this on our blog:
http://placebojournal.blogspot.com/
3. Placebo Journal Update
The June issue is just around the corner. We really have some great stuff in this one and it is guaranteed to tickle your funny bone. We give a jab to those California hospitals that like to literally dump patients on the street. We poke fun at those medical training mannequins. There are tons of really funny and weird true stories of medicine as well. And don’t forget our cool x-rays.
If you are interested in getting a medical journal that you will read from cover to cover, then subscribe below:
PLACEBO JOURNAL: THE ONLY MEDICAL JOURNAL THAT MAKES YOU LAUGH...ON PURPOSE
4. There Be Fraud In Them Thar Hills
Regulators are ramping up the efforts to spot fraud in the managed-care industry. That is ridiculous. What is so wrong about cherry -picking patients, short -changing doctors on their pay, and denying patients treatments or medications? I highly recommend you read the article entitled “Regulators Eye New Health Frauds.” The funny thing to me is that this “fraud” is not so much illegal as it is there modus operandi. By paying doctors less, playing hardball in negotiating fees or by blocking out certain doctors, managed care has been squeezing physicians for years. And before you get the wrong idea that the money they steal is given back to the patients, think again. Remember their profits and stock continues to grow while they somehow raise premiums at a double-digit rate. It bothers me that it took the fact that some Medicare or Medicaid patients to be enrolled with these companies before they would even start the investigations. Well, better late than never.
5. Look Who Is Going Ethical?
Zimmer, an orthopedic prosthetic manufacturer, is taking a step at stopping their practice of buying out orthopedic surgeons. Zimmer is “banning all company gifts to healthcare professionals” and “prohibiting Zimmer-sponsored healthcare professional presentations at medical society events,” the company says. Funding for medical education will go through third-party institutions. Wow.
Their new compliance model is going to hurt a little; that is until all their other competitors go the same route. Why are they doing this? They say they want to reduce their perceived conflict of interest. Perceived? Paying $85 million in the first 10 months of last year is a little more than a perceived conflict of interest.
Why is Zimmer feeling all ethical all of a sudden? Well a big settlement last year in which Zimmer and the other big players in the field agreed to pay the government a total of more than $300 million and to post their payments to doctors online may have had something to do with it.
To all those orthopods out there, welcome to the new world of intense scrutiny. We FPs no longer get an occasional golf outing. You orthopods don’t get hunting trips in Africa. Damn, I should have been born twenty years earlier and I should have picked ortho!
6. Who Needs Evidence When Malaria Is All You Need?
Check out the Wall Street Journal editorial on the connection between malaria and global warming. The Senate Health, Labor and Pensions Committee is looking into the possibility that our U.S. energy policy is “indirectly exporting diseases to other parts of the world”. Some professors think that the increased temperatures may be leading to the increase of mosquitoes and subsequently the diseases they spread. The piece refutes this by stating that progress in modern transportation is the real culprit. Instead of blaming the jet airplane for transporting the tiger mosquito that caused a specific illness, WHO is blaming the temperature conditions in Italy as the reason. Could this just be a ruse so they can bring attention to global warming? Makes you wonder.
Don’t get me wrong, I believe attention to carbon footprints and global warming is extremely important. Like Paul Reiter and Roger Bate, however, I think scientists should stay out of the opinion arena and leave that to radio talk show hosts or idiots like me. Scientists have a higher bar to uphold and need to let the facts speak for themselves. Using global warming as the excuse for everything only dilutes the real problem that it is. By the way, being that it is in the 30s today in Maine makes it very hard to not want a little global warming anyway.
7. Joke of the Week
The seven-year old girl told her mom, "A boy in my class asked me to play doctor."
"Oh, dear," the mother nervously sighed. "What happened, honey?"
"Nothing, he made me wait 45 minutes and then double-billed the insurance company."
8. Give Us Some Credit
Vance Lassey, a contributor to the Placebo Journal, was at a recent conference. Here is his story:
I was at the big AAFP boards review course in KC this week. If you aren't familiar, it's a 7 day suckfest where you basically drink from an academic fire hose for 11 hours a day. Anyway, there were roughly 600 docs there from all over the country.
You know how these kind of conferences are really big into the no-advertising, no sponsorships, no drug companies, no bias, etc etc, etc? Well, I figured the AAFP could make an exception for PJ.
We had a lecture on Friday, and the guy giving the talk broke it up for a brief bit of laughter by showing the "self-disposing narcotics" video that's on the PJ website (by the way, it got a bigger laugh than any cartoon or joke of the whole conference) Now, I had and have no idea if this video belongs to PJ copyright-wise, or if Doug just found it and put it on the website. But I figured I'd take a chance for a massive 600 doctor live PJ pimping opportunity.
These things are so huge and rushed, there is no time for questions, so every 3 lectures they pause for a 15 minute break/ question session. You write down any questions ahead of time, and they go through them quickly. I handed in a question that read:
"Could you please credit the source for the "self-disposing narcotics" video in your talk? It is from www.placebojournal.com, the only medical journal that will make you laugh...on purpose. Thanks!"
And he did it! I think the note made him nervous or scared. Here's what he said: "I just got a note here...That video I showed was given to me by a pharmacist, and I didn't know where it came from. It's been brought to my attention that it came from placebojournal.com, so I guess these are the people that made that video. I certainly want to give the proper credit...so... www.placebojournal.com." And then he went back to the legit questions. Probably half of the group was out of the room to pee by the time he got to it, but still, that's gotta be 250-300 docs. I was proud.
***Dr. Michael Gorback made and donated the narcotic mystery video to me.
9. Always Looking For Stories and X-rays
As we roll around to the next issue, I want to give a thanks to all those who have contributed the print edition of the Placebo Journal. We are always looking for humorous medical stories from ANYONE’S perspective. We could always use some cool looking x-rays. If you have something to share, please see this section entitle SUBMIT A STORY and send it on. If we publish it then you will receive a free subscription or extend the one you already have.
10. Fortifido
As gas prices rise, food costs go up and we balance on the precipice of recession, what does a country of overweight and whiney people do? They buy vitamin- infused drinks……for their dogs! Fortifido includes peanut-butter flavored water with calcium. Another one has zinc in it and another one has a touch of spearmint. Mmm...Mmm…Mmm. If you don’t like to buy the bottle, another company sells tablets of chicken or chicken liver flavor to add their water bowl. I love this country but it scares me how we can bitch about how bad our lives are in one breath and yet talk about buying specialty water for our dogs in another. I know of enough poor kids who have lead flavored water that it kind of made me cringe when I read this article. Basically, there are some bad things going on in this world. Times are a little tougher. Our lives, however, are not that bad. The poor in this country would be considered wealthy in most other countries. If we can treat our animals with flavored drinks, then we can surely survive most things thrown at us; except our own self-destructive habits, that is.
11. Sign This To Get Your Relative Into The Nursing Home
It is tough to find a good nursing home. On the other end of the spectrum is that lawsuits against nursing home are on the rise. Most of those are totally unjustified. To fix this problem, many nursing homes are having the patients and their families sign a clause that they will go to binding arbitration if a problem arises instead of going to court and suing. The effects of this trend have lowered the average cost to settle cases. The good news, other than the possibility of lowering nursing home costs, is that the lawyers and consumer advocates are pissed!
The goal of this agreement is not to screw the patient but to get away from the ridiculous jury system which is based mostly on emotion. Awarding families $95 million because an elderly woman broke her hip and shoulder because she was allegedly dropped by the nursing home staff is ridiculous. Don’t get me wrong, offenders should be penalized but huge lawsuits only hurt the population and patients at large in the long run.
The arbitration system is starting to spread to restaurants and other businesses. I have mentioned before how doctors who go naked in the malpractice insurance due to cost are doing the same thing. The nicest part of this whole thing is that the lawyers are not able to get around it…yet. As the article in the WSJ states, they are hitting up some senators to try to have the practice banned. Who would have thought that congress is in bed with lawyers?
My favorite line in the add-on piece was when a lawyer recommends if you have to sign this clause write “I’m signing this because I was told I have to”. What a moron. That is when the nursing home hands it back and says that you have the choice to go anywhere else and welcomes you to what’s called a free market.
12. Let The Wars Begin
Medstar Health and Rite Aid Corp. are opening a different type of retail health clinic, one that will be staffed by doctors. Sure it will still fragment care. Sure it is too much convenience for some patients (sometimes a cold is actually, well, a cold). It seems though that this trend will continue for a while until the big box stores start getting sued. And trust me, that is coming. Even though these new places will have doctors at the helm, I still am not going to be a huge supporter of any type of convenience store clinic. I am licking my chops, though, as the battles will heat up. It will be rent-a-doc vs. rent-a-nurse practitioner. As Apollo Creed said in Rocky, “sounds like a damn monster movie”!
13. As The Money Goes, So Goes Treatment Options
It was sad to read that hormone therapy for prostate cancer declined probably as a result of the fact that Medicare slashed what it paid doctors for using it. A study from 2003 to 2005 showed that the number of injections fell by 14%. Financial pressures should not influence our medical decisions, but unfortunately they do. To be fair, the cuts by Medicare were so steep to urologists that giving the shots actually doesn’t even cover their cost to the doctor. On the flip side, prostate surgeries are up and that means more money to the urologist. For the primary doc who spends all that time discussing whether getting a PSA test is worthy or not and why most men die from something other than their prostate cancer, he or she is also getting cut my Medicare. Unfortunately, we don’t have a surgery or other procedure to make up for the loss. A nice “thank you” letter from the urologist for the referral would be nice, though.
14. Feedback About The Placebo Gazette
