Placebo Journal - Medical Humor With A Purpose

1. Fake Medical Journal

I wish I could say it is this one but, alas, it is not to be. KevinMD.com has received many honors over the years and deserves all the accolades it receives. Kevin Pho MD runs the site and I am proud to say that we have been "Blog Buddies" for a few years now. I highly recommend you check out his blog and even get his newsletter. His thoughts are insightful and he always displays the facts while trying to give all points of view. With that, he still has the balls to call a spade a spade and is not afraid to give his a opinion. He is a practicing internist in NH and his opinion is important because he is still on the front lines of medicine.

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2. Was It Really Worth It?

Here is some news to lighten things up....or not. An Egyptian man decided to cut off his penis because he was unable to marry a girl from a lower class family. Vincent van Gogh would have been very proud. Our hero was rushed to the hospital but doctors were unable to reattach his little friend. The article states that marriages in that part of the world are usually "between similar social classes and often within the same extended families — and are rarely for love". Whatever. All I know is that in this part of the world the man has his penis cut off AFTER the marriage. Okay, I will be in trouble from my wife for that one. The point is you never want to cut off your penis to spite your....well, forget about it.

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3. Placebo Journal Proven To Lower Heart Disease

This headline is an absolute stretch (lie) that I am using to promote our product. This is not unlike what you see on TV commercials for fat reducing products or even for Cheerios which claims to lower cholesterol. There is evidence, however, that laughter may be beneficial for your heart. Two studies presented at the American College of Sports Medicine's 56th Annual Meeting showed improved arterial compliance and improved vascular function after the patients watched a comedy versus a documentary. Do imagine what the differences would be when comparing subjects who read the Placebo Journal versus the New England Journal of Medicine? Scary.

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4. Placebo Journal Update

We have started to work hard on the next issue (August) in order to keep the laughs coming. June is being printed/mailed as we speak. We consisently are told that our journal is the only one read cover-to-cover. Isn't time you found your smile again? We have the answer and it comes right to your house every other month. If you want something that is all humor and guaranteed to make you a little incontinent then:

The battle is on. Two Democrats are going at it head to head. Ted Kennedy wants "a robust public health care plan, a government-sponsored entity that would compete with private insurers". Max Baucus is working with Chuck Grassley (Republican) on a compromise that pushes that public option aside. They state, rightfully so, that we can't afford the public options we have already; that being Medicare and Medicaid. The latter group is exploring the "the public plan" as a threat or as a way to extort the private insurance companies to make "meaningful, affordable coverage available to all Americans within several years". Let's see, they have been raising their rates by double digits almost every year and now they are going to start cutting their prices? Yeah, right. Here is my favorite part of this NY Times article:

The split reflects not only political differences between the two men but also differences between their committees, racing to write the most ambitious health care legislation in the nation’s history.

Is this more about ego than about real change? Did I mention Ted Kennedy was involved?

I am not smart enough to know which proposal will work. I do believe, however, that no matter what comes down the pike, we ALL have to contribute something to it. No matter what a person's income is, he should have to pay - even a little bit. Only then will that person value this service. Just my thoughts.....for now.

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UnitedHealth wants to show Obama how to save $500 billion in Medicare spending. Since they have been raking in the cash over the years they just wanted to show the rest of us how they did it. Check out some of their proposals here and you will see how easy it is to save money. Let me summarize it for you this way:

Use less doctors.
Make it harder for doctors to order tests.
Find a way to manipulate the grading systems on doctors and then steer patients away from them.
Take the decision on which medications to prescibe out of the doctors' hands
Ration health care
Pay your CEO huge bonuses each year

Sounds like a recipe for success. The only reason they are giving out such advice free to Congress is that they fear that their head is on the chopping block. I sure hope so.

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The guys behind the so-called retail clinics proclaimed that they would help the poor and uninsured get health care. They were going to be saviors. At least it sounded good and sometimes style is much more important than substance. It turns out that these retail clinics are following Sutton's Law and they found out that the money is in the more affluent neighborhoods. By mapping the 930 retail clinics operating last year, the authors of a study in the Archives of Internal Medicine then crosschecked those operations with the U.S. Census data . Interestingly enough, only 123 clinics are located in areas defined by the federal government as medically underserved. This means those the areas which had less black and Hispanic residents and less poverty were prime locations for retail clinics. This doesn't mean that blacks and Hispanics couldn't get their health care there but they just needed to drive, take a bus, hitchhike or walk to a nicer area of the state. Now, how about someone calling the backers of the retail clinics to task on this? Oh, wait a minute, I just did.

The big news this month is that Medicare is not going to pay for virtual colonoscopies. In this method, images of the colon are generated by a noninvasive body scan versus sticking a long fiberoptic scope up someone's well, butt. A lot of people choose NOT to have the second option because of fear. The most unpleasant part of the deal is really drinking all the laxative agent the night before in order to clean out before the procedure. That would still happen with the virtual scan as well so the real inconvenience won't change. I understand Medicare's point of view. We keep adding newer technology and rarely get rid of older ones. This keeps adding to the price tag of a bankrupt system. The regular versus virtual colonoscopy debate also pits gastroenterologists against radiologists. The latter would be taking a huge bite out of the former's cash cow. Here is how I would settle that. Since it only takes about 30 minutes of the physician's time for each procedure, Medicare should reimburse the same amount of wRVU or "work relative value units" that it gives for a complete physical exam. That would be around 2 RVUs or about $80 to $90. That would end the battle right there. The conversation would then become:

"Be my guest, you can do the procedure".

"No, no, my good sir. By all means, this is your area of expertise. Go right ahead".

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I WANT TO KNOW WHAT YOU THINK. Please go to each individual story and follow the link. If you do not have access to the blog you can also post your thoughts under the WRITE A REVIEW section.

Until next time, keep smiling, keep laughing and keep out of the sample closet.

Doug

King of Medicine