More is Better, Right?
Nonprofit Bonus
Shooting Up
WHO Done It?
Placebo Journal Update
Sexsomnia
Creative and Imaginative
That Smoke Is Making Me Crazy
Samples by Ted Bacharach MD (retired)
1. More Is Better, Right?
We in this country truly believe that more is better. This usually flows into peoples' beliefs about health care as well. The problem, as doctors know, is that this is not only NOT true but also can be bad for you. A recent AP article describes this problem and notes that the "US accounts for half of the most advanced procedures that use radiation, and the average American’s dose has grown sixfold over the last couple of decades." Wow. There are a lot of reasons for this. There are primary care docs who keep ordering tests out of either stupidity or fear (of being sued). There are patients that demand the tests. Lastly, there are radiologists who keep recommending them and it is impossible to refuse those recommendations (see above for fear of lawsuits). Gee, I sure hope this changes because we are going to be the only population that will glow at night. We will be a nation of fireflies
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2. Nonprofit Bonus
Did you ever wonder whether the health insurance companies were hurting in this economy? Well, wonder no more. William Marino, CEO of Horizon Blue Cross Blue Shield of New Jersey earned $934,615 in base salary and $7.8 million in bonuses and additional pay in 2009. The total compensation was up 59% from 2008. And this is a nonprofit plan. How does this dude look at himself in the mirror each morning?
Here is the best part:
In a news release, Horizon maintained that executive pay is in line with what other, similar companies would pay. The company said that executive pay is only "0.24% of our members' monthly premiums."
A couple things to note. I agree that the executive pay is in line with other companies but that is because other companies continue to use each others numbers which causes a never ending cycle of increasing executive pay. Second, since they were so quick to point out how little of the members' monthly premium was eaten up by the CEO's salary, I was wondering how much all the ADMINISTRATORS added together cost each member. It would probably be astronomical!
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3. Shooting Up
Here is a great little news anecdote that you just know the media got wrong. The headlines go as follows:
Woman shoots self to get surgery. Desperate and uninsured, Kathy Myers hoped wound would lead to shoulder repair she couldn't afford.
Supposedly, this 41-year-old took a .25-caliber handgun and shot her own arm because she couldn't see a specialist about her "lingering" shoulder pain. A few sentences later, a father of a friend states that she had a shoulder injury from about a month ago. A month ago!!! That's lingering? Even if you did have insurance you wouldn't have been evaluated and had surgery within a month. Only in America do people expect a fix that fast.....and for free.
There is more to this story. The article states that she was out of work as an asbestos remover for about a year and did not have any health insurance. Myers was seen by doctors and given pain meds, though. Her care was not neglected. I guess since her shoulder was not immediately "fixed" she thought mangling it with a bullet would get those doctors off their lazy fannies.
The media loves this because it gets to play up how bad our country is that its people have to shoot themselves in order to get proper health care. Reading between the lines, as a doctor myself, I see this differently. Most shoulder injuries do NOT need surgery. Pain can be controlled with ice, NSAIDS, and then corticosteroid injections. Rehab can be easily done at home with an exercise form and a cheap rubber band. If not better in a few months then an MRI can be done to assess the damage and see if surgery is truly needed.
I would love to hear the real story behind this case. If she didn't have insurance for a supposed surgery then how would she have the insurance or the money for her gunshot wound and the fix that she thought would come with it? If anyone hears any more on this please send it my way.
4. WHO Done it?
There is a big controversy now about World Health Organization's handling of the H1N1 pandemic and the fact that they failed to disclose possible influence by the pharmaceutical industry on its recommendations for how countries should respond. Call me crazy but that little secret is bad, right? The Washington Post states that the Geneva-based arm of the United Nations relied on advice from experts with ties to drug makers in developing the guidelines it used to encourage countries to stockpile millions of doses of antiviral medications. Are they saying that WHO can't just ask a pharmaceutical company their opinion even though it would put billions in their piggy banks? Of course not. WHO has had problems like this before and need to straighten their stuff out. WHO Dat Idiot!! 5. Placebo Journal Update
 We are presently working hard on the August issue. If you have any stories you want to share then this is the time to send them in. If you did something in the past and it wasn't used then it probably didn't make the cut. Sorry. That doesn't mean other anecdotes you are holding onto wouldn't work. Send them all in here:
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6. Sexsomnia
One in twelve patients reported engaging in sexual activity while sleeping according researchers at the Sleep Research Laboratory at the University Health Network’s Toronto Western Hospital. They describe parasomniacs as people who complain of not feeling rested, but they were actually walking, talking, eating or having sex while sleeping. In fact, the new term is "sexsomnia" and first coined when it was used in a court case to free some dude charged with sexual assault in 2003. This whole concept is still controversial but the article is a good read. Rumor has it that many of our Congressmen are trying to having a National Sexsomnia Day here in the United States.
FOLLOW this link to comment on this story 7. Creative and Imaginative
Take a look at this opinion piece by Bob Dorigo Jones. Though his name may be weird, his thoughts are not. He talks about "warning label overload" and how this is all due to the fear of lawsuits. He lists a lot of interesting examples but there are too many to mention here. The one I want to quote is this one:
We all know about the hot coffee lawsuit against McDonald's. But did you know that McDonald's was also sued over a milkshake? Several years ago, a man went through a drive-through at McDonald's and bought a milkshake and fries. He put the shake between his legs, the fries next to him and drove away. As he reached for the fries, he squeezed the drink between his legs and it spilled on him. Distracted, he rear-ended another car and caused minor damage. Incredibly, the owner of the damaged car sued McDonald's for failing to warn the customer about drinking a milkshake while driving.This case went all the way to the New Jersey Supreme Court before finally being thrown out for good. But when the restaurant asked to be reimbursed for the thousands it spent on legal fees in this frivolous case, the judge refused. He actually said the plaintiff shouldn't be penalized for being "creative and imaginative."
Can you imagine a doctor getting off on a malpractice case because the judge felt he shouldn't be penalized for being "creative and imaginative"? In fact, it is just the opposite. With the advent of evidence based medicine guidelines, a doctor has to be VERY careful about doing anything not exactly in those guideliness less those guidelines are used AGAINST him or her in a court of law. FOLLOW this link to comment on this story
Doug Farrago MD King of Medicine
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