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refers to the meetings that were traditionally held on Tuesday evenings where
physicians met with their colleagues and the interested business and
professional communities to discuss the medical and health care issues of the
day. As major changes occurred in health care delivery during the past several
decades, the need for physicians to meet with the business and professional
communities became even more important. However, proponents of third-party or
single-payer health care felt these meetings were counter productive and they
essentially disappeared. Rationing, a common component of government medicine
throughout the world, was introduced into the
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Politics of the Self-Esteem Myth
Surgery No Better Than Rehab for Low
Dermatologists' Practice Eliminates
Paper to Boost Productivity, Cut Errors
This Week’s Review of Medicare or
Medical Gluttony: One Freebie That
Doesn't Cost More - Unnecessary Lab Tests
Medical Myths: Myth 7-Every Employer
Must Pay for Employees’ Health Insurance
Overheard in the Medical Staff Lounge
- Are Polls Confusing or Dishonest?
The MedicalTuesday Recommendations for
Restoring Accountability in Medical Practice, HealthCare and
* * * *
The Politics of the Self-Esteem
F. Baumeister and his colleagues, reporting in
this month’s Scientific American,
discuss boosting people's sense of self-worth which has become a national
preoccupation. Americans see a favorable opinion of oneself as the central
psychological source from which all manner of positive outcomes spring. The
corollary, that low self-esteem lies at the root of individual and thus
societal problems and dysfunctions, has sustained an ambitious social agenda
for decades. Indeed, campaigns to raise people's sense of self-worth abound.
what transpired in
California task force disbanded in 1995, but a nonprofit organization called
the National Association for Self-Esteem (NASE) has picked up its mantle,
aiming (according to its mission statement) to "promote awareness of and
provide vision, leadership and advocacy for improving the human condition
through the enhancement of self-esteem." Vasconcellos,
one can draw on many more studies now than was the case 15 years ago, enough
to assess the value of self-esteem in several spheres. Regrettably, the
authors maintain, those who have been pursuing self-esteem-boosting programs,
including the leaders of NASE, have not shown a desire to examine the new
recall when Vasconcellos tried to pass a mandate
that courses on "Self Esteem" be taught in our schools to create a
better society. This article reports some findings that even suggest that
artificially boosting self-esteem may lower subsequent academic performance.
This is another example where a government mandate (fortunately this one was
never passed nor implemented) usually creates the opposite result. It also
points out that failed efforts by politicians have great difficulty in simply
dying. Unfortunately, even without scientific support or awareness of
scientific data that negates their findings, politicians will spend their
lives, even obtain tax-free funding, to give a dead horse another life. God
help us all if they should ever gain control of health care. That really would
be like dying.
review of the author’s survey of the scientific literature and the entire
article can be found at http://www.sciam.com/article.cfm?chanID=sa006&articleID=000CB565-F330-11BE-AD0683414B7F0000&pageNumber=1&catID=2.
so many laws (mandates) are passed that no one can observe all of them, then
you have a nation of lawbreakers. You can then get conviction after conviction
for total servitude.
- Ayn Rand
* * * *
No Better Than Rehab for Low Back Pain
Wendling reports on the annual meeting of the
North American Spine Society in this month's Internal
Medicine News. Dr. James Wilson-Macdonald said at the meeting "There
is no clear evidence that spinal surgery is more effective than an adequate
rehabilitation program for chronic low back pain." In his multicenter
trial of 349 patients, aged 18-55 years, with at least a year's history of
chronic back pain, 176 were randomized to spinal surgery and 173 were assigned
to participate in a 3-week rehabilitation program based on cognitive
behavioral principles. Two years after randomization, both groups reported
clinically significant reductions in disability.
patients where spinal fusion is indicated, rehabilitation may offer a cheaper,
noninvasive alternative,” added Dr. Wilson-Macdonald of the Nuffield Orthopaedic
were 19 complications in 139 surgeries, and 11 patients had revision
surgeries. No complications occurred in the rehabilitation group. Specific
fusion surgery techniques did not appear to alter the outcome, Dr.
read the entire report go to http://www2.einternalmedicinenews.com/scripts/om.dll/serve?action=searchDB&searchDBfor=art&artType=full&id=aqm05038108.
concept that surgery recommended on one day may no longer be indicated later
on is difficult for some health care planners to grasp. It is also difficult
to incorporate into medical guidelines. In socialized medicine countries, once
a recommendation for an operation is made, it is carried on the waiting list
for years. When the name comes up, sometimes years later, the patient reports
for surgery even if the need no longer is present. For instance, what happens
to the patients that were told that they needed a heart transplant or they
would die? Because of the limited supply of beating hearts available, many did
not receive transplants. However, follow up studies have shown that a
significant percent of these patients got well enough that they could function
normally and no longer needed a transplant. When the state or insurance
carriers rather than doctors and their patients are in charge, it can be a
very expensive proposition, decreasing the quality of care and increasing
Body Restorative Functions Are Difficult to Predict.
It's Best to Leave the Daily Evaluation with the Doctor–Patient Team.
* * * *
Dermatologists' Practice Eliminates
Paper to Boost Productivity, Cut Errors
Richmond reports in the Wall
Street Journal that Sherwin Parikh might serve as a model for a new
medical maxim: Physician, heal thy office.
Parikh is on the cutting edge of a group of physicians and dentists in private
practice who believe that digital technology can boost office productivity,
while reducing expenses, headaches and mistakes. "One of the pitfalls of
practicing medicine is the bureaucracy of the actual business of it," Dr.
Parikh says. The high-tech system "frees me up to deal with the patient
as an actual person, rather than a manila folder."
Damm, 37, Dr. Parikh's business partner, says
doctors at the
center's automated system also reduces simple errors that cause insurance
companies to reject claims in part by reducing the number of times data are
transposed from one record to another. Mr. Damm
says typically only 3% to 5% of the center's claims are outstanding. But these
results, he says, rely on absolute fealty to a paperless system. Although a
prescription or a requested receipt may still need
a piece of paper, Mr. Damm has mercilessly removed
nearly all other paper -- and pens -- from the office. He's even considering
taking back the small rainbow-colored spiral notepads he had given office
workers to use in a pinch.
practice's system begins before a patient's first appointment, when the person
submits a medical history using the center's Web site or the PC in the
office's glass-walled, wood-floored waiting room. During visits, doctors
record diagnoses and treatment plans, add notes, write prescriptions and mark
insurance codes using wireless tablet PCs. Typed prescriptions wait for
departing patients at the front desk, and billing happens automatically.
Software converts faxed biopsy reports into e-mails that are routed to the
doctors' offices have brought in electronic scheduling and claim-filing
systems, but most still lack the real emblem of a wired health-care outfit:
electronic medical records (EMR). Only about 5% of small doctors' offices have
adopted EMRs, with another 5% planning to make the
move, according to the Health Information Management and Systems Society, an
industry group. That compares with the 56% of hospitals and large institutions
and 40% of large clinics that have or plan to implement them.
larger organizations' adoption of EMRs to reduce
health-care costs and medical errors is likely to drive the industry,
including small doctors' offices, toward use of digital records. To read the
entire article, go to http://online.wsj.com/article/0,,SB110237426083592516,00.html.
It is critically important to note that the electronic medical record utilized
by a doctor or group of doctors in private practice protect patients’
privacy. A five percent increase in utilization in small offices and 40
percent in large clinics in one year is actually rather rapid and probably as
fast as practices can assimilate new technology. Remember it has only been a
few years since 95 percent of physicians acquired internet access. The current
government proposals to implement EMR will be cumbersome, will not improve
efficiency since medical office staffs are not yet attuned to them, as the
above example suggests, and primarily gives the government access to patients'
confidential medical files. Although this is denied by government spokesmen,
it was also denied in the HIPAA discussions, and then passed by assuring
patient confidentiality. In reality, it has given insurance carriers,
including Medicare and Medicaid, access to confidential medical information
without patient knowledge or disclosure.
* * * *
This Week’s Review of Medicare or
security has been on a slow downward spiral towards insolvency for about 70
years, with its 100th anniversary a possible bankruptcy sale. Most of my
patients don't believe that. Medicare has been on the hyperbolic slope towards
bankruptcy for 40 years. None of my patients seem to believe this. They expect
that the kind and benevolent government will take care of them and raise the
taxes as necessary. One even suggested that as far as he was concerned they
could raise taxes to 100 percent–because the rich can well afford that.
Times reported last week that Vodafone
restated their financial status using a new accounting method. By treating the
goodwill value of its acquisition in the new method, they went from a £1.9 bn
($3.6 bn) loss, the largest in
wonder many don't believe in statistics or statistical projections.
They think Social Security and Medicare are really running a surplus. They
just haven’t adopted the new accounting methods.
is not the solution to our problems, government is the problem.
* * * *
Medical Gluttony: One Freebie That
Doesn't Cost More - Unnecessary Lab Tests
are getting used to acquiring a lot of freebies or a chance to win a prize;
i.e. getting 15,000 frequent
flyer miles for changing your long distance phone carrier; getting a free VISA
with no interest for 6 months. However, the fine print indicates that if
you're late in any payments, not only on this credit card but any other credit
card, your interest rate goes to 25.9 percent in addition to a $39 late fee
which may drive the interest rate for the month to over 90 percent (instead of
the zero percent expected).
their health insurance policy carries no such restriction, risks, or penalty.
Every day we have requests from patients who have had a series of normal
chemistry and lipid panels demanding an unnecessary yearly repeat panel. Why? Because
IT'S FREE. Patients who
have elevated lipids but decline treatment and refuse to alter their diets to
low fat demand an unnecessary yearly lipid panel "just to see if it's
still abnormal." Of course it will remain abnormal without dietary or
medical attention or treatment. Why do they want it? Because
IT'S FREE. Not really,
their employer prepaid it and they are now running out of money.
and insurance carriers should not have to control patient gluttony. It should
be left to the patient and the doctor working in the free Medical MarketPlace
environment. With a reasonable copayment of, say 30 percent, the patient will
listen to the doctor's advice and follow it without being an adversary. The
insurance carrier (or HMO) should be left out of the picture,
and simply pay for the lab if it's a policy benefit. The practice of medicine
would again become a pleasant experience for both the doctor and the patient
without the unnecessary intrusion of the insurance (or HMO) carrier.
* * * *
Myths: Myth 7 - Every Employer Must Pay for Employees’ Health Insurance
Pelner Cosman, PhD, JD, Esq, in her
upcoming book, Who Owns Your Body,
gives Nine Myths of American Medicine. Today we review Myth
7. For the previous six, see http://www.healthplanusa.net/MC-WhoOwnsYourBodyIntro.htm.
chapter explores the history of employer-sponsored health insurance resulting
in each employee’s lower wages and restricted medical choice.
employer in the
War II wage and price controls made it necessary for employers to offer more
salary without offering more money. Medical insurance was the hidden way to
sneak valuable benefits to employees without violating the wage control law.
Half a century later, every employee still actually pays 100% of his or her
medical insurance policy by salary-substitute.
employees threaten to strike because their employer, for example, General
Electric or Verizon, requires them to pay a larger
percentage of health care "insurance" costs. The workers do not
understand that no matter what percentage they think they pay, it is always
who volitionally pay for medical care with their own money might or might not
select HMOs. Few employees freely would buy "employer-provided medical
insurance" and pay 100% of the cost in lost wages and 100% of the cost in
lost choice. Employees who volitionally elect HMOs with their own money merit
admiration for their tolerance of risk or for their own certitude of their
good health. Apparently only 16 % of people with freedom to elect or reject
HMOs select HMOs, low cost being the dominant reason. That is valid freedom of
those forced into HMOs because their employer offers nothing else, if the HMO
refuses necessary care the employee can sue both the HMO and his employer via
the deeply flawed Patients’ Bill of Rights. The employer who selects an HMO
that denies medicine or surgery to an injured or sick employee also takes on
an unwitting moral liability for he has used the employee’s own money to
prevent care of the employee’s own body.
method for restoring order and body ownership is to change the tax code to
allow employees a tax advantage as
opposed to employers. Employers who
will have no tax incentive to continue in the medical care business will be
glad to see their employees deal with medical professionals directly. Workers
need a tax incentive to buy their own care, such as simple tax deduction for
all medical expenses, as opposed to the Tax Code’s current requirement that
only medical expenses over 7.5 percent of adjusted annual gross income qualify
for deduction. Working people with a tax incentive to buy medical care the way
they buy all other assets and services will then stop demanding that
employers, who are amateurs in medicine, provide medical care.
tax exclusion for employers costs
7: Employee Health Insurance Began as a Salary-Substitute during World War II
* * * *
in the Medical Staff Lounge - Are Polls
Confusing or Dishonest?
ABC News-Washington Post Poll was reported in an article (Associated Press -
Will Lester) titled
"Support builds for health care, prescription drug changes."
"By almost a 2-1 margin in this poll, Americans said they preferred a
universal system which would provide coverage to everyone under a government
program, as opposed to the current employer-based system."
support drops significantly, however, if universal coverage would mean a
limited choice of doctors or longer waits for non-emergency treatment"
people were asked the questions slightly differently in a poll a year ago,
they were less enthusiastic. Asked is they wanted a taxpayer-funded, health
care system run by the government, fewer than half said yes."
are very confusing to the public. Most engage in statistical subterfuge. Dr
John Goodman of the NCPA points out that when people use third-party health
care, they are spending only 15 percent of their own money and 85 percent of
other people's money. This not only explains massive overutilization by
patients with third-party payment of benefits, but also unrealistic approval
for such systems that always have rationing, waiting lists, and restrictions
in health care providers, which if honestly portrayed in the poll, would cause
the vast majority to vote against it. Hence, we will continue to have an
uphill battle for saving health care for the benefit of our patients who may
have difficulty understanding the political implications and privacy risks.
* * * *
MedicalTuesday Supports These
Efforts of the Medical and Professional Community in Restoring Accountability
in Medical Practice, HeathCare and Government
Vern Cherewatenko is achieving success
in restoring private-based medical practice which has grown internationally
through the SimpleCare model
Any patient or provider may become a member of SimpleCare. A number of
brochures are available on line about a practice that is becoming increasingly
popular. There have been a number of news network and press reports. For the
AP article: on
David MacDonald started Liberty
Health Group, http://www.LibertyHealthGroup.com,
to assist physicians in controlling their own medical benefit costs for their
staff and patients. He is now helping corporations design their health plans
to control costs. There is extensive data available for your study. Dr Dave is
available to speak to your group on a consultative basis.
and Alieta Eck, MDs, for their
first-century solution to twenty-first century needs. With 46 million people
in this country uninsured, we need an innovative solution apart from the place
of employment, and apart from the government. Please visit them at http://www.zhcenter.org/
and check out their history, mission statement, newsletter, and a host of
other information. For their article “Are you really insured?” go to http://www.healthplanusa.net/AE-AreYouReallyInsured.htm.
Pelner Cosman, JD, PhD, Esq, has made
important efforts in restoring accountability in health care. Please visit http://www.healthplanusa.net/MPCosman.htm
to view some of her articles that highlight the government’s efforts in
criminalizing medicine, and the introduction to her new book, Who
Owns Your Body. For other OpEd articles that are important to the practice
of medicine and health care in general, click on her name at http://www.healthcarecom.net/OpEd.htm.
J Gibson, MD, Consulting Partner of Illumination Medical, Inc.
has made important contributions to the free Medical MarketPlace in speeches
and writings. His series of articles in Sacramento
Medicine can be found at http://www.ssvms.org/.
Dr Gibson edited the March/April historical issue. To read his "Lessons
from the Past," go to http://www.ssvms.org/articles/0403gibson.asp.
For additional articles such as Health Care Inflation at http://www.healthplanusa.net/DGHealthCareInflation.htm.
Richard B Willner, President, Center
Peer Review Justice Inc, reports his latest success story and the secret
of helping doctors keep their medical license. On a daily basis, doctors are
reviewed, are suspended, lose their medical licenses and go to jail on
trumped-up charges. These "extra"-legal services are necessary
services that your lawyer does not offer. Stay posted with a wealth of
information at http://www.peerreview.org/.
The Center for Peer Review Justice has been very successful for those MDs who
have been DataBanked and cannot find a new job. This is Dr Willner's
livelihood and a fee-based service may apply.
Society International, Verner S. Waite MD, FACS, Founder; Henry Butler MD,
FACS, President; Ralph Bard MD, JD, Vice President; W. Hinnant MD, JD,
Secretary-Treasurer; is named after
Ignaz Philipp Semmelweis, MD (1818-1865), an obstetrician who has been
hailed as the savior of mothers. He found maternal mortality of 25-30 percent
in the obstetrical clinic in
Gabos, MD, President of the Society for
the Education of Physicians and Patients (SEPP),
http://www.sepp.net/, for making
efforts in Protecting, Preserving, and Promoting the Rights, Freedoms and
Responsibilities of Patients and Health Care Professionals, with a special
page for our colleagues in nursing. Several free newsletters are available. Be
part of protecting and preserving what is right with American HeathCare–physicians,
nurses, pharmacists, psychologists, all health professionals and all concerned
individuals are urged to join.
J Cihak, MD, former president of the
AAPS, and Michael Arnold Glueck, M.D,
write an informative Medicine Men
column. Please log on to review the last five weeks topics at http://www.newsmax.com/pundits/Medicine_Men.shtml.
This week’s column is "Two-Faced Medicare Enforcement." Federal
government prosecutors are sending doctors to prison for making mistakes in
filing Medicare paperwork. At the same time, Medicare customer service
representatives are apparently not even reprimanded for a 96 percent error
rate in answering questions about how to handle physician billings. Read the
entire column at http://www.newsmax.com/archives/articles/2005/1/19/140320.shtml.
of American Physicians & Surgeons (http://www.aapsonline.org/),
The Voice for Private Physicians Since 1943, representing physicians in their
struggles against bureaucratic medicine, loss of medical privacy, and
intrusion by the government into the personal and confidential relationship
between patients and their physicians. Be sure to scroll down on the left to
departments and click on "What's New?" and also for the “News of
the Day.” The “AAPS News,”
written by Jane Orient, MD, and archived on this site, provides valuable
information on a monthly basis. You can sign up for regular alerts and news
releases about patients' rights, privacy and government action that could have
a tremendous on impact on you, your family, your practice and your patients.
Scroll further to the official organ, the Journal
of American Physicians and Surgeons, with Larry Huntoon, MD, PhD, a
* * * *
Tuned to the MedicalTuesday.Network and Have Your Friends Do the Same
MedicalTuesday site has now been automated. Each individual on our mailing
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the latest medical news of the day at http://www.healthplanusa.net/MedicalNews.htm
which will also lead you to the headlines for the past month.
you would like to participate in this informational campaign on behalf of your
patients or the HeathCare community, please send your resume to Personnel@MedicalTuesday.net.
you would like to participate in the development of the affordable HealthPlan
for All Americans, please send your resume to Personnel@HealthPlanUSA.net.
Meyer, MD, CEO & Founder
J. O'Rourke: If you think that health
care is expensive now, wait until you see what it costs when it's free.
Churchill: We contend that for a nation
to try to tax itself into prosperity is like a man standing in a bucket and
trying to lift himself up by the handle.
Langley, Artist 1928-1995: What this
country needs are more unemployed politicians.
Baker Eddy, Science and Health, 1908:
Health is not a condition of matter, but of the Mind.
is better than wealth.
can learn good eating habits from
the bad eating habits of others.
doctor who makes no mistakes does
not usually make anyone well.
some recent postings below.
of Medicine: To read a review of the
first issue of Sacramento Medicine in 1950 go to http://www.ssvms.org/articles/0403vom.asp
remembering that the first 132 years are no longer available. To read the
current series of my column, the "Voices of Medicine," go to http://healthcarecom.net/vom2004.htm.
You may also access my former "Hippocrates and His Kin" and as well
as my "Book Review" columns from the same site. The direct link is http://healthcarecom.net/hhkintro.htm.
at Risk: Single-Payer National Health Insurance Around
the World shows that national
single-payer health care systems in countries such as
B Clark, MD: A Piece of the Pie: What
are we going to tell those bright-eyed little boys and girls who are going to
be the doctors of tomorrow? When there isn’t anything left for them, are we
going to tell them we didn’t fight because the changes were inevitable
anyway? What are we going to say when they ask us why we laid down and died
when things got a little tough? Are we going to feel good about ourselves when
we tell them it’s all right because we got a piece of the pie? Read Dr Clark
Read his most recent posting, Feeding
the Monster, at http://www.healthcarecom.net/CBCFeedingMonster.htm.
Pelner Cosman, JD, PhD, Esq:
The chapter summaries of her latest book, Who
Owns Your Body, to be published early next spring are now available at http://www.healthplanusa.net/MC-WhoOwnsYourBodyIntro.htm.
Chang, MD: WEIGHT
LOST FOREVER - The Five Second Guide to Permanent Weight Loss suggest
daily weights to stem the weight loss before it becomes a problem and, if it
does, how to take it off and keep
it off. Congratulations to Dr Chang for winning the Sacramento Publishers and
Authors 2004 award for “Best Health Book of the Year.” Read our review at http://www.healthcarecom.net/bkrev_WeightLostForever.htm.
Death of Right and Wrong (Understanding the difference between the right
and the left on our culture and values.) http://www.townhall.com/bookclub/bruce.html.
Reviewed by Courtney Rosenbladt
Alzheimer's Story: To read a touching
story by a nurse about her Alzheimer's patient, go to http://www.delmeyer.net/MedInfo2003.htm.
Entrepreneur's Story: AriadneCapital (http://www.AriadneCapital.com)
provided the initial funding for MedicalTuesday
and the Global Trademarking. Julie Meyer, the CEO, has a clear vision in her
mind of the world that she wants to live in, and it's considerably different
from how it looks now. If you're an entrepreneurial woman,
or if you lost hope or are having difficulty envisioning success, (if you'll
forgive a little nepotism), the following article may be of interest to you.
this date in 1890, Nellie Bly completed her trip
around the world in 72 days, 6 hours,
and 11 minutes. Although her name was Elizabeth Cochrane, she wrote for The
New York World as Nellie Bly.
this date in 1915, Alexander Graham Bell completed the transcontinental
telephone call in the U.S. inaugurating
a new era in speedy communication.
this date in 1959, American Airlines flew
the first schedule transcontinental Boeing 707 jet flight.
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