Year ago, when I lived in Cleveland, Ohio, my wife and I had a dispute with a landscaper. He claimed that what he was cutting were "trees" and we said they were "bushes." The pay differential was significant, so we went to a wise lawyer, and he gave us a lesson to carry with us through life. He said, "If you get into a situation, and it is not going right, get out of it as soon as you can." Over the years, I have followed that advice in other situations, and it has saved me a lot of heart aches. The story related in the WSJ on March 29 relates the "affairs" of a young neurosurgeon who would do well to listen to the above advice.
The complete story is at this link:http://online.wsj.com/article/SB10001424052748703858404576214642193925996.html?KEYWORDS=Vishal+James+Makker , .
Apparently, this surgeon finished his training in 2002, and went to Washington State to practice. Since then, he has been involved in 9 law suites (some settled), investigation by the state board of medicine, investigated by the FBI (the case was dropped), and underwent a divorce. In addition, he preforms a large number of surgeries each year. Now I know he is young, but all that takes an enormous amount of energy.
The major problem he has with his surgery seems to be multiple operations on the same patients. The story begins with an unfortunate patient who had undergone six operations on his back in less than two years. Medicare records (the point of the article) show that he stands out as a common returnee to the same patients.
What I can't understand is how he can even get privileges at a hospital, or even malpractice insurance. I have been on peer review committees, and someone with that record would have gotten to know the members of the peer review committee well.
Reading that article upped my Tums taking, as my stomach cramped in numerous ways. Life it tough, but do you have to make it that way for yourself. "If you get into a situation, and it is not going right, get out of it as soon as you can." My advice, Dr. Makker, is just that. You will live longer.
Wednesday, March 30, 2011
Wednesday, March 16, 2011
United States Code: Title 42,1395. Prohibition against any Federal interference | LII / Legal Information Institute
United States Code: Title 42,1395. Prohibition against any Federal interference | LII / Legal Information Institute
The above reference is the actual first paragraph of the Medicare Law which was passed in 1965. It is clearly an example of the extension of control that results when the Federal government "moves" into an area of public interaction. Even the title is, unfortunately, a lie: "Prohibition Against Any Government Interference. " Please follow the above link, and read the paragraph.
It is a fact, that the Federal government totally controls (or interferes) with the delivery of medical care. It controls admissions, discharges, payment to all involved, and rules, rules, rules. There are career ending "threats" if you don't obey these rules, and overall it has become an oppressive system for all "providers."
There are many reasons physicians are losing--or have lost-- their Professionalism, but the above departure from this earlier "promise" is pivotal. Society shouldn't want physicians to lost their distinction as "Professionals" for if they lose it, when someone is sick and in need of a physician's help their will be the feeling that you were treated with the same level of compassion as a customer ordering a hamburger at the McDonald's take out window. Not a pleasant thought!
I think it is important that we remain vigilant of this departure from government's original promises when Medicare was passed, and its eventual control of the system. Didn't we just pass a "drug benefit"? Where will the "control"of the pharmaceutical industry be ten years from now and how will it affect the pharmaceutical industry. Keep your eyes open.
The above reference is the actual first paragraph of the Medicare Law which was passed in 1965. It is clearly an example of the extension of control that results when the Federal government "moves" into an area of public interaction. Even the title is, unfortunately, a lie: "Prohibition Against Any Government Interference. " Please follow the above link, and read the paragraph.
It is a fact, that the Federal government totally controls (or interferes) with the delivery of medical care. It controls admissions, discharges, payment to all involved, and rules, rules, rules. There are career ending "threats" if you don't obey these rules, and overall it has become an oppressive system for all "providers."
There are many reasons physicians are losing--or have lost-- their Professionalism, but the above departure from this earlier "promise" is pivotal. Society shouldn't want physicians to lost their distinction as "Professionals" for if they lose it, when someone is sick and in need of a physician's help their will be the feeling that you were treated with the same level of compassion as a customer ordering a hamburger at the McDonald's take out window. Not a pleasant thought!
I think it is important that we remain vigilant of this departure from government's original promises when Medicare was passed, and its eventual control of the system. Didn't we just pass a "drug benefit"? Where will the "control"of the pharmaceutical industry be ten years from now and how will it affect the pharmaceutical industry. Keep your eyes open.
Tuesday, March 15, 2011
Patrick Henry's Memorial in VA
Yesterday was a pre-spring day for me: temperature approaching 70 degrees, mild breezes, and no rain. Time for me to get the ole motorcycle out and take one on my favorite rides to Red Hill, Virginia to visit the Patrick Henry National Memorial. I have taken this trip many times. I would take it if I had particularly difficult problems to mull over, as it inspired me to be in the presence of such an historic and noble figure. His epic speech-- delivered at the second Virginia Convention in Richmond, March 1775--ended with the classic words, "Give me Liberty, or give me death." With that speech, he moved the Convention towards unity, and carried the day.
The Memorial is straight up 501, about 80 miles from Durham, and a pleasant ride. Mostly country, there are signs in Brookneal to the Patrick Henry boys home. The first sign is just after you cross the railroad tracks in Brookneal where you turn to the right. Follow the main road about 5 miles to the next sign, and you are almost there. It takes about 1 1/2 hours by motorcycle (traveling at 90 miles/hr), and when you get there, you will have the opportunity to review his and our history, and regain those patriotic feelings that so rarely touch us these days.
There are multiple attractions at the Memorial including quite surroundings, his reconstructed house and Law office, blacksmith shop, a souvenir shop, and other outbuildings. Most importantly, is his grave. Not elaborate at all, it is a place of reverence. Take the time to read the words in his famous speech, and try to imagine who, among today's leaders, might have uttered these same words when facing the daunting battle that lay ahead for Virginians in 1775. You are visiting the place that embodied Patrick Henry's values of virtue, independence, family, and nation.
My trip that day took about 6 hours, and it allowed me to have a pleasant contemplative day. I had the time to remember the origins of our Country, the current troubles facing us, and to realize, again, that it will all be OK as long as we look back to the fundamental principles that made this nation strong and great-- try individual Liberty!
You might want to visit the website (http://redhill.org/ ) as it will give you a lot of information about this pleasant location. I'm certain I will go there again when I am looking for some peace and inspiration. Enjoy, enjoy.
I do have to admit that I always keep a piece of Mr. Henry's speech with me when I ride. It's on the back of my motorcycle for all to see. It's probably one of the most important ideas ever introduced into the concepts of governance which America tries to spread around the world. I couldn't get the "correct" spelling, because someone else (I don't know who it is) had the same idea. I try every year at renewal time but haven't been able to get it yet. I'm going to keep trying.
Sunday, March 13, 2011
Saturday, March 12, 2011
The Obama Doctrine--The Wall Street Journal
Great article today in the WSJ. Wanted to share it with all. http://online.wsj.com/article/SB10001424052748703597804576194690095426116.html?mod=WSJ_Opinion_LEADTop. Seems to clarify our problem with the Libya crisis. Hope it changes in the future.
Friday, March 11, 2011
Wisconsin, What a Spectacle
My God, the legislators in Wisconsin just voted to stop collective bargaining for labor unions in their state. I cannot believe the response of the unions. The behavior has been appalling: death threats, blocking sessions, shouting, false "sick excuses," and it's not over yet.
The saddest part of this entire debacle, has been the fact that this behavior ignores the PROCESS that we are supposed to be living under. It's called DEMOCRACY! Shall we just have rule by demonstration? How about death threats? These demonstrations are an affront to the process that we should all respect.
The reality of the situation is that this process occurred at the poles, in November, when the people of Wisconsin voted and elected their new governor, Scott Walker. One of the problems with a democracy is that the winner takes all. The unions will get another chance to overturn or modify the November result when the vote comes back.
This behavior reminds me of the losers at a sports event that complain that the "referees cheated us," or "we out-played them anyway." No we didn't. The game is over, but we need to continue to play by the rules. The shouting matches are difficult to witness. Are these people teaching the children of Wisconsin? Shame, shame.
I am not denying that these changes are upsetting for people. They are taking a financial hit, but no system is perfect, and the public labor unions have some real problems with "limits" to their bargaining power. It has happened in multiple states. The main problem is that the politicians can give benes to the unions to gain their votes. When the benefits come due--pensions, health care costs-- the politician who granted these gifts will most likely not be around, and the taxpayers are left holding the bag.
Contrary to what Richard L . Trumka (President of the AFL-CIO) says, this is not a war against Wall Street, or the big corporations. This is a war with the citizens of Wisconsin, because they pay for the union benefits. Trumka knows that it's easy to blame Wall Street, and the "big" corporations, because they represent greed and wealth to most people. If he stood up and pointed at the people of Wisconsin as the villains he would not get his intended response. Demagogues know how to use words.
Finally, it would be best if the demonstrators would just go home and get organized for the next election. Get your message out, and clarify WHY you think this should not have happened. Write some fine essays that you can publish, and use the words to get your points across that you are supposed to be teaching to the students of Wisconsin. Most importantly, tell the truth. It seems to me that the protesters have become as a "clanging cymbal" at this point, and that doesn't cut it in debate.
The saddest part of this entire debacle, has been the fact that this behavior ignores the PROCESS that we are supposed to be living under. It's called DEMOCRACY! Shall we just have rule by demonstration? How about death threats? These demonstrations are an affront to the process that we should all respect.
The reality of the situation is that this process occurred at the poles, in November, when the people of Wisconsin voted and elected their new governor, Scott Walker. One of the problems with a democracy is that the winner takes all. The unions will get another chance to overturn or modify the November result when the vote comes back.
This behavior reminds me of the losers at a sports event that complain that the "referees cheated us," or "we out-played them anyway." No we didn't. The game is over, but we need to continue to play by the rules. The shouting matches are difficult to witness. Are these people teaching the children of Wisconsin? Shame, shame.
I am not denying that these changes are upsetting for people. They are taking a financial hit, but no system is perfect, and the public labor unions have some real problems with "limits" to their bargaining power. It has happened in multiple states. The main problem is that the politicians can give benes to the unions to gain their votes. When the benefits come due--pensions, health care costs-- the politician who granted these gifts will most likely not be around, and the taxpayers are left holding the bag.
Contrary to what Richard L . Trumka (President of the AFL-CIO) says, this is not a war against Wall Street, or the big corporations. This is a war with the citizens of Wisconsin, because they pay for the union benefits. Trumka knows that it's easy to blame Wall Street, and the "big" corporations, because they represent greed and wealth to most people. If he stood up and pointed at the people of Wisconsin as the villains he would not get his intended response. Demagogues know how to use words.
Finally, it would be best if the demonstrators would just go home and get organized for the next election. Get your message out, and clarify WHY you think this should not have happened. Write some fine essays that you can publish, and use the words to get your points across that you are supposed to be teaching to the students of Wisconsin. Most importantly, tell the truth. It seems to me that the protesters have become as a "clanging cymbal" at this point, and that doesn't cut it in debate.
Thursday, March 10, 2011
My Cats: Daisy and Sunshine
Daisy is up above, and she has a calm temperament. Daisy is about 8 years old, and she "picked" me for her new home when I was out looking at a tree farm. I had lost "Crook" our 20 year old cat about two years prior, and Daisy must have known I was an easy target. She was about 8 months old at the time, and she just came over from the weeds (she was a stray) and jumped on my lap while she purred up a storm. It was cold, so I put her inside my jacket, and we went home. She has never left since.
She does have some strange habits. She figured out, long ago, that I usually have a glass of ice water on my bedside table, and she discovered the pleasure of drinking ice water. So it's not unusual for her to leap up on the table and begin drinking from my glass--it immediately becomes her glass. She also needs a lot of loving, and she will "lead" me up stairs to the guest room, leap onto the bed, and "ask" me to pet her with a nice long back rub. I can't resist those eyes and that purr. What a darling cat.
Daisy is not aggressive, and she will watch Sunshine go after a mouse. Indeed, when Sunshine was about 4 months old, I watched as Daisy catch a mouse, bring it over to Sunshine, and set it on the floor in front of her. Then she just watched as little Sunshine had a "cat and mouse game" with the present.
Sunshine, now, is a bit different. She is about three years old now, and she still has a bit of wildcat in her. We have a cat door, so they both can go outside when they want (helps with the kitty litter problem), and Sunshine takes full advantage of this. She is a hunter: birds (sorry) lizards, moles, mice....dogs, not quite.
The other day, Sunshine caught three mice (I discovered the corpses in the morning). I think, I hope she goes outside at night and fines them. I can tell, though, that she is getting a softer personality as she ages: she doesn't go after Daisy quite as much, and she lets us pet her more now, and doesn't "attack" us because we have aroused her "crazy chip." You know, when you pet a cat they will sometimes grab you with their claws and start to fight.
Either way, they are both part of the family now, and they are great cats. I believe cats have a special purpose besides entertaining us, and giving us love and affection. I think they are here to teach us about separation and loss. Losing a pet from death is a real loss. It hurts. I think it hurts because they become a valued member of the family, and they get into your soul. I find it hurtful the way some people treat animals. They are helpless in some ways, and when they die (they have a short life span) it gives us the "opportunity" to feel profound loss. I have had that experience, and I will have it again when I lose Daisy or Sunshine. For now, I'm just going to continue to spoil them, and they will continue to train me to satisfy their wants. What a life.
Friday, March 4, 2011
Nigerian doctors strike work - Africa - Al Jazeera English
Nigerian doctors strike work - Africa - Al Jazeera English
What a sad story. Doctors in Nigeria are on strike. Patients die and no care is given, because they want to be paid the same as doctors in "government" hospitals. They currently earn about $700/month. http://english.aljazeera.net/video/africa/2011/03/201132154530341529.html
All doctors, and I'm certain these Nigerian doctors, respect the "Oath" to treat patients, and realize that patients are the number one priority for a physician. How could they not? Patients, that are suffering, are vulnerable, and hurting are difficult to ignore. To deny their patients care, I believe reflects on the work environment of these physicians. Giving up a fundamental obligation would only be done if the pressures are too great.
A host of pressures will effect U.S. doctors as health care reform takes hold, and the pressure "to earn" increases. Will that happen? Certainly. ObamaCare, or something like it is coming down the pike and I don't think the Republicans will stop this freight train. Even the American people believe something needs to be done and so do many doctors. One group that is not mentioned much during this debate are the doctors, and I believe that portends trouble for physicians.
Insurance companies are discussed frequently because they take too big a share of the health care dollar. Pharmaceutical companies are also mentioned for the same reason. Why are the doctors not mentioned-- aren't they are the driving force in the health care system?
The reason is that they are a small group, and they don't have enough political might to affect the deliberative process. Doctors in the U.S. pledge themselves to the welfare of the patient, and the politicians will surely take advantage of that promise in the "new" system. What are they going to do anyway, leave medicine?
But how will these health care delivery changes affect the function of physicians? I worry. Will it make them lean a bit more to doing a procedure that could wait for a test of time? Will it make them order an additional CAT scan on the machine they have invested in? Will they order another lab test from the lab they own a share in? Probably, and why, because earning a living is a potent motivator. Witness Nigeria.
I believe that this challenge ahead--income versus service--for the medical profession is as great as it has ever been. There will be no place for the Mercedes, the "mansions," and the elaborate life styles in the future. Physicians will be "public servants" in the real sense, or they will leave the profession. This will not happen in a short time, but in the future, the forces of control will change medicine from a "lucrative profession" to a field of giving. To avoid disappointment, young trainees need to hear and understand this message.
The premeds currently in college will realize these changes in their 40s, as the pressures of college age children, lifestyle, and retirement begin to enter their horizon. The majority of them will not have the "loose change" available to assuage their fears of "downsizing." Plainly, there will not be as much profit in the future for physicians and they will have to decide whether they will become public servants or leave medicine.
Don't be alarmed by these predictions. These days, I predict, lie 10 or 20 years in the future. But they will come. Unfortunately, when they do, the public will have to develop a keen sense of their medical care to survive as long as they can at a reasonable price.
What a sad story. Doctors in Nigeria are on strike. Patients die and no care is given, because they want to be paid the same as doctors in "government" hospitals. They currently earn about $700/month. http://english.aljazeera.net/video/africa/2011/03/201132154530341529.html
All doctors, and I'm certain these Nigerian doctors, respect the "Oath" to treat patients, and realize that patients are the number one priority for a physician. How could they not? Patients, that are suffering, are vulnerable, and hurting are difficult to ignore. To deny their patients care, I believe reflects on the work environment of these physicians. Giving up a fundamental obligation would only be done if the pressures are too great.
A host of pressures will effect U.S. doctors as health care reform takes hold, and the pressure "to earn" increases. Will that happen? Certainly. ObamaCare, or something like it is coming down the pike and I don't think the Republicans will stop this freight train. Even the American people believe something needs to be done and so do many doctors. One group that is not mentioned much during this debate are the doctors, and I believe that portends trouble for physicians.
Insurance companies are discussed frequently because they take too big a share of the health care dollar. Pharmaceutical companies are also mentioned for the same reason. Why are the doctors not mentioned-- aren't they are the driving force in the health care system?
The reason is that they are a small group, and they don't have enough political might to affect the deliberative process. Doctors in the U.S. pledge themselves to the welfare of the patient, and the politicians will surely take advantage of that promise in the "new" system. What are they going to do anyway, leave medicine?
But how will these health care delivery changes affect the function of physicians? I worry. Will it make them lean a bit more to doing a procedure that could wait for a test of time? Will it make them order an additional CAT scan on the machine they have invested in? Will they order another lab test from the lab they own a share in? Probably, and why, because earning a living is a potent motivator. Witness Nigeria.
I believe that this challenge ahead--income versus service--for the medical profession is as great as it has ever been. There will be no place for the Mercedes, the "mansions," and the elaborate life styles in the future. Physicians will be "public servants" in the real sense, or they will leave the profession. This will not happen in a short time, but in the future, the forces of control will change medicine from a "lucrative profession" to a field of giving. To avoid disappointment, young trainees need to hear and understand this message.
The premeds currently in college will realize these changes in their 40s, as the pressures of college age children, lifestyle, and retirement begin to enter their horizon. The majority of them will not have the "loose change" available to assuage their fears of "downsizing." Plainly, there will not be as much profit in the future for physicians and they will have to decide whether they will become public servants or leave medicine.
Don't be alarmed by these predictions. These days, I predict, lie 10 or 20 years in the future. But they will come. Unfortunately, when they do, the public will have to develop a keen sense of their medical care to survive as long as they can at a reasonable price.
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