America Out Loud PULSE: What People Want from Their Patient-Physician Relationship

From my America Out Loud Pulse podcast with Travis Morell, MD – https://www.americaoutloud.news/what-people-want-from-their-patient-physician-relationship/

Works on the scientific and ethical practice of medicine called the Corpus Hippocraticum are attributed to Hippocrates (450 – 375 BC), considered the father of medicine. The quote “do no harm” is not in the Oath of Hippocrates, but rather in another volume, Of the Epidemics. Additionally, the writings were written in Greek and the Latin phrase primum non nocere comes from a 17th Century English physician, Thomas Syndenham. Irrespective of the authorship’s history, for centuries the medical profession adopted the Oath as a guide of professional conduct.

Patients likely don’t know the instructions in the Oath, nonetheless, patients trust doctors with their health. The Oath advises physicians, among other things, to do everything for the benefit of the sick, to keep private whatever physicians see or hear in the lives of their patients, or as some translations say, treated as “holy secrets.” These duties attached whether the patients were “free or slaves.”

Multiple surveys (here, here, here, here) have asked patients what they really want from their patient-physician relationship. Just as with any close relationship, undistracted listening tops the list. Another constant is that patient prefer the total experience with the doctor and his or her office over price. If one wish could be granted for patients it would be for more time with their doctor.

What makes are some of the other factors that make a good experience? In todays’ era of electronic medical records and computer screens, eye contact is more important than ever. If a doctor is open and honest about his knowledge base, gives truly informed consent to proposed treatments with risks and benefits, patients will develop trust. We need to have patients feel comfortable telling us everything that is going on in our lives. And doctors mustn’t be reluctant to form an emotional bond when making a connection with their patients. Patients want to know their doctor is not doing procedures for financial gain. Patients also want access to their physician. This is one of many reasons that direct primary care practices are growing increasingly popular.

Patients, like all of us want to be treated with respect. That means having their time and needs respected. Simple apology from the front desk if the doctor is running late goes a long way to letting patients know you care. Another thing patients need is clear communication, not ‘medicalese.’ Finally, patients want a partnership and giving then the opportunity to express their opinion about the proposed treatment.

My guest today is one of those physicians who is working to keep skill, compassion, and honesty in medicine – despite the roadblocks put up by current political winds and corporate takeovers.

Bio

Travis Morrell, MD, MPH, is a husband, father and physician leader. A lifelong learner to a fault, his medical training in five specialty departments gives him a broad perspective. He is a Board Certified dermatologist and dermatopathologist in private practice in Western Colorado. Dr. Morrell is also Chair of Colorado Principled Physicians, a truly grassroots organization defending non-partisan physician values such as free speech and evidence-based medicine.

Website:

Colorado Principled Physicians – https://www.coloradodocs.org

America Out Loud PULSE: Hacking Electronic Health Records, Medicare Dis-Advantage, and Measles with Twila Brase, RN, PHN

From my America Out Loud Pulse podcast with Twila Brase, RN, PHN –https://www.americaoutloud.news/hacking-electronic-health-records-medicare-disadvantages-and-measles/

Hacking into electronic databases has become child’s play. Since 2018, the Health and Human Services (HHS) Office for Civil Rights tracked a 256 percent increase in large data breaches involving hacking and a 264 percent increase in ransomware. With ransomware, the database owner must fork over a ransom in order to get cannot get access.

On February 21, 2024, United Health’s Change Healthcare was hacked. Change Healthcare processes 15 billion healthcare transactions annually and touches one in every three patient records. The outage has multiple drug stores and health systems and affected billing and physician payments, electronic medical records retrieval by insurers, verification of insurance eligibility, prior authorization requests, and prescription processing. Health systems are having difficulty billing for most hospital services. Some pharmacists are charging patients the full price because they are unable to access the co-pay information. According to an estimate from a digital health risk assurance firm, First Health Advisory, the outage is costing health care providers over $100 million daily. The American Hospital Association president and CEO said, “We cannot say this more clearly — the Change Healthcare cyberattack is the most significant and consequential incident of its kind against the U.S. healthcare system in history.”

According to a March 4, 2024 Wired magazine article, one of the partners of the hackers known as AlphV or BlackCat revealed that the hackers received 350 Bitcoins in a single transaction worth $22 million. On March 3rd, someone describing themselves as an affiliate of AlphV posted to the cybercriminal underground forum RAMP that AlphV had cheated them out of their share of the Change Healthcare ransom. Change Healthcare did not confirm or deny the ransom to Wired, commenting that “we are focused on the investigation right now.”

UnitedHealth apparently is offering paltry sums to physicians who have not been reimbursed for their services or in some cases, costly cancer medications.

There is nothing more private than our personal health information. Artificial Intelligence (AI) is erasing what little privacy we had left in the era where mot doctors’ offices use electronic health records (EHRs). This brings up another issue on the horizon is something called ambient artificial intelligence. It listens to your “private” patient-doctor conversation and processes information, then writes a clinical note summarizing the visit. More than 3,400 physicians at Kaiser Permanente Medical Group of Northern California have been using this since October 2023. Some positives include the physician being more attentive to patients since they are not writing notes. The automatic transcription lessened the up to six hours a day spent on electronic medical records. The question is obvious: who controls this information and what else will it be used for?

We’ll talk about this and so much more with my guest, a nationally recognized expert in the field of medical privacy.

Bio

Twila Brase is President and Co-founder of Citizens’ Council for Health Freedom (CCHF), a national patient-centered, privacy-focused, free-market policy organization established 25 years ago in Minnesota to support health care choices, individualized patient care, and medical and genetic privacy. Her efforts led to a national law requiring parental consent for research using newborn DNA.  Ms. Brase is author of the eight-time award-winning book Big Brother in the Exam Room: The Dangerous Truth About Electronic Health Records.

Ms. Brase’s “Health Freedom Minute” is heard weekdays by more than 5 million listeners across the United States. She provides testimony at state legislatures, meets with members of Congress and health care policymakers, and has been featured in major news outlets such as the Wall Street Journal and the Washington Post.

Citizens Council for Health Freedom website: https://www.cchfreedom.org

The Wedge of Health Freedom (independent physicians) website: https://jointhewedge.com

Big Brother in the Exam Room: The Dangerous Truth About Electronic Health Records. https://www.amazon.com/Big-Brother-Exam-Room-Electronic/dp/1592987060/ref=monarch_sidesheet

America Out Loud PULSE: Doctors and Patients or Bureaucrats: Who’s in Charge of Our Medical Care? with Andy Schlafly, JD

From my America Out Loud Pulse podcast with Andy Schlafly, JD – https://www.americaoutloud.news/doctors-and-patients-or-bureaucrats-whos-in-charge-of-our-medical-care-2/

Political persecution through the legal system has become the new American justice. But it can work both ways – if we have the courage.

President Calvin Coolidge, a strong proponent of limited government, believed that “in order for the Constitution and self-government to survive, the people had to be vigilant in its preservation.” Covid-19 started a government and media censorship juggernaut. It is imperative that we all join to stop it in its tracks. The case currently being argued in front of the Supreme Court, Murthy v Missouri arose from – you guessed it – Covid. Missouri and other states assert that the government’s attempts to suppress so-called Covid misinformation went beyond mere public health information to suppression of speech via social media. At oral arguments, Justice Jackson seemed to feel that suppressing speech is the government’s job. To quote: “My biggest concern is that your view has the First Amendment hamstringing the government in significant ways.”  The First Amendment to the Constitution says the government cannot abridge freedom of speech. As Justice Brandeis wrote in the 1927 free speech case, Whitney v California, free speech is at the heart of a democratic society and the answer to alleged falsehoods is “more speech, not enforced silence.”

Medical freedom for doctors and patients is becoming a distant memory. Physicians are afraid to go into pain management for fear of being labelled a pill pusher. Patients with chronic pain are resorting to getting heroin on the streets rather than be put in a government database. Physicians are bullied by medical boards with the specter of losing their licenses for having valid alternative views regarding medical treatment plans.

Lawyers—who we all know can strike fear into our hearts—can be a big part of preserving our liberty. The legal fights to reign in government overreach are about more than Covid. Lawyers are here to help protect the rights of the individual citizens. They are our last defense against government oppression and corporate corruption. Lawsuits can amplify a few lone voices and let those in power get the message: Our bodies and minds belong to us, not to the government.

I love quotes. Let me give you a few of my favorites on this topic:

“Heresy is another word for freedom of thought.” Graham Greene

“Blind belief in authority is the greatest enemy of truth.”  Albert Einstein

“All progress has resulted from people who took unpopular positions.”  Adlai Stevenson

“The cure for a fallacious argument is a better argument, not the suppression of ideas.”  Carl Sagan

“When the people fear the government, there is tyranny. When the government fears the people, there is liberty.”  Thomas Jefferson

Attorney Andy Schlafly a wonderful friend of the show and general counsel to the Association of American Physicians and Surgeons is here today to discuss freedom of speech and a recent case headed to the Supreme Court.

Link to amicus brief PDF: https://aapsonline.org/judicial/aaps-amicus-murthy-v-missouri-2-7-2024.pdf

Bio

Andy Schlafly is general counsel to the Association of American Physicians and Surgeons. He received a B.S.E. in electrical engineering and certificate in engineering physics from Princeton University. After graduating from Princeton, Mr. Schlafly briefly worked as a device physicist for Intel, then became a microelectronics engineer at the Johns Hopkins University Applied Physics Laboratory. He then attended Harvard Law School along with Barack Obama. For two years Mr. Schlafly was an editor of the Harvard Law Review. After law school, Mr. Schlafly served as an adjunct professor at Seton Hall Law School and worked for a large law firm before beginning private practice. Mr. Schlafly created the wiki-based Conservapedia in November 2006 to counter the apparent liberal bias in Wikipedia.

America Out Loud PULSE: From Physician to Activist with Dr. Jane Hughes

From my America Out Loud Pulse podcast with Dr. Jane Hughes – https://www.americaoutloud.news/from-physician-to-activist-meet-jane-hughes-md/

There was a time when patients sought medical care from a physician, not a “healthcare system.” Now there’s over-priced health insurance that falls short when you actually need it; Medicare Advantage plans that trap you like a roach motel and then don’t provide care when you actually get sick.

Rather than going after flash mob thieves, the government eyeballing parents who have the audacity to actually go to PTA meetings. Schools are supporting so-called gender affirmation without parental notification or consent. Physicians are acquiescing to government, corporate, and political pressures rather than individualized patient care. What’s a person to do?

Almost 50 years ago, an iconic speech in a critically acclaimed film written by Paddy Chayesfsky expressed it better than I ever could: (Peter Finch as Howard Beale, Network, 1976.)

I don’t have to tell you things are bad. Everybody knows things are bad. It’s a depression. Everybody’s out of work or scared of losing their job. The dollar buys a nickel’s worth; banks are going bust; shopkeepers keep a gun under the counter; punks are running wild in the street, and there’s nobody anywhere who seems to know what to do, and there’s no end to it.

We know the air is unfit to breathe and our food is unfit to eat. And we sit watching our TVs while some local newscaster tells us that today we had fifteen homicides and sixty-three violent crimes, as if that’s the way it’s supposed to be!

We all know things are bad — worse than bad — they’re crazy.

It’s like everything everywhere is going crazy, so we don’t go out any more. We sit in the house, and slowly the world we’re living in is getting smaller, and all we say is, “Please, at least leave us alone in our living rooms. Let me have my toaster and my TV and my steel-belted radials, and I won’t say anything. Just leave us alone.”

Well, I’m not going to leave you alone.

I want you to get mad!

I don’t want you to protest. I don’t want you to riot. I don’t want you to write to your Congressman, because I wouldn’t know what to tell you to write. I don’t know what to do about the depression and the inflation and the Russians and the crime in the street.

All I know is that first, you’ve got to get mad.

You’ve got to say, “I’m a human being, goddammit! My life has value!”

So, I want you to get up now. I want all of you to get up out of your chairs. I want you to get up right now and go to the window, open it, and stick your head out and yell:

“I’m as mad as hell, and I’m not going to take this anymore!!”

I recently heard someone say that there are three kinds of people in this world: those who make things happen, those who watch things happen, and those who wonder what happened. We must be the people who makes things happen. No act is too small. As Sir Edmund Burke said 200 years ago, “Nobody made a greater mistake than he who did nothing because he could only do a little.”

My guest, Dr. Jane Hughes has put the act in activism and will share her thoughts about medicine, our health care “system,” and the government’s role in our lives.

Bio

Dr. Jane Hughes is the current president of the Association of American Physicians and Surgeons. She is a board-certified ophthalmologist and a fellow of the American College of Surgeons. She received her medical degree from the University of Texas Health Science Center in San Antonio where she also completed her residency. Dr. Hughes is co-founder of American Doctors for Truth and serves on Congressman Chip Roy’s Physician Advisory Council for Healthcare Policy.

America Out Loud PULSE: DEI Meets Antisemitism Meets a Lawsuit

From my America Out Loud Pulse podcast with Tammy Weitzman – https://www.americaoutloud.news/dei-and-antisemitism-meet-a-lawsuit-with-tammy-weitzman/

What strange times we live in now. We have gone from the era of Ralph Ellison’s novel, Invisible Man, brilliantly exploring what it means to be socially or racially invisible to almost every ad on television including a person of color. Segregated army barracks, motels, restaurants, clubs, entertainment venues were socially and politically acceptable even after integration became the law of the land. And as time passed, people realized that they were missing out on a whole side of life by closing the door on meeting new and interesting people. We were organically moving to a blended society where people were looking at one another just as people, judging them by their job or hobbies but not by their race. Now we have segregated college dorms, dining halls, and so-called affinity groups. What happened?

After years and years of progress we have a sick regression into separatism. Instead of “if you are white, you’re all right, if you’re black, stay back,” all white people are inherently evil deep down inside and should flagellate themselves for the sin of being born white; all black people should be forgiven for any anti-social behavior because they can’t help themselves. How racist is that supposedly progressive mindset?

This new Diversity, Equity, and Inclusion (DEI) crusade is yet another elitist movement that does nothing to help the people they movement portends to help. The DEI movement is stripping mainly blacks, but ultimately all people of their dignity. When we lose our individuality, we lose our true selves, our souls. Human nature being what it is, people do not want to be labelled as victims. But propaganda and indoctrination being what it is, anyone can be demoralized into—as the Soviets would say—ideological subversion.

Yes, racism exists. Racists exist. But the DEI cure is worse than the disease. (One of my dream conversations is asking a professed racist in kidney failure on dialysis if he would accept a kidney transplant from a black person.)

Students in as young as kindergarten are being taught to judge others by their race. In reality, most children do not focus on their differences but wonder whether their classmate likes the newest video game. How could someone think that it is acceptable to poison young minds? The same young minds were told in Brown v the Board of Education in 1954 that separate is inherently unequal. Instead of learning the necessary skills to race to the top of the ladder of success, children have the tools to win the victim triathlon. The prize: dependency on government resources. What a waste of government money. This money would be better spent on junior science fair projects or field trips to the museum of science and technology.

Schools at all levels now have institutionally supported affinity groups that are the Newspeak word for segregated groups. The DEI adherents are echoing the rhetoric of the opponents to integrated schools: people of different races learn better in separate environments where they can be their true selves. Some schools have separate times for black and LGBT students to use the swimming pool. How is this diversity and inclusion? It seems like grouping together children with the same interests, like math, science, sewing, music, or sports would be a more enriching program.

It doesn’t stop with the unsuspecting children. Corporations have devoted time and money into DEI trainings. Let’s have a re-education session and tell people they are a racist and tell them how to be an anti-racist. How? Don’t be a racist.

And of course, I wonder about the effect of DEI on medicine. There is no question that there are racial disparities in many aspects of life in the United States, including medical care. It seems that instead of doing the hard work of getting down to the root of the problems, academia has taken the easy way out by declaring that racism is the cause of health care disparities. The solutions start with racism and end with indoctrination into reverse racism.

The DEI focus on the oppressed and oppressors has fostered antisemitism as well. After all, despite the history of Jewish slavery, oppression, and genocide, they are deemed part of the oppressor class. This is a logical outgrowth of the DEI mindset that focuses on differences rather than our shared humanity.

The deafening drumbeat of race, racism, and more race is leaving its mark. The workplace has turned into a minefield. Some wokenistas cannot see that denigrating others does nothing to advance the group they purport to uplift. When reason fails, we have to turn to the law. Sometimes lawsuits are the only way we can get people to wake up.

My guest is a social worker who despite the presumed empathy and compassion of her colleagues was caught in a workplace web of wokeness gone amok and antisemitism.

Bios

Tammy Weitzman is a child of an Israeli mother and Canadian father. After her father’s death from cancer, the family lived in Israel for 3 years before returning to Toronto, Canada. She completed graduate work in social work at Yeshiva University in New York City. She spent 23 years in oncology mental health at large academic hospitals and has presented her work with oncology patients nationally and internationally.

Peter Barwick is the general counsel for the Coalition for Liberty, https://www.coalitionforliberty.com. Coalition For Liberty is a 501(c)(3) nonprofit organization whose central mission is to promote the right of all Americans to exercise their freedom of speech, expression and thought; and support the establishment of new classical model apolitical schools, while also supporting efforts to have existing schools move back to this tried-and-true model, which has been proven to obtain superior results for children.

Healthcare Redefined: Finding the Right Doctor Once They’ve Retired

Guest Column by Virginia Cooper.

Embarking on the journey to find a new primary care physician (PCP) can be challenging, particularly when your long-trusted doctor decides to retire. For many, this transition is not just about finding a new healthcare provider, but also about ensuring that their specific health needs, especially as minorities, are understood and respected.

The importance of finding a physician who not only has the skills but also the cultural competence to manage your health is paramount. This guide aims to streamline your transition to a new PCP, ensuring your healthcare needs continue to be comprehensively addressed, respecting both your health and cultural background.

Leverage Referrals from Your Retiring Doctor

When your trusted healthcare provider decides to retire, it’s an opportunity to benefit from their professional network. Your retiring doctor, familiar with your health history and needs, can provide targeted referrals to other healthcare professionals who share a similar commitment to patient care.

These referrals are often more than just names; they come with the retiring physician’s endorsement, providing you with a vetted starting point in your search. It’s an approach that not only saves time but also offers a sense of continuity in your healthcare journey.

Assess Online Patient Reviews

In today’s interconnected world, online reviews have become a crucial tool in evaluating potential healthcare providers. Platforms like Google, Healthgrades, and specialized healthcare forums are treasure troves of patient experiences and feedback. When sifting through these reviews, pay attention to comments about the doctor’s approach to patient care, their ability to listen, and their effectiveness in treatment. This insight is invaluable in gauging whether a potential PCP is not just competent but also the right fit for your unique healthcare needs. Be aware that some reviews may not be accurate or based on actual patient experiences.

Digitize Your Medical Records

In a world increasingly moving towards digital solutions, having your medical records in digital format is a significant advantage, especially to help with searching for documents. Saving documents as PDFs not only makes your personal health information readily accessible to you but also eases the process of sharing these details with a new healthcare provider.

Digital records allow your new primary care physician to quickly search and review your health history, allergies, past treatments, and medications, ensuring they can provide informed and personalized care from the start. Plus, you can change a file back to its original format easily if needed.

Opt for an In-Network Physician

Navigating the complexities of health insurance can be daunting. One practical step to ensure affordability in your healthcare is to select a PCP who is in-network with your insurance provider. This choice not only helps in maximizing the benefits you receive under your plan but also plays a crucial role in managing out-of-pocket costs. It’s a decision that balances financial prudence with access to quality healthcare.

Connect with Culturally Competent Physicians

For minority patients, the importance of finding a culturally competent physician cannot be overstated. Such physicians bring an understanding of the nuances of different cultures and how these can impact health and healthcare experiences. They are better equipped to provide care that is respectful of and tailored to your cultural background, leading to more effective and personalized healthcare outcomes.

Evaluate the Physician’s Location and Accessibility

When choosing a new PCP, practical considerations such as the location of their clinic, office hours, and the ease of scheduling appointments are important. A conveniently located clinic reduces the stress and time involved in accessing healthcare. Additionally, the AMA Ed Hub notes that flexible office hours that match your schedule can make a significant difference in maintaining regular health check-ups and treatments.

Explore Healthcare Coverage Options

For those who are freelancers or self-employed, traditional employer-based health insurance may not be an option. In such scenarios, Policygenius points out that exploring healthcare coverage through the Affordable Care Act (ACA) becomes essential. The ACA offers a range of plans that can provide comprehensive coverage, ensuring that you have access to quality healthcare regardless of your employment status. You can also consider Direct Primary Care and other cash-based practices.

The transition to a new primary care physician post the retirement of your current doctor can be seamless with the right approach. By seeking referrals, researching thoroughly, maintaining digital medical records, choosing in-network physicians, valuing cultural competence, considering logistical aspects, and exploring coverage options, you ensure a smooth transition. This proactive approach guarantees continuity in your healthcare journey, with your unique needs as a minority patient being met with empathy and expertise.

Read more informative articles on the Marilyn Singleton, MD JD blog today!

Bio

Virginia Cooper is a retired community college instructor. She always encouraged her students to see the real-world value in their education, and now, she wants to spread that message as wide as possible. Her hope is that Learn a Living (learnaliving.co) will be a go-to resource for adult learners embarking on starting, continuing, or finishing their education.

Image: Freepik

America Out Loud PULSE: Unveiled: One Woman’s Story, Trapped by Fundamentalist Islam

From my America Out Loud Pulse podcast with Yasmine Mohammed – https://www.americaoutloud.news/yasmine-mohammed-unveiled-one-womans-story-trapped-by-fundamentalist-islam/

Violence is becoming commonplace. We cannot let it become inured to it. We hear about weekend violence on the big cities, shrug it off and are thankful that it was not in our neighborhood. But there is a particular kind of violence that happens in every neighborhood: violence against women. Sadly, so many of abused women trusted their partners who professed their love and devotion. Some women escape their abuser with their lives and mental state intact. Others are not so fortunate.

Women have been duped by men for millennia. The same can be said for religion. Faith in a higher power is a good thing to remind us that we are but a tiny fraction of the universe and humankind. In my view, no legitimate religious or secular philosophical tenet commands that we should subject ourselves to abuse at the hands of another human being.

My guest tonight lived through abuse for years and I’m sure her story will touch us all.

Yasmine’s book: Unveiled: How Western Liberals Empower Radical Islam

Yasmine’s websites: https://www.yasminemohammed.com; https://www.freeheartsfreeminds.com

Bio

Yasmine Mohammed advocates for the rights of women living within Muslim majority countries, as well as those who struggle under religious fundamentalism in general. She is the founder and President of Free Hearts Free Minds, a nonprofit charity that provides mental health support for members of the LGBT community and freethinkers living within Muslim majority countries where both so-called “crimes” can be punished by execution. She hosts the podcast Forgotten Feminists where she has conversations with inspirational women from restrictive religious backgrounds who have fought and who have overcome. Her book, Unveiled: How Western Liberals Empower Radical Islam is a memoir of her experiences growing up in a fundamentalist Islamic household and her arranged marriage to a member of Al-Qaeda.

America Out Loud PULSE: Employer Based Health Insurance

From my America Out Loud Pulse podcast with Matt Ohrt –https://www.americaoutloud.news/matt-ohrt-healthcare-policy-from-an-insurance-agent/

Medical care is expensive. Hospitals can cost anywhere from $1,305/day, to $4,181/day depending on the state where you live. The top reason that non-elderly adults do not have health insurance is that they cannot afford it. Worse, half of insured adults say they have trouble affording health costs. To save money on prescription drugs, 20 percent of folks either don’t fill the prescription, use over-the-counter medicines, skipped doses, or cut pills in half.

Two-thirds of Americans have private health insurance and the remainder have public health insurance. Nearly half of Americans receive health insurance through an employer. According to Aon, a business consultant, projects that the average healthcare costs for U.S. employers will increase 8.5% in 2024 to more than $15,000 per employee. Aon suggests that given the tight labor market, employers will absorb the increased cost rather than raise the employees’ contribution – that is already several thousands in premiums, deductibles, and copays. But we are asleep at the wheel. According to Forbes, employees spend 18 minutes selecting their benefits, and 42 percent wait until the last minute to enroll.

Entrepreneur Mark Cuban , the co-founder of the discount drug program, Mark Cuban Cost Plus Drug Co., “[CEOs] waste a sh-tload of money on less than quality care for their employees, and more often than not it’s their sickest and lowest paid employees that subsidize the rebates and deductibles.” Until we can move to a system where financing healthcare is not tied to the employer, employers have to take the lead in reducing costs.

Bio

Throughout his career, Matt Ohrt has served as an influential executive leader, working for companies such as Toyota Motor Manufacturing, Badger Mining (#1 Great Place to Work in America awards), and as the Vice President of HR for Merrill Steel in Schofield, WI. While at Merrill Steel in Wisconsin, he led the company on a healthcare transformation journey to implement a multitude of healthcare services at no cost to employees and their families, such as onsite clinics, a mobile clinic (converted ambulance), physical therapy, chiropractic, MRI, bundled orthopedic surgeries, and a world-class wellness program. He has received numerous awards for his healthcare innovations. In 2018 Matt founded the Healthcare Best Practice Group. He has written a book about his plan, Save Your Company, Don’t Feed the Beast – The Employer Healthcare Success Formula.

Relevant Websites:

America Out Loud PULSE: The Highs and Lows of Medical Cannabis with Dr. Dustin Sulak

From my America Out Loud Pulse podcast with Dr. Dustin Sulak – https://www.americaoutloud.news/the-highs-and-lows-of-medical-cannabis/

Pot, Mary Jane, weed, grass, and reefer are among the many names for marijuana. Marijuana is one strain of cannabis, the plant species that includes hemp. Hemp contains low levels of the psychoactive compound delta-9-tetrahydrocannabinol (THC) and marijuana has high levels. Another active compound in cannabis is cannabidiol (CBD) and it is non-psychoactive. Any Baby Boomers who indulged can confirm that the amount of THC in marijuana has increased over the last 25 years. In the mid-1990s, the average THC content of confiscated weed was roughly 4 percent. By 2014, it was about 12 percent, with a few strains of pot containing THC levels as high as 37 percent.

Cannabis was a key crop of the early American colonists. Indeed, one of our first president, George Washington’s main crops was hemp. In fact, the Virginia, Massachusetts, and Connecticut colonies were required to grow it. Hemp was used for fabric and rope. It wasn’t until the mid 1800s that cannabis was sold in doctors’ offices and pharmacies for medicinal purposes in the United States, mainly for stomach problems.

Cannabis had been used medicinally and recreationally for thousands of years, with artifacts from China suggesting it was used for malaria, poor memory, gout, and rheumatism. Immigrants from Mexico during the Mexican Revolution in the early 1900 were primarily responsible for the start of recreational use in the U.S. Unfortunately, during the Depression and the Prohibition era, the focus shifted to outlawing cannabis as an evil brought here by Mexican immigrants. By 1931, 29 states had outlawed cannabis. The Marijuana Tax Act of 1937 made selling, possessing or transferring hemp products for anything but industrial use a crime. The first person to violate the Act was sentenced to 4 years of hard labor.

Although the Controlled Substances Act of 1970 repealed the Marijuana Tax Act, the law made marijuana a Schedule I drug, meaning it had no medical use and the potential for addiction. This is the category that includes heroin, ecstasy, and LSD! But things began to change when California’s Compassionate Use Act of 1996 legalized marijuana for medical use by chronically ill persons. Today medical marijuana is legal in all but 11 states, although it remains illegal under federal law.

Recreational marijuana has been gradually moving from the culprit in “Reefer Madness” to a mainstream indulgence. However, many fear complete legalization as cannabis – thanks to its narcotic Schedule I status – has not had the research it deserves. (Fortunately, the Department of Health and Human Services has recommended to the Drug Enforcement Administration that the cannabis be downgraded to the class of drugs with more safety and lower potential for abuse.)

Many doctors are not familiar with the types of cannabis and the various uses. It can sometimes help patients when other more mainstream medications and treatments have failed.

My guest today is an integrative medicine physician and a highly regarded national expert in the use cannabis.

Dr. Sulak’s website: Healer.com; HealerCBD.com

Bio

Dustin Sulak, D.O. is a renowned integrative medicine physician based in Maine, whose practice balances the principles of osteopathy, mind-body medicine, spirituality in healthcare, and medical cannabis. Dr. Sulak educates medical providers and patients on its clinical use. Dr. Sulak excels in the treatment of patients with conditions that have not responded well to conventional treatment. Dr. Sulak received undergraduate degrees in nutrition science and biology from Indiana University, a doctorate of osteopathy from the Arizona College of Osteopathic Medicine, and completed an internship at Maine-Dartmouth Family Medicine Residency.

America Out Loud PULSE: Opioid Addiction and Settlement Funds with Dr. Molly Rutherford

From my America Out Loud Pulse podcast with Dr. Molly Rutherford – https://www.americaoutloud.news/its-2024-what-is-happening-with-opioid-addiction-and-the-settlement-funds/

In 2020, 54 million U.S. adults were living with chronic pain. Management of non-cancer pain went through a slow evolution starting in 1980 to include opioids. While opioids are indicated in many types of pain, they carry potential risk of addiction and overdose. The National Institute on Drugs Abuse data in 2019 revealed that 21 to 29 percent of patients prescribed opioids for chronic pain misuse them; between 8 and 12 percent of people using an opioid for chronic pain develop an opioid use disorder.

In 1995, the pharmaceutical companies insisted that their new opioid pain relievers, particularly OxyContin, were safe and effective and not addictive. Not true. Worse yet, an April 13, 2022 congressional oversight committee report revealed that at least 22 McKinsey consultants were simultaneously working with the Food and Drug Administration (FDA) on opioid safety and advising Purdue Pharma on how to influence the regulatory decisions of the U.S. FDA, as well as how to maximize sales. The bad behavior travelled down the food chain. For example, an email in the records of distributor AmerisourceBergen revealed during a state trial last year in West Virginia described their addicted consumers as “pillbillies” and referred to OxyContin as “hillbilly heroin.” Distributors also sent massive quantities of OxyContin to small rural communities clearly disproportionate to the population.

Now many of the major players in the prescription opioid debacle are paying the piper. Several physicians have been prosecuted – some unjustifiably – for overprescribing, others were a frank embarrassment to the profession by operating pill mills.

The national opioid settlement resolved thousands of civil lawsuits by state, local, and Native American governments. The lawsuits alleged that the sometimes sketchy business practices of many firms in the chain of commerce contributed to the opioid crisis. The national opioid settlements are the second-largest public health settlement of all time, following the $246 billion tobacco master settlement of the 1990s.

The largest pharmaceutical opioid distributors, (McKesson, AmerisourceBergen, and Cardinal Health) will pony up $21 billion and one manufacturer (Johnson & Johnson) will contribute $5 billion as well as cease manufacturing prescription opioids. Teva, Walgreens, and Walmart and several other smaller companies add to the financial mix.

The creator of OxyContin, Purdue Pharma (not to be confused with Perdue, the chicken supplier) entered into a separate settlement for $6 billion as part of its bankruptcy proceedings. While 60,000 vocal victims approved of, and were awaiting the funds, the federal government decided the terms immunizing Purdue’s owners, the Sacklers, from personal liability was not consistent bankruptcy law since the Sacklers did not declare personal bankruptcy. The case is currently in front of the Supreme Court and no ruling is expected until June 2024.

Who will control the funds? Currently several states have created councils that vary in their make-up but generally include health professionals, law enforcement, and victims of addiction. Importantly, where will the money go?

These councils are deciding on where to allocate the funds and are now the objects of multiple companies pitching their products. Most agree that the biggest portion should go to treatment by building treatment facilities and increasing access to medications for opioid use disorder, including for the uninsured, and providing naloxone to reverse overdoses. Some local governments want to use the funds to purchase law enforcement tools. Despite usefulness in curbing drug trafficking, as you can imagine, many groups are unhappy with this option. Additionally, many worry that as with the tobacco settlement, monies would go to unrelated projects.

My guest will share her expertise in addiction medicine and public policy.

*Dr. Rutherford’s website: Blue Grass Family Wellness: https://bluegrassfamilywellness.com

*To find how the settlement funds will be used in your area go to:

https://www.naccho.org/uploads/downloadable-resources/OpioidSettlementsPDFFinal.pdf

Bio

Molly Rutherford, MD, MPH is the founder, medical director, and physician at Bluegrass Family Wellness—a direct primary care clinic in Kentucky. She is board certified in Family Medicine and Addiction Medicine, and employs a holistic approach to her patients’ physical health. She has more than a decade of experience treating opioid addiction.

1 2 3 15