Expand search form

Culture & Society, Doctors, Featured, Health Policy, Medical Ethics, Politics, What's New

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

No Comments

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

Culture & Society, Current Events, Featured, Law, Medical Ethics, Politics, What's New

America Out Loud PULSE: DEI Meets Antisemitism Meets a Lawsuit

No Comments

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.

Culture & Society, Featured, Health Policy, Law, Medical Ethics, Medicine, Politics, What's New

America Out Loud PULSE: Defining Death with Dr. Heidi Klessig

No Comments

From my America Out Loud Pulse podcast with Dr. Heidi Klessig – https://www.americaoutloud.news/defining-death-with-heidi-klessig-md/

Historically, people advocated for at least 24 hours between the diagnosis of death and burial in case a mistake was made in the diagnosis. For years physicians searched for a sure sign of death. Some thought putrefaction of tissues was the only sure sign. Ultimately it seemed reasonable to define death as when all spontaneous vital functions ceased permanently. Then came organ transplantation and the whole concept of the moment of death has changed— irreversibly, like death itself.

The advances in medical science have made adherence to medical ethics more essential than ever. Cardio-pulmonary resuscitation (CPR), mechanical ventilation and artificial nutrition were only the beginning. We now are experimenting with pig to human transplants and freshly obtained aborted fetal tissue is being used to create “humanized mice”. We can’t get carried away with the technology and forget the humanity. First and foremost, a patient has the right to self-determination and the physician’s duty is to respect the patient’s decisions and to do no harm to the patient. Incidents where patients were labelled DNR (Do Not Resuscitate) without their (or their family’s) consent are unacceptable.

Unfortunately, along with the innovations that can prolong life and sometimes cure, we have drifted into a utilitarian mindset when considering patient treatment alternatives. Often times, the suggested treatment—or non-treatment—pathway is at odds with the concept of the innate dignity of being a living human being. All involved persons must remember that we are far more than clumps of cells or a collection of body parts for future use.

Also disturbing is the popularity of euthanasia and physician assisted suicide, euphemistically called “medical aid in dying” (MAID). In Canada, assisted suicide has been in effect since 2016. In 2022 medically assisted deaths constituted 4.1 per cent of all deaths in Canada. This was a 30 percent increase from 2021. The patient who partakes need not be terminally ill. According to a BBC news report, social problems like poverty, lack of housing, or extreme loneliness may contribute to the patient’s willingness to request MAID, and this “prompted fears it could be used as a solution for societal challenges.” As of March 17, 2024. Now persons suffering solely from a mental illness will be eligible for MAID.

As there is more and more discussion of scarce medical resources, we have to be vigilant that as physicians we maintain our commitment to respect human life. Marilyn believes death is a separation of body and spirit, but Dr. Singleton must deal with ethics, legal definitions and guidelines.

Today my guest will discuss the past, present, and future of the concept of “brain death.”

Dr. Klessig’s website: https://www.respectforhumanlife.com

Dr. Klessig’s latest book: https://www.respectforhumanlife.com/books

Bio

Dr. Heidi Klessig attended medical school at University of Wisconsin, where she also completed her residency in anesthesiology. She received the American Board of Anesthesiology’s certificate of added qualification in pain management. She was a founding partner of the Pain Clinic of Northwestern Wisconsin and was an instructor for the International Spinal Injection Society. She recently authored The Brain Death Fallacy. Dr. Klessig and Christopher W. Bogosh, RN-BC also maintain a website called Respect for Human Life that deals with issues surrounding organ transplantation

Culture & Society, Featured, Health Policy, Medical Ethics, Medicine, Politics, What's New

America Out Loud PULSE: One Surgeon’s Fight Against Race-Baiting Radicalism

No Comments

From my America Out Loud Pulse podcast – https://www.americaoutloud.news/one-surgeons-fight-against-race-baiting-radicalism-2/

Medicine as profession has advanced to include all races and males and females. My father went to an all-black college and medical school. I went to a “white” college and medical school. When I was in medical school, the OB-Gyn department accepted its first female resident. Now over half of OB-Gyns are female. Times change – thank goodness.

Medicine as a science has advanced over the years to treat and cure more and more complex conditions. Unfortunately, there are certain groups of patients who don’t have access to good medical care. Sometimes this is because of lack of insurance or they have Medicaid that many doctors do not accept. Some have no transportation or babysitting or a myriad of other socio-economic issues standing in their way. We must do our best to sit down as a health care team and work on getting proper medical care to all Americans.

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 deciding that the cause of health care disparities is racism. Now all solutions start with racism and end with indoctrination into reverse racism. The academicians and mainstream medical associations write articles that erroneously conclude that minority patients are better off by having a doctor with the same skin color. Of course, this only works for patients of color. A white patient would be a racist if he asked for a white doctor. This obsession with race is clouding deeper societal issues. It is also violating Hippocrates’ oath to treat all patients with the same respect and skill.

My guest today has taken his fight against indoctrination to the streets, so to speak. First direct to the top of the American College of Surgeons and then in the National Review.  https://www.nationalreview.com/2023/10/the-american-college-of-surgeons-doubles-down-on-anti-racism/

Link to Dr. Bosshardt’s petition for reinstatement: https://www.change.org/ACS-petition-reinstate-Bosshardt

Do No Harm website – https://donoharmmedicine.org

Foundation Against Intolerance and Racism in Medicine website – https://fairforall.org/fair-in-medicine/

Bio

Dr. Rick Bosshardt is a board-certified plastic surgeon in private practice in Lake County, Florida for over 33 years. He graduated from University of Miami Medical School and completed his general surgery training in the U.S. Naval Hospital, Oakland, California. After serving as a surgeon at the U.S. Naval Hospital in Okinawa, Dr. Bosshardt returned to Miami in 1987 to train in plastic surgery. He wrote a weekly medical column, entitled House Calls, for the Orlando Sentinel for over 25 years and was a contributing writer to Lake Healthy Living Magazine for over 10 years. He is a member of the American Society of Plastic Surgeons and a Fellow in the American College of Surgeons.

Culture & Society, Featured, Law, Medical Ethics, What's New

America Out Loud PULSE: Forensic Psychiatry – Guilty or Insane?

No Comments

From my America Out Loud Pulse podcast with Dr. Renée S. Kohanski – https://www.americaoutloud.news/renee-s-kohanski-md-forensic-psychiatry/

Today we are going to seriously talk about psychiatric issues in crime. First, let me do some venting.

I think it’s a crime that people are punished for so-called microaggressions while bad guys committing macroaggressions, like burglarizing stores and assaulting people, face no consequences. In 2014, the foolish California electorate passed Proposition 47 that was supposed to reduce prison overcrowding by making it so a person can steal up to $950 and only be charged with a misdemeanor. There is no jail time and no requirement for bail. The criminals are free to commit more crimes. The theft flash mobs are spreading across the country in high-end neighborhoods. Moral codes have flown out the window—not only for the perpetrators but for some of these Soros-funded district attorneys.

I remember during the 1992 presidential election when Bill Clinton returned to Arkansas to oversee the execution of Ricky Ray Rector. Mr. Rector indeed murdered someone but was so mentally disabled at the time of the execution due to a suicide attempt by a gunshot wound to the head. This execution was particularly memorable: when the guards asked him whether he was finished with his meal, he said he would save the pecan pie “for later”. Ten years later, the Supreme Court ruled that putting mentally retarded people to death was “cruel and unusual”, and therefore unconstitutional.

Some criminologists question whether all murderers are mentally ill. After all, taking a human life is a grossly abnormal thing to do. (I’m not talking about protecting oneself or others or sadly, war). Many of us might have imagined killing someone in anger but would never actually do it. The Bureau of Justice Statistics (BJS) estimated that over 50 percent of inmates suffer from a significant mental condition. And that number is 80 percent for death row inmates. Some psychologists say it is not the mental illness, but the attendant substance abuse, living in high crime neighborhoods, low income, and similar social factors.

I’m not a fan of the death penalty. Physicians are not supposed to kill people. Moreover, too many people have been exonerated after many years of incarceration. If the wrong man was executed, death is irreversible. And the death penalty costs too much money. Up to 10 times more money (our tax dollars) is spent on death penalty cases than to house someone for life without parole. According to BJS, as of 2019 the average stay on death row is 19 years. In California, more death row inmates have died from natural causes or suicide than from executions since 1978.

If we want maximum accountability, there’s always Pelican Bay and the like. At Pelican Bay, half the inmates are in the Security Housing Unit (SHU) and are confined to their assigned cells for up to 22 hours a day. Correctional officers deliver food through a slot in the cell door. That sounds pretty grim to me.

My guest and I will discuss crime, punishment, and mental health.

Bio

Dr. Renée S. Kohanski, MD is a board-certified psychiatrist with fellowship training in forensic psychiatry. She completed her residency at Georgetown University where she served as Chief Resident and her fellowship at the William S. Hall Psychiatric Institute at the University of South Carolina. Dr. Kohanski has enjoyed a broad-based practice in academic, community, and forensic psychiatry. She has been a board examiner for the American Board of Psychiatry and Neurology, an Assistant Clinical Professor of Psychiatry at the Medical College of Georgia and the University of Connecticut schools of medicine. She has also served on the Editorial Advisory Board of MDEdge Psychiatry. Dr. Kohanski currently serves on the Board of Directors for the American Association of Physicians and Surgeons.

Culture & Society, Featured, Health Policy, Medical Ethics, Politics, What's New

America Out Loud PULSE: Mental Health and Gender Care

No Comments

From my America Out Loud Pulse podcast with Lauren Schwartz, MD –https://www.americaoutloud.news/mental-health-and-gender-care-with-dr-lauren-schwartz/

Words mean everything. There is a growing movement in certain medical circles to change the name of obesity to make it more patient friendly. Adiposity-Based Chronic Disease (ABCD) was proposed in 2016 but hasn’t seemed to have caught on. Abortion services became reproductive health. That one stuck.

Sex-change surgery is now called gender affirming care. Sex-change sounded a bit clownish since most people knew you really could not change your sex. Except for some rare conditions, a person is born with a set of XX (female) or XY (male) chromosomes. Gender affirming care sounds so compassionate, so medically reasonable to physically change a person to comport with the gender by which he or she wants to, as they say, “identify as.” But it is some sort of delusion that injecting children with drugs will magically turn them into the opposite sex. The wordsmithing seems to have no limits. One child psychologist at a major medical center has suggested that children can identify as “gender hybrids.” The Assistant Secretary of Health and Human Services agrees with eliminating the word “mother” in exchange for “egg carrier” or “gestational parent,” or birthing parent.” The Centers for Disease Control and Prevention (CDC) offers advice on “chest feeding.”

Changing words is reminiscent of George Orwell’s “Newspeak,” used in his oft-cited novel, 1984.The point of Newspeak was to control the language and discourage individual thought and critical thinking. Unfortunately, the medical establishment has demonstrated that it is not immune from making medical decisions based on the winds of politics. It seems this frightening trend to put ideology over science will result in permanent scarring of some of our most precious and vulnerable human beings.

There is hope. More and more states and sports groups are recognizing the unfairness and safety concerns of permitting biological men to compete in women’s sports. Nineteen states have laws protecting youth from medical procedures that would likely permanently and do irreparable harm to their bodies. Mind you, we are talking about minors, not adults who are presumably mature and capable of thinking through a serious decision.

My guest will explore these issues and much more. She, like so many other good doctors, believes instead of injecting politics we should exercise our duty as physicians to treat every patient with developmentally appropriate, comprehensive care, dignity, respect, empathy and compassion through excellence in medicine and mental health.

Bio

Dr. Lauren Schwartz is a psychiatrist certified by the American Board of Psychiatry and Neurology. She graduated from the University of Oklahoma College of Medicine with distinction and completed her residency in psychiatry at the University of Oklahoma’s Health Sciences Center with additional training in psychoanalytic theory through Oklahoma’s psychoanalytic society. She is currently in private practice in Oklahoma, applying a psychodynamic approach to both psychotherapy and psychopharmacology. Most recently she has collaborated with Dr. Miriam Grossman and authored 2 appendices for Dr. Grossman’s book, “Lost in Trans Nation, A Child Psychiatrist’s Guide Out of the Madness.”

Culture & Society, Current Events, Featured, Medical Ethics, Politics, What's New

America Out Loud PULSE: I Have 5 Words for These Legislators: Stay Away From Our Children

No Comments

From my America Out Loud Pulse podcast with Dr. Diana Blum –https://www.americaoutloud.news/i-have-5-words-for-these-legislators-stay-away-from-our-children/

Who on earth came up with the idea that having a race to the bottom would close the achievement gap among minorities and Whites and Asians. Some schools are going gradeless, and cancelling honors classes, and not informing students that they received National Merit scholarships. This is carrying diversity, equity, and inclusion too far. As Booker T. Washington said, “No greater injury can be done to any youth than to let him feel that because he belongs to this or that race, he will be advanced in life regardless of his own merits or efforts.” The whole point is to raise the achievement level of underachievers, not to stunt the progress of the high achievers to even things out.

This reminds me of various programs in 1964’s War on Poverty that sought to raise people out of poverty but resulted in, for many, intergenerational dependence on the government and for many, stagnation at subsistence level.

The tactics of the War on Poverty included AFDC—Aid to Families with Dependent Children—where if there was a man in the house, there were no welfare benefits. What happened to keeping a family together during troubled times? What happened to encouraging families to lean on one another and discuss and hopefully resolve their financial issues?

The thought process behind AFDC was only the beginning of the state’s new role of in loco parentis. This goes beyond co-parenting: parental rights are under assault. Laws are emerging that allow teachers more control over the intimate details of our children’s lives than their parents have. In multiple states children can have abortions with no parental involvement, irrespective of possible harm due to abuse in several states.

A proposed California law (AB665) would allow any minor as young as age 12 to seek mental health services and go to a government “residential shelter” without their parents’ knowledge or consent. Current law quite reasonably allows parents to be out of the loop only if the child presents as danger of serious physical or mental harm to themselves or others or to be the alleged victim of incest or child abuse.

Another California bill (AB957) that has passed through the assembly “would include a parent’s affirmation of the child’s gender identity as part of the health, safety, and welfare of the child.” This would become as factor in determining whether as parent is guilty of child abuse in custody hearings. How is this in the best interests of the child when this bill applies to children of all ages, not just, for example, 12 and up? So, the parent who “affirms” gets custody and the other parent is labeled a child abuser.

I have five words for these legislators: stay away from our children.

My guest and I will discuss some policies of some of our schools that intrude on parental rights, many times resulting in harm to children medically and educationally.

Bio

Dr. Diana Blum is a board-certified neurologist who completed her medical school training at the University of Chicago, Pritzker school of Medicine and her Neurology Residency training at Stanford University Medical Center. She is currently in private practice in Silicon Valley, California where she focuses on the chronic management of patients with Parkinson’s Disease. When not practicing clinical medicine, Dr. Blum is a fierce patient and physician advocate, defending Hippocratic oath medicine and the sanctity of the doctor-patient relationship through education and activism.

Culture & Society, Health Policy, Law, Medical Ethics, Medicine, Politics, What's New

America Out Loud PULSE: The Myth of Medical Privacy

No Comments

From my podcast with Twila Brase, RN, PHN – https://www.americaoutloud.com/the-myth-of-medical-privacy-with-twila-brase-rn/

Back in 2018, Amazon made a software application that can mine a patient’s medical data and convert it to a searchable database. Amazon could customize the database for pharmaceutical companies, insurers, hospitals, researchers, and clinicians. Amazon claims the application would comply with HIPAA, the Health Insurance Portability and Accountability Act of 1996. By the way, isn’t it interesting that the word “privacy” is not in the title of the law that everybody thinks is a law that protects privacy?

Worse, some electronic health records had an embedded app (developed by Xealth, Inc.) that prompted doctors to recommend health products to their patients that—surprise!—were sold on Amazon.

Amazon is being hailed as a “disruptor” in medical care with its online clinics. For a flat fee, you can get in touch with a clinician of some sort and describe your symptoms or needs. As one customer testimonial reads, “Amazon Clinic was incredibly easy and convenient to get my thyroid medical refilled. No hidden fees, no in person visit. Also for someone without health insurance the cost was the absolute best part.” But there is a giant “but.” Amazon’s health clinic requires patients to give Amazon the authority to redisclose their health information in the future.

Cost effective, yes; but Amazon clinic’s terms of use raise the question: How much is your medical privacy worth? I remember the attempt to discredit Daniel-Ellsberg who exposed damaging information regarding the Viet Nam War with the release of the “Pentagon Papers”. Operatives dispatched by the President broke into Ellsberg’s psychiatrist’s office looking for juicy tidbits. Imagine how easy that would be now. Hacking into electronic databases has become child’s play.

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

Twila Brase, RN, PHN 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.

Health Policy, Law, Medical Ethics, Medicare, What's New

America Out Loud PULSE: Long Term Care

No Comments

From my America Out Loud Pulse Podcast with  Stephen Moses – https://www.americaoutloud.com/the-ins-and-outs-of-long-term-care/

People are living longer and by 2030 about one in five Americans will be aged 65 years and older. Unfortunately, around 60 percent of adults suffer from at least one chronic condition, while 42 percent suffer from multiple conditions. Among those 60 or older, at least 80 percent have one chronic illness and 50 percent have two. Such conditions include heart disease, cancer, stroke, dementia, Parkinson’s, diabetes, kidney disease, debilitating hearing loss, blindness, and chronic lower respiratory disease (COPD, bronchitis, emphysema, asthma). Seventy percent of people who reach age 65 will eventually develop severe need, and 48 percent will receive paid care.  The need for paid care spikes around age 85.

We hear interminable ads for life insurance with guaranteed acceptance and no physical exam that you can get in your 70s for under $10 a month! The unvarnished truth is that the death benefit is about $500 to $700—that amount would hardly pay cab fare to your funeral. We rarely hear ads for a type of insurance that we actually need and would improve our lives: long-term care insurance.

Ideally, our life’s medical trajectory would be good health for many years, then keel over one day and meet our Maker without going through a period of debilitation. I would venture to guess that most people cringe at the thought of spending their last years on this earth in a nursing home. Long term nursing care can be as high as $100,000 per year and many people look to the government to pay their nursing home bill.

But given the low reimbursement to facilities from the government and the low pay for workers in the long term care industry, it leads us to question the quality of care the residents receive.

My guest will discuss the ins and outs of long term care and what we should do to protect ourselves.

Bio

Steve Moses is president of the Center for Long-Term Care Reform. The center promotes universal access to top quality long-term care by encouraging private financing as an alternative to Medicaid dependency for most Americans. Previously, Mr. Moses was president of the Center for Long-Term Care Financing (1998-2005), Director of Research for LTC, Inc. (1989-98), a senior analyst for the Inspector General of the U.S. Department of Health and Human Services (1987-89), a Medicaid state representative for the Health Care Financing Administration (1978-87), an HHS departmental management intern (1975-78), and a Peace Corps volunteer in Venezuela (1968-1970). He is widely recognized as an experienced expert and innovator in the field of long term care. His recent monograph on the issue is Long-Term Care: The Problem.

Doctors, Health Policy, Medical Ethics, Medicine, What's New

America Out Loud PULSE: Ego Must Not Trump Patient Care

No Comments

From my America Out Loud Pulse podcast with Dr. Lawrence Huntoon –https://www.americaoutloud.com/ego-must-not-trump-patient-care/

When clinical practice guidelines were first introduced, they sounded like a good idea. Some experts in a certain field of medicine would get together and decide what is the best thing to do for patients. It didn’t take much time for the flaws in the guidelines concept to emerge. We saw that some of the recommendations were designed to save money rather than benefit patients. Some guidelines appeared to be influenced by the companies who would make money from their use—aka Big Pharma. We certainly learned during Covid-19 that the experts were not always right and were corrupted by influence from pharmaceutical companies.

Medicine traditionally is full of all sorts of information and differing opinions. After all, the human body and its reaction to medications and other treatments are not always predictable. Continually questioning the so-called settled science is how progress is made. It became clear to discerning physicians that these guidelines became a crutch, promoting “cookbook” medicine and as my guest puts it, “eliminates unproductive time spent taking the patient’s individual circumstances, conditions, and needs into consideration so as to provide optimal care.”

Worse yet, these guidelines have been used a weapon against good, innovative physicians, sometimes to crush a competitor or someone who refuses to sell his practice to a large group. The critics of innovative physicians conflate the guidelines with the “standard of care”—the standard of practice to which physicians are legally held. This is a legal definition of good medical practice in a community with the same resources as the physician at issue. What constitutes the standard of care will change from community to community as well as evolve over time. Guidelines may be considered as a factor, but they do not define the standard of care.

In the 1995 South Carolina malpractice case, McCourt v. Abernathy, the Court stated:

“The mere fact that the plaintiff’s expert may use a different approach is not considered a deviation from the recognized standard of medical care. Nor is the standard violated because the expert disagrees with a defendant as to what is the best or better approach in treating a patient. Medicine is an inexact science, and generally qualified physicians may differ as to what constitutes a preferable course of treatment. Such differences due to preference…do not amount to malpractice”.

My guest and I will discuss these issues and how needlessly attacking doctors harms patients.

1 2 3 … 6
Close Menu