Two Teenagers Charged With Setting Cat on Fire
Sewell Chan
The New York Times
March 19, 2009
Two teenage boys were arrested two weeks ago for pouring lighter fluid on a cat and burning it alive inside an occupied building. The cat was so badly burned that it had to be euthanized. The teenagers face up to 25 years in jail if convicted. One of the teenagers had a previous conviction for beating a man in his bed before demanding money from the victim. This is a very short article about the abuse of a species that has had a very long and colorful history. My blog is not meant to minimize the abuse of any other species.
People who are cruel to animals usually have a callous disrespect for any life: It is known that serial killers characteristically begin their careers by torturing and killing small animals. Twenty-five years is a just punishment for these boys’ crimes, especially in light of the progression to bigger, human targets that their actions are likely to take.
Cruelty against animals is despicable. Crimes against cats are particularly odious because of the hate-related nature of these acts. Cat torture and immolation is a centuries-old “pastime”: The New York Times has articles in its archives dating back to the 1800s describing such acts of violence. Often, such acts were simply dismissed as "boys being boys." Cat burning was a also a form of mass entertainment in 16th century Paris;
and the Danish fastelavn carnival that occurred seven weeks before Easter traditionally included beating a barrel with a black cat inside it to ward off evil. I also found lots of links on UTube pertaining to live cat burnings (links not provided). I didn't open them so I can't tell you if they were real.
There is much superstition surrounding cats and they have long been associated with witches and “crazy cat ladies” (myself being one – or both). Millions of women and cats were burned to death and tortured during the witch trials, here and in Europe. Much has been written about the social, economic, and religious politics of these acts. But karma has its way of working things out: The slaughter of cats (and dogs, to a lesser degree) during the medieval period (1230 to 1700) contributed to the bubonic plague that devastated Europe in the 1600s. The rat population, allowed to multiply unchecked, attacked the grain stores, devouring the grain and dropping infectious fleas that spread the disease. More than 25 million people died during the plague.
There are many misconceptions about cat behavior and the physical and emotional needs of cats, which can lead to such acts of torture and violence and just plain old neglect. People generally believe that cats can fend for themselves and be left alone for long periods. This is not true. Cats are more individualistic than dogs but their basic needs are the same, no matter how differently they may be expressed. They have a strong need for company, affection, food, and shelter. The difference between a cat and a dog is that the cat will demand it on its own terms. Companion animals, both cats and dogs, are not able to fend for themselves once they have become dependent on humans.
I have heard otherwise intelligent human beings and self-proclaimed animal lovers make some of the most outrageous statements, and behave accordingly, regarding cats. Last year, a former neighbor sought my advice regarding a friend who had a situation with her 17 year-old-cat. The woman recently moved in with her boyfriend, who had a two-year-old cat. The two cats did not get along and no measures had been taken to ease the transition for the new housemates—they had simply been thrown together into their new environment and expected to get along. After about two months, hardly enough time to adjust, it was decided that the older cat had to go. My neighbor, who is the most devoted of dog owners, suggested taking the cat to another location and abandoning it, since cats can just fend for themselves. I did mention that the cat was 17-years-old. This neighbor also found it amusing that her Chow dog (a fighting breed), who was often poorly secured, often got into our yard and terrorized our cats. This activity was actually encouraged. The dog did eventually take a nip at a human.
Negligence is a very common form of cruelty. The French writer and pilot, Antoine de Saint-Exupery, wrote in his book, The Little Prince, “You are responsible forever for what you have tamed.” I wholeheartedly agree with his philosophy and I would take it a step further to say that we, as humans, are responsible for taking action against all acts of cruelty, especially those involving the most vulnerable members of our society. A kind neighbor took the initiative to seek medical help for the poor cat. We, as a society, can demand strict punishments for those who abuse and torture animals. By stopping an animal abuser, you may also be saving a human life.
Sunday, March 29, 2009
Being Friends With Your Doctor Improves Your Health?
The article, “How Connected Are You to Your Doctor?” reveals that in a study, “…investigators studied over 155,000 patients…about 60 percent of patients studied had the kind of relationship with their specific doctors that could be considered ‘connected.’ But a sizable minority did not. About one in three patients were merely ‘connected’ to an entire practice of physicians but not a single doctor; and just over 5 percent of patients were not ‘connected’ at all.” The study revealed that “patients with the strongest relationships to specific primary care physicians were also more likely to receive recommended tests and preventive care. In fact, this sense of connection with a single doctor had a greater influence on the kind of preventive care received than the patient’s age, sex, race or ethnicity.”
In my experience, I have always found that being friends or more connected with my doctor made me more comfortable talking about personal issues in my life and more open to trying other types of treatments. I have hypertension and being friends with my doctors allowed me to be open to discussing stresses in my life that could have an influence on my blood pressure, like experiencing the grief over my father’s death. Talking about my father’s death and being open about my feelings helped my doctor know the appropriate medicine to prescribe or if medicine was even needed, especially since stress is a major cause of hypertension. When I had insurance, I had a primary care physician.
According to the article, different practice models, from walk-in clinics (docs-in-the-box) to solo practice models, were originally designed to meet the need of the patient, but has instead met the need of the physicians. In the article, Dr. Steven J. Atlas, the lead author and co-director of primary care quality improvement at Massachusetts General Hospital in Boston, “That business model (walk-in clinics) says we are fulfilling a need, but is it really what patients want, or is it the only thing they can get? You could argue that the way we provide care now is to meet our needs as physicians. We are telling patients what we want to do. What we have to do is flip that around.” Now that I don’t have insurance, I have to go to the health department to see the doctor, and because those doctors see a number of patients daily, it is less likely that they will have good relationships with their patients or be connected with them. I’m sure my doctor wouldn’t remember my name or my recurring diagnoses without my chart in front of her. Also, I’m not open with this doctor like I was with my previous primary care physician who I saw regularly, and I don’t discuss any personal issues because I don’t feel connected with her, which reduces my trust level and comfort level with the doctor. This doctor doesn’t encourage me to share my feelings and my life with her, like my previous primary care physician. I wonder if it’s because of reduced costs, too many patients, and not enough time? So, is it better to schedule as many patients as you can in one day to meet revenue goal, or to leave more time for patient care to improve quality of life?
According to the Spiral Notebook, “In a video-taped study of 171 office visits, doctors who encouraged patients to talk about psychosocial issues such as family and job had more satisfied patients and the visits were only an average of two minutes longer. Incidentally, doctors also benefit from the patient-centered approach, researchers note, because they feel more job satisfaction and are less likely to burn out.” A New York Times article on "Doctor and Patient, Now at Odds," reports that “The relationship is the cornerstone of the medical system – nobody can be helped if doctors and patients aren’t getting along. But increasingly, research and anecdotal reports suggest that many patients don’t trust doctors.” The NY Times blames higher costs and declining reimbursements for the reasons doctors don’t spend more time with patients. The NY Times reveals that “News reports about medical errors and drug industry influence have increased patients’ distrust. And the rise of direct-to-consumer drug advertising and medical Web sites have taught patients to research their own medical issues and made them more skeptical and inquisitive.”
A good relationship with your doctor can improve patient care and quality of life. A Psychcentral article, "Improving the Doctor/Patient Relationship in Medicine," reports that “Physicians who communicate well with their patients and listen more carefully to their complaints score higher in doctor satisfaction scores, have fewer complaints filed against them, and may even help their patients’ health outcomes. Good doctor interpersonal and communication skills, the authors argue, are integral to helping patients get better.” In the article, Dr. Atlas notes that “‘By focusing on new treatments, new technology and instant access, we (doctors) have undermined the patient’s ability to have a longstanding relationship with a doctor, to have a doctor who knows him or her as a human being. If all your primary care doctor does is order tests and make referrals to specialists, he or she will miss the fact that you are stressed out because you lost your job or your health insurance.’”
To have better quality of life and improved patient care, we must be connected with our doctors, so that we can be more open and more comfortable.
In my experience, I have always found that being friends or more connected with my doctor made me more comfortable talking about personal issues in my life and more open to trying other types of treatments. I have hypertension and being friends with my doctors allowed me to be open to discussing stresses in my life that could have an influence on my blood pressure, like experiencing the grief over my father’s death. Talking about my father’s death and being open about my feelings helped my doctor know the appropriate medicine to prescribe or if medicine was even needed, especially since stress is a major cause of hypertension. When I had insurance, I had a primary care physician.
According to the article, different practice models, from walk-in clinics (docs-in-the-box) to solo practice models, were originally designed to meet the need of the patient, but has instead met the need of the physicians. In the article, Dr. Steven J. Atlas, the lead author and co-director of primary care quality improvement at Massachusetts General Hospital in Boston, “That business model (walk-in clinics) says we are fulfilling a need, but is it really what patients want, or is it the only thing they can get? You could argue that the way we provide care now is to meet our needs as physicians. We are telling patients what we want to do. What we have to do is flip that around.” Now that I don’t have insurance, I have to go to the health department to see the doctor, and because those doctors see a number of patients daily, it is less likely that they will have good relationships with their patients or be connected with them. I’m sure my doctor wouldn’t remember my name or my recurring diagnoses without my chart in front of her. Also, I’m not open with this doctor like I was with my previous primary care physician who I saw regularly, and I don’t discuss any personal issues because I don’t feel connected with her, which reduces my trust level and comfort level with the doctor. This doctor doesn’t encourage me to share my feelings and my life with her, like my previous primary care physician. I wonder if it’s because of reduced costs, too many patients, and not enough time? So, is it better to schedule as many patients as you can in one day to meet revenue goal, or to leave more time for patient care to improve quality of life?
According to the Spiral Notebook, “In a video-taped study of 171 office visits, doctors who encouraged patients to talk about psychosocial issues such as family and job had more satisfied patients and the visits were only an average of two minutes longer. Incidentally, doctors also benefit from the patient-centered approach, researchers note, because they feel more job satisfaction and are less likely to burn out.” A New York Times article on "Doctor and Patient, Now at Odds," reports that “The relationship is the cornerstone of the medical system – nobody can be helped if doctors and patients aren’t getting along. But increasingly, research and anecdotal reports suggest that many patients don’t trust doctors.” The NY Times blames higher costs and declining reimbursements for the reasons doctors don’t spend more time with patients. The NY Times reveals that “News reports about medical errors and drug industry influence have increased patients’ distrust. And the rise of direct-to-consumer drug advertising and medical Web sites have taught patients to research their own medical issues and made them more skeptical and inquisitive.”
A good relationship with your doctor can improve patient care and quality of life. A Psychcentral article, "Improving the Doctor/Patient Relationship in Medicine," reports that “Physicians who communicate well with their patients and listen more carefully to their complaints score higher in doctor satisfaction scores, have fewer complaints filed against them, and may even help their patients’ health outcomes. Good doctor interpersonal and communication skills, the authors argue, are integral to helping patients get better.” In the article, Dr. Atlas notes that “‘By focusing on new treatments, new technology and instant access, we (doctors) have undermined the patient’s ability to have a longstanding relationship with a doctor, to have a doctor who knows him or her as a human being. If all your primary care doctor does is order tests and make referrals to specialists, he or she will miss the fact that you are stressed out because you lost your job or your health insurance.’”
To have better quality of life and improved patient care, we must be connected with our doctors, so that we can be more open and more comfortable.
Wednesday, March 25, 2009
P-R-A-C-T-I-C-E…But not on me!
There are times in our lives when, no matter how strong we think we are, we are placed in a vulnerable situation. Such instances may include a simple visit to a doctor's office or more a severe event such as surgery. At these times, we, as patients, are placed in an extremely vulnerable position. We are ill or injured, and we are putting our health in the hands of another.
Well, what happens when you visit a doctor who appears to be "wet behind the ears", or you find out that your surgeon is actually a resident and the attending will not even be in the room? Does this make you feel comfortable in your vulnerable state, or are you wondering if you are actually getting the best care possible?
A recent New York Times article poses this same type of ethical consideration. According to the article, "to become a medical expert it takes practice, practice, practice, and, unfortunately, some error along the way." This conflict is at the heart of medical training; what might be best for making a skilled, independent-thinking doctor may not always be best for the patient.
In the pursuit of patient safety, educators have deliberately prevented residents from acting independently on their own judgment in situations where a patient poses a theoretical risk. The fact is that all physicians in training pose an inherent risk to patients.
Educators should do everything they can to minimize this risk but recognize that it may impair physicians’ self-confidence. However, it is hard to feel confident and independent unless you are given ample opportunity to stand on your own and risk making a mistake.
And how does a physician obtain that confidence? As stated earlier, practice, practice, practice.
This may seem acceptable to the patient during a simple doctor's visit; however, physicians are in a bit of an ethical conundrum in the more serious situations such as surgery. Is the patient really getting the best care possible in this situation?
Atul Gawande, author of Complications: A Surgeon's Notes on an Imperfect Science1, addresses this same conundrum. Gawande introduced surgeons as human with common human traits and faults. He stressed that, as humans, surgeons must practice their skill.
Gawande then went into further detail to discuss the ethics involved with training. As humans, we must follow a code of ethics; and, as humans, surgeons are no exception.
When given the choice, patients would choose an attending physician over a resident. This decision is based on the fact that patients want the best care possible. However, in order to get that care, surgeons must be trained. Therefore, learning is usually "hidden behind drapes".
While Gawande is a surgeon and he understands the importance of this hidden training, he admitted that he has been guilty of acting like a normal human-being. When his daughter was ill, he chose the best care possible instead of the training opportunity for another physician. With this example, he depicted the human side of a surgeon as being a caring father who only wants the best for his daughter. Therefore, with this example, it appears that there is no simple answer to this training issue.
As a patient, I not only perceive physicians to be infallible but I also expect them to be. However, although surgery has become as high-tech as medicine gets, I guess we must retain a recognition for the limitations of both science and human skill….not very easy to do when your life is on the line.
1.) Gawande, A. Complications: A Surgeon's Notes on an Imperfect Science. New York, NY: Picador; 2002.
BW706 Blog #9
By: Lisa Menard
Well, what happens when you visit a doctor who appears to be "wet behind the ears", or you find out that your surgeon is actually a resident and the attending will not even be in the room? Does this make you feel comfortable in your vulnerable state, or are you wondering if you are actually getting the best care possible?
A recent New York Times article poses this same type of ethical consideration. According to the article, "to become a medical expert it takes practice, practice, practice, and, unfortunately, some error along the way." This conflict is at the heart of medical training; what might be best for making a skilled, independent-thinking doctor may not always be best for the patient.
In the pursuit of patient safety, educators have deliberately prevented residents from acting independently on their own judgment in situations where a patient poses a theoretical risk. The fact is that all physicians in training pose an inherent risk to patients.
Educators should do everything they can to minimize this risk but recognize that it may impair physicians’ self-confidence. However, it is hard to feel confident and independent unless you are given ample opportunity to stand on your own and risk making a mistake.
And how does a physician obtain that confidence? As stated earlier, practice, practice, practice.
This may seem acceptable to the patient during a simple doctor's visit; however, physicians are in a bit of an ethical conundrum in the more serious situations such as surgery. Is the patient really getting the best care possible in this situation?
Atul Gawande, author of Complications: A Surgeon's Notes on an Imperfect Science1, addresses this same conundrum. Gawande introduced surgeons as human with common human traits and faults. He stressed that, as humans, surgeons must practice their skill.
Gawande then went into further detail to discuss the ethics involved with training. As humans, we must follow a code of ethics; and, as humans, surgeons are no exception.
When given the choice, patients would choose an attending physician over a resident. This decision is based on the fact that patients want the best care possible. However, in order to get that care, surgeons must be trained. Therefore, learning is usually "hidden behind drapes".
While Gawande is a surgeon and he understands the importance of this hidden training, he admitted that he has been guilty of acting like a normal human-being. When his daughter was ill, he chose the best care possible instead of the training opportunity for another physician. With this example, he depicted the human side of a surgeon as being a caring father who only wants the best for his daughter. Therefore, with this example, it appears that there is no simple answer to this training issue.
As a patient, I not only perceive physicians to be infallible but I also expect them to be. However, although surgery has become as high-tech as medicine gets, I guess we must retain a recognition for the limitations of both science and human skill….not very easy to do when your life is on the line.
1.) Gawande, A. Complications: A Surgeon's Notes on an Imperfect Science. New York, NY: Picador; 2002.
BW706 Blog #9
By: Lisa Menard
Yes, Doctor, Come On In…
The article, “Having Almost Become Extinct, House Calls Stage A Welcome Recovery,” reports that although doctors making house calls stopped in the 1980s because of lack of insurance coverage, a small group of doctors, nurses, physician assistants, and practitioners are “reviving this once-common practice for keeping Americans healthy and in touch with their doctors.” I say, about time. I miss those days when you could call the doctor late at night and he’d come to your house to check on you, instead of you having to drive to the ER and wait for hours to hear, “Oh, it’s just a cold. Take two aspirin and call me in the morning.” According to the article, “For generations, the home visit was an institution, something a doctor, black bag in hand, just did. In 1930, house calls made up about 40 percent of physician encounters with patients in the United States, according to a recent article in the journal Clinics in Geriatric Medicine. By 1950, that number had dropped to 10 percent. And by 1980, home visits accounted for a mere 1 percent.”
I guess the question here is what are the ethical implications to house visits? How will this affect new regulations, like HIPAA? House calls faded away because of technological advancements, increased non-coverage by private insurance companies, and financial incentives. “As new diagnostic tools and advanced treatments became available in hospitals and clinics, that's where people wanted to go…More doctors chose specialized fields that relied on the technology of hospitals, while those who chose primary care could see easily twice as many patients in offices and clinics as they could traveling from home to home…And then there's the fact that private insurance has rarely fully covered such visits.”
Too, I would suspect that many doctors’ malpractice insurance premiums would drastically increase. With home visits, how will the doctor insure himself against being sued for wrongful deaths and other medical malpractice? Without the supervision of other staff members as well as the necessary tools if something goes wrong while at the home visit, doctors increase their risks for malpractice suits. However, I would think this practice would increase quality of life for the elderly, who have problems making it to doctor’s visits, but need them regularly. According to the article, home visits are increasing quality of life for the “forgotten population,” who don't see a doctor routinely because getting out is so difficult, are “getting much lower-quality care than they should have.” Too, this would also help reduce costs for the elderly by decreasing the amount of co-pays for each clinic visit.
Although the practice of house calls has long been uncommon in the U.S., it is still common practice in other countries, including France, Denmark, Netherlands, and Canada, according to the article. “According to the Clinics article, in Britain, which has a strong tradition of primary care medicine and a national system of subsidized health care, doctors make 10 times as many house calls per 1,000 patients each year as do U.S. doctors.” Though we don’t hear much about doctors making house calls in these times, Medicare modified its billing procedures in 1998 to enable practitioners to easily receive payments for house calls. “Since then, Medicare statistics show a large bump in physician house calls, from 1.5 million in 2000 to almost 2.2 million in 2007.”
Although technological advancements were one reason for the decline in house calls, “Ironically… technology has now made the house call a reasonable alternative to office or hospital visits for certain patients. Doctors still rely on the black bag basics (stethoscope, otoscope, blood pressure cuff, blood-drawing equipment), but now they also come equipped with laptops with electronic medical records and wireless capabilities, portable EKG machines, even bedside X-ray and ultrasound devices that were once found only at a hospital, according to Ernest Brown of Unity Health Care, which mainly serves poor people in the District.” In addition, “Point-of-care testing (where blood, urine and other tests are done at the bedside, with results available in minutes) has become so easy that home-care practitioners can operate very efficiently.”
So, why are more people not taking advantage of this practice? Why are more doctors not making house calls and encouraging this practice among their colleagues? “According to the Clinics article, studies have suggested that house calls may keep people in their homes longer and reduce mortality, particularly in the frail elderly population. That is probably due in part to physicians' being able to identify new or worsening medical problems that, left untreated, could contribute to further disability and even death.” Increased quality of life should be reason enough for physicians’ to begin offering house calls as part of their clinic visits, especially for the elderly who have to see a doctor regularly, but are not able to get out. Not only will this improve quality of care, but it will reduce costs associated with caring for the elderly. The article states that, “Although homebound patients represent only 5 percent of the Medicare population, they consume more than 43 percent of the budget, according to a congressional analysis. An ER visit can be more than 10 times the cost of a typical house call, which Row pegs at $100 to $150.” However, on the other hand, “…the cost-saving benefit of house calls might actually hurt the medical centers that provide them.”
So, the question would be, is it better to increase quality of life by providing house calls or not provide them to maintain quality care at medical centers? Is it better to enhance the life of elderly patients, increasing the length of their lives, or risk decreasing their quality of life for monetary purposes? I know that I’d love it if my mother’s physician provided house calls to her patients, and especially when my father was getting sicker with Alzheimer’s and getting him to office visits became a chore. Many times we had to take him to the ER for non-emergencies that could have been taken care of at home. It would have definitely made life easier. That would have been one less argument and one less frustration.
I guess the question here is what are the ethical implications to house visits? How will this affect new regulations, like HIPAA? House calls faded away because of technological advancements, increased non-coverage by private insurance companies, and financial incentives. “As new diagnostic tools and advanced treatments became available in hospitals and clinics, that's where people wanted to go…More doctors chose specialized fields that relied on the technology of hospitals, while those who chose primary care could see easily twice as many patients in offices and clinics as they could traveling from home to home…And then there's the fact that private insurance has rarely fully covered such visits.”
Too, I would suspect that many doctors’ malpractice insurance premiums would drastically increase. With home visits, how will the doctor insure himself against being sued for wrongful deaths and other medical malpractice? Without the supervision of other staff members as well as the necessary tools if something goes wrong while at the home visit, doctors increase their risks for malpractice suits. However, I would think this practice would increase quality of life for the elderly, who have problems making it to doctor’s visits, but need them regularly. According to the article, home visits are increasing quality of life for the “forgotten population,” who don't see a doctor routinely because getting out is so difficult, are “getting much lower-quality care than they should have.” Too, this would also help reduce costs for the elderly by decreasing the amount of co-pays for each clinic visit.
Although the practice of house calls has long been uncommon in the U.S., it is still common practice in other countries, including France, Denmark, Netherlands, and Canada, according to the article. “According to the Clinics article, in Britain, which has a strong tradition of primary care medicine and a national system of subsidized health care, doctors make 10 times as many house calls per 1,000 patients each year as do U.S. doctors.” Though we don’t hear much about doctors making house calls in these times, Medicare modified its billing procedures in 1998 to enable practitioners to easily receive payments for house calls. “Since then, Medicare statistics show a large bump in physician house calls, from 1.5 million in 2000 to almost 2.2 million in 2007.”
Although technological advancements were one reason for the decline in house calls, “Ironically… technology has now made the house call a reasonable alternative to office or hospital visits for certain patients. Doctors still rely on the black bag basics (stethoscope, otoscope, blood pressure cuff, blood-drawing equipment), but now they also come equipped with laptops with electronic medical records and wireless capabilities, portable EKG machines, even bedside X-ray and ultrasound devices that were once found only at a hospital, according to Ernest Brown of Unity Health Care, which mainly serves poor people in the District.” In addition, “Point-of-care testing (where blood, urine and other tests are done at the bedside, with results available in minutes) has become so easy that home-care practitioners can operate very efficiently.”
So, why are more people not taking advantage of this practice? Why are more doctors not making house calls and encouraging this practice among their colleagues? “According to the Clinics article, studies have suggested that house calls may keep people in their homes longer and reduce mortality, particularly in the frail elderly population. That is probably due in part to physicians' being able to identify new or worsening medical problems that, left untreated, could contribute to further disability and even death.” Increased quality of life should be reason enough for physicians’ to begin offering house calls as part of their clinic visits, especially for the elderly who have to see a doctor regularly, but are not able to get out. Not only will this improve quality of care, but it will reduce costs associated with caring for the elderly. The article states that, “Although homebound patients represent only 5 percent of the Medicare population, they consume more than 43 percent of the budget, according to a congressional analysis. An ER visit can be more than 10 times the cost of a typical house call, which Row pegs at $100 to $150.” However, on the other hand, “…the cost-saving benefit of house calls might actually hurt the medical centers that provide them.”
So, the question would be, is it better to increase quality of life by providing house calls or not provide them to maintain quality care at medical centers? Is it better to enhance the life of elderly patients, increasing the length of their lives, or risk decreasing their quality of life for monetary purposes? I know that I’d love it if my mother’s physician provided house calls to her patients, and especially when my father was getting sicker with Alzheimer’s and getting him to office visits became a chore. Many times we had to take him to the ER for non-emergencies that could have been taken care of at home. It would have definitely made life easier. That would have been one less argument and one less frustration.
Thursday, March 19, 2009
Do you wear a helmet?
My husband became very interested in snowboarding last year. So he convinced me to go the local ski shop were we purchased him all the gear that he needed. One thing that we did not purchase however was a helmet. I figured my husband was going to be taking it pretty easy and sticking to the bunny slope since this was his first season of snowboarding.
Unfortunately, Natasha Richardson passed away on March 18, 2009 from a traumatic brain injury. Richardson was taking a beginner lesson for skiing when she fell and hit her head on the BUNNY SLOPE with no helmet for protection. At first Richardson felt fine, but later complained of a headache and was rushed to the emergency room where they found bleeding in her brain.
The death of Richardson has once again sparked the idea of whether or not to make it a requirement to wear helmets on the slopes. Some agree that it is important for people to wear helmets and that is should be made a requirement. Studies do show that helmets do help protect the head from significant blunt trauma when in an accident.
However, there are those for example that work at ski resorts that say if helmets were made a requirement, it would significantly make their job more difficult. It would require employees to police the slopes to make sure that people were abiding by the rule.
Jeff Hanle, a spokesperson from Aspen Skiing Company, stated that at their resorts “only children under the age of 12 at the Aspen ski schools are required to wear helmets”.
So the great debate begins… should people be required to wear helmets or not? I believe that everyone should be required to wear helmets and professional athletes should promote the importance of wearing helmets. If seatbelts are required by law, helmets should be as well.
Unfortunately, Natasha Richardson passed away on March 18, 2009 from a traumatic brain injury. Richardson was taking a beginner lesson for skiing when she fell and hit her head on the BUNNY SLOPE with no helmet for protection. At first Richardson felt fine, but later complained of a headache and was rushed to the emergency room where they found bleeding in her brain.
The death of Richardson has once again sparked the idea of whether or not to make it a requirement to wear helmets on the slopes. Some agree that it is important for people to wear helmets and that is should be made a requirement. Studies do show that helmets do help protect the head from significant blunt trauma when in an accident.
However, there are those for example that work at ski resorts that say if helmets were made a requirement, it would significantly make their job more difficult. It would require employees to police the slopes to make sure that people were abiding by the rule.
Jeff Hanle, a spokesperson from Aspen Skiing Company, stated that at their resorts “only children under the age of 12 at the Aspen ski schools are required to wear helmets”.
So the great debate begins… should people be required to wear helmets or not? I believe that everyone should be required to wear helmets and professional athletes should promote the importance of wearing helmets. If seatbelts are required by law, helmets should be as well.
Transplanted Kidneys: Love em', then leave em'
A recent New York Times article tells of a heart-wrenching story of a woman, named Margaret Oliver, who received a lifesaving kidney transplant. The government covered the costs under a special Medicare program for the hundreds of thousands of Americans with kidney failure; the only condition for which Medicare extends coverage to everyone.
Three years later, Medicare stopped paying for the expensive immunosuppressive drugs that Ms. Oliver needed to minimize the risk that her body would reject the organ. This was because the program covers 80 percent of the cost of immunosuppressive drugs, but only for 36 months after the transplant.
This week two senators introduced legislation that would require Medicare to cover the drugs for the life of the transplanted kidney. This legislation is not only beneficial for a transplant recipient's health status; it also provides a significant pharmacoeconomic benefit.
Transplantation generally provides better long-term outcomes and a higher quality-of-life than dialysis; however, patients then need to take immunosuppressive drugs for as long as they have the transplanted kidney. While many organ recipients are able to obtain health insurance through employers or spouses, others, like Ms. Oliver, find themselves with few options in the private insurance marketplace. If they lose the kidney, they have to return to dialysis and return to the organ waiting list. This may be the case with Ms. Oliver because the many months of interrupted treatment significantly weakened her new kidney and increased the chances that she will lose it in the near future.
Now that just doesn't sit right with me. If the immunosuppressive drugs are only covered for three years, then we might as well give in and offer transplants to known alcoholics; there is the same post-transplant liver failure possibility in both instances….so why the heck not?
Okay, well let's say that the government just isn't quite getting the health benefit. So let's put it in terms the government will understand; money.
While a transplant costs more than $100,000, the annual expenses for drugs versus dialysis speak for themselves. Medicare spends, on average, $17,000 a year for the immunosuppressive drugs for a kidney transplant recipient, compared to about $70,000 for a year of dialysis. As far as pharmacoeconomics go, the monetary benefit of extending
immunosuppressive drug coverage should be sufficient rationale for the government to pass the senators' legislation. I mean, isn't money all the government is worried about anyway?
BW706: Blog #8
Lisa Menard
Three years later, Medicare stopped paying for the expensive immunosuppressive drugs that Ms. Oliver needed to minimize the risk that her body would reject the organ. This was because the program covers 80 percent of the cost of immunosuppressive drugs, but only for 36 months after the transplant.
This week two senators introduced legislation that would require Medicare to cover the drugs for the life of the transplanted kidney. This legislation is not only beneficial for a transplant recipient's health status; it also provides a significant pharmacoeconomic benefit.
Transplantation generally provides better long-term outcomes and a higher quality-of-life than dialysis; however, patients then need to take immunosuppressive drugs for as long as they have the transplanted kidney. While many organ recipients are able to obtain health insurance through employers or spouses, others, like Ms. Oliver, find themselves with few options in the private insurance marketplace. If they lose the kidney, they have to return to dialysis and return to the organ waiting list. This may be the case with Ms. Oliver because the many months of interrupted treatment significantly weakened her new kidney and increased the chances that she will lose it in the near future.
Now that just doesn't sit right with me. If the immunosuppressive drugs are only covered for three years, then we might as well give in and offer transplants to known alcoholics; there is the same post-transplant liver failure possibility in both instances….so why the heck not?
Okay, well let's say that the government just isn't quite getting the health benefit. So let's put it in terms the government will understand; money.
While a transplant costs more than $100,000, the annual expenses for drugs versus dialysis speak for themselves. Medicare spends, on average, $17,000 a year for the immunosuppressive drugs for a kidney transplant recipient, compared to about $70,000 for a year of dialysis. As far as pharmacoeconomics go, the monetary benefit of extending
immunosuppressive drug coverage should be sufficient rationale for the government to pass the senators' legislation. I mean, isn't money all the government is worried about anyway?
BW706: Blog #8
Lisa Menard
Teen Pregnancy on the Rise...Again
In the article, "Teenage Birth Rate Increase for Second Consecutive Year," it is reported that the, "Nationally, the birth rate among 15-to-19-year-olds rose 1.4 percent from 2006 to 2007, continuing a climb that began a year earlier. The rate jumped 3.4 percent from 2005 to 2006, reversing what had been a 14-year decline." Although the reason for the increase is unknown, they speculate that, ".. it could be a result of growing complacency about AIDS and teen pregnancy, among other factors. The rise may also reflect a broader trend that affects all age groups, because birth rates have also increased among women in their 20s, 30s and 40s and older unmarried women." The article also suggests that the economic downturn may contribute to the rise in teen pregnancies because, "When families are stressed by economic forces, parental communication and supervision may decline, which in turn may have an effect..." So, can we assume then that parental communication and supervision the previous years were better, or is it safe to say that parental communication and supervision has been lacking for years.
Today, unlike in the past, most households are two-income with both parents working long hours and away from home for long periods. A recent poll estimated that 34% of teens and parents blame parental work on the reason they don't spend more time together (http://clinton4.nara.gov/WH/EOP/First_Lady/html/teens/survey.html). And if parents aren't spending time with their teens, then they're not talking to them about sex or other issues. The article, however, doesn't list a decline in parental communication or supervision as an underlying problem to teen pregnancy. Instead, the article notes failed policies and governmental programs. "But opponents said the findings provide new evidence that the approach (abstinence education) is ineffective and that the money should be shifted to programs that include educating young people about contraceptives -- efforts that have been shown to be highly effective." The article also reports that, "...other experts said the two-year data probably represent a trend and fit with other research showing a stall in the long drop in sexual activity among teenagers, as well as a decrease in condom use."
Is it the job of the government to primarily plan programs to reduce teen pregnancy, or does some of the responsible lie with the parents, too? Is it ethically sound to make the government primarily responsible for educating our children and talking to them about issues like sex, drugs, and alcohol? According to the National Campaign to Prevent Teen and Unplanned Pregnancy (NCPTUP), “There are many different solutions to the widespread problems of teen and unplanned pregnancy, at the individual and societal level, and public policy certainly plays a key role.” However, it does not play the primary key role. The NCPTUP reports that, “Teens consistently say that parents most influence their decisions about sex. However, the vast majority of parents (82%) agree that when it comes to talking about sex, they often don’t know what to say, how to say it, or when to start the conversation. Investments should be made to help parents—through a variety of innovative and user-friendly resources—communicate their values on sex, love, and relationships to the next generation.”
Yes, I agree that policies and programs implemented by the government are necessary, but is it not the job of the community and the parents to educate teens on this issue to improve quality of life, not only for the teen, but the child they would have? According to NCPTUP, “A child’s chance of growing up in poverty is nine times greater if the mother gave birth as a teen, if the parents were unmarried when the child was born, and if the mother did not receive a high school diploma than if none of these circumstances are present.” In addition, “Teen childbearing cost taxpayers $9.1 billion nationally in 2004 and the one-third decline in teen childbearing between 1991 and 2004 saved taxpayers $6.7 billion in 2004 alone.” If the numbers reported by NCPTUP that, “three in ten teen girls gets pregnant at least once before the age of 20, resulting in well over 400,000 teen births each year, and the United States still has the highest teen pregnancy and birth rates in the industrialized world,” then that is a number of children living in poverty.
To combat this problem, not only do we need to implement more policies and programs to educate teens, but we also need to educate parents on talking to their kids. It is the job of the government, the community, and the parents to provide assistance to the nationwide problem. If not to reduce the amount of money spent, but to reduce poverty and improve quality of life for teens and babies born into these situations.
Today, unlike in the past, most households are two-income with both parents working long hours and away from home for long periods. A recent poll estimated that 34% of teens and parents blame parental work on the reason they don't spend more time together (http://clinton4.nara.gov/WH/EOP/First_Lady/html/teens/survey.html). And if parents aren't spending time with their teens, then they're not talking to them about sex or other issues. The article, however, doesn't list a decline in parental communication or supervision as an underlying problem to teen pregnancy. Instead, the article notes failed policies and governmental programs. "But opponents said the findings provide new evidence that the approach (abstinence education) is ineffective and that the money should be shifted to programs that include educating young people about contraceptives -- efforts that have been shown to be highly effective." The article also reports that, "...other experts said the two-year data probably represent a trend and fit with other research showing a stall in the long drop in sexual activity among teenagers, as well as a decrease in condom use."
Is it the job of the government to primarily plan programs to reduce teen pregnancy, or does some of the responsible lie with the parents, too? Is it ethically sound to make the government primarily responsible for educating our children and talking to them about issues like sex, drugs, and alcohol? According to the National Campaign to Prevent Teen and Unplanned Pregnancy (NCPTUP), “There are many different solutions to the widespread problems of teen and unplanned pregnancy, at the individual and societal level, and public policy certainly plays a key role.” However, it does not play the primary key role. The NCPTUP reports that, “Teens consistently say that parents most influence their decisions about sex. However, the vast majority of parents (82%) agree that when it comes to talking about sex, they often don’t know what to say, how to say it, or when to start the conversation. Investments should be made to help parents—through a variety of innovative and user-friendly resources—communicate their values on sex, love, and relationships to the next generation.”
Yes, I agree that policies and programs implemented by the government are necessary, but is it not the job of the community and the parents to educate teens on this issue to improve quality of life, not only for the teen, but the child they would have? According to NCPTUP, “A child’s chance of growing up in poverty is nine times greater if the mother gave birth as a teen, if the parents were unmarried when the child was born, and if the mother did not receive a high school diploma than if none of these circumstances are present.” In addition, “Teen childbearing cost taxpayers $9.1 billion nationally in 2004 and the one-third decline in teen childbearing between 1991 and 2004 saved taxpayers $6.7 billion in 2004 alone.” If the numbers reported by NCPTUP that, “three in ten teen girls gets pregnant at least once before the age of 20, resulting in well over 400,000 teen births each year, and the United States still has the highest teen pregnancy and birth rates in the industrialized world,” then that is a number of children living in poverty.
To combat this problem, not only do we need to implement more policies and programs to educate teens, but we also need to educate parents on talking to their kids. It is the job of the government, the community, and the parents to provide assistance to the nationwide problem. If not to reduce the amount of money spent, but to reduce poverty and improve quality of life for teens and babies born into these situations.
Wednesday, March 18, 2009
From Tragedy to Triumph
Scientist at Work: Alice W. Flaherty
From Bipolar Darkness, the Empathy to Be a Doctor
By Elissa Ely, MD
The New York Times
March 17, 2009
I’m glad to be writing about someone who used a personal tragedy to help others. Dr. Alice W. Flaherty had achieved more as a medical doctor, neuroscientist, and published researcher by the age of 35 than most people accomplish in a lifetime. However, a postpartum crisis of grief following the delivery of stillborn twins triggered the onset of mania that was characterized by hypergraphia, the compulsion to write anything and everything, anywhere and everywhere, including the use of her own body as a manuscript page. Dr. Flaherty was ultimately hospitalized for bipolar disorder. Her experience with mental illness led to a bestselling book, “The Midnight Disease: The Drive to Write, Writer’s Block and the Creative Brain,” and a new, empathetic approach to treating patients that stemmed from her own need for empathy during her illness.
Ten years after the initial onset of mania, Dr. Flaherty is director of the movement disorders fellowship at Massachusetts General Hospital, specializing in deep brain stimulation, and an assistant professor of neurology at Harvard Medical School. She applies her preoccupation with the neuroanatomy of empathy to the treatment of her own patients, always aware of the fact that she is also a patient. She has been able to channel this seeming disability into something greater: the ability to relate to patients from a place of experience, especially depression, that allows them to identify with her. Dr. Flaherty manages her illness with medication, but she still has periods of mania and she still writes on her arms. But she wouldn’t have it any other way. She uses her manic episodes as the driving force for new ideas about treatments and theories of the mind; the subsequent depressions are used to consolidate her thoughts and edit the flood of writing from the manic wave.
Such creativity and brilliance are characteristic of many patients with bipolar disorder: Jim Carrey, Robin Williams, Robert Downey Jr., Tracey Ullman, Sting, Jane Pauley, Winston Churchill, and Virginia Woolf are some names that may be familiar. Robert Downey Jr., one of the “brat pack” of the 1990s, attained notoriety for his well-publicized struggle with drugs and the law, as much as for his brilliant acting. Drug and alcohol abuse, hypersexuality, excessive spending, psychosis, and violence are all characteristics of the manic phase of bipolar disorder. The suicide rate is high. Many don’t achieve the level of insight that Dr. Flaherty has been able to attain in order to transform the mood swings into something constructive. Many patients don’t adhere to their treatment regimens and wind up losing careers, relationships, and even their lives.
Bipolar disorder is so difficult to treat because it often takes years to diagnose accurately. The standard therapies are valproic acid (an anti-seizure medication) or lithium (a mood stabilizer) and adjunctive anti-depressant and atypical anti-psychotic medications. These drugs cause numerous side effects, including weight gain, hyperglycemia, sexual dysfunction, and feelings of dullness. Many patients who have enjoyed the euphoria and high energy of hypomania and mania can’t tolerate the “earthbound” heavy feeling caused by their medications. An acute episode of mania or depression or refractory chronicity that result in hospitalization can take months and even years to rebound from. Not to mention the stigma of having a mental illness. Another physician and well-known spokesperson for mental disorders, Kay Redfield Jamison poignantly described her journey into madness in the autobiography, “An Unquiet Mind.” Dr. Jamison survived numerous suicide attempts before she was finally able to gain control of her disease and reclaim her life. Such is the course of bipolar disorder.
According to Dr. Flaherty, “Neurology and psychiatry should be treating the same organ.” Indeed, some psychiatrists do treat bipolar disorder as a neurological condition. But a mental illness is more than a condition; it is a person’s life. What distinguishes Dr. Flaherty from most caregivers of psychiatric patients is her own patient status. The injection of empathy and identification into the patient-physician relationship can have a more profound effect on the prognosis for that patient than simple adherence to a medication regimen. This type of relationship provides hope to patients. They are able to see a successful, healthy individual who had to transcend many of the barriers that they now face and translate that picture into a possibility for their own lives. Dr. Flaherty is able to empower her patients because she sees things as they would and can adjust her treatments accordingly. Caregivers in any situation have the opportunity to transform lives with a simply shift in perspective in their communication with patients. And it wouldn’t cost anything in terms of time or money.
Donna Proszynski
Blog 5
From Bipolar Darkness, the Empathy to Be a Doctor
By Elissa Ely, MD
The New York Times
March 17, 2009
I’m glad to be writing about someone who used a personal tragedy to help others. Dr. Alice W. Flaherty had achieved more as a medical doctor, neuroscientist, and published researcher by the age of 35 than most people accomplish in a lifetime. However, a postpartum crisis of grief following the delivery of stillborn twins triggered the onset of mania that was characterized by hypergraphia, the compulsion to write anything and everything, anywhere and everywhere, including the use of her own body as a manuscript page. Dr. Flaherty was ultimately hospitalized for bipolar disorder. Her experience with mental illness led to a bestselling book, “The Midnight Disease: The Drive to Write, Writer’s Block and the Creative Brain,” and a new, empathetic approach to treating patients that stemmed from her own need for empathy during her illness.
Ten years after the initial onset of mania, Dr. Flaherty is director of the movement disorders fellowship at Massachusetts General Hospital, specializing in deep brain stimulation, and an assistant professor of neurology at Harvard Medical School. She applies her preoccupation with the neuroanatomy of empathy to the treatment of her own patients, always aware of the fact that she is also a patient. She has been able to channel this seeming disability into something greater: the ability to relate to patients from a place of experience, especially depression, that allows them to identify with her. Dr. Flaherty manages her illness with medication, but she still has periods of mania and she still writes on her arms. But she wouldn’t have it any other way. She uses her manic episodes as the driving force for new ideas about treatments and theories of the mind; the subsequent depressions are used to consolidate her thoughts and edit the flood of writing from the manic wave.
Such creativity and brilliance are characteristic of many patients with bipolar disorder: Jim Carrey, Robin Williams, Robert Downey Jr., Tracey Ullman, Sting, Jane Pauley, Winston Churchill, and Virginia Woolf are some names that may be familiar. Robert Downey Jr., one of the “brat pack” of the 1990s, attained notoriety for his well-publicized struggle with drugs and the law, as much as for his brilliant acting. Drug and alcohol abuse, hypersexuality, excessive spending, psychosis, and violence are all characteristics of the manic phase of bipolar disorder. The suicide rate is high. Many don’t achieve the level of insight that Dr. Flaherty has been able to attain in order to transform the mood swings into something constructive. Many patients don’t adhere to their treatment regimens and wind up losing careers, relationships, and even their lives.
Bipolar disorder is so difficult to treat because it often takes years to diagnose accurately. The standard therapies are valproic acid (an anti-seizure medication) or lithium (a mood stabilizer) and adjunctive anti-depressant and atypical anti-psychotic medications. These drugs cause numerous side effects, including weight gain, hyperglycemia, sexual dysfunction, and feelings of dullness. Many patients who have enjoyed the euphoria and high energy of hypomania and mania can’t tolerate the “earthbound” heavy feeling caused by their medications. An acute episode of mania or depression or refractory chronicity that result in hospitalization can take months and even years to rebound from. Not to mention the stigma of having a mental illness. Another physician and well-known spokesperson for mental disorders, Kay Redfield Jamison poignantly described her journey into madness in the autobiography, “An Unquiet Mind.” Dr. Jamison survived numerous suicide attempts before she was finally able to gain control of her disease and reclaim her life. Such is the course of bipolar disorder.
According to Dr. Flaherty, “Neurology and psychiatry should be treating the same organ.” Indeed, some psychiatrists do treat bipolar disorder as a neurological condition. But a mental illness is more than a condition; it is a person’s life. What distinguishes Dr. Flaherty from most caregivers of psychiatric patients is her own patient status. The injection of empathy and identification into the patient-physician relationship can have a more profound effect on the prognosis for that patient than simple adherence to a medication regimen. This type of relationship provides hope to patients. They are able to see a successful, healthy individual who had to transcend many of the barriers that they now face and translate that picture into a possibility for their own lives. Dr. Flaherty is able to empower her patients because she sees things as they would and can adjust her treatments accordingly. Caregivers in any situation have the opportunity to transform lives with a simply shift in perspective in their communication with patients. And it wouldn’t cost anything in terms of time or money.
Donna Proszynski
Blog 5
Thursday, March 12, 2009
Homeless Veterans...?
Many argue that war is a necessary evil. It is justified by both aggressors and defenders and even aggressors disguised as defenders. On either side of the argument are soldiers deemed heroes – despite the politics behind a war its citizens are asked to support the troops who stand in harms way to defend their way of life. In the
The research results for post-traumatic stress disorder (PTSD) for war veterans as well as other war-related psycho-social traumas successfully averted the media’s attention toward the psychological consequences of war. Thus, soldiers from Desert Storm received ceremonial welcome-home celebrations while the VA braced itself for the onslaught of physical disabilities as well as needed mental-health services. Unfortunately, there exists a gap in services such that the VA estimates that approximately one-third of the adult homeless population are veterans – mostly from
Indicators for homelessness are complicated but decipherable. And the risks for homeless veterans can be averted by ensuring that funding is allocated for Veteran’s Affairs medical facilities. That’s obvious. However, what may not be so obvious is the relationship the indicators have to our current health care, educational, and economic quagmire. That is, we have to be persistent about changing our current systems and implementing policies that ensure both security and health so that no one falls in the gaps. Particularly for veterans who are charged with ensuring our security. Thus, support of our troops should not be relegated to a mere slogan for t-shirts and bumper stickers but truly be part of the demand in our current state of reform. NYC should not have to “bolster its efforts to shelter homeless veterans” (www.nytimes.com/2008/12/16/nyregion/16vets.html?_r=1 ) if policies are in place to usurp risk factors for homelessness among veterans and non-veterans to begin with.
Holly Tomlin
BW 706, Blog 5
Becoming Thin…At What Cost?
We have all heard about crazy diets such as the grapefruit, pickle, Atkins and so on. Well there is a new diet on the market…brain surgery. Now we can all eat what we want until we get nice and plump. Then we will just get brain surgery to help us stop our cravings.
As technology advances so do our outrageous ideas. It used to be when someone was overweight, they would go on a healthy balanced diet and hit the gym a couple of days during the week. Now people are having their skulls drilled into.
Carol Poe of West Virginia was recently the second woman ever to undergo deep brain stimulation for weight loss. Before the surgery, Poe age 60 that stands 5’2 weighed 230 pounds. At Poe’s highest, she weighed a staggering 490 lbs.
Dr. Julian Bailes, chairman of West Virginia University’s department of neurosurgery, stated that Poe was a great candidate for this clinical trail approved by the FDA. During the three- hour surgery, Poe was awake. They drilled into her brain and inserted wires that carried electrical impulses into her brain. The wires were linked to a pacemaker device that was implanted in her chest. Over the months to come, doctors will increase the voltage going into Poe’s brain. One week after the surgery, Poe had lost 3 lbs.
It is very important that we continue to expand our knowledge about the human body and the way it works. However, spending money on such clinical trails I find to be a waste. None of us were born overweight. I understand that it can be extremely difficult for those that are, but whatever happened to the tried and true way of just eating healthy? It’s not a mystery of how to lose weight… but were not sure yet how to cure cancer. What is more important?
As technology advances so do our outrageous ideas. It used to be when someone was overweight, they would go on a healthy balanced diet and hit the gym a couple of days during the week. Now people are having their skulls drilled into.
Carol Poe of West Virginia was recently the second woman ever to undergo deep brain stimulation for weight loss. Before the surgery, Poe age 60 that stands 5’2 weighed 230 pounds. At Poe’s highest, she weighed a staggering 490 lbs.
Dr. Julian Bailes, chairman of West Virginia University’s department of neurosurgery, stated that Poe was a great candidate for this clinical trail approved by the FDA. During the three- hour surgery, Poe was awake. They drilled into her brain and inserted wires that carried electrical impulses into her brain. The wires were linked to a pacemaker device that was implanted in her chest. Over the months to come, doctors will increase the voltage going into Poe’s brain. One week after the surgery, Poe had lost 3 lbs.
It is very important that we continue to expand our knowledge about the human body and the way it works. However, spending money on such clinical trails I find to be a waste. None of us were born overweight. I understand that it can be extremely difficult for those that are, but whatever happened to the tried and true way of just eating healthy? It’s not a mystery of how to lose weight… but were not sure yet how to cure cancer. What is more important?
Doctor Fabricates Studies on Pain Medication
One would assume that doctors are ethical. However, in an article on MSNBC.com, an anesthesiologist from Boston Massachusetts is being accused of fabricating studies completed on the pain medications Vioxx and Celebrex. According to the article, Dr. Scott Reuben made up some or all of the data that was published in anesthesiologist journals from 1996 to 2008. There were a total of 21 papers published.
Dr. Scott Reuben from the Springfield Baystate Medical Center is now on leave. In his research he stated “favorable results” from the pain killers that he tested. They included Bextra, Celebrex, Lyrica, and Vioxx. Dr. Reuben also stated that the antidepressant Effexor worked effectively as a painkiller.
In reviewing the research completed by Dr. Reuben you would assume that he had personal ties with some of the companies. Well, Dr. Reuben received five research grants from Pfizer the maker of Bextra, Celebrex and Lyrica between 2002- 2007. In addition, Dr. Reuben was a member of the Pfizer’s speaker bureau in which he gave talks to other colleagues about Pfizer’s drugs.
Dr. Reuben’s research may have had an everlasting effect on some patients that were treated by doctors that believed his research. According to the article, Dr. Benzon the chief of pain medicine at Chicago’s Northwestern Memorial Hospital stated that “studies show that Celebrex and its relatives have been shown in some studies to interfere with bone healing — but not in Reuben’s research. Because of that, Benzon said he, and probably other doctors, too, began using those drugs more often in patients having bone-related operations including spinal surgery”. In addition, Dr. Benzon explained that the most alarming issue is that some of this research has been out there for over 12 years. No one knows to what extent Dr. Reuben’s research has affected patients.
When articles come out explaining the unethical behavior of those very people we trust our families lives with, you wonder “who can I really trust”. It is not known if Dr. Reuben fabricated his research for monetary gain. However, the next time you go to the doctors and they are pushing you to take a medication that does not seem right to you….get a second opinion. Anyone of us could have been a patient of Dr. Reuben’s.
Wednesday, March 11, 2009
Female Condoms to Prevent HIV?
From my understanding, male condoms and other contraceptives warn that these products may not prevent sexually transmitted diseases, pregnancy, or HIV/AIDS. But the article, “FDA approves inexpensive female condom,” touts that the new female condom, made with less expensive materials, will be targeted to “women in Africa and other areas where AIDS is a major concern.” According to the article, “Female Health’s initial Female Condom was approved in 1993 to prevent pregnancy, as well as sexually transmitted diseases, but has not been widely used in the United States, which made up just 10 percent of its 34.7 million unit sales in 2008.” The company hopes that the reduced costs “will help more groups offer more condoms in the hope of preventing HIV/AIDS and other STDs.”
But is it probable to believe that women in Africa will be able to not only have access to this product, but will be able to use it? How logical is it to believe that a female condom will reduce the occurrence of HIV/AIDS in Africa? If this was possible, would it be safe to assume that men in Africa had access to male condoms, and yet did not use them? According to AVERT, “Relative to the enormity of the HIV/AIDS epidemic in Africa, providing condoms is cheap and cost effective. Even when condoms are available, though, there are still a number of social, cultural and practical factors that may prevent people from using them. In the context of stable partnerships where pregnancy is desired, or where it may be difficult for one partner to suddenly suggest condom use, this option may not be practical.”
AVERT also mentions that, “the distribution of condoms to countries in sub-Saharan Africa has also increased: in 2004 the number of condoms provided to this region by donors was equivalent to 10 for every man, compared to 4.6 for every man in 2001. In most countries, though, many more condoms are still needed. For instance, in Uganda between 120 and 150 million condoms are required annually, but less than 40 million were provided in 2005.”
So, based on these statistics, would making female condoms accessible to females in Africa make a difference in the HIV/AIDS epidemic? Would these condoms have an impact on the US population affected by HIV/AIDS? Although condoms may reduce the risk of STDs, HIV/AIDS, and pregnancy, if not used properly, their effectiveness decrease. According to AVERT, “The main reason that condoms sometimes fail to prevent HIV/STD infection or pregnancy is incorrect or inconsistent use, not the failure of the condom itself. Using oil-based lubricants can weaken the latex, causing the condom to break. Condoms can also be weakened by exposure to heat or sunlight or by age, or they can be torn by teeth or fingernails. Also, remember to check the expiry date of your condom!”
The article reports that the FDA allows the United States Agency to distribute the female condom to global programs dedicated to preventing the spread of the virus that causes AIDS. My question is that if male condoms have always been available in the US and other countries, why is the numbers for AIDS, teen pregnancy, and STDs still continually rising? Shouldn’t we try to educate on these issues, rather than just developing and selling products that may or may not reduce the risks of attracting these diseases or unexpected pregnancies? Don’t we have an ethical responsibility to prevent these risks through knowledge than through profit?
But is it probable to believe that women in Africa will be able to not only have access to this product, but will be able to use it? How logical is it to believe that a female condom will reduce the occurrence of HIV/AIDS in Africa? If this was possible, would it be safe to assume that men in Africa had access to male condoms, and yet did not use them? According to AVERT, “Relative to the enormity of the HIV/AIDS epidemic in Africa, providing condoms is cheap and cost effective. Even when condoms are available, though, there are still a number of social, cultural and practical factors that may prevent people from using them. In the context of stable partnerships where pregnancy is desired, or where it may be difficult for one partner to suddenly suggest condom use, this option may not be practical.”
AVERT also mentions that, “the distribution of condoms to countries in sub-Saharan Africa has also increased: in 2004 the number of condoms provided to this region by donors was equivalent to 10 for every man, compared to 4.6 for every man in 2001. In most countries, though, many more condoms are still needed. For instance, in Uganda between 120 and 150 million condoms are required annually, but less than 40 million were provided in 2005.”
So, based on these statistics, would making female condoms accessible to females in Africa make a difference in the HIV/AIDS epidemic? Would these condoms have an impact on the US population affected by HIV/AIDS? Although condoms may reduce the risk of STDs, HIV/AIDS, and pregnancy, if not used properly, their effectiveness decrease. According to AVERT, “The main reason that condoms sometimes fail to prevent HIV/STD infection or pregnancy is incorrect or inconsistent use, not the failure of the condom itself. Using oil-based lubricants can weaken the latex, causing the condom to break. Condoms can also be weakened by exposure to heat or sunlight or by age, or they can be torn by teeth or fingernails. Also, remember to check the expiry date of your condom!”
The article reports that the FDA allows the United States Agency to distribute the female condom to global programs dedicated to preventing the spread of the virus that causes AIDS. My question is that if male condoms have always been available in the US and other countries, why is the numbers for AIDS, teen pregnancy, and STDs still continually rising? Shouldn’t we try to educate on these issues, rather than just developing and selling products that may or may not reduce the risks of attracting these diseases or unexpected pregnancies? Don’t we have an ethical responsibility to prevent these risks through knowledge than through profit?
Hepatitis Secrets Revealed
According to results of an investigation published by the CDC, at least nine kidney patients were infected with hepatitis C while being treated at Life Care Dialysis Center. This fact may sound like just another story concerning hospital acquired infections; however, there is much more to the story. The Center's closing by state health officials was warranted in more ways than one.
On the surface, the clinic was described as a filthy place where employees did not wash their hands properly, disinfect equipment, or always wear gloves when treating patients. Dried blood was even found on treatment chairs. As it turns out, this was not just pure laziness; many staff members were unaware of the center’s written policies about cleaning and disinfection. Whether or not the staff was telling the truth remains to be seen, but it appears that the center has severe training issues; untrained staff should not have been dealing with patients in the first place.
Medical guidelines require strict testing and monitoring of dialysis patients for hepatitis C infection; however, the clinic tested patients on an erratic basis. Out of the patients that they did test, the aforementioned nine tested positive for hepatitis C.
Hold on, this is the worst part of the story. The clinic knew that these nine became infected after they started coming to the clinic, but it never informed them; it notified state health officials in only three cases. This deviance combined with erratic testing means that many other patients may also have been infected at the clinic.
Dr. Walter Wasser, the physician who was the operator and medical director of the dialysis center, was fined $300,000 and surrendered the clinic’s operating certificate, but the state Office of Professional Medical Conduct has not taken formal action against him. Where is the justice in that? Does a fine and a bit of public embarrassment make up for the patients' losses?
The future of these nine newly-positive hepatitis C patients may include cirrhosis, liver failure, and cancer. If you add the diminishing quality of life over an extended period of time, does this punishment seem fair? What about the family members of these patients? Who is reimbursing them for their inherent struggles and emotional setbacks due to the clinic's carelessness and deceit? Even if large sums of money were given to these patients and the careless were sent to prison, would it still be enough?
This is the type of story that makes me hope and believe in Karma….
Reference:
The New York Times Website. Rabin RC. Hepatitis C found in clinic patients page. March 2009. Available at: http://www.nytimes.com/2009/03/06/health/06clinic.html?_r=1&ref=health. Accessed 04 March 2009.
On the surface, the clinic was described as a filthy place where employees did not wash their hands properly, disinfect equipment, or always wear gloves when treating patients. Dried blood was even found on treatment chairs. As it turns out, this was not just pure laziness; many staff members were unaware of the center’s written policies about cleaning and disinfection. Whether or not the staff was telling the truth remains to be seen, but it appears that the center has severe training issues; untrained staff should not have been dealing with patients in the first place.
Medical guidelines require strict testing and monitoring of dialysis patients for hepatitis C infection; however, the clinic tested patients on an erratic basis. Out of the patients that they did test, the aforementioned nine tested positive for hepatitis C.
Hold on, this is the worst part of the story. The clinic knew that these nine became infected after they started coming to the clinic, but it never informed them; it notified state health officials in only three cases. This deviance combined with erratic testing means that many other patients may also have been infected at the clinic.
Dr. Walter Wasser, the physician who was the operator and medical director of the dialysis center, was fined $300,000 and surrendered the clinic’s operating certificate, but the state Office of Professional Medical Conduct has not taken formal action against him. Where is the justice in that? Does a fine and a bit of public embarrassment make up for the patients' losses?
The future of these nine newly-positive hepatitis C patients may include cirrhosis, liver failure, and cancer. If you add the diminishing quality of life over an extended period of time, does this punishment seem fair? What about the family members of these patients? Who is reimbursing them for their inherent struggles and emotional setbacks due to the clinic's carelessness and deceit? Even if large sums of money were given to these patients and the careless were sent to prison, would it still be enough?
This is the type of story that makes me hope and believe in Karma….
Reference:
The New York Times Website. Rabin RC. Hepatitis C found in clinic patients page. March 2009. Available at: http://www.nytimes.com/2009/03/06/health/06clinic.html?_r=1&ref=health. Accessed 04 March 2009.
He Went Down in a Blaze of Bullets - No! That’s Just PowerPoint.
At training, the presenter stood in front of PowerPoint slides with data embedded in text masquerading as sentences that were really fragments. On the first slide, the first bullet stated that with treatment A only a “small percentage” of patients achieved goal on all four target indicators. A second bullet indicated that after administration of drug X about 80% of patients reached goal on one of the four target indicators; thus, making the assertion that prognosis improves drastically with drug X. Shouldn’t the other 3 indicators be included in order to make this assertion? The third bullet on the slide skipped to another topic and the fourth bullet introduced another topic all together. The fifth bullet attempted to tie the first four bullets together with a summary statement that only pointed to a failed attempt at a conclusion in the sixth bullet. Next to the table of bullets stood a bar graph – lonely and pathetic in it’s attempt to illustrate a health trend. The graph did not relate to the six statements crammed in the table at all. Confusing? Confusing, annoying, and misleading.
Yet, this is our modern day tool for information exchange: PowerPoint or ppt if you, too, suffer from abbreviation turrets. The example above may be more illustrative of the presenter’s inability to put together a coherent presentation. However, the information contained on one slide, in fact, the first slide is indicative of poor presentation skills that significantly impacts effective communication. PowerPoint is a useful tool for presentations when used properly – sentences uncomplicated by jargon and straightforward data that stands alone for the reader to make logical deductions from one bullet to the next. And don’t forget the references when introducing unique data. Instead, the fragmented ideas and thoughts of presenters are literally replacing technical reports and passing off as original data sources.
What happens when technical reports are replaced with incomplete data? Anarchy! Ok, maybe that’s a bit extreme; but there are serious implications for misinformation that has consequences for every industry. Health and science industries are no exceptions and, perhaps not surprisingly, encourage this type of information exchange (for example, see http://www.edwardtufte.com/bboard/q-and-a-fetch-msg?msg_id=0001yB). As such, vital statistics are misrepresented and incorrectly interpreted by both the presenter and audience alike. PowerPoint presentations should be restricted to presentations – a brief synopsis of a full report that decision makers, in particular, should have access to while providing the rest of the audience references to verify the validity of the presentation content.
Trainings, lectures, and reports are essential to an organization’s vitality. Unfortunately, it appears that many organizations are taking the lazy way out of communication by offering representations of incomplete data that bias the audience. This ultimately jeopardizes the organizations’ reputation. PowerPoint in and of itself is not to blame; however, lazy reporting and sloppy presentation cannot be a substitute for communication, especially when important decisions are at stake.
Holly Tomlin
BW 706, Blog 6
Yet, this is our modern day tool for information exchange: PowerPoint or ppt if you, too, suffer from abbreviation turrets. The example above may be more illustrative of the presenter’s inability to put together a coherent presentation. However, the information contained on one slide, in fact, the first slide is indicative of poor presentation skills that significantly impacts effective communication. PowerPoint is a useful tool for presentations when used properly – sentences uncomplicated by jargon and straightforward data that stands alone for the reader to make logical deductions from one bullet to the next. And don’t forget the references when introducing unique data. Instead, the fragmented ideas and thoughts of presenters are literally replacing technical reports and passing off as original data sources.
What happens when technical reports are replaced with incomplete data? Anarchy! Ok, maybe that’s a bit extreme; but there are serious implications for misinformation that has consequences for every industry. Health and science industries are no exceptions and, perhaps not surprisingly, encourage this type of information exchange (for example, see http://www.edwardtufte.com/bboard/q-and-a-fetch-msg?msg_id=0001yB). As such, vital statistics are misrepresented and incorrectly interpreted by both the presenter and audience alike. PowerPoint presentations should be restricted to presentations – a brief synopsis of a full report that decision makers, in particular, should have access to while providing the rest of the audience references to verify the validity of the presentation content.
Trainings, lectures, and reports are essential to an organization’s vitality. Unfortunately, it appears that many organizations are taking the lazy way out of communication by offering representations of incomplete data that bias the audience. This ultimately jeopardizes the organizations’ reputation. PowerPoint in and of itself is not to blame; however, lazy reporting and sloppy presentation cannot be a substitute for communication, especially when important decisions are at stake.
Holly Tomlin
BW 706, Blog 6
Monday, March 9, 2009
In Healthcare Reform, Caveat Emptor
Some might take issue with this article’s title. Applying ‘”caveat emptor” (“buyer beware”) to healthcare reform presupposes that healthcare is a commodity to be bought and sold. Like other services, healthcare IS a commodity that (to an extent) NEEDS to be bought and sold.
I admittedly do not know the details of the President’s health care proposal (I can not find any), but I know what I do not want to happen. I do not want the system to lose performance (including efficiency) incentives for doctors, patients, insurers, pharmaceutical companies, and device manufacturers. While some people are altruistic, the vast majority of people (and companies) are not.
Communism failed because there was no incentive for anyone to do anything.
The same principles apply to healthcare. If all doctors are paid the same, doctors will have no incentive to be better doctors. Even further, if the exceptional doctors are not rewarded, then exceptional people will not become doctors.
People like to rail against “the obscene profits of the drug companies.” Those obscene profits are the reason that drug companies bother to invent new drugs. It is not a coincidence that most pharmaceutical research is based in the United States. Our policies reward innovation and investment. Price controls on drugs would have many undesirable “side effects.”
If health care is "free," people are more likely to run to the doctor for trivial health complaints, further clogging a system that is guaranteed to become backlogged.
Getting any non-emergency procedure would likely require getting on a long waiting list, as they have to do for non-emergency procedures in Canada and Britain. There is a reason many Canadians come to the US for non-emergency procedures, and whatever the reason (waiting list or available quality of care), it is undeniable evidence that their system is not superior to ours.
One reason our health care system is comparatively expensive is the higher availability quality of care. Competition between hospitals and health care companies spurs them to have the latest technology to diagnose and treat patients. On the other hand, if people are forced to go to your hospital, you can do without that new MRI machine. You have no incentive to retain the best doctors, who WANT to have the latest technology to treat their patients. If it is a government monopoly, where else are the patients going to go? Where else are the doctors going to go? Perhaps, they will both go to another country.
While demonized (admittedly, some criticism is valid), health insurance companies do create pressure for efficiency. Without such scrutiny, inefficiencies would never be addressed. Money and resources that could have been used to actually treat people would be wasted.
Besides, I am not sure that private health insurance is currently as cost prohibitive as many people contend. On my own, I purchased health insurance from a major insurer that is almost as good as the programs I had through employers, and it is only $114 per month, including prescription benefits and the ability to choose my own doctor. Granted, I am a single man, but I am over 40 years of age. People use Cobra all the time as an example of out of control health premiums, but Cobra is a rip-off. After leaving my last two radio companies, I had Cobra offers of $500 and $600 per month. No thanks.
As the administration embarks on their effort to sell health care reform, people need to pay attention to the details. Scanning the administration’s health care reform website (http://www.healthreform.gov/), I found it contained a lot of platitudes and nebulous goals, but concrete recommendations were conspicuously absent.
If one pays attention to the details of the administration's sell job, it gets harder to buy into the feel good hype and harder to be frightened by the scare tactics. For instance, the number of Americans who have been bankrupted by medical expenses is grossly exaggerated by the administration. (http://blogs.abcnews.com/politicalpunch/2009/03/false-talking-1.html). While a comparatively smaller number of medical bankruptcies STILL is something that needs addressing, a comparatively smaller number of bankruptcies makes the changes needed to address them much less drastic.
Socialized medicine would not be free, as proponents think it would be. It would cost.
Boy, would it cost.
I admittedly do not know the details of the President’s health care proposal (I can not find any), but I know what I do not want to happen. I do not want the system to lose performance (including efficiency) incentives for doctors, patients, insurers, pharmaceutical companies, and device manufacturers. While some people are altruistic, the vast majority of people (and companies) are not.
Communism failed because there was no incentive for anyone to do anything.
The same principles apply to healthcare. If all doctors are paid the same, doctors will have no incentive to be better doctors. Even further, if the exceptional doctors are not rewarded, then exceptional people will not become doctors.
People like to rail against “the obscene profits of the drug companies.” Those obscene profits are the reason that drug companies bother to invent new drugs. It is not a coincidence that most pharmaceutical research is based in the United States. Our policies reward innovation and investment. Price controls on drugs would have many undesirable “side effects.”
If health care is "free," people are more likely to run to the doctor for trivial health complaints, further clogging a system that is guaranteed to become backlogged.
Getting any non-emergency procedure would likely require getting on a long waiting list, as they have to do for non-emergency procedures in Canada and Britain. There is a reason many Canadians come to the US for non-emergency procedures, and whatever the reason (waiting list or available quality of care), it is undeniable evidence that their system is not superior to ours.
One reason our health care system is comparatively expensive is the higher availability quality of care. Competition between hospitals and health care companies spurs them to have the latest technology to diagnose and treat patients. On the other hand, if people are forced to go to your hospital, you can do without that new MRI machine. You have no incentive to retain the best doctors, who WANT to have the latest technology to treat their patients. If it is a government monopoly, where else are the patients going to go? Where else are the doctors going to go? Perhaps, they will both go to another country.
While demonized (admittedly, some criticism is valid), health insurance companies do create pressure for efficiency. Without such scrutiny, inefficiencies would never be addressed. Money and resources that could have been used to actually treat people would be wasted.
Besides, I am not sure that private health insurance is currently as cost prohibitive as many people contend. On my own, I purchased health insurance from a major insurer that is almost as good as the programs I had through employers, and it is only $114 per month, including prescription benefits and the ability to choose my own doctor. Granted, I am a single man, but I am over 40 years of age. People use Cobra all the time as an example of out of control health premiums, but Cobra is a rip-off. After leaving my last two radio companies, I had Cobra offers of $500 and $600 per month. No thanks.
As the administration embarks on their effort to sell health care reform, people need to pay attention to the details. Scanning the administration’s health care reform website (http://www.healthreform.gov/), I found it contained a lot of platitudes and nebulous goals, but concrete recommendations were conspicuously absent.
If one pays attention to the details of the administration's sell job, it gets harder to buy into the feel good hype and harder to be frightened by the scare tactics. For instance, the number of Americans who have been bankrupted by medical expenses is grossly exaggerated by the administration. (http://blogs.abcnews.com/politicalpunch/2009/03/false-talking-1.html). While a comparatively smaller number of medical bankruptcies STILL is something that needs addressing, a comparatively smaller number of bankruptcies makes the changes needed to address them much less drastic.
Socialized medicine would not be free, as proponents think it would be. It would cost.
Boy, would it cost.
Thursday, March 5, 2009
Finally, I'll Be Able To Get That Surgery I Need
Every since I braved the obstacles and overcame my fears to reach my dream of becoming a writer, I have been without health insurance. After quitting my 8 to 5 job at the Children's Hospital in pursuit of a career as a writer, I became self-employed and like so many others, uninsured. I will never forget the day I received that letter in the mail from Blue Cross Blue Shield informing me that although my coverage under the hospital had become unactive, I could remain covered for only $600 each month. Well, I quickly and swiftly began to ponder my current situation of no income, rent, bills, and car note before the earth-shattering realization that I could not afford to remain covered. Normally, this would not have bothered me, except I have had recurring medical problems beginning with hypertension and high cholesterol. I could not bear the thought of having to seek health care at the public health department. I could not fathom having to go to the Coop (Cooper Green Hospital, the hospital for the uninsured that was known for losing patients to death and losing them literally in the hospital), but here I was, self-employed and uninsured. So, when the time came for my annual pap smear (which I hate and can not stand to think about, and it is due in a couple of months), I had to muster the courage, gird my loins, so to speak, and make the dreaded appointment for the public health department.
So, you can imagine my elation and utter excitement to learn that President Obama was making plans to change health care and decrease health care costs, making it affordable for everyone, including me. In a recent article in the Washington Post, "At Summit, President Obama Urges Solutions for Rising Cost of Health Care," President Obama made further progress on his promise to make health care affordable when he addressed the White House Summit. In the article, President Obama promises to expand insurance coverage, improve health care quality, and decrease skyrocketing health care costs. "'The same soaring costs that are straining families' budgets are sinking our businesses and eating up our government's budget, too,' Obama said in an East Room appearance."
Although it feels as if I am alone in my struggle to receive high quality health care without insurance, I know there are millions of people in the US struggling to make insurance costs. And many of those people have to also worry about insuring their families. Thankfully, I am only worried about insuring myself, so the costs for health care are slightly less for an individual. However, it is still difficult because of my preexisting conditions. In the article, President Obama, "...stressed that reform efforts cannot succeed without reducing costs, but he also said it was important to distinguish between short-term and long-term costs."
For 3 years, since the beginning of my self employment, I have seen and experienced the desperate for need for not just health care, but quality health care. Because the health department physicians work in this public health environment, they are not as vigilant and caring in their health care practices. Thankfully, I know more than others and am able to ask the right questions and conduct the necessary research into my condition and the medications I am prescribed. But what about the others in the office who are not fortunate enough to have those resources available to them? Would they receive the care they deserve, or will they fall through the cracks of the health care system? Is it too late for health care reform? Has the damage already been done?
In my case and those of millions of others, it is not too late to take advantage of the much needed health care reform proposed by President Obama. Of course, there are the naysayers and the skeptics who believe that President Obama's plan is too risky and right now is not the time to take on more problems. To this President Obama replies, "'When times were good, we didn't get it done. . . . There's always a reason not to do it. And it strikes me that now is exactly the time for us to deal with this problem...What better time than now, and what better cause for us to take up.'"
To those people, I say, when will be the right time. It is almost as if they are saying to me that it is not a good time for me to get health care coverage; not a good time for me to receive quality health care. When will it be a good time? When my hypertension becomes severe and I become more susceptible to heart attack and stroke? According to the article, "Medical spending, now about $2.3 trillion, consumes about 16 percent of the gross domestic product. And although the United States spends more per capita on health care than any industrialized nation, Americans do not live longer or healthier lives, according to a range of international measures."
President Obama's inital plan includes "...(setting) aside $634 billion in his proposed budget to be dedicated to health reform. The 10-year reserve fund could be used to provide health insurance to some of the 46 million Americans who do not have it today. To raise that money, Obama would cut itemized tax deductions for the wealthiest Americans and trim federal payments to hospitals, home health aides, drug manufacturers and some physicians." Unfortunately, the budget must be approved by Congress before it can take effect.
So, once again, I wait and hope. I wait for the day when health care will be affordable and hope that it comes one day soon. President Obama's goal of The Summit: "'...to start determining how to lower costs, improve quality and expand coverage to all Americans. And our goal will be to enact comprehensive health care reform by the end of this year.'" Maybe by the end of this year, I will be able to go to the hospital when I am sick, go to the doctor knowing I have an appointment (not hoping one will be available if I can not get through on the line within the two hours alloted for appointment time in the morning like at the health department), and go to the emergency room of a high-quality hospital without worrying that I will receive the quality health care I deserve.
So, you can imagine my elation and utter excitement to learn that President Obama was making plans to change health care and decrease health care costs, making it affordable for everyone, including me. In a recent article in the Washington Post, "At Summit, President Obama Urges Solutions for Rising Cost of Health Care," President Obama made further progress on his promise to make health care affordable when he addressed the White House Summit. In the article, President Obama promises to expand insurance coverage, improve health care quality, and decrease skyrocketing health care costs. "'The same soaring costs that are straining families' budgets are sinking our businesses and eating up our government's budget, too,' Obama said in an East Room appearance."
Although it feels as if I am alone in my struggle to receive high quality health care without insurance, I know there are millions of people in the US struggling to make insurance costs. And many of those people have to also worry about insuring their families. Thankfully, I am only worried about insuring myself, so the costs for health care are slightly less for an individual. However, it is still difficult because of my preexisting conditions. In the article, President Obama, "...stressed that reform efforts cannot succeed without reducing costs, but he also said it was important to distinguish between short-term and long-term costs."
For 3 years, since the beginning of my self employment, I have seen and experienced the desperate for need for not just health care, but quality health care. Because the health department physicians work in this public health environment, they are not as vigilant and caring in their health care practices. Thankfully, I know more than others and am able to ask the right questions and conduct the necessary research into my condition and the medications I am prescribed. But what about the others in the office who are not fortunate enough to have those resources available to them? Would they receive the care they deserve, or will they fall through the cracks of the health care system? Is it too late for health care reform? Has the damage already been done?
In my case and those of millions of others, it is not too late to take advantage of the much needed health care reform proposed by President Obama. Of course, there are the naysayers and the skeptics who believe that President Obama's plan is too risky and right now is not the time to take on more problems. To this President Obama replies, "'When times were good, we didn't get it done. . . . There's always a reason not to do it. And it strikes me that now is exactly the time for us to deal with this problem...What better time than now, and what better cause for us to take up.'"
To those people, I say, when will be the right time. It is almost as if they are saying to me that it is not a good time for me to get health care coverage; not a good time for me to receive quality health care. When will it be a good time? When my hypertension becomes severe and I become more susceptible to heart attack and stroke? According to the article, "Medical spending, now about $2.3 trillion, consumes about 16 percent of the gross domestic product. And although the United States spends more per capita on health care than any industrialized nation, Americans do not live longer or healthier lives, according to a range of international measures."
President Obama's inital plan includes "...(setting) aside $634 billion in his proposed budget to be dedicated to health reform. The 10-year reserve fund could be used to provide health insurance to some of the 46 million Americans who do not have it today. To raise that money, Obama would cut itemized tax deductions for the wealthiest Americans and trim federal payments to hospitals, home health aides, drug manufacturers and some physicians." Unfortunately, the budget must be approved by Congress before it can take effect.
So, once again, I wait and hope. I wait for the day when health care will be affordable and hope that it comes one day soon. President Obama's goal of The Summit: "'...to start determining how to lower costs, improve quality and expand coverage to all Americans. And our goal will be to enact comprehensive health care reform by the end of this year.'" Maybe by the end of this year, I will be able to go to the hospital when I am sick, go to the doctor knowing I have an appointment (not hoping one will be available if I can not get through on the line within the two hours alloted for appointment time in the morning like at the health department), and go to the emergency room of a high-quality hospital without worrying that I will receive the quality health care I deserve.
To Take or Not to Take (the keys)…That is the Question
Normally, when formulating my blogs, I ponder the ethics involved and make judgments based on my present knowledge; and while I may feel strongly about a certain point of view, my emotions rarely get involved. However, a recent New York Times article, Safety: When to Ground Alzheimer's Drivers, found me on a personal level.
This article interested me because my grandmother was diagnosed with Alzheimer's many years ago. In general, the disease has gradually taken away her "personhood". However, recently, she has gone downhill rather quickly. She doesn't recognize herself in pictures, and the depression/anger has begun to set in.
My family got lucky with my grandmother; she voluntarily took herself off the road many years ago. However, what if that was not the case? Figuring out when to take the keys away poses a problem for doctors and families. With so much already taken away from her, mentally and physically, how could we take away her freedom and mobility without much thought?
A new study reports that a series of cognitive tests may help doctors determine which early Alzheimer’s patients are likely to pose a danger behind the wheel. The researchers said the findings could prove valuable as an aging population results in more drivers with dementia on the road.
I was eager to read on to find out what is being done to protect Alzheimer's drivers and other drivers on the road; however, I soon found that the study did not meet my expectations.
For the study, researchers asked 40 drivers with probable Alzheimer’s disease and 115 elderly drivers who were healthy neurologically to undergo a battery of cognitive, visual and motor tests. They were also asked to take a 35-mile driving test with a research assistant in the car and cameras recording their performance.
First of all, I have a problem with the lack of numbers in this study. With only 40 test subjects and 115 control subjects, how can these data be generalized to the actual population with any power of confidence?
Not only are the populations too small, but why are they unbalanced? Why would researchers compare 40 to 115? It seems like the study design is a bit biased and any results would embellish differences between the two groups.
Now, for the actual study results, the Alzheimer’s drivers made about 25 percent more mistakes than the other drivers. This may be an expected result; however, the actual number of mistakes was not given. How can a statistically significant difference be stated on percentages alone?
It is obvious that, from my personal experience, concrete predictions cannot be made as to when an Alzheimer's driver should be grounded. The progression of the disease varies to such a degree, even in the individual, that judgments must be made on a continual basis. I feel that to make a generalization from a small-scale, biased study would be unethical on multiple levels.
It is one thing to administer driving tests for teenagers; it is a prize and a right of passage. However, testing Alzheimer's drivers has a completely opposite connotation; it means you are no longer fit to take care of yourself or to make your own decisions. Autonomy is definitely at stake, and it should be a conjoined effort among all involved, not a set point based on one study.
This article interested me because my grandmother was diagnosed with Alzheimer's many years ago. In general, the disease has gradually taken away her "personhood". However, recently, she has gone downhill rather quickly. She doesn't recognize herself in pictures, and the depression/anger has begun to set in.
My family got lucky with my grandmother; she voluntarily took herself off the road many years ago. However, what if that was not the case? Figuring out when to take the keys away poses a problem for doctors and families. With so much already taken away from her, mentally and physically, how could we take away her freedom and mobility without much thought?
A new study reports that a series of cognitive tests may help doctors determine which early Alzheimer’s patients are likely to pose a danger behind the wheel. The researchers said the findings could prove valuable as an aging population results in more drivers with dementia on the road.
I was eager to read on to find out what is being done to protect Alzheimer's drivers and other drivers on the road; however, I soon found that the study did not meet my expectations.
For the study, researchers asked 40 drivers with probable Alzheimer’s disease and 115 elderly drivers who were healthy neurologically to undergo a battery of cognitive, visual and motor tests. They were also asked to take a 35-mile driving test with a research assistant in the car and cameras recording their performance.
First of all, I have a problem with the lack of numbers in this study. With only 40 test subjects and 115 control subjects, how can these data be generalized to the actual population with any power of confidence?
Not only are the populations too small, but why are they unbalanced? Why would researchers compare 40 to 115? It seems like the study design is a bit biased and any results would embellish differences between the two groups.
Now, for the actual study results, the Alzheimer’s drivers made about 25 percent more mistakes than the other drivers. This may be an expected result; however, the actual number of mistakes was not given. How can a statistically significant difference be stated on percentages alone?
It is obvious that, from my personal experience, concrete predictions cannot be made as to when an Alzheimer's driver should be grounded. The progression of the disease varies to such a degree, even in the individual, that judgments must be made on a continual basis. I feel that to make a generalization from a small-scale, biased study would be unethical on multiple levels.
It is one thing to administer driving tests for teenagers; it is a prize and a right of passage. However, testing Alzheimer's drivers has a completely opposite connotation; it means you are no longer fit to take care of yourself or to make your own decisions. Autonomy is definitely at stake, and it should be a conjoined effort among all involved, not a set point based on one study.
Wednesday, March 4, 2009
Is that Smell Tobacco Smoke or the Smell of Sausage Being Made?
If someone has read my blog postings and my comments on others’ blogs, it is not hard to figure out that I am conservative. True conservatives are often misunderstood, and the term “conservative” is most often erroneously viewed as interchangeable with the word “Republican.”
As a conservative, I believe that, as a general rule, less government interference is better. Also, I believe, as a general rule, that government agencies should exist only if they provide a service that directly benefits the entire population and that the private sector by its nature is incapable of providing. Examples of such agencies are the FAA (Federal Aviation Administration), the military, and the FDA (Food and Drug Administration).
The FDA is critical for the prosperity of this nation. For instance, I can be a lot more productive if I can concentrate on my business or job because I do not have to take a substantial part of my day every day to test my food to make sure it is not poison.
I read an article in today’s Washington Post (http://www.washingtonpost.com/wp-dyn/content/article/2009/03/03/AR2009030303661.html?hpid=moreheadlines) reporting that there is a bill making its way through Congress designed to allow the FDA to take over tobacco regulation. Such legislation is long overdue. However, there is one fatal problem with the bill. Existing products are grandfathered in, making the new rules essentially irrelevant. The new rules would apply only to new products.
Understandably, the tobacco company with the largest market share, Philip Morris, supports the legislation, while the companies that hope to take Philip Morris’ market share, namely everyone else, is against the legislation. New products that could conceivably take away Philip Morris’ market share would face the more daunting regulatory hurdles, while the existing products would not. Thus, the status-quo would be solidified.
Congressional politics are keeping the FDA from properly regulating tobacco, just as Congressional politics kept the FDA from properly regulating “dietary supplements” that (in most cases) do little more than produce very expensive urine.
In politics, they say that one needs to take what one can get. “Two steps forward, one step back.”
As a conservative, I believe that, as a general rule, less government interference is better. Also, I believe, as a general rule, that government agencies should exist only if they provide a service that directly benefits the entire population and that the private sector by its nature is incapable of providing. Examples of such agencies are the FAA (Federal Aviation Administration), the military, and the FDA (Food and Drug Administration).
The FDA is critical for the prosperity of this nation. For instance, I can be a lot more productive if I can concentrate on my business or job because I do not have to take a substantial part of my day every day to test my food to make sure it is not poison.
I read an article in today’s Washington Post (http://www.washingtonpost.com/wp-dyn/content/article/2009/03/03/AR2009030303661.html?hpid=moreheadlines) reporting that there is a bill making its way through Congress designed to allow the FDA to take over tobacco regulation. Such legislation is long overdue. However, there is one fatal problem with the bill. Existing products are grandfathered in, making the new rules essentially irrelevant. The new rules would apply only to new products.
Understandably, the tobacco company with the largest market share, Philip Morris, supports the legislation, while the companies that hope to take Philip Morris’ market share, namely everyone else, is against the legislation. New products that could conceivably take away Philip Morris’ market share would face the more daunting regulatory hurdles, while the existing products would not. Thus, the status-quo would be solidified.
Congressional politics are keeping the FDA from properly regulating tobacco, just as Congressional politics kept the FDA from properly regulating “dietary supplements” that (in most cases) do little more than produce very expensive urine.
In politics, they say that one needs to take what one can get. “Two steps forward, one step back.”
Tuesday, March 3, 2009
War and Human Rights
Last week President Obama announced his much anticipated plan to extricate the
I’m not a strategist. I’m not a political analyst.
I am a human being.
I know this because there are more human rights documents now than any other time in our history (Geiger 2000) – each filled with definitions, explanations and examples of what constitutes humanness and the rights associated therewith. However, after sifting through the rhetoric and digging through their debris, you will find the contents of those documents buried right next to the very bodies they were developed to protect: mostly women… and children. Ostracized, beaten, and victimized in peace-time there lives should not be further subjugated by war and it’s crimes.
War is not the Hollywood-esc-romanticized barbarism of Gladiator where two opposing sides meet face to face until “the death” – defeat and surrender. It is, as it has always been, a mix of technologically advanced calamity (Diamond 1999) and merciless abuse and torture (
War is the invention of the desperate. There are no victors in war and the victims have all-too-familiar faces. No matter their color or race, age, religious belief, social or political stature – there is no difference between them and us. Thus, it is imperative that we remain vigilant about war and its manifestation through global illiteracy that would have too many people thinking that military strength is the way to peace (Miles 2000, Macedo 2006).
Peace is not a reward. It is not a right defined by mere documents that too many cannot read nor fully embrace even if they tried (this does not preclude a personal desire to have peace); however, peace cannot be limited to buzzwords, catch-phrases, or social-political welfare for free-press and celebrity. The road to peace does not have to be so long or as destructive as long as we work earnestly toward social justice (Hammad 2005) and continue to put pressure on the political administration to seek alternatives to war; unless we prefer to live in a vicious cycle of retaliation and destruction.
Holly Tomlin
BW 706, Blog 4
References
Diamond J. Guns, Germs, and Steel: The Fates of Human Societies. New York, NY: W. W. Norton & Company Inc; 1999.
Geiger HJ. The Impact of War on Human Rights. In: Levy BS and Sidel VW, eds. War and Public Health. Updated Edition. Washington, DC: American Public Health Association; 2000: 39 - 50.
Hammad S. First Writing Since. In: Zaatar Diva. New York, NY: Ram Devineni; 2005: 98 - 102.
Macedo D. Literacies of Power: What Americans Are Not Allowed to Know. Boulder, CO: Westview Press; 2006.
Miles L. Education for Peace. In: Levy BS and Sidel VW, eds. War and Public Health. Updated Edition. Washington, DC: American Public Health Association; 2000: 323 - 335.
Watts S. Epidemics and History: Disease, Power and Imperialism. Great Britain: Redwood Books, Wiltshire; 1997.
Subscribe to:
Posts (Atom)
