Paramedic Perspective: Never Forget the Wisdom of the ‘Shirky Principal’

“Institutions will try to preserve the problem to which they are the solution.” (Clay Shirky)

So our advice for the day? Keep this in mind the next time the wacky world of medicine tries to lure you into an annual flu shot.  Chances are . . . your immune system knows best how to handle the occasional cootie. It’s been around a lot longer; it knows you far better . . . and it never asks for cash.

 

SNAKE OIL art

How gullible are YOU in the face of incessant medical advertising?

 

 

 

Advertisements

California Senator Wants to Make it Harder to Catch Bad Doctors. How Cool is That?

(Steve Lopez reports in the LA Times)

Sen. Ricardo Lara

By introducing State Senate Bill 641, Lara will be able to say he succeeded in putting up yet another wall of protection for criminal physicians. 

The prescription drug epidemic is a serial killer, claiming thousands of lives in the U.S. each year.

Opioid pill mills, trading in dangerous narcotics like oxycodone, have been shut down in Southern California and beyond, but investigators say there’s more work to be done.

Doctors have been arrested and prosecuted, including a Rowland Heights physician convicted of murder a year and a half ago in the deaths of three patients who overdosed on prescription meds.

So here’s a quiz.

A bill pending in Sacramento would:

A) Strengthen protections for patients and the general public
B) Stiffen sanctions against offending doctors
C) Make it easier to prosecute dirty doctors
D) Make it harder to prosecute dirty doctors

Hard to believe, but the answer is “D”.

As the law stands now, officers who investigate tips about doctors who write questionable prescriptions can check a monitoring database maintained by the California Department of Justice. There, they can look for patterns, or connections to criminal enterprises. including big-time distributors and gang operations.

This database, which goes by the unfortunate name of the Controlled Substance Utilization Review and Evaluation System (CURES), is a vital resource, law enforcement officials say.

Is this (Bill) helping patients or doctors?

Under Senate Bill 641, by Sen. Ricardo Lara (D-Bell Gardens), law enforcement officials would need a search warrant before using CURES to check on a doctor.

Why the change?

“Given the sensitive and confidential nature of the information within this system, there is a need to strengthen patient privacy protections,” Lara said in a statement emailed to me by his staff.

Lara, who is running for state insurance commissioner and is the author of California’s pending single-payer healthcare bill, said New York and Oregon require judicial permission before investigators can access their prescription-monitoring systems.

The patient privacy spin is also coming from the bill’s biggest cheerleader — the California Medical Association, a powerful lobbying force on behalf of doctors.

“People expect their medical records to be kept private,” Joanne Adams, associate director of communications for Cal Med, said in a statement. “But the law does not currently hold medical information in CURES … to the same standards that protect medical records in hospitals and doctors’ office.”

Well, if it’s such an invasion of patient privacy, why hasn’t there been an outcry from patients in the decade or so that CURES has been in use?

Critics argue this isn’t at all about protecting patients. Rather, it’s about protecting doctors by trying to keep investigators out of their business. In a somewhat related matter, there’s a case before the state Supreme Court right now in which a doctor is arguing that the state medical board violated his patients’ privacy in using information obtained from CURES to suspend him for three years.

Why make it harder to catch bad doctors?

Prosecutors aren’t going after good doctors, but the tiny minority of those who shouldn’t be in practice. So why do we need this bill at all?

Lara’s staff denies it has anything to do with $11,000 in campaign donations to Lara from the California Medical Association. He’s received loads more from other medical industry sources, by the way.

Lara’s staff claims the senator is trying to find a fair balance between investigative authority and privacy rights. The bill has already been amended and may come in for more fine tuning in the future. Lara has been at odds with Cal Med in the past, his staff notes. Last year, the doctor lobby was no fan of a Lara bill (SB 482) that required doctors to check the state’s prescription monitoring database before writing scripts for opioids.

Some people are confused about where Lara really stands.

“I’m very surprised he is carrying this bill,” said Bob Pack, a Bay Area man who worked with Lara on SB 482.

Pack, who has written two letters to Lara’s office protesting the current bill, has a personal connection to the issue. His two children, 10 and 7, went out for an ice cream with their mother in 2003 and were struck and killed by a driver who was under the influence of alcohol and prescription drugs. Pack, who works in tech, helped design CURES. And he isn’t buying the patient-privacy argument.

“Law enforcement has to get a warrant in order to investigate a patient. That’s already required,” said Pack. “Why would you try to inhibit looking for and catching a bad doctor who is going to cost lives or has cost lives?” 

Continue reading.

It seems very much as though Senator Lara’s motivation for this bill is the $11,000 he received.

Our Observation:

Send a note to this confused state senator and let him know that Senate Bill 641 absolutely does NOT protect the citizens of California – which just happens to be a key component in his swearing in as a senator in the first place.

http://www.ricardolara.com/contact

(We thank Steve Lopez for forwarding this revealing case, of how state politics damage healthcare by protecting criminals)

Patient Deaths Reported After Stomach Balloon Weight Loss Procedures

A recent Food and Drug Administration report reveals that 5 obesity treatment patients, who underwent stomach balloon placement, have died over the last 18 months.

BALLOON INSERTION

The procedure takes about 30 minutes and costs about $3,000

 

Four of the 5 had what is called the Orbera Intragastric Balloon System inserted. The other underwent a procedure involving the ReShape Integrated DualBalloon System.

All of the patients died within 30 days of the balloon insertions, and several died in less than a week.

And doctors say they have no idea what went wrong.

The balloon insertion procedure involves placing either one or two un-inflated balloons through the patient’s mouth and into the stomach. Sterile salt water is then squirted into the balloons. The usual plan is for the balloons to lay in the stomach for 6 months. The result is that patients eat far less because they feel “full.”

The FDA says they are working to determine the exact causes of the deaths. They are looking into possible complications such as sudden over-inflation.

“At this time, we do not know the root cause or incidence rate of patient death, nor have we been able to definitively attribute the deaths to the devices or the insertion procedures for these devices,” the FDA said in a safety alert issued Thursday.

The FDA announced they are also investigating 2 other patient deaths, that could be related to possible complications of gastric balloon treatment. 

In those cases, there were accidental punctures of the throat and the stomach.

In total, there have been 21 known deaths over the last decade.

Here’s more from the FDA:

Most of the over-inflation reports involved the Orbera System that uses a single balloon, although some reports involved the ReShape Dual Balloon System that uses two balloons. Neither product mentions over-inflation risk. “At this moment there is not enough information to determine what is causing the balloon to overinflate.”

Other side effects involved sudden pancreatitis caused when the balloons compress other abdominal organs. Both the Orbera and ReShape products are associated with pancreatitis, Neither company lists pancreatitis as a potential complication. Pancreatitis was reported as early as 3 days after implantation, and symptoms included severe back and abdominal pain.

California State Agency Names Surgeons with Highest Patient Death Rate

“This is the first time California has ever reported the surgical mortality results for individual doctors. It will help patients choose better surgeons and a better hospitals, and will provide an incentive to improve quality care.” (Dr. David Carlisle, Director, Office of Statewide Health Planning and Development)  

As of this month, California residents can now learn the names of both hospitals and surgeons that score higher or lower, when it comes to cardiac bypass death rates. 

CABG

The Office of Statewide Health Planning & Development, which compiles statistics, now publishes coronary bypass death rates for 300 cardiac surgeons working at 120 hospitals. That’s the good news. The bad news is the most recent information covers surgeries performed in 2003-2004. In other words, the information is 14 years old.

The study was ordered by the California state legislature in 2003 and cost just under $2,000,000. It revealed that while 95% of California heart surgeons scored at, or about the expected, mortality average of 3% patient deaths, some performed considerably better, and some measurably worse.  As an example, Doctor Alexander Giritsky at La Jolla Scripps Memorial, was one of only 4 surgeons with the lowest heart bypass mortality rates. Not one of his 126 surgical patients died.

On the other end of the scale,  Doctor Jeffrey M. Rosenburg and Doctor Leland B. Housman were among the 12 physicians with the highest patient death rates. Rosenburg operated on 12 patients – 3 of whom died. Housman performed surgeries at Scripps Mercy in San Diego. Rosenburg operated at Palomar Medical Center Escondido. Housman operated on 140 patients – 9 of whom died during the reporting period.

By contrast, at Arcadia Methodist Hospital, a surgeon named Ismael Nuno tallied just under a 90% patient death rate.

About 400 patients each week undergo bypass surgery in California. Called a “cabbage” behind closed doors, the CABG procedure normally involves taking a blood vessel from the chest or leg and using it to create a new route for blood flow within the heart. 50% of these procedures are done on emergency patients.

It is important to note that dire surgical outcomes ought not be laid solely at the feet of the physicians. Some surgeons are quick to point out – and rightfully so – that their statistics are skewed from the start, because they are treating extremely sick patients to begin with, whose chances of surviving – especially in an emergency – are poor at best. Doctor Housman said it very well. “They died mainly because I accepted a mix of people who were older and sicker than most other surgeons are willing to take.”

Here’s another look:

http://www.latimes.com/business/la-fi-heart-surgeon-database-20170714-story.html

 

The Indecent Assault of Advertising: In a Brighter Future It’ll be Criminal

Go ahead. Tell us. How much smarter the ads of today really are. How much healthier are we now, than we were then, because scamsters convince you to pop stuff into your mouth without thinking?

BABY 7 UP

 

In some communities 40% of grade-schoolers are obese. Our chubby kid rate has gone up 300% since 1980. Can’t imagine why.

 

DOC n CIGS

 

It doesn’t matter what your situation is, the toxin cartels are expert at convincing you that you have a problem , , , and they have the cure.

FEM HYGIENE   Facing divorce?  Simple fix: Lysol your genitals.   

CHICKS n BURGERS          How would YOU sell hamburgers?

Think these are wise ads for the mentally fragile to see? 

Vintage Ad Prozac

TOE BUG

 

 

 

How much dumber are those, than this of today?

PEP VITAMINS       

 

 

You’d have to be pretty darn naïve to believe the old stuff, right?

 

 

 Well, if it’s named after doctors . . . .

MD TOILET PAPER

                    Yep. We’d never fall for these blatant manipulators these days

BEER Gardening ad

CELERY ENEMA

 

 

 

Who could fall for this idiocy?

 

 

 

 

Want the short answer?HEALTHY CIGS

You do. Your neighbors do. Your family does. Millions fall for nonsensical, manipulating advertising, every damned minute of the day. Why?

Because we are too mentally lazy to look up the truth, even when it’s right at your fingertips.

It has never been easier than right now, to wise up about what you put into your mouth, or allow in our homes.

Think about it.

KID w ASSAULT RFLE

We reap what we sow.

EKG art