THE CASE OF THE WOMAN WHO LOST HER ARM

Very sorry to hear about the lady who lost her arm from an intra-arterial injection of phenergan. Equally sorry that the Supreme Court and other courts clearly do not understand the difference between an arterial and venous injection. It clearly states that Phenergan should not be injected into an artery. It is not the responsability of the manufacturer to make sure the administrating person injects into a vein.

OBAMA'S PLAN

Just caughgt up with the sketches of the proposal by the President to define universal health care for the U.S. It's not that I am against coverage for everyone, and God knows I would like to see insurance companies lose for once, but I donlt think the American public will like rationing healthcare. But that is exactly what will happen. I deal mostly with Medicare patients, and no primary care doctor wants to accept Medicare patients because they lose money on those patients. I am very afraid for people. I do not get the impression Obama knows what he is talking about. As for the saving of money by making electronic medical records (EMR)mandated, that is a pie in the sky idea. The only people who will benefit from that idea are the software vendors for EMR. They will sell lousy, clumsy systems that don't communicate with one another to seperate physician and hospital groups. It will be a bloody disaster. I sincerely hope for the best with Mr. Obama, but it is quite clear to me that he does not know what he is talking about.

EATING DISORDERS

About 11 million Americans suffer from eating disorders, according to the National Eating Disorders Association. Most of these patients are female. The two most common forms of eating disorders are anorexia, which has the highest mortality rate of any mental illness, and bulimia. About 25 million more people have some form of binge eating disorder, according to the association. Binge eating disorder has been linked to a high incidence of being overweight or obese.

New Republican Editorial About Health Care

Love it, an editorial about the value of preventative health care, and there is an ad for Dunkin Donut in the middle of the article. Go figure.

WALL STREET JOURNAL LETTER

This posting copies 2 recent letter to the Wall Street Journal concerning the Health care portion of the stimulus bill. I cannot agree more with the sentiment of these authors. Having some experience in Health care IT, I find it to be an instacne of wishful thinking that throwing billions of dollars into health It will help to make patient safety better, or eliminate waste. The problem is that the Health IT folks try to make it all inclusive, promising everything and delivering a clunky system that does not function well. This was quite evident when UCLA went all digital to great fanfare several years ago, but had to quit after there were so many problems with the system.

"The collateral damages from the HIT stimulus will be far worse than you project. Since free-market competition has not yet winnowed the 300-plus electronic medical records (EMR) systems to a viable number of good products, the stimulus will favor the old, clunky, entrenched products over the newer and fleeter.
In the meantime, a 2005 study on EMRs and health-care fraud done for the Department of Health and Human Services showed that EMRs will make fraud initially worse. The HIT billions will be spent to speed the uptake of bad systems and help to increase health-care fraud.
This is like dusting off the infamous Yugo automobile and spending billions so that everyone has his own bad car by 2014. And, more sadly, it's probably a done and irreversible deal. It would be merely another pathetic exposure of government gone wild if so many patients, doctors, and health-care institutions weren't doomed to suffer for this, leaving aside the demise of better, more conscientiously designed electronic medical records systems. But, at least everyone will have an EMR. I guess that is what matters in America today, keeping an ill-informed, short-sighted, nonrational, dogma-driven promise."
Reed D. Gelzer, MD, MPH, CHCC Data Quality and EHR Integrity Consulting Advocates for Documentation Integrity and Compliance Wallingford, CT and Boston, MA


"You observe that the true political goal is socialized medicine facilitated by health care information technology. You note that the public is being deceived, as the rules behind this takeover were stealthily inserted in the stimulus bill.
I have a different view on who is deceiving whom. In fact, it is the government that has been deceived by the HIT industry and its pundits. Stated directly, the administration is deluded about the true difficulty of making large-scale health IT work. The beneficiaries will largely be the IT industry and IT management consultants.
For £12.7 billion the U.K., which already has socialized medicine, still does not have a working national HIT system, but instead has a major IT quagmire, some of it caused by U.S. HIT vendors.
HIT (with a few exceptions) is largely a disaster. I'm far more concerned about a mega-expensive IT misadventure than an IT-empowered takeover of medicine.
The stimulus bill, to its credit, recognizes the need for research on improving HIT. However this is a tool to facilitate clinical care, not a cybernetic miracle to revolutionize medicine. The government has bought the IT magic bullet exuberance hook, line and sinker.
I can only hope patients get something worthwhile for the $20 billion."

Scot Silverstein, M.D. Faculty Biomedical Informatics Drexel University Institute for Healthcare Informatics PhiladelphiaPrinted in The Wall Street Journal, page A16

Amen to these smart physicians and their warnings about Health IT.

All Issues Of Prevention

Sorry, I have to snicker cynically when I hear that President Obama has assigned money to preventative health issues. Not that I don't agree with the premise. I was trying to get companies to start preventative health care lunch time talks in the DFW area for free 10 years ago. None of the major companies I contacted at that time were interested in having a specialist come in for free and discuss cardiovascular health risk factors and prevention with their employees. Crazy! I don't think throwing a bunch of money at it will change the problem either. Its going to take a lot of thinking before the money is spent. One problem is that people's image of the normal human body has changed. Everyone is over 6 foot tall and weighs 250 pounds or more (not literally everyone but you get my point). I remember visiting the USC campus when I was 17 and bumping into Anthony Munoz, who at that time played for the USC football team before he went on to a great career with the Cincinnati Bengals. I thought he was the biggest person I had ever seen. Now some of the linebackers in the NFL are that size, and much faster. It's just not natural. Kids coming out of high school weighing 300 pounds. Hell, I weighed all of 150 pounds when I was 18, not that I am 6'8" but still! People are looking for size rather than fitness. Look at the gym when you go work out. There are some strong people there tossing around a bunch of weight, but they are also usually fat. There has been a definite change in the perception of normal body size.