Week of April 7 - In Case You Missed It...TOMF Medical News Roundup
April 11, 2014
In Case You Missed It...
April 7, 2014
Three's Company - and Efficient, Too
We are used to visiting the doctor by ourselves but lately they seem more preoccupied with the electronic medical record than us. Often we wish we could take over the typing. Our high school skills are better than their hunt and peck.
Enter the scribe. Usually they are college students interested in a health career. They take the notes, record the diagnosis and treatment plan, select the billing codes and allow the doctor to concentrate on us.
Today's Wall Street Journal has an editorial ("In Praise of Medical Scribes") with anecdotal evidence that using a scribe not only is more efficient, but allows physicians to stay on time and go home at a reasonable time most nights.
911 Pranks
Today's Wall Street Journal also has a story about a good rule gone wrong.
In 1997 the Federal Communications Commission enacted a rule that cell phones without a calling plan needed to still be able to call 911. Good idea at the time, but today pranksters are using untraceable, out of service, phones to call emergency centers with false calls. One man in the Bay Area has made 30,000 false calls since 2007.
No one has died because resources are tied up with false calls, but many priority police and fire calls have been delayed while rescuers scour areas to which pranksters have called them.
At Least We Didn't Live Then
Lapham's Quarterly sends a weekly e-mail of some forgotten gem from history. Today it sent a missive, written by Robinson Crusoe creator Daniel Defoe for dealing with plague - which he witnessed firsthand as a child.
1665: Notice to be given of the Sickness
The Master of every House, as soon as any one in his House complaineth either of Botch, or Purple, or Swelling in any part of his Body, or falleth otherwise dangerously Sick without apparent Cause of some other Disease, shall give knowledge thereof to the Examiner of Health, within two Hours after the said Sign shall appear.
Sequestration of the Sick
As soon as any Man shall be found by this Examiner, Chirurgeon, or Searcher to be sick of the Plague, he shall the same Night be sequestered in the same House, and in case he be so sequestered, then, though he afterward die not, the House wherein he sickened should be shut up for a Month, after the use of the due Preservatives taken by the rest.
Burial of the Dead
That the Burial of the Dead by this Visitation be at most convenient Hours, always either before Sun rising, or after Sun setting, with the Privity of the Church wardens or Constable, and not otherwise; and that no Neighbours nor Friends be suffered to accompany the Corps to Church, or to enter the House visited, upon pain of having his House shut up and imprisonment.
In Case You Missed It...
April 8, 2014
Drugs, Drugs, Drugs
Today's Arizona Daily Star carries a Washington Post story by Nick Miroff about the re-emergence of heroin now that marijuana is more accepted and after the crackdown on prescription drugs. Heroin cost $4 a hit; seizures at the border have climbed seven-fold in five years and heroin use is up 79 percent.
It is not yet the killer it was. Over the weekend the Star reported meth is leading cause of overdose death in Pima County.
Mexican farmers are growing poppies now that marijuana is being decriminalized and legalized in various states. Mexico has surpassed Columbia as the largest source of heroin in the United States.
Today's Star also has a story about a recall effort against Kimberly Yee, the Arizona senator who killed a bill that would have allowed money collected from marijuana dispensaries to pay for a marijuana/PTSD study. The recall is led by Kathy Inman, who is secretary of the newly formed Arizona Veteran's Assistance committee. Ms Inman's daytime job is state director of the National Organization for Reform of Marijuana Laws.
Just say "No" is beginning to sound as quaint as an LP record.
In Case You Missed It...
April 9, 2014
Data Dump
The Government released Medicare payment numbers to 825,000 individual physicians and found the top 1000 doctor billers were paid $3 billion of the total $77 billion spent on Medicare in 2012. Expect some revelations in coming months as the data is mined.
Data Not Dumped
Despite the claims that up to 10 million more people are uninsured through the Affordable Care Act - and counterclaims that most of those insured through the website are people who lost insurance through employers - the truth is, no one knows.
The headlines about people getting insured through employers, the percentage of youth who signed up, etc, are the results of polls done by various organizations. Until we get a data dump similar to what occurred with Medicare we just have to wait and see.
Next time to sign-up is in November. Although plan can still sell individual policies, very few health insurers are doing so.
In Case You Missed It...
April 11, 2014
Sebelius Leaves Gracefully, as Usual
Washington is a place successful politicians go to die as administrators, and former popular Kansas Governor Kathleen Sebelius is no exception. Her resignation was leaked, confirmed and a successor announced this week.
No matter where you stand on the Patient Protection and Affordable Care Act Sebelius, Health and Human Services Secretary did her best not to be a lightning rod of partisanship. When the rollout of the marketplace website proved a disaster, she was called in front of a congressional panel and excoriated.
Those who watched the hearings, however, were not treated to a blame-fest. Although media leaks -- last minute additions to the website, political machinations surrounding vendor selection and budget delays awaiting the Supreme Court decision - gave her political cover, Sebelius did not take them. She was asked which official is most to blame, she answered, "Hold me accountable for the debacle. I'm responsible." When the panel ended its grilling, Sebelius stood up straight, grabbed her purse and threaded her way past the chairs and reporters, a woman completely unbroken and unafraid.
Today's editorial page of the Wall Street Journal mused that this was a political resignation and the timing a cynical calculation. Perhaps. It could equally be Sibelius's way of holding herself accountable now her job is somewhat done.
There will be barbs and accolades. Of the latter, one of the first - and nicest - comes from Senator Jay Rockefeller. "She never backed down from the tremendous responsibilities of her position, which were of a magnitude no other cabinet secretary has had to face with regard to domestic policy."
Sylvia Matthews Burwell is the announced nominee to replace Sebelius.
Measles Watch on in Phoenix
You get off a plane, grab a snickers at an empty airport vending area, use a crowded restroom then fight the mobs at the baggage carousel. Which place won't you be exposed to measles?
Answer: none. The measles virus can live in the air for hours, and is highly contagious for those who are not vaccinated.
A traveler returning from Europe exposed thousands in many Phoenix public places March 29-31 - including Sky Harbor Airport. The traveler's measles have been confirmed and now the watch is on for an Arizona outbreak.
Locations and times of public exposure were listed in various health department memos and in today's Arizona Daily Star ("Health officials wary after Phoenix measles report").