Week of March 31 - In Case You Missed It...TOMF Medical News Roundup
April 4, 2014
In Case You Missed It...
March 31, 2014
Get in Line If You Want Health Insurance
Today is the deadline under the Affordable Care Act for you to obtain health insurance and avoid paying a fine for 2014. If you try today and fail you may still sign up next week when Healthcare.gov has a lower volume.
You may also go to an insurance broker, or seek help from patient navigators (694-0418).
According to many media sources, the fastest growing segment of those obtaining insurance are age 34 and younger. This, despite a new Associated Press-GfK poll that shows only 26 percent of Americans support the ACA. Perhaps they are signing up because the same poll shows only 13 percent expect the ACA to be repealed.
If you pay the fine keep in mind next year's enrollment period will be much shorter than this year. Even after enrollment ends you can shop in advance to find the best prices as well as ask your neighbors about the policies they've purchased.
Osteopathic Medicine's Beginnings
We are reading the Autobiography of A.T. Still and will share tidbits from the pages over the next couple weeks leading up to the Southwestern Conference on Medicine® which gets underway April 24 at the JW Marriott Starr Pass Resort and Spa.
The following takes place in 1847 when Still was 19 years old. His father had not given him permission to volunteer for the war in Mexico. One of his boyhood chores on the frontier was to kill dangerous snakes. As the scene opens he has just spotted a large snake track in the dust.
"I knew I could get war and plenty of it without going to Mexico. I rode out into the weeds, which were about a foot high, in the direction I thought I was most likely to find him. I found Mr. Snake coiled up; coil snake and all would easily filled a half-bushel. He raised his head two feet above the ground and fixed his eyes upon me. His head measured about three inches across, just back of the eyes. I knew well enough if this snake was ten feet long he could jump his length. To run was cowardice, to fight was dangerous. The thought came into my mind. How will it look in a young man who wants to fight all Mexico to back out and run from a snake? I had seen the snake and could not tell mother it had run off and I could not find it.
"In desperation I took the stirrup strap off my saddle, to which was attached a very heavy iron stirrup, and with a great amount of emotion in both legs approached the general commanding the opposite side. He had ordered music by the band, which band was twenty-nine rattles fastened to the rear rank of the whole army. I gave the command in a low whisper to strike. With a circuitous swing with strap and stirrup, which weighed about a pound and a half, I unjointed the general's neck and took his whole army prisoner."
Still said, "Thus ended the greatest snake fight I ever had." His enemy turned out to be a little over ten feet long. As usual in his autobiography, Still drew a moral from this incident.
"As the snake is the emblem of poison, and as all drugs are poison, this conflict may be said to be the first conflict between Osteopathy and poison, in which Osteopathy came off victorious."
FDA and Drug Imports
Today's Arizona Daily Star editorial page has a nice look, from two different sides, at whether the FDA is doing enough to guarantee safety and efficacy of pharmaceuticals manufactured in China and India. Check it out.
US Autism = 1/68 Children
You've seen the news. You have heard the dispute - is autism on the rise or are more pediatricians willing to make the diagnosis? But what is the number?
Autism, the Centers for Disease Control estimates, affects 1.2 million kids. This number goes across the whole spectrum of this disorder, from almost unnoticeable to debilitating.
In Case You Missed It...
April 1, 2014
Quite a Day for Health Insurance
Three million people logged onto Healthcare.gov and one million accessed call centers on March 31, during the last day to obtain health insurance without paying a fine, the Centers for Medicare and Medicaid reported this morning.
Glitches with the website were widespread and those who tried and failed to obtain insurance yesterday are allowed to continue the process this week.
Many sources reported today that the administration's goal of seven million sign-ups may be exceeded. Final numbers will not be available until late registrants get insurance and those who ordered policies actually pay for them.
Quite a Day for Congress
The US Senate voted yesterday to a House compromise and helped create the 17th patch to the flawed Medicare payment system (Sustained Growth Rate formula) since the law was enacted in 1998. Under the patch, there will be a 1 percent physician payment bump for the next 12 months.
The House and Senate agree in principle that the SGR must be scrapped but disagree about how to pay for it. The SGR "savings" have been part of budget calculations for 15 years and must be accounted for under congressional pay-as-you-go rules.
Part of what was passed by the Senate was a House amendment that postpones "for at least a year" implementation of ICD-10 codes. The American Hospital Association, whose member hospitals have spent millions getting ready for the October 1st ICD-10 start date, opposed the amendment although most physician organizations mainly applauded the delay.
ICD-10 basically quadruples the number of billable codes for health care providers - mainly by becoming much more specific about the cause and extent of the patients health care problem.
Quite a Day
The Battle of Westport was a Civil War engagement in October 1864 near present day Kansas City. Andrew Taylor Still, the founder of osteopathic medicine, was a major in the 21st Kansas Militia and has this to say in his autobiography.
"During the hottest period of the fight a musket-ball passed through the lapels of my vest, carrying away a pair of gloves I had stuck in the bosom of it. Another minie-ball passed through the back of my coat just above the buttons, making an entry and exit about six inches apart. Had the rebels known how close they were to shooting Osteopathy, perhaps they would not have been so careless."
Although the Civil War would rage another six bloody months, the Battle of Westport essentially ended serious Confederate operations west of the Mississippi.
In Case You Missed It...
April 2, 2014
God Bless You! Allergy Season Arrives
Our mild winter has brought out yellow Palo Verde blossoms a bit early - and seems to have awakened other dormant plants to spring. With it comes the misery of stuffed noses, fogged brains and watery eyes for those with allergies.
According to the Centers for Disease Control and Prevention you are not alone. Allergies are the sixth leading cause of chronic illness in the United States, affecting 50 million Americans annually.
There is some good news. Today the FDA approved Oralair, a new under-the-tongue medication aimed at reducing symptoms from grass and hay fever allergies. And - even though no one today would seriously think of sending their sinus to Arizona - USA Today ranks Tucson as only the 52nd worst metro area for allergies, about dead average for the US.
Physicians can identify what allergies bother you and can recommend strategies and medications to aid you through the worst of the season.
If you choose to go it alone, Web MD recommends staying indoors in the mornings, changing clothes when you get home, showering before bed. Sheets and pillow cases can also be run through the dryer and sleeping with a HEPA room air cleaner can provide some relief.
Malpractice Award Referendum Stirring in California
In 1975 California capped pain and suffering awards at $250,000. Today the plaintiff bar and consumers are launching a referendum bid to raise that cap substantially - and test physicians randomly for drug and alcohol.
Health industry officials will watch this effort closely because California is often a change leader and its laws are often copied by other states.
In Case You Missed It...
April 3, 2014
Telemedicine Growing in Arizona
Unlike many other states, telemedicine in Arizona has grown in a slow manner and has been studied by top-flight researchers every step of the way. As it has developed, solid rules have been placed to protect Arizonans from physicians in other states and countries that may have more lax rules.
Major telemedicine rules will speed up this process starting in January 2015. A series of small changes in SB-1339, however, are on track to pass this session to remove the unprofessional conduct telemedicine strictures from pharmacist, naturopathic, allopathic and osteopathic physician statutes.
For example, on aspect of unprofessional conduct for osteopathic physicians will soon be defined as:
(32-1854 (48)) Prescribing, dispensing or furnishing a prescription medication or a prescription only device to a person if the licensee has not conducted a physical or mental health status examination of that person or has not previously established a physician patient relationship. The physical or mental health status examination may be conducted during a real-time telemedicine encounter with audio and video capability if the telemedicine audio and video capability meets the elements required by the centers for medicare and medicaid services, unless the examination is for the purpose of obtaining a written certification from the physician for the purposes of title 36, chapter 28.1. This paragraph does not apply to:
(a) Emergencies.
(b) A licensee who provides patient care on behalf of the patient's regular treating licensed health care professional or provides a consultation requested by the patient's regular treating licensed health care professional.
(b) (c) Prescriptions written or antimicrobials dispensed to a contact as defined in section 36 661 who is believed to have had significant exposure risk as defined in section 36 661 with another person who has been diagnosed with a communicable disease as defined in section 36-661 by the prescribing or dispensing physician.
(c) (d) Prescriptions for epinephrine auto-injectors written or dispensed for a school district or charter school to be stocked for emergency use pursuant to section 15 157.
(e) Prescriptions written by a licensee through a telemedicine program that is covered by the policies and procedures adopted by the administrator of a hospital or outpatient treatment center.
This is NOT the law yet, but the bill is on track to pass and the Governor's signature is expected.
Medicare to Release Physician Billing Data Next Wednesday
Barring expected injunction requests, Medicare plans to post billing data from 880,000 providers next Wednesday, overturning 40 years of promises and policy.
The associated Press reports Medicare Deputy Administrator Jonathan Blum sent a letter to the American Medical Association that was quoted in part as stating, "the healthcare system is changing from a system dominated by a dearth of usable, actionable information to one where care coordination and dramatically enhanced data availability will power greater innovation, higher quality, increased productivity and lower costs."
The same story quotes the AMA president as objecting to the data release because it will be misleading, career destroying, prone to error and an invasion of privacy.
Still on Westerners
Far from being ashamed of his backwoods upbringing, Osteopathy Founder Andrew Taylor Still rejoiced in it. The following is from the 1908 edition of his Autobiography (Chapter VI, pp 85-86).
"The frontier is the great book of nature. It is the fountain-head of knowledge, and natural science is here taught from first principles. How does a scientist learn of the habits and manners of the animals that he wishes to study? By the observation the animals. The old frontiersman knows more of the customs and habits of wild animals than the scientist ever discovered. Agassiz (the 19th Century's leading naturalist), with all his knowledge of natural history knew not as much about the mink and beaver as the trapper whose life business has been to catch them."
In Case You Missed It...
April 4, 2014
Needles Make You Nervous? Help is Coming
No one going to the doctor ever says, "Boy, I hope I get a shot today!"
You may want to check out the video here of an effective method being tested right now. The speech was filmed not far from where the syringe was invented 160 years ago and is a lively look at what may be the future. Click here to view.