Archive for the ‘Medical Care’ Category

Service of a New Twist on Identity Theft: A Hemorrhage in Medical Care

Thursday, August 13th, 2015

identity theft

Identity theft has spread from retail and banks to hospitals according to Stephanie Armour who reported the new contamination in her Wall Street Journal article, “How Identity Theft Sticks You With Hospital Bills: Thieves use stolen personal data to get treatment, drugs, medical equipment.

The only way that Kathleen Meiners, the mother of a man in his 30s with Down syndrome, could stop harassment by a hospital that claimed he’d had an operation was through the newspaper’s intervention.  Mrs. Meiners figured her son would quickly be off the hook after bringing him to the hospital so staff could see he’d had no procedure for a leg injury. But someone had to pay for the operation the identity thief had undergone so the hospital, ER physicians and radiologist continued to go after her son, eventually via collection agencies.

There’s more. With the thief’s medical charts “folded into” the victim’s, a person who doesn’t have diabetes might be shown to have it or the thief’s blood type might be listed as theirs. Mrs. Meiner’s son had no drug allergies but was listed as having some. Guess what? The victim can’t see the messed up medical records to untangle them because of privacy laws that protect the thief’s information.

Mrs. Meiners son isn’t alone. Armour wrote about a Florida woman who was charged for a foot amputation who showed up at the hospital to point out her two feet to no avail. A man learned someone had stolen all his benefits when he was refused a prescription refill.

Armour continued, “Fueling medical identity theft is the surge in electronic medical records and data breaches at insurers and health-care providers. Medical identity theft—in which someone fraudulently uses data to bill for medical services—affected 2.3 million adult patients in 2014 versus 1.4 million in 2009, according to a survey published in February by the Ponemon Institute LLC, a research concern.”

EmergencyTo help stem the tide, insurance companies have formed a Medical Identity Fraud Alliance and the FBI, Department of Health and Human Services [HHS] and the Justice Department are also investigating, according to Armour. And hospitals are getting into the act she wrote.  BayCare Health System in Florida asks patients if they want the veins in a palm scanned which is then “converted into a number that correlates with the patient’s medical record.” Other hospitals ask to see photo ID and are increasing digital security. Medicare cards distributed by HHS will no longer imbed social security numbers or show code according to a law the President signed in April.

“Unlike in financial identity theft,” wrote Armour, “health identity-theft victims can remain on the hook for payment because there is no health-care equivalent of the Fair Credit Reporting Act, which limits consumers’ monetary losses if someone uses their credit information.” In Ponemon’s survey “65% of victims reported they spent an average of $13,500 to restore credit, pay health-care providers for fraudulent claims and correct inaccuracies in their health records.”

Armour reported that social security, Medicare and Medicaid numbers are sold on the black market for $50 vs. $6-$7 for a credit card number. The latter can be cancelled quickly hence the lesser value. “Sometimes, health-care providers are the perpetrators,” she wrote. “Federal prosecutors charged Dr. Kenneth Johnson with using Manor Medical Imaging, a Glendale, Calif. clinic, to write prescriptions for drugs and then sell them on the black market.”

Were you aware of this twist in identity theft? What can be done about it?

Identity theft 2

Service of Cost vs. Benefit in Healthcare: Who Decides?

Monday, July 6th, 2015

Photo rinehartclinic.org

Photo rinehartclinic.org

This New York Times article, “Cancer Doctors Offer Way to Compare Medicines, Including by Cost,” made significant—if terrifying–points in addition to how cost impacts what drugs a patient may get. Given their ineffectiveness, I wondered why those given as examples are prescribed in the first place.

If you or a loved one has a heart condition, don’t click away just yet: Reporter Andrew Pollack noted that cardiology societies are following in oncologists’ footsteps. And I wouldn’t be surprised if this trend soon affects patients with any and all conditions if it effectively cuts costs for insurers. 

Actor Robert Young playing Marcus Welby, MD

Actor Robert Young playing Marcus Welby, MD

Pollack wrote “Roche’s Avastin, when added to chemotherapy, had a net health benefit of 16 out of 130 possible points when used as an initial treatment for advanced lung cancer. Its monthly cost was $11,907.87, compared to $182.09 for the chemotherapy alone.

“Eli Lilly’s Alimta for that same use had a net health benefit of zero with a cost exceeding $9,000 a month compared to about $800 a month for the drugs it was compared to in the clinical trial.”

Later in the article Pollack spelled out the rating system: “Drugs for advanced cancer are given a score from 0 to 130. Up to 80 of the points are based on a drug’s effectiveness in prolonging lives, delaying the worsening of cancer or shrinking tumors. Then up to 20 points can be added or subtracted based on side effects. And up to 30 bonus points can be granted if the drug relieves cancer symptoms or allows a patient to go without treatment for a period of time.” 

Actor Hugh Laurie who plays Dr. House

Actor Hugh Laurie who plays Dr. House

Regardless of cost why would anyone prescribe a drug that benefits a patient from zero to 16 “points” out of 130?

Other news that was unsettling: “The release by the American Society of Clinical Oncology of what it calls its ‘value framework,’ is part of a change in thinking among doctors, who once largely chose drugs based on their medical attributes alone.” [The underline is mine.] Silly me: and I thought doctors still prescribe what they do according to how a drug helps a patient.

According to Pollack the average cost of cancer drugs runs $10,000/month and some as much as $30,000/month. This is information, Dr. Richard Schilsky said at a news conference, that some doctors don’t know nor do patients. Schilsky is chief medical officer of the American Society of Clinical Oncology. [Why is this significant? Even if you've been paying for health insurance for eons and have hardly used a cent until you need to, you can reach the ceiling when off goes the insurance spigot.]

Pollack wrote that this value framework considers the cost to the patient and the health system.  I assume “health system” translates to government supported Medicare and Medicaid plans. 

Ingrid Bergman playing Dr. Constance Petersen

Ingrid Bergman playing Dr. Constance Petersen

As a result, Pollack observed, doctors are now put in the role of “being stewards of societal resources.” He continued, “That is somewhat of a controversial role for doctors, since it might conflict with their duty to the patient in front of them. But the oncology society said it did not see those roles as being in conflict.”

Other points Pollack made include:

  • A rep for the Pharmaceutical Research and Manufacturers of America said the cost of drugs represents only 20 percent of treatment.
  • The cost of drugs is unrelated to how “novel it is or whether it prolonged life versus just shrinking tumors.”
  • In Britain, a drug is rated according to its “cost per extra year of life they provide adjusted by side effects and symptoms.”
  • Starting in June United Healthcare requires “oncologists to get prior approval from the insurance company for every cancer drug they administer. The company will then track what happens to patients and eventually provide information to doctors about how well each drug works.”

Summarizing the questions:

  • Why prescribe a drug that does little if anything to better a patient’s health or length of life?
  • Is a doctor who chooses a drug for a patient based solely on its medical attributes old fashioned and out of step and will he/she soon be forced out of work by insurance companies?
  • If a patient can scrape together the co-pay of a super expensive drug, can an insurance company refuse to pay its part? Then what?
  • Will United Healthcare only use its approval to track drug effectiveness, as Pollack suggests, or eventually will it control costs by refusing to pay?
  • Is the American Society of Clinical Oncology correct when it asserts that there is no conflict for doctors who are now made responsible for the country’s medical resources and their responsibility to their patients?
  • Unless people have unlimited incomes, most adults are aware of what they pay for food, beverages, clothing, shelter and only recently have they become aware of the cost of healthcare. Isn’t this a good thing?

  pills 2

Service of Medical Care Going the Extra Mile

Thursday, April 30th, 2015

Extra mile

J. McCarthy, who posted a comment on my recent post, “Service of Little If Any Assistance: Physician Admin Staffs Fall Down on the Job,” followed up a few days ago with another relevant comment describing medical care that he had just received from several doctors and their staffs.  It warranted a post of its own, not just to present a fresh perspective on medical care, but also because the woman who wrote the previous post made the most distressing point about how horribly she had been treated by several of her doctors and their administrative staffs.

He wrote:

I’m referring to my previous advice, “Do what a specialist with a national reputation told me to do. ‘If you want to get a good doctor, get an old doctor.’ Old doctors tend to have competent staffs.” The following story about what led up to the unsolicited, unexpected phone call my ophthalmologist’s most solicitous, crack, long-time nurse just made to me, might be of interest to your readers.

happy patient 3On a visit for my routine annual eye checkup, I told the ophthalmologist about something strange that had happened recently with one of my eyes. He took it seriously and gave me an even more extensive examination than usual. After it, he told me that there was nothing wrong with my eyes, but that he suspected I might have a circulation problem. He asked me if I still was seeing my longtime cardiologist who coincidentally is his patient as well. I said yes, and he picked up the telephone and called him.

Three days later, I was in the cardiologist’s office. We go back 30 years, and even though he practically has my heart memorized by now, he thoroughly examined me. (He took my blood himself as he always does.) Next, he had his nurse, who has been with him since he opened his practice, hook me up to a bunch of machines and do a series of heart tests. I’ve known her as long as him, and trust her absolutely.

Happy patient 4The next day, the doctor called to tell me that the tests had turned up nothing new and that, as far as he could tell, I did not have a circulation problem. Then, he gave me two choices: Either I could see more specialists and take more tests to double check, or I could do nothing and see what happened. I chose to do nothing. My doctor agreed and said that he would follow up with our ophthalmologist. I was satisfied and thought that was the end of it, but it was not.

Nurse on phone 1What did theophthalmologist’s nurse call me about? Her boss wanted me to know that he fully concurred with thecardiologist’s and my decision. That was a call  that did not have to be made. It was going the “extra mile.”

Incidentally, both doctors accept insurance and are all well over 65. Their nurses both have been with them at least 20 years.

Have you heard of doctors who collaborate with each other and their nurses in this way? Or is medicine more like Washington where the executive and legislative branches clash, and our senators and congressmen and women don’t cooperate with each other? Do you have examples of medical admins in today’s “rush-rush” climate who make your day rather than ruin it?

Great communication

 

Service of Little If Any Assistance: Physician Admin Staffs Fall Down on the Job

Thursday, April 16th, 2015

Health admin staff 1

A friend, asked: “Have you done any posts about the outrageously discourteous way patients are sometimes treated by admin staff at doctors’ offices?”

I probably have, but neither recently nor covering any of these instances so I kept on reading as I trust you also will. I wish that her experiences were the exception. I fear that too many of us have similar ones to share.

She continued:  

health admin staff 2“I often wonder if these people are lazy, stupid, incompetent, or all three. Earlier today I brought Mom to a long-ago-scheduled appointment with an ophthalmologist. I called 30 minutes before the appointment to ask if the doctor was running on time with his appointments. I was told that he was. Mom and I arrived 10 minutes early, told the receptionist that we were there, then signed in on the clipboard. We spent the next 30 minutes watching patients who arrived after us get called in to see the doctor before us. When I checked the list we’d signed I found that four patients had signed in after Mom. When Mom asked the admin for an explanation, she was told there had been an emergency with a patient. That explanation may fly in a cardiologist’s office but I’m not buying it from an ophthalmologist.

“Although I wanted to walk out, we stayed so Mom could have her procedure. After it was complete and there was no longer a chance of alienating the doctor, I told him in so many words that his staff stinks. It’s unlikely we’ll go back. This won’t be the first time Mom or I have left a doctor’s practice, not because of an inadequacy on the physician’s part but because of incompetent staff.

Prescription“In another annoying medical-related incident, we learned that the results of Mom’s blood test, which had been performed March 25, still had not arrived at her cardiologist’s office as of March 30. We called the lab and learned that lab personnel had faxed the results to the wrong number. The transmission failed, of course, but apparently it didn’t occur to anyone at the lab to check the number on the test prescription or to call the doctor’s office and confirm it. Instead they did nothing whatsoever.

“Last week I received a bill for $240 for a simple procedure I’d had done in a dermatologist’s office. It was my first appointment with this doctor. I have a very pricey insurance policy that, in the past, always has covered this type of procedure 100 percent, so you can imagine my surprise at receiving this bill. Upon closer inspection I found a line that said: “No insurance information is on file at this doctor’s office.” Really? Was it my imagination that I spent 15 minutes filling out paperwork before the doctor saw me? Was I hallucinating when I handed the admin my insurance photocopiercard and saw her copy it on the photocopier?

“I try to give people the benefit of the doubt when it comes to a lot of things but this lack of courtesy and common sense by admins in medical facilities makes me absolutely crazy. I’m sure I’m not alone.”

My friend asks for strategies on how you navigate through the oceans of incompetency in this industry. I’d like to know if you’ve experienced similar inexplicable glitches, if there seem to be more nowadays or, on the other hand, if the doctors you see are backed by teams of efficient, smart administrators?

 health admin staff 4

 

Service of It Must Be Good: It’s Expensive Part II

Monday, February 9th, 2015

placebo

The previous post covered wine, this one medical treatment.

What a Pill

“When patients with Parkinson’s disease received an injection described as an effective drug Getting an injectioncosting $1,500 per dose, their motor function improved significantly more than when they got one supposedly costing $100, scientists reported,” wrote Sharon Begley in “Expensive’ placebo beats ‘cheap’ one in Parkinson’s disease” on reuters.com.

“Underlining the power of expectations, the motor improvements, measured by a standard Parkinson’s assessment, occurred even though both injections contained only saline and no active ingredients.

“The research, said an editorial in the journal Neurology, which published it, ‘takes the study of placebo effect to a new dimension.’”

Of the dozen volunteers in the study, observed neurologist Alberto Espay, the greatest improvement happened for the eight who expected the expensive drug to be more effective. The other four, who didn’t anticipate benefits, showed little change, wrote Espay, University of Cincinnati, who led the study.

In your experience, what part of a successful treatment for illness involved the mind and what the medicine? If you pay a lot for a drug, treatment or physician, are you more confident that the results will be positive?

leaving a hospital

 

Service of Privacy II

Thursday, January 15th, 2015

watching tv late at night

In a holiday card a friend mentioned that she suffered from a condition I wasn’t familiar with. So I looked it up on Google, but I did so reluctantly. I figured that my SPAM file would soon be filled with remedies for the disease and that commercials about them would appear every time I opened Facebook, CVS or Amazon.

In The New York Times Metropolitan section Charles Ornstein wrote “Dying in the E.R. and on TV,” about a family shocked to learn that their father/husband’s last minutes on earth in an ER appeared on “NY Med.” His wife happened upon the program during a sleepless night about a year after her husband’s death. He’d been run over and doctors were shown trying to save him. They couldn’t.

no entry without permissionNobody got his or the family’s permission to film him nor were they aware that a film crew was in the ER. Even though the health department concluded that the hospital “had violated” the patient’s “rights and indeed, its own privacy policy” regulators “did not impose any sanctions on the hospital,” wrote Ornstein.

He continued, “Federal health officials are still reviewing whether NewYork-Presbyterian was obliged to get permission” from the patient “or his family before allowing a TV crew to film him.” The hospital’s lawyers argued in State Supreme Court that you need permission to share information after a person has been examined/treated but that the film was shot before. An appellate panel dismissed the case. The conduct “‘was not so extreme and outrageous’ to justify a claim of intentional infliction of emotional distress,’ the judges wrote.”

Hospital erThe hospital also claimed that they didn’t identify the patient and nobody would know who he was. However a woman who knew the family called the patient’s wife and asked if she’d seen the program as she’d recognized her husband on the show. The wife and children said that they were traumatized.

The family wants the case to go in front of a jury as they feel that their peers would agree that “a wrong was done.” At the moment apparently there is no case. The dead man’s wife said that if there wasn’t a law to prevent such filming there should be one and she plans to make it her business to get one.

Would you want to be photographed in the E.R. without permission while out of it or subject a family member to the same, regardless of outcome of the treatment? Do you feel this instance was a breach of privacy? Do you think that the judges, who wrote that there was no ”intentional infliction of emotional distress,” might say the same of anyone who has injured someone in an accident that clearly they did not mean to happen? Wouldn’t such a precedent remove the potential of millions of lawsuits in any number of instances?A law

Service of Credibility II

Monday, October 13th, 2014

Trust me

I keep hearing on newscasts and in quotes by doctors and politicians how we shouldn’t panic about the ebola virus, that you can only catch it if you come in direct contact with an infected person’s fluids; that if you share the air of an elevator or plane with a sick person, you won’t catch it and that this or that city is ready to isolate and harness any case that crops up.

One of the doctors pointed out that only one person has died of ebola in this country in comparison to 20,000 who die each year of flu. [I checked the Center for Disease Control website to confirm this figure. It can't track a statistic as states are not required to report deaths from flu of people older than 18.]

The problem is how often have public figures told us not to worry when it turnedworld trade center pile out we should? Christine Todd Whitman, former New Jersey Governor and administrator of the Environmental Protection Agency told workers at the World Trade Center pile that they were in no danger of getting sick. Since then many have succumbed to cancer. Perhaps she was instructed to say this. Not only did it trash her political career, it was one more nail in the coffin of the public forced to question the people they are supposed to believe.

Congressional committees have let corporate executives get away with product safety claims for years while the facts proved otherwise: Smoking is one glaring example.

Train tunnel ny njWhat about the crumbling infrastructure? Governor Christie cancelled a train tunnel project between New Jersey and New York called “Access to the Region’s Core” which would build a new tunnel. The existing one was built between 1904 and 1908, according to Wikipedia. True, “they knew how to build things in those days.” But is counting on an essential 106 year old structure realistic just because the Governor says it is? Especially if you suspect the real reason is that he doesn’t want to spend the money under his watch?

Do you accept what you hear and go about your business or are you more skeptical?

 Pinnochio

Service of Seeing the Light

Thursday, April 10th, 2014

eyes 3

Iris Bell described the impact of her cataract operation in an enlightened way. She is a graphic artist which is apparent in her descriptions of color.

If you know someone faced with such a procedure and is hesitating, it would be worth passing along her narrative. She noted: “It’s as if the very stuff the world is made of has changed.”

This is what else she wrote:

eyes 4I had the cataract in my right eye removed and replaced with a lens that gave me 20/20 vision. The result: I see colors accurately and have perfect distance and night vision.

People who’ve had similar procedures told me the effect was dramatic. I knew the brownish cast of my cataract had made it hard for me to see the difference between my blue and green bracelets unless I looked at them under a strong light. Over the last year I also noticed I had trouble seeing outside after dark.

Throughout this period of change I wondered what the real colors of some things were and how bright or intense colors and whites might be. After the surgery my husband, Paul, and I took the bus home. For 10 blocks I looked out the window at the familiar shop fronts, checking back and forth between my eyes, one as yet uncorrected. The effect was as if I took on and off sunglasses with brown lenses.

eyes 5When I got home I was overwhelmed by the feeling of joy the colors gave me. It was exciting to look at my things with my corrected eye. I’d bought many items for their special colors because they have a major effect on my emotions.

With my uncorrected eye my periwinkle items looked grayish blue. With my corrected eye I saw the color I loved. I’ve always thought of periwinkle as the last blue before a color become lilac. The cataract hid the essential subtle reddish tint which turns a blue into periwinkle.

In subsequent days I’ve been shocked by rediscovering the true colors of things I’d lived with for years: A kitchen sponge is vibrant lilac; a sparkle-covered fingernail file an elegant purple not what I’d previously thought of as an unremarkable pinkish purple and a ream of paper and bath towel are the color of the newest spring grass with sunlight shining through…not the dull hue of older grass. And I’d forgotten how bright green bok choy at my favorite Chinese restaurant looked.

eyes 6Dyes on different fabrics are too subtle for my uncorrected eye to register and the intense purple underside of a vine I’ve grown under plant lights for years is back for the right eye.  The gas flame in the stove startled me,  transformed from dull aqua to a brilliant spectrum blue with a fine edging of purple.    

There was a loss: My corrected eye sees the russet and golden grapes in a photo hanging in the kitchen as bland pastels, no longer the richer colors tricked by the cataract.

The most startling effect of the surgery lasted only a few minutes some 10 hours afterward. We were in our supermarket just before twilight: The clear glass front window looked as if it had been replaced by blue stained glass. We’d spent time walking in the grocery, with its warm lighting. I was now looking out at the cool light of early evening. It had been years since I’d recognized either of these types of light. My brain didn’t know what to do with them. By the time we were on the sidewalk I was getting proper information from my brain, there was nothing special to see, no bright blue light. Only if I was planning to paint a watercolor would I study the quality of the light and notice it had a blue cast to it. Non-artists usually don’t notice the color of light.

One of the reasons I wanted the operation was that my night vision was  so poor that I was uncomfortable walking outside after dark, even on our block. People would suddenly appear walking toward me. I’d only see them when they were several feet away.  The day after my surgery it was hard to believe this block had always been this brightly lit between the street lights, decorative lights on buildings and from entryways.

This new world of lovely colors and light sources is a pleasure to experience. I’m not ready to have my other eye corrected quite yet, I’m having such fun comparing the two worlds I see with my two eyes.

Since she wrote this, Iris said she plans to have the other cataract removed in a few months.

Not once did she mention discomfort or pain. Isn’t it remarkable that she took a bus home after an operation that once kept people in the hospital for a week? Have you undergone a procedure–or known someone who has–that has similarly so dramatically [and effortlessly] transformed a life?

eyes 7

Service of Great Medicine

Thursday, November 7th, 2013

old fashioned pharmacy

My husband, Homer Byington, wrote this post a few hours after he returned from having his appendix removed.

As Jeanne well knows, and suffers through patiently– usually — I am one of the world’s most notorious pessimists,  a doubting Thomas, a Luddite, a true Cassandra and chronic complainer who is always telling anyone who cares to listen that life was better 50 years ago.

Like so many others, I have been knocking the way medicine functions in this country for years and even more so recently as a consequence of the inauspicious startup of Obama care. Yes, all sorts of things are wrong with the system, and much needs fixing. But people like me tend to forget how lucky we have been to have had the great doctors and nurses we’ve had and great treatment we’ve received at various hospitals both on an inpatient and an outpatient basis. Today was a good reminder.

Dr. AronoffThis morning, just a few hours ago, I was in an operating room at Lenox Hill Hospital under the knife of a surgeon, Dr. Jeffrey Aronoff, [Photo at right] who was trying to resolve what he described as an “enigma.” I’ll skip writing about medical stuff because I’ll just get it wrong, and it is quite complicated, but both he and I fully expected my hospital stay to be considerably longer than just a few hours. Dr. Aronoff and my wife and I go back more than 20 years when, as low man on the totem pole of a team of five doctors doing colonoscopies, he first treated us. Then, when he went out on his own, we followed. Why?

A month or two ago, to resolve my problems, Dr. Aronoff suggested a routine preliminary colonoscopy. Then the question arose whether he, a busy surgeon working 12 plus hours a day, or another doctor should do the job. He told me bluntly, “I’m doing it. I’ve always done yours.” That is the nature of the man. In this cynical age, how could anyone resist such a doctor’s loyalty to his patients?

Lenox Hill HospitalThe O.R. on the 10th floor of Lenox Hill Hospital is a busy place at 6:00 a.m. Milling about are staff and patients of every shade of color, sex, age, accent and language, but it is an orderly and well-paced chaos managed by experienced professionals, a scene a little like what one might see in a well-danced modern ballet. It sure didn’t hurt that the two R.N.s who interviewed me first were old timers who fondly remembered our family doctor cardiologist Dr. Paul Bienstock. Each of them then spontaneously volunteered that I was lucky to have Dr. Aronoff as my surgeon and said that he was the best. (It did occur to me that they said that about their doctors to all the patients they interviewed, but in this case, I think they both meant it, and their positive words bucked up my already considerable confidence about what I was about to have happen to me.) Then the doctor stopped by. We chatted, and he listened and did not later forget something enigma-related that I had suggested to him.

A few minutes later I was on the operating table, and there he was again with a bunch of other people cheerfully doing various complicated looking things. The mood was calm and positive. An hour and half later when I came to there was Dr. Aronoff smiling. “You can go home. It turned out to be your appendix after all. It was pretty inflamed and I took it out. Everything else looked O.K.” We talked a minute and then he went off to the waiting room to update Jeanne.

The recovery room fascinated me, especially the interplay between all those different people with different problems and different duties. Like the prep area it was an ordered chaos, but all the professionals, busy as they were, took the time to be solicitous to their patients. There may have been the usual friction between staff members that occurs in hospitals and nursing homes, or, for that matter, at any large institution, but it certainly wasn’t evident here. Somebody brought me a cup of ice chips for my throat; somebody else, a cup of tea and a plate of crackers. Even one or two doctors I didn’t know who were coming to see other patients smiled or said, “Hi.” Or, “How are you doing?” Jeanne showed up an allotted five minutes to make sure I was alive, and then Dr. Aronoff visited yet again to check up on me.

Next I was moved to the main floor recovery room, Jeanne in tow, where one terrific nurse gave us common sense, understandable answers to all sorts of questions like when I could take a shower and what I should eat. We were not rushed but as soon as I felt ready, off we went home just before 2:00 p.m.

Looking back on the experience a few hours later, I thought to myself that this is how medical care should be delivered. Maybe I received special attention, but I don’t think so. Everyone else around me seemed to be being treated the way I was.

At least ten different professionals dealt with me and they all acted like they cared about what they were doing and about me. There is no way for me really to know whether Dr. Aronoff is the miracle worker I think he is, but his results do speak for themselves. Here I am at home, never in pain– and hardly at all during the day –and painkiller free, writing a blog post just after having had two procedures performed on me, my inflamed appendix removed, and I am damn near 80. Now that’s great medicine! Yes, we haven’t doped out all of the enigma that brought me to the O.R. in the first place, but we may have that answer also by the time pathology gets through with my appendix.

The question is if Lenox Hill and Dr. Aronoff were able to deliver like they did for me in the middle of a healthcare crisis, shouldn’t we trust them, and the many like them, to come up with a sensible, efficient way to keep us healthy instead of the Washington politicians who seem to be at the beck and call of Big Business, Big Insurance, Big Labor and their battalions of highly competent, self-serving lobbyists?

Lobbyist 2

 

Service of Watching Your Back on Social Media

Thursday, October 31st, 2013

spy with magnifying glass

Friends and relatives post all matter of information on Facebook and Twitter thinking it will never adversely bounce back at them. I hope it never does.

Tourists at Eiffel towerThink of the contradictions. On the one hand we’re horrified that the government is spying on us—with good reason. Yet many hand scofflaws buckets of ammunition by  posting photos of family members [kidnapping?], sharing intimate information [will anyone be home when you’re at a funeral?] and political views [potentially losing clients or a job] without a thought of the future.

We purchase security systems and ask a neighbor to empty the mailbox so would-be robbers bypass the house as we simultaneously post photos of ourselves in front of the Eiffel Tower and the family waving from a gondola in Venice.

 

Art Caplan, PhD.

Art Caplan, PhD.

The head of the Division of Medical Ethics at NYU Langone Medical Center and contributor to NBC News, Art Caplan, Ph.D., told of a young man who was removed from a liver transplant list because he posted a transplant-damming photo of himself on Twitter. In “Is your doctor spying on your tweets? Social media raises medical privacy questions” he wrote: “There he was for all the world to see, surrounded by booze, hoisting a cold one in a picture he himself had posted,” wrote Caplan. The photo was seen by a person on the transplants team who sent it to a psychiatrist who was about to approve him for the list.

Caplan noted that no liver transplant team would accept a person who was drinking alcohol.  Result of this photo, according to Caplan, “in all likelihood a death sentence.”

With his ethics hat on Caplan asked: “Should this doctor or any health care professional have checked the transplant candidate out on social media?” He continued: “But even if ethical restrictions existed, it is probably fair to assume that a lot of doctors and those who work with them, many who grew up with Facebook and Twitter and the like, will be tempted to do so.

tennis player“Take for example, you say your back really hurts and you are disabled — let’s take a peek at your Facebook page to see if you manage to hit the tennis court, the jogging path or the golf links. Promise to be abstinent due to your venereal disease—what are you doing on dating sites on Craigslist? Swear to stay away from fatty foods and high calorie treats—why did your doctor just read a review by you of barbecue joints on Yelp or Zagat?”

He continued: “I think the transplant candidate had the right to know that he tweeted himself right out of a shot at a liver transplant. And you need to realize that information you put up on social media sites may wind up being used by your doctor, hospital, psychologist, school nurse or drug counselor.”

He concluded what we know—the Internet is the Wild West, without rules. “If they [doctor and patient] are going to continue to trust one another then we need to recalculate existing notions of medical privacy and confidentiality to fit an Internet world where there is not much of either.”

Do you think that it’s fair game for a doctor to research a patient’s social media sites to check up on them? Do you believe that there will ever be rules impacting social media? What’s the point of lying to your doctor anyway?

Wild west

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