Hypoprimarenia

Post  tryptophane tremors Why are there  not enough Primary Careologists? This sounds very familiar. The problem with medical school begins in the first year. Most of the two preclinical years have little to do with practicing medicine. Those trained in some basic science in the last several years of college realize very quickly that medicine has little to do with science or curiosity about science and/or health. It is more like elementary school for doctors…just like you learned reading, writing and rythmatic to prepare you for middle school, and high school to learn trig, algebra and calculus. What you learn during those first two years is nomenclature, and linguisitics…much like any vocation which has specific terms. Lawyers...

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Health and Human Services

Quackbooster nominated for HHS Secretary. Cabinet Secretarys seem to play musical chairs and/or musical titles.  HHS Secretary Mike Leavitt was formerly head of the EPA. from  Quackwatch: Tom Daschle, who is President-Elect Barack Obama's nominee for Secretary of Health and Human Services, provided strong support to unscientific practitioners while serving in the U.S. Congress from 1979-2003. Daschle has not made intentions clear as to whether or not he will run again for office; however, he  signed on as a Senior Policy Advisor with the K Street law firm Alston & Bird.[15][16] Health care interests, including CVS Caremark, the National Association for Home Care and Hospice, Abbott Laboratories and HealthSouth,...

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World AIDs Day

December 1st next week marks another annual event. HIV/AIDS awareness day, presents an opportunity to educate, promote testing,and obtain posters, marketing materials and plan an event for your area. The web site asks bloggers to participate in a  number of ways. Participate!!! There are many ways. Take Action There are many ways you can take action in response to HIV/AIDS: get tested for HIV practice safe methods to prevent HIV decide not to engage in high risk behaviors talk about HIV prevention with family, friends, and colleagues provide support to people living with HIV/AIDS get involved with or host an event for World AIDS Day in your community del.icio.us Tags: HIV,AIDS,WORLD AIDS DAY...

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Engage with Grace

  Again, re-posted from November 2008   This weekend there is a 'BLOG RALLY' taking place. Matthew Holt of The Health Care Blog promoting  Engage with Grace. The blog link contains video and text regarding this worthwhile viral marketing message regarding end of life care. One of the issues regarding the escalation of health care costs is the magnitude of expenses during the last one or two years of life. Engage with Grace addresses this issue and calls  for promoting the message. HealthCare in America, written by Kenneth Fisher,   M.D.  also the author of  " In Defiance of Death" (available at Amazon) closely mirrors what Engage with Grace is all about. Dr. Fisher is featured on "Monday Night Live"...

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Cyberchondria

Quote of the day: I have been through some terrible things in my life, some of which actually happened. - Mark Twain *************************************************** Are you examining and possibly treating  a cyberchondriac?  Perhaps our review of symptoms should now include a new category under mental health. An important question may be 'how many hours a week do you spend searching the internet?' As reported in the New York Times, "If that headache plaguing you this morning led you first to a Web search and then to the conclusion that you must have a brain tumor, you may instead be suffering from cyberchondria A recent research report completed by Microsoft (those folks who now bring us "Health Vault" reveals...

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Erratum

Whoops! In the last post I credited Dr Rowsey as the 'inventor of lasik'.  I was mistaken.  However, he is a certified VIS-X instructor. A change has been made in the original aticle....

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Health Train at The Mission Inn

I spent the afternoon yesterday with my former classmate who has had an illustrious career in Ophthalmology. John James Rowsey MD, a corneal specialist, and former Chairman of the Department f Ophthalmology at University of South Florida  travelled to California from Florida to ask how to get  physicians involved and become stakeholders in health care reform.   Idea Man   I am not sure I gave him an adequate answer while we were enjoying a fabulous brunch at a National Historic Landmark, The Mission Inn in Riverside, CA.   I could not immediately crystallize my thoughts , but this morning I have a long laundry list of ideas. Jim works for and with Senator Tom Coburn (Oklahoma) travelling each month to a...

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Health Train Daschle

What's your take on this new announcement today regarding Tom Daschle's most likely nomination to replace Mike Leavitt as head of HHS.? What is the connection here? What does Tom Daschle really know about health care? We could at least say that Mike is a physician, MD. Mr Daschle recently published a book " Critical: What We Can Do About the Health-Care Crisis   Since 2007, Daschle has been an advisor to the law firm of Alston & Bird LLP. Although Daschle is not a registered lobbyist, his firm was paid $5.8 million between January and September to represent companies and associations before Congress and the executive branch, with 60% of that money coming from the health industry.  I didn't see any physician representation...

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Health Train Next Stop Bagdad

Panel Confirms Gulf War Syndrome Is Real and Causes Are Definable WASHINGTON, Nov. 17 -- The Gulf War illness was caused by pyridostigmine bromide pills taken by U.S. troops to neutralize the effects of nerve gas attacks and by exposure to neurotoxic insecticides, according to a VA advisory panel. These two factors amounted to a definable scientifically valid illness with significant nervous system symptoms often still affecting veterans of the 1991 conflict in Kuwait and Iraq, said the Research Advisory Committee on Gulf War Veterans' Illnesses At the same time, the report exonerated a number of other suspects in symptoms reported by returning veterans of Operation Desert Storm, including depleted uranium, anthrax vaccine, infectious diseases, and stress. Much of the report echoed a meta-analysis...

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Health Train Survey

The results of my survey on Sermo have just been released. I am posting the question and the results here QUESTION: IF OBAMA WINS THE ELECTION WHAT WILL BE THE RESULTS IN TERMS OF HEALTH CARE CHANGES??   ANSWERS" If Obama wins Tuesday, I think Wednesday I'll get up, take my kids to school, go to work, come home, have a beer with my wife and soak in the hot tub. Get over yourselves, people, you sound like a bunch of Nostradamus wannabees. 8%   (3/36) No 6%   (2/36) Be afraid, be very afraid. 6%   (2/36) All those anti-Obama doctors will be investigated by Medicare and the IRS. BestGuess will be Secretary of Health and Human Services. 3%   (1/36) I will be very sad. ...

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Health Train Express

For the next week or so I will not be posting at Health Train Express.  I will be over at my other blog  THE VIEW FROM HERE Tank up, turn off, and tune in for rants about politicians,economists, and our esteemed leaders... I will be posting daily..   ...

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Health Train Security Alert

  Like all professionals, we physicians need to be policed. There are some of us  (not me)  who are impaired, drug dependent, and present a risk to patients.. Certainly today with 'transparency' as the new  buzz word it is now expected that consumers will have a seat on the medical board as reviewers and decision makers. This blog is transparent and read by physicians, administrators, pundits and yes, even 'consumers' (I prefer patients). In California the administrative functions of the Medical Board have changed drastically in the past year. Enforcement issues have been taken away from the Medical Board.  It was found that the 'diversion program'  for physicians who are impaired was flawed and inadquate...

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Why is Healthcare so Expensive

This, found in Planet Money as a feature on NPR. Today, NPR featured this video which simplifies the problem(s) Planet Money explains further....................... Health Train Express has found that there are many prolific writers from the likes of the WSJ, NPR, and many other sources in the media and the business world who  are addressing healthcare financing.  In some cases they seem to have a better grasp of the big picture while we physicians flail about just trying to survive and earn our daily bread.  Despite that none or few of these writers  have ever had the day to day and night to night responsibilty for human lives they seem to or think they have all the problems accounted for..  Yet their solutions do and would have enormous collateral 'damages'...

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Health Train Overload

ALL ABOARD THE HEALTH TRAIN ...

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Health Train Engineer Ratings

e-Patients.net today had an interesting topic about the value of doctor rating sites on the internet.  John Grohel and Ruth Given elaborate on the worth, value, and the economics of these web sites as sources of valid and credible information for patients. Some of these sites should have their title "Buy  your Grades"...These sites are not even secure...what is to stop hacking in to the 'teacher's"  grading books??  The whole issue seems a bit sophomoric. 1. It is not unbiased 2. Who reviews and rates the comments 3. Is there any credibility and accountability for ratings and/or comments. 4. Do the rated physicians have the ability to offer answers to criticisms?? 1.true 2 ?? 3.no 3.no 'nuff said?...

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Health Train Reports

Pay for Performance:  It's a no way street, since medicare has failed to live up to it 's promise.  Providers are struggling to determine what went wrong...Not a win-win situation, and a loser for both sides.  The experiment to improve outcomes by requiring coding for certain behavior on the part of providers and rewarding them for the same is flawed fundamentally by a rigid set of parameters to measure, which in the long run will most likely evolve with time.  It's going to be the dog chasing it's own tail.   Most providers do not have the time or resources for this unless it is a substantial size group.  2 percent  incentives for hiring administrators and software to perform this function is offset...

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HEALTH TRAIN CONTRIBUTES TO THE ECONOMY

A long time ago in a distant past my parents told me that if I became a physician I would always have work to do. They also told me I would probably never be a rich man.  I did not pursue medicine as a 'job'  My very worth is embedded in being a physician and surgeon... Like most physicians I wonder what I could do if I    could no longer care for patients.  At times while it is exhausting and saddled with many 'duties' such as becoming a secretary filling out forms, entering data and patient histories into an electronic health record.  While most clerical personell earn about 10-15 dollars/ hour my pay grade is far above that figure.  For me it is a good deal. The downside for providers is less...

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