Hippocratic Oath, Then and Now

 

In the midst of chaos and turmoil for physicians in America it is as important as ever to maintain our hippocratic oath.  Now is the time to review what we swore to (if your medical school even does this at graduation. )  This should excite you as much as your first ‘white coat’.

 

As you will read below it has been modified somewhat.

           OR          

Let this be your ‘straight ruler’ to compare to what we are all going through at the moment, and remember, it too shall pass, and change….but real meaningful ethics barely change. The FTC, FDA, SEC, CMS and government  will change and change as people do. Physicians, Ministers, Rabbis, ( I include Priests) (and MDs are ministers to your health)

Few medical schools today require students to recite the classical version of the oath. Enlarge Photo credit: public domain

Hippocratic Oath: Classical Version

I swear by Apollo Physician and Asclepius and Hygieia and Panaceia and all the gods and goddesses, making them my witnesses, that I will fulfill according to my ability and judgment this oath and this covenant:

To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers in male lineage and to teach them this art—if they desire to learn it—without fee and covenant; to give a share of precepts and oral instruction and all the other learning to my sons and to the sons of him who has instructed me and to pupils who have signed the covenant and have taken an oath according to the medical law, but no one else.

I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.

I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art.

I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work.

Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves.

What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself, holding such things shameful to be spoken about.

If I fulfill this oath and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot.

—Translation from the Greek by Ludwig Edelstein. From The Hippocratic Oath: Text, Translation, and Interpretation, by Ludwig Edelstein. Baltimore: Johns Hopkins Press, 1943.

Just as medical textbooks have come a long way from Hippocrates' archaic writings, the modern versions of the oath veer far from the classical. Enlarge Photo credit: Aldus Manutius/public domain

Hippocratic Oath: Modern Version

I swear to fulfill, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

—Written in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University, and used in many medical schools today.

 

                             

 

Editor's note: To add your own comment as a doctor or a non-doctor,

 

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Mayo Clinic Report on Physician Burnout

 

A national survey of 7,288 physicians (26.7 percent participation rate) finds that 45.8 percent of physicians reported at least one symptom of burnout, according to a report published Online First by Archives of Internal Medicine, a JAMA Network publication.

The Mayo Clinic today released the finding of a study on physician burnout. Not surprisingly (if you are a physician) the stunning findings, perhaps to the public, is that over 30% of physicians in general have documented burnout (according to psychiatric standards), and the highest rates of over 50% were among emergency room,family doctors (primary care physicians) and the internal medicine specialty.

Symptoms and signs include depersonalization, lack of involvement with patients, insomnia, loss of appetite and other signs of clinical depression. It was also found that over 50% of physicians are considering leaving clinical practice, early retirement or part-time medical practices.

This is occuring at a time when patient load will increase by about 25% due to health reform, which includes increasing bureaucracy not directly connected with patient care.

Most physicians recognize their own burnout symptoms and categorize it as depression. It however has other signals which differentiate it from clinical depression. It mimics post traumatic stress disease, seen in the military. The duration of chronic stress exacerbates signs of burnout.

There are physiologic and biochemical changes which occur during burnout, much like clinical depression. It is well known that anxiety creates the release of circulating hormones such as norepinephrine and corticosteroids as well as changes in neuro-mediators in the brain, such serotonin and inhibitors.

The obvious outcome of this is markedly reduced physician efficiency, increased errors, and disability, either acute or chronic.

The figures reveal how health care is impacted by these numbers.

A lack of control about the future and working conditions in many professions reveals that these factors also lead to apathy and burnout.

In medicine this is apparent. Most physicians know that physicians have little to do with the operations of the business of medicine, health insurance reimbursement, regulations, medicare and medicaid regulations.and find a greater and greater percentage of work time involves non- clinical work.

When queried physicians in the majority enjoy charitable care, however cannot individually support it in the present setting of medicine in the United States. While medicare payment have a due process for adjudication of disputed or rejected claims, often times state medi-caid plans do not have a mechanism which is usable to dispute disagreements. These factors contribute much to the uninsured challenge.

 

For providers time is money just as it is for all employers/employees. There is a limit as to how long a medical business can pursue these claims. It is also possible to seek legal relief, however the cost of this is prohibitive for small groups. Some hospitals or larger groups can afford the legal fees to pursue this course, and occassionally successful. While a patient can be sent to collections, how does one send medicaid or medicare to collections. In fact the provider is effectively extorted to agree to the rules present in the credentialling process. It's one thing to say okay I am going to extend 'credit' or discounted rates by choice, but another to coerced or mandated discounts. In fact most insurers have a disclaimer that their rates can be altered at anytime. The provider is free to disenroll or accept the changes. The provider has an ongoing ethical and legal obligation to continue care or be sued for abandonment if continuing care is not arranged.

While patient care can be stressful, the training process usually deals with clinical issues that cause stress. It is all of the above collateral challenges that cause burnout. Long hours, lack of recognition and the blatant disregard for physicians by insurers. Rarely does an insurer send a note of appreciation to their panels for 'good care' for the companies insured.

The fact that almost 1 in 2 U.S. physicians has symptoms of burnout implies that the origins of this problem are rooted in the environment and care delivery system rather than in the personal characteristics of a few susceptible individuals," the authors conclude. "Policy makers and health care organizations must address the problem of physician burnout for the sake of physicians and their patients."

 

Technorati Tags: physician burnout,depression,bureaucracy,uninsured,physician dissatisfaction,mayo clinic,medicare,medicaid

Money Money, Who’s Got The Money?

 

Most of us know where the money is going, and it’s not to physicians or providers. There is much money to be made and had in our health system, whether it becomes socialized, nationalized or universally paid.  Universal payor? It’s your wallet. What’s left? Not much.

Insurance companies are doubling down  to hedge their bets.

Health insurance companies bitterly opposed the health care reform law but, as the merger between Aetna and Coventry Health Care announced Monday shows, the industry knows there's still money to be made.

The $5.6 billion Aetna-Coventry Health Care merger is the biggest in the health care sector since President Barack Obama enacted the reform law in March 2010. The deal will give Aetna, the third-largest health insurer in the U.S., a big increase in Medicare and Medicaid customers, including poor elderly people on both programs, and in the number of people who buy insurance on their own or get coverage from small businesses. Aetna will gain 5 million new customers when the merger is complete and stands to get even more in the near future.

"You've got an arms race going on in health care," said Robert Laszewski, a health care consultant and president of Health Policy and Strategy Associates in Alexandria, Va. Laszewski said health insurance companies, hospitals and other players are merging into bigger entities in hopes of restraining their own costs and grabbing larger shares of the markets as they are reshaped by health care reform. What the Aetna-Coventry Health Care merger won't do, at least in the short term, is lower anyone's health insurance premiums, he said.

The health insurance industry is undergoing a transformation as a result of the health care reform law, which the Supreme Court upheld in June. Twenty-five million people will buy health insurance on the law's regulated "exchange" marketplaces in the states, according to the Congressional Budget Office. Many of those small businesses and people who don't receive health benefits from their jobs will get federal tax credits. Medicaid will also add 11 million poor people and states are expected to contract with private health insurance companies to cover them.

Huffington Post expands on this post.  It’s worth reading….Health Insurance companies, like the American Medical Association and others did the ‘FLIP-FLOP’ at the last minute, they saw where your money is going….

                                      

 

Technorati Tags: health reform law,mergers,aetna,coventry health,obamacare,ppaca,medicare budget,medicaid

Sunday Morning Brunch Topic, Is PPACA’s Demise Pending?

 

Another Elephant in The Room……summer edition.

President Obama’s dream team’s health reform law may becoming unhinged as more people read the law (thank you, Nancy Pelosi) If you have a week of spare time, you can read it also.

It shouldn’t take a panel of experts, such as healthcare executives, supreme court justices or ordinary citizens to read a document that encompasses their health and lives.

Written in verse similar to a ‘bible’ it states  multiple times that “the Secretary of Health and Human Services shall………”

 

GOP presidential candidate Mitt Romney, running mate Paul Ryan, and other Republicans are stressing $716 billion in cuts to Medicare that are part of President Obama's health care plan.

The $716 billion in cuts are aimed not at Medicare recipients, but at health care providers, such as hospitals and medical device makers; they also target what the administration calls waste and inefficiency in Medicare. 

Meanwhile, speaking in Florida -- where the Medicare issue is particularly resonant -- Ryan told a group of senior citizens that Obama's plan "raids $716 billion from the Medicare program to pay for the Obama care program."

Ryan said the cuts are hurting nursing homes and Medicare Advantage insurance plans, and that "Medicare should not be used as a piggy bank for Obama care."

Ryan’ plan includes a voucher system for private care, the details of which were not explained, although it has been claimed it would increase the cost of care by $6400/Medicare recipient.

Obama’s plan calls for reducing payments to nursing homes and providers amount to $ 716 billion over ten years.  Obama claims that Romney’s plan would shorten the life of Medicare by ten years and end Medicare as we know it, because of the voucher system Romney and Ryan propose.

While there is some substance to these arguments and which deserve an open, transparent and public debate, it skirts the real issues of why Obamacare is poorly constructed.

The public debate has been superficial and couched not only in political terms, but fundamental issues of the form of government our Republic proposes to represent.

 

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No Hospital Left Behind !

 

Is health care going to follow along the failed path of Education in the United States?

More than 2,000 hospitals — including some nationally recognized ones — will be penalized by the government starting in October because many of their patients are readmitted soon after discharge, new records show.

Together, these hospitals will forfeit about $280 million in Medicare funds over the next year as the government begins a wide-ranging push to start paying health care providers based on the quality of care they provide. One proposed measure is the rate of readmission.

With nearly one in five Medicare patients returning to the hospital within a month of discharge, the government considers readmissions a prime symptom of an overly expensive and uncoordinated health system.

Nearly 2 million Medicare beneficiaries are readmitted within 30 days of release each year, costing Medicare $17.5 billion in additional hospital bills. The national average readmission rate has remained steady at slightly above 19 percent for several years, even as many hospitals have worked harder to lower theirs.

These results reported by The Happy Hospitalist who also blogs and specializes in 'in patient hospital medicine".The report is in Kaiser Health News.

The penalties, authorized by the 2010 health care law, are part of a multipronged effort by Medicare to use its financial muscle to force improvements in hospital quality. In a few months, hospitals also will be penalized or rewarded based on how well they adhere to basic standards of care and how patients rated their experiences. Overall, Medicare has decided to penalize around two-thirds of the hospitals whose readmission rates it evaluated, the records show.

Kaiser Health News analysis of the records shows.  Hospitals that treat the most low-income patients will be hit particularly hard.

A total of 278 hospitals nationally will lose the maximum amount allowed under the health care law: 1 percent of their base Medicare reimbursements. Several of those are top-ranked institutions, including Hackensack University Medical Center in New Jersey, North Shore University Hospital in Manhasset, N.Y. and Beth Israel Deaconess Medical Center in Boston, a teaching hospital of Harvard Medical School

Most of these teaching hospitals treat  r uninsured patients on Medi-caid programs or other public safety net systems. Outpatient services are often very restricted, or unfunded. The patients have an increased rate of chronic illness which are more advanced in the first place since these patients do not get admitted until their disease is well advanced. Their care must be maximized prior to discharge, since their support  system is fragile or even not existent. This requires longer hospital stays, (which offsets the reduced re- admission rate)

"A lot of places have put in a lot of work and not seen improvement," said Dr. Kenneth Sands, senior vice president for quality at Beth Israel. "It is not completely understood what goes into an institution having a high readmission rate and what goes into improving" it.

Sands noted that Beth Israel, like several other hospitals with high readmission rates, also has unusually low mortality rates for its patients, which he says may reflect that the hospital does a good job at swiftly getting ailing patients back and preventing deaths.

Data for readmission rates are available in PDF or CSV files.

Atul Grover, chief public policy officer for the Association of American Medical Colleges, called Medicare’s new penalties "a total disregard for underserved patients and the hospitals that care for them." Blair Childs, an executive at the Premier healthcare alliance of hospitals, said: "It’s really ironic that you penalize the hospitals that need the funds to manage a particularly difficult population."

Does this sound familiar....??

Perhaps a wiser more prudent decision would be to implement this as a pilot program with regional distribution accordingly.

 

 

 

 

http://feeds.feedburner.com/blogspot/rWIA

A Critical Need. The System needs CPR

 

The passage of the Patient’s Protection and Affordable Act may be a mandate with an empty  promise.  Although it sets forth a detailed plan to build a new health insurance system, it does not address many issues in an orderly fashion. 

In fact the majority of physicians recognize and espouse the observation that the law will make the system worse.  It has been designed for political expediency to deliver visible benefits to expand access to healthcare, remove pre-existing barrier to coverage, and other highly visible benefits that are front-end loaded which will drive up costs, not decrease them.

One system cannot solve the multitude of challenges which are quite diverse between communities such as New York, Chicago, Los Angeles, rural cities such as Indio, California, Desert Hot Springs, California, Atlanta, Georgia or Oglethorpe GA.

A study that is often quoted is the “Dartmouth Study” of utilization and costs of a community such as McAllen Texas and  Portland Maine or Madison, WI or Mason City Iowa.  Statistics do not lie, but can be very deceiving when comparing such radically different demographics and diverse cultures.

Our community in the Inland Empire region of Southern California  combines a multi-cultural population, a high rate of unemployment (one of the highest in the  nation) and uninsured or medi-caid eligibles.  Riverside County and San Bernadino Counties are large, as large as some of the smallest states in the east. The western portions of both counties are metropolitan and the eastern portions rural, much like many states such as Maryland, New York and Georgia. This is not a unique problem in most states.             .

 

sy

 

Technorati Tags: aco,ppaca,health insurance,health train express,ucr,healthreform,medical school,physician shortage

Health Train at the Olympics 2012

 

Most of us have been watching the Olympics from London. It’s amazing  how records keep being broken.  Is it about more information about physiology, nutrition, and hopefully not  ‘doping’.  The medal winners seem to be getting younger and younger. ..why is that ?

As you may  be sitting on your couch or favorite chair some of you my increase your heart rate by that bag of popcorn, chips, cookies and milk, or that fast food brought home on the way from home.

Since studies have shown that 55% of us hold a smartphone in one hand while surfing the TV channels you want to look at all the new health mobile apps for exercise, and monitoring the state of your health and wellness.

Health Care IT: 2012 Olympics Shines Spotlight on Mobile Health and Fitness Apps

By Brian T. Horowitz on 2012-08-02

The Olympics are truly a great motivational event for young and older adults. Physical fitness is encouraged as a social event.

We hope your days are full of feel good summer fun! Those Olympians sure know how to play hard, so as the Olympic Games race full speed ahead, let's capture some of the athletes' positive energy and be inspired to live healthier today. Luckily, over 13,000 compassionate Medical Experts on HealthTap are always there to help you with your health questions, so ask away, and you'll learn ways you can feel better one day at a time. Wishing you all the best for a healthy week!

Here is a great place to begin your quest for “Olympic Gold”’.

Here's what's happening on HealthTap:

YOUR HEALTHSCORE:

 

WELLNESS SERIES- Let’s Get Grilling !

How do you Match Up  for the Gold ? Your Olympic athlete body match

Imagine the rush of an Olympic sprint, high dive, or pole vault: now that's easier than ever with the BBC's "Your Olympic athlete body match" app. Find out if you are built like a Chinese gymnast, an American swimmer, or a Ukrainian lifter. Dream big and be inspired!

Find a Social Media Companion for Wellness

 

Technorati Tags: #hcsm,#health,#wellness,#social,#olympics,#london,#mhealth,#mapp

 

 

Health Train Express is Social Media, is Your Blog?

 

I spoke to soon. Health Train Express will be around for a long time.

The responses to my announcement surprised me. I had many more readers than I had realized.  I guess analytics don’t always work, or I used the wrong ones.

After the announcement I quickly realized that blogs will never be dead. They amount to the  21st century ‘Journal’ for daily thoughts (used to be called a diary).  Perhaps I should rename it  e-Diary

While I enjoy using Google Plus, Twiiter, Facebook, to gesticulate, propose, analyze or ridicule.

Health Train will remain an important piece in my social media project.

I admit it, I failed I could not give up my platform.  There are  too many issues to  write about and a blog is the best for me. 

Physicians must not allow their patient to remain passive and just accept what Government decides to offer them in health. 

Physicians empower your patients. Patients empower your physicians.

What changed my attitude?   Of course, it is Regina Holladay

          

Here is a larger version of The Walking Gallery…deserves a better view.

 

There you have it.  Regina Holladay has been at this for several year . All of the stories are a visual treat and a testimony to patients.  Regina expresses her pain and frustration let hospital systems while her husband suffered with cancer.  Something we all know about and share our concerns with her.  Thank you Regina Holladay

WILL YOU TAKE THE RED PILL, OR THE BLUE PILL ?

MedStarter is an outgrowth of a social network innovation, KickStarter. Kickstarter is another social media approach to funding startups that require small amounts of capital as an investment through donations for worthwhile ideas.

 

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End of An Era

 

As I have read somewhere, ‘Nothing lasts forever’.

And so too are the lights going off here at Health Train Express.

It has been an eight year run with close to 1000 posts.

This will be the last Health Train Express blogpost.  A big thank you to ‘Blogger’ as well, now owned by Google.

In keeping with the trend Digital Health Space will assume the role of The Health Train Express

Health Care is undergoing some radical and important changes, and deservedly so in the 21st Century,  Now that we have survived Y2K (I think that is a pretty safe bet) I have evaluated the blog and what is happening in social media as well.

During the past six months our analytics reveal that my opinions and comments receive a much more global audience using social media, and further analysis also revealed that Google Plus will become my exclusive platform for the forseeable future. Of course nothing on the internet can be set in stone. Social media in medicine and health care has become well established. While Twitter and Facebook offer platforms, the unity of Google, Google Docs, Gmail, YouTube, Google Plus and Video Conferencing will allow me to video broadcast and interview important social media personalities using an integrated platform.

See you on the ‘other side’.

Gary Levin MD

This will allow the use of a central publishing source and eliminate much repetitive work.

Look for my comments, opinions, and diatribes on Google Plus at  +Digital Health Space.  Better yet put +Digital Health Space in one of your favorite circles.

 

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The Costly Consequence of Health Care Reform

 

The Costly Consequences of Health Care Reform (Courtesy of the Budget Committee)

Paul Ryan, Chairman, Committee on the Budget, U.S. House of Representatives

 

Let’s carry that a little bit more, forward, “If you earned a medical degree, or PhD, thank the government.  I remember borrowing and working my way through college and medical school.  The government did not give me loans, the banks did and the government ‘backed them’ since students did not have income or usual credit standing.  For a man who went to Harvard, Obama does not seem to understand very much. Who paid for his education?  Did he make it on his own, does he thank the government for what he has….the best insurance in the nation, a 747 to fly on, limousines, secret service, free room and board.  Barry, give us a break ! You are a liar and a hypocrite.  I don’t expect you to tell us that you lie, liars never do and liars never even know they lie !

Posted April 8, 2010

“I can make a firm pledge.  Under my plan, no family making less than $250,000 a year will see any form of tax increase.  Not your income tax, not your payroll tax, not your capital gains taxes, not any of your taxes,”
President Obama, September 12, 2008

Beginning January 1, 2013, Obama Care imposes a 3.8% Medicare tax on unearned income of “high-income” taxpayers which could apply to proceeds from the sale of single family homes, townhouses, co-ops, condominiums, and even rental income, depending on your individual circumstances and any capital gains tax exclusions. Importantly, the “high income” thresholds are not indexed for inflation so will reach increasing numbers of middle-class taxpayers over time.

In February 2010, 5.02 million homes were sold, according to the National Association of Realtors (NAR). On any given day, the sale of a house, townhome, condominium, co-op, or income from a rental property could slam middle-income families with a new tax they can’t afford.

The new Obama Care tax is the first time the government will apply a 3.8 percent tax on unearned income. This new tax on home sales and unearned income and other Medicare taxes raise taxes more than $210 billion to pay for Obama Care.

The Costly Consequences of Health Care Reform (A legislative Review)

The issues are bi-partisan, Responsibility lies both at the feet of Republicans and Democrats.  Neither side can plead innocence.

 

Technorati Tags: Paul Ryan,Obamacare,healthcare social media,congressional budget

PPACA is Coming Soon To Your Neighborhood

 

“No matter how we reform health care, we will keep this promise to the American people: If you like your doctor, you will be able to keep your doctor, period.”

President Barack Obama,
Speech to the American Medical Association
Chicago, June 15, 2009

In truth, prospects are bleak that you will be able to keep your doctor and even bleaker that there will be enough doctors to meet demand under Obamacare.

Patients and physicians are about to be hit smack in the face by the increased demand for healthcare services that will occur as PPACA becomes effective.  Physicians will no longer to be able to bear the brunt of reductions or new methodology of physician reimbursement.

Studies show that the rate of early physician retirement, or a move to another professional career,  are and will be occurring over the next 15 years. There is also  no way to predict what the effect of PPACA will have on older practicing physicians. Many will chose to leave without their retirement portfolio fully funded.  Rather than risk future losses from their medical business with increased overhead, the burden of IT, malpractice risks, and increased patient volume….many will leave medicine and seek other opportunity.

An Investor’s Business Daily/TIPP survey conducted in September of 2009 found that 45 percent of doctors said they “would consider leaving their practice or taking an early retirement” if the health law stands.

More than 800,000 doctors were practicing in 2006, according to government data. Projecting the poll’s finding onto that population means that 360,000 doctors would consider quitting!

And even without a mass exodus, the Association of American Medical Colleges envisions a shortage of about 160,000 doctors by 2025.

The greatest tragedy of Obamacare may be losing prematurely a generation of the most highly-trained, skilled physicians in history to a health overhaul law that the American people did everything they could to stop.

Physicians say they simply won’t practice under Obamacare rules that strip away much of their autonomy, drown them in bureaucracy, and leave them even more exposed to lawsuits.

Doctors are quietly making their plans now to restructure their practices, retire early, get another job, or otherwise protect themselves from the coming regulatory avalanche and payment cuts. 

ref:  National Review Online 

Another significant change has been the lack of trust in the AMA as witnessed by their flip flop during the debate on PPACA.  At first the AMA was in favor of the measure and then at the last moment was opposed to it as they measure the grassroots reaction to  PPACA.  With 850,000 physicians, only about 150,00 physicians belong to the AMA. 

By their own admission “AMA estimates that 60 percent of membership dues are allocable to lobbying activities of the AMA, and therefore are not deductible for income tax purposes. i.e., they are lobbyists. The question is who are they lobbying for? Physicians, patients, or themselves? Their self-interest is in survival, selling books, marketing insurance products, publishing a journal, and other activities.

The AMA has  radically reduced it’s membership dues to attract new members. Many of the members are students, or resident physicians in training, who received a special rate for membership.

I am an ardent supporter of health care reform, but can’t support PPACA (Obamacare) in it’s present form.  Some are now pronouncing how much easier it would be “just to continue on the present path.

What do you think?

The Olympic Flame Out for the N.H.S.

 

Feeling the Heat ?

   

During the past year or I have been reading about the change being made to the NHS, and the privatization as well as de-constructing it’s bureaucracy to allow more local control and administration..

So what was this opening ceremony about how wonderful the NHS is?  Certainly it did honor the thousands of health care professionals,nurses, and physicians who work in the setting of the NHS.  It also shamefully ignored the international theme of past Olympics and inappropriate for the setting, although it was masterfully done.  I don’t want my humble opinion overshadowing the event itself.   The two most  notable events were James Bond and Queen Elizabeth sky diving to the opening ceremony.  Mr. Bean also added a symphonic note to the ceremonies.  No one can fault the Brits for their ‘dry humor’.  It eclipsed  G.W.H. Bush and his sky-diving antics for several  birthdays.

This may have been staged to honor the NHS workers, but it came across as a politically inspired, and government funded advertisement, for who? Was this a message to the United States for Donald Berwick’s acclaim for socialized medicine?

They have had this system for decades, it’s taken that long to analyze it’s worth, and that long to make a change.  It’s going to take some time to analyze the internal workings of NHS to find out how they use outcome studies, assess quality of care and other metrics. (do they have meaningful use for their electronic health record system?)

  Marilyn Tavenner, MHA, BSN, RN.

Does our current ‘acting head of CMS participate in social media to effect openness and transparency (a ‘buzzword’) for President Obama.  It would be far more effective and efficient to use social media rather than the hierarchy of titles, distant meetings by health consultants and the multiplicity of meetings, mostly held in the Washington, D.C. area at one end of our large country. 

Most physicians can ill afford the time lost to go to a distant meeting, that does not offer CME.  There is no reason whatsoever that HHS cannot schedule meaningful webinars and links to information about the processes.

Technorati Tags: cms shared savings,transparency,cme,nhs,olympics

Digital Health Space

 

      

We have been working on a new entity for about 12 months on Google Plus. Digital Health Space.

Google plus is now a key feature for Google, which is tightly integrated with Gmail, Search, Google Docs,  and many other  features for Google.  Google has become much more than a search engine.  Vic Gundrota, Vice-President responsible for the new Google Plus and Google Hangouts likes to call Google a ‘destination site'”.

Google purchased YouTube a little more than a year ago, and has now tightly integrated it into their overall selection of application.  Many healthcare providers have produced videos of surgeries, educational materials and much more, hosted on YouTube,, and easily accessible from their social media stream on Google Plus.

Google Gmail has added a hangout feature on their email site. It is possible to open a hangout directly from Gmail.   It is also  possible to build several different business pages on Google Plus.  Among our pages are +Digital Health Space, +Health Care Social Media, + G+MD .

Digital Health Space is also developing a weekly Hangout on Air for health professionals.  Watch for further announcements here, on Google + and twitter as well as Facebook.

Technorati Tags: digital health space,G+MD,healthcare social media,sliderocket,Google plus,Google hangout,YouTube,Gmail,Google search,Vic Gundotra