Primary care doctors are staying out of the fight against opioids

During the past six months public health officials have labelled the overuse of opiod pain killers and opiod dependence (addiction)  It amounts to a larger problem than diabetes mellitus. It may very well be the greatest Population Management challenge.

Paradoxically opioid abuse has worsened since many state medical licensing boards now issue CME requirements for physicians to obtain CME regarding opioid prescription for re-licensure.  Is this a statistical oddity ?  Several years ago a rating scale from 1-10 was recommended to quantify patient  pain.  How bad is your pain?  It is mostly a subjetive statement b a patient. A 10 is the worst pain you have ever experienced, affecting thought or movement This measures intensity but ignores duration of pain which can be as important as the level of pain.

The scarcity of doctors trained to deal with addiction is acute, and the issue resonates in cities and towns across the country, where roughly 20,000 people die annually from opioid-related overdoses. In the face of one of the country’s most pressing and fastest-growing public health crises, few primary care doctors treat substance abuse disorders, even though they are uniquely positioned to recognize problems and help patients before it’s too late.

Instead, many primary care doctors follow an old script: Refer patients to addiction centers and Narcotics Anonymous, and move on.

The scarcity of doctors trained to deal with addiction may be particularly acute in Española, but the issue resonates in cities and towns across the country, where roughly 20,000 people die annually from opioid-related overdoses. In the face of one of the country’s most pressing and fastest-growing public health crises, few primary care doctors treat substance abuse disorders, even though they are uniquely positioned to recognize problems and help patients before it’s too late.

Instead, many primary care doctors follow an old script: Refer patients to addiction centers and Narcotics Anonymous, and move on.

“We’re just watching the ship sink, even though we have the pumps to easily keep the water out,” said Dr. R. Corey Waller, an addiction-treatment specialist who leads the advocacy division of the American Society of Addiction Medicine, or ASAM.

FACT SHEET: Obama Administration Announces Public and Private Sector Efforts to Address Prescription Drug Abuse and Heroin Use

Primary care doctors are staying out of the fight against opioids

(28) National Eye Health Education Program (NEHEP)

Join us and learn more about diabetic eye disease.  Health Train Express is pleased to be a sponsor as well as a proponent of managing diabetic eye disease.

The progress in treatment of early diabetic retinopathy has  improved immeasurably.

A key component for diabetics is to monitor your blood sugars.  An annual eye examination or an annual fundus  photo of the retina  will often find undiagnosed diabetic retinopathy.  This can be accomplished by your regular vision provider, optometrist or ophthalmologist. An annual fundus screening using photography provides an excellent means for screening and it provides a permanent record for comparison from year to year. Often the earliest changes from diabetic retinopathy are not symptomatic. Diabetics who experience blurring of vision may have the earliest form of macular edema.  Any diabetic who has vision problems or changes in vision should be examined immediately.

The treatment of late diabetic retinopathy (proliferative) has evolved from laser photocoagulatioin to medical drug therapy using intraocular inhibitors of new vessel growth (Avastin).  This new treatment minimizes retinal damage and often restores lost vision.

The NEHEP provides an excellent presentation, which was featured on 'Facetime'. In this video Dr Emily Chu a prominent eye research scientist at the National Eye Institute..

The progress has been amazing.  When I began my ophthalmology practice in 1975 most patients with proliferative diabetes were blind within five years.  It was very disheartening.

Today there is no reasnn why anyone with diabetes should go blind from diabetes.

Sam Omar,,M.D. a fellow ophthalmologist has this to say,

" During my training at UCLA in 1997 I was speaking to one of my mentors Dr Straatsma. I was particularly excited one day because I had assisted the retina fellow in repairing a detachment for a patient. My mentor had told me when he was in training in the late sixties he had attempted to surgical reattachment repair for a detached retina and was unsuccessful in three out of three patients. Those patients all went on to becoming permanently blind. Fast forward - 2015 the technology has improved so much in my short life span of Ophthalmology over the past 20 years. The first picture shows a retina specifically the central retina detached with fluid floating underneath it that's the black in the lower part of the picture. The next picture shows the retina completely reattached so perfectly that the organization of the photoreceptors and the retinal pigment epithelial cells is entirely intact. There is normal organization of the retinal layers and the retina is set up perfectly to heal and function properly. This repair was done by a particularly skillful surgeon. Technology is everywhere and I even used it to dictate this Facebook post with no mistakes in all of the above technical terms."








(28) National Eye Health Education Program (NEHEP)

Lessons I’ve Learned from Patricia Bath, MD F.A.A.O.

The title seems ordinary enough, but hidden in it's meaning is the life of the first woman ophthalmologist of color.  One who broke through  'the glass ceiling' as early as 1974.

For those who speak of breaking through a glass ceiling for women.....you are a bit late !  Medicine however offers an undeniable metric for advancement, achievement and dedication. In other disciplines such as business financial measures, leadership ability or political persuasion are more amorphous measures for a 'glass ceiling.

Patricia Bath's career path runs very similar to Ben Carson, MD (former Presidential candidate for President of the United States. She was born in poverty, and went to what some would call a second rate School of Medicine.  That was the last step in 'second rate' institutions. From there she was accepted to a major world class ophthalmology training program, eventually earning faculty status.



For me as the average white male  American I don't think I can fully appreciate her journey. With all the   privilege of being white I still had challenges pursuing my education. The competition to become accepted to medical school is extremely high,  the competition to be accepted into an ophthalmology training program is even more intense, and becoming the chair of an ophthalmology training program one of those 'never events' we speak of in complications of surgery.

The graphic below  succinctly maps her progress to recognition

The Career path of Patricia Bath M.D. F.A.A.O.



Her inspirational thoughts will fuel the desire of many more women and men of color.

When she chould not  penetrate an impregnable barrier, she went around it,  preferring to not waste energy  and to pursue her own interest.  All of which is evident from her outcome.

My favorite motivational saying is "Believe in one-self"  Ask  few for opinions (be sure who you ask in t he first place.  Don't listen to negative answers.  Remain committed to your goals. Find people who believe in  you and will assist you, or at least not stand in your way.

I salute all the 'suffragettes who strive to improve humanity with their standards, goals.

This post gave me great pleasure, one of the most enjoyable as well as satisfying, to recognize a great physician (ophthalmologist)  I have written (in my humble opinion)

Gary M. Levin M.D. F.A.A.O.





more.......





Lessons I’ve Learned

How Government Solved the Health Care Crisis - Animation

The Lodge and Fraternal Society Model for Health Care was the forebearer of our present dilemna, of inadequate access to health care.  Those who do not know history are doomed to repeat it.

Government solved the last crisis !

How Government Solved the Health Care Crisis

Family Practitioner Awarded Family Physician of the Year

Family medicine has always been at the heart of medicine. If you ask a patient they willl usually say 'Our family doctor is .....  It bespeaks much of the complexity of credentials, board certification and the rest of it. Most patients are not that aware of what all those diplomas are on the wall. And with  the general training all young physicians obtain, and are licensed as MDs in all states, not as a specialist most MDs are capable of handling routine complaints and treat simple disorders. If they can't then they should not be practicing medicine (in my opinion)

My perspective may be a bit skewed by the fact that I did general medicine after internship in t he Navy and practiced family medicine for three years afterward.  When I had a major heart surgery, I relinquished my scalpel for several years, returning to family medicine with a colleage who  used to refer to me.

This announcement caught my eye and is well worth recognition.
******************************************************************************************************


At just 11 years old, Karen Smith, M.D., went on the trip of a lifetime.

Smith's mother wanted to visit Walt Disney World with her children. In 1972, the family made the trip to Orlando, Fla., and it's where a young Smith learned the power of imagination, belief and creativity. Walt Disney's famous saying, "If you can dream it, you can do it," resonated with her.

Smith's mother died from sarcoidosis not long after the trip, but the memories they created inspired her daughter to pursue a career of medical service.

"It's amazing what a mother can instill in her children," Smith told AAFP News. "Those memories are in us, and those memories are what have allowed me to do what I've done … with the grace of God."

For her efforts, Smith has been named the Academy's 2017 Family Physician of the Year. The award recognizes a family physician who stands out among his or her colleagues for providing compassionate and comprehensive care, enhancing the quality of the community, and acting as a credible role model. Today, 43 years after her first trip to Orlando, Smith has returned to the city to accept this award during the AAFP Family Medicine Experience.

Another example of the unsung, underpaid, overwhelmed primary care internists, pediatricians and family medicine physicians...In today's world primary care providers take a residency as long as most other specialtlies.  

STORY HIGHLIGHTS

• Karen Smith, M.D., of Raeford, N.C., has been named the 2017 Family Physician of the Year.
• The award recognizes a family physician who stands out among his or her colleagues for providing compassionate and comprehensive care, enhancing the quality of the community, and acting as a credible role model. 
• After more than two decades in rural practice, Smith says she still is driven by the power of touch -- physical, emotional and spiritual.

Compassion, Imagination and Belief Inspired 2017 FPOY

How those pharmacy coupons may increase your health care costs

How drug coupons 'undermine' payers' efforts to limit healthcare costs

Consumer drug vouchers for pricey pharmaceuticals--like Mylan’s EpiPen--may lead to market failures that dissolve the incentive for powerful pharmaceutical firms to reduce prescription drug prices, hurting payers' cost-control efforts.

Here are five ways, according to a article published in the Annals of Internal Medicine, that vouchers to help offset the cost of drugs like EpiPens interrupts the proper functioning of the market--and subsequently contributes to higher future healthcare costs:

• Co-pay assistance placates “public outcry.” Public pressure, such as articles about the high cost of EpiPens, seemed to be correlated with a “reduction in the magnitude” of price hikes by Mylan, the authors note. Appeasing consumer anger can circumvent such processes, and therefore lessen pressure on companies like Mylan to reduce prices.  
• The vouchers subvert insurers' strategies to limit healthcare utilization for low-premium, high-deductible enrollees. Low-premium, high out-of-pocket expense health insurance plans shift the burden of healthcare utilization onto consumers, nudging them to use fewer healthcare services--which lower total healthcare expenditures. The co-pay assistance programs “undermine” this effort, pressuring insurers to increase premiums across the board, the authors say.
• They create an artificial price distortion. High prices are supposed to encourage consumer shrewdness in the marketplace, according to the authors, which theoretically should “include scrutiny” of product price and quality. The researchers thus conclude copay coupons “keep patients from acting as consumers,” reducing the incentive for consumers to factor price into their decisions and further decreasing the incentive for pharmaceutical firms to lower their prices.
• The tactic handcuffs insurers’ leverage during negotiation with drug companies. Insurers that reach price concession agreements with drug producers reflect this in their formulary tiers with lower out-of-pocket costs--and vice versa for manufacturers that insist on high prices. Pharmaceutical companies like Mylan, which offered patients $300 coupons, are able to sidestep this mechanism by keeping out-of-pocket expenses lower for consumers when insurers aim to keep them high.
• Co-pay assistance programs don’t live up to their promises.Pharmaceutical companies don’t provide financial assistance to all filled prescriptions, only for patients who haven’t hit their deductible to have their insurer prescription benefit kick in. Insurers can’t ascertain payments made by patients versus those covered by the co-pay coupons, ultimately helping patients hit out-of-pocket maximums quicker. For specialty drugs that can cost up to $10,000 per month, insurers can be left to foot the bill much earlier in the year.

Medicare Part D spending on EpiPens grew more than 1,150 percent over a seven-year period from 2007 to 2014 while the number of beneficiaries receiving the treatment increased a disproportionate 164 percent. The ensuing public frustration resulted in CEO Heather Bresch to testifying at a Senate hearing to defend the 400 to 500 percent price hikes.

Most health cost containment programs just shift the burden or cost to another segment of the health industry.  There is one big pot, which we must all share. And the partcipants do not play fair.

Thanks to Fierce Health Care Payer for most of this article.

Anthem, Cigna Have Accused Each Other of Merger Breach - WSJ

The ink has barely made it to the paper, and Anthem and Cigna have gotten cold feet regarding their proposed merger.

The blowback from the public and the DOJ, FTC are working, even without a formal filing or restraining order. In order to save face....blame each other. It's a no lose situation for counsel for either company.  What the heck, those guys are on multi-mllion dollar retainers either way...A nice cash flow for the junior non  partner attorneys for the big law firms in the health and insurance niche.  They most likely reasoned it would cost more money to litigate than to simply carry on as they are now. (that is how obscene the amount of money is at stake and how much money these companies have under their mattresses. How long is the American public going to put up with these rules that bankers and insurance companies write for themselves ? Are we a ship of fools ? Yes

Sometimes it makes me wish I had gone to law school...no HMOs no ObamaCare, no EMRs Meaningful use, MACRA, MIPS, Accountable Care Organization, getting paid for volume, not outcomes....etc. Now that I am retired (I am young only 73 and my life expectancy is still pretty good according to the latest stats. I could retrain here at my local Western law school and make some really big bucks !

Doctors don't seem to have time anymore for Wednesday (or is it Thursday) afternoon golf..but since I am retired I do. Even though I don't play golf I am willing to give up my afternoon nap time to study for my new profession.

Anthem, Cigna Have Accused Each Other of Merger Breach - WSJ

The Top Gun of Health Train Express Blogs for 2016 (so far)

Our readership fluctuates quite a bit, averaging a paltry 200-300 users/day. Most of the readership is from the U.S. and the U.K.

This year we had several posts that went well above 1000 readers/day.  Like most internet publications readership depends heavily upon Google searchs.  Readership continues for days, weeks months and even years.  We network our contributions on facebook, twitter Newsana, Digg, Redditr and a list of email subscribers. We have an RSS  feed as well.

Top Gun Posts:

11 TOP PATIENT QUESTIONS ABOUT TELEHEALTH Affordable Care Act causing more mega=-mergers Sleep is not an Option Revised Food and Drug Labels New Hope for Stroke Patients The Senior Learning Network The Five Percent in Health Curing Cancer MentalHealth, Behavioral Health, and Neuroscience. Patients Cannot Always Access Complete Medical Records There were many others receiving between 750 and 950 readers/day.  Our readership continues to grow consistently...thanks for  your interest.

Mark Zuckerberg, Priscilla Chan unveil $3 billion effort to cure disease

Mark Zuckerberg and spouse have joined the list of other philanthropists such as William and Melinda Gates,  Paul Allen, Sean Parker, Mayor Michael Bloomberg, and the Koch brothers are donating billions of dollars to many scientific and health related research efforts.

Sean Parker, the cofounder of Napster, has committed $250 million to develop new cancer treatments. Former New York City Mayor Michael Bloomberg is leading a coalition of philanthropists putting up $100 million for a separate cancer initiative. And philanthropist and entrepreneur Paul Allen committed $100 million in March to an initiative that backs risky, cutting-edge science that more conventional funders might avoid.

Paul Allen created the Paul G. Allen Family Foundation  launched in 2010, funds scientists who take “out-of-the-box approaches at the very edges of knowledge,” as Allen put it. The program’s 2015 awards for Alzheimer’s research, for instance, largely passed over scientists who focus on the leading (and, so far, leading-to-nothing-useful-to-patients) hypothesis that the disease can be treated by eliminating amyloid plaques.

Billionaire businessmen Charles and David Koch have also given tens of millions to cancer research.

And Bill Gates funds public health projects around the world, including malaria and polio prevention efforts, through his charitable foundation.

Mark Zuckerberg, Priscilla Chan unveil $3 billion effort to cure disease

UnitedHealth survey: More shop around for healthcare, but insurance literacy falls short

While more American consumers are taking advantage of tech tools to comparison shop for healthcare, they still lack basic knowledge about health insurance and dread selecting a health benefits plan.

This one of the major failures of the American Health System.  Interestingly it is also a major failure in the American Tax System.  Two items so important to every citizen cause great angst and frustration for all.

A new survey from UnitedHealth details those and other findings, offering both positive signs for consumer engagement and areas that suggest health insurers have more work to do as they look to improve their members' experience.

Indeed, “this survey underscores why UnitedHealthcare is working to simplify the healthcare experience for people and help them take full advantage of their healthcare benefits,” Rebecca Madsen, UnitedHealthcare chief consumer officer, said in an announcement.

Here’s a look at some of the survey’s key findings:

Highlights:

• Nearly a third of respondents have used the internet or mobile apps during the last year to compare the cost of medical services, which is more than double the rate in 2012. The uptick was most significant among young people.
• Among all comparison shoppers, 81 percent described the process of using online or mobile resources as “very” or “somewhat” helpful.
• Fifty-six percent of survey respondents who are employed full time said they would be interested in using a wearable fitness tracker as part of a workplace wellness program.
• Thirty-seven percent of respondents said they were “very" or “somewhat" likely to use telemedicine to access healthcare services.
• 
  

Lowlights:

• Only 7 percent of respondents could successfully define all four basic health insurance concepts: plan premium, deductible, co-insurance and out-of-pocket maximum. Consumers had the most trouble defining co-insurance and out-of-pocket maximum.
• Many survey respondents underestimated the actual cost of specific healthcare services. For a knee replacement procedure, for example, 63 percent estimated the cost to be lower than the national average of $35,000, and only 11 percent answered correctly.
• The task of selecting a health plan is not one that consumers relish, as 25 percent would rather file their annual income taxes. And 28 percent said having to review their health benefits during open enrollment would be worse than the hassle of losing their mobile phone.
• 
  

In addition, despite the increased uptake of tech tools by consumers, 78 percent of respondents preferred speaking with a customer service representative to resolve an issue or ask a question--the clear winner over email, online chat or mobile app. When customers do speak to a representative, 30 percent ranked the person’s knowledge as the most important factor of the experience.

The system must be deconstructed to one in which the number of choices is much less, more intuitive and less subject to making critical errors in selecting coverage.

Fierce HealthCare

Forbes column: CBO Blesses Violation of Separation of Powers - gmlevinmd@gmail.com - Gmail

Forbes column: CBO Blesses Violation of Separation of Powers - gmlevinmd@gmail.com - Gmail

'Micro-hospitals' offer alternative to urgent care model | FierceHealthcare

A revolution is taking place in the delivery of health care

Bedless hospitals. 

Consumers like the convenience and accessibility of urgent care clinics. But hospitals may have found another model that better meets the needs of patients: the “micro-hospital.”

While the state of Colorado prefers to call them "community hospitals," these licensed facilities offer emergency medical care, inpatient care, surgery, laboratory and radiology services, Michael Slubowski, president of CEO of SCL Health told Hospital & Health Networks. SCL, which is based in Denver, plans to open four locations in neighborhood settings with it's partner Emerus. The facilities are priced higher than urgent care centers, but less than a full-service hospital, and can treat a wider range of conditions because they have inpatient beds, he said. 

Most micro-hospitals operate 24 hours a day, seven days a week and usually have eight to 10 inpatient  beds for observation and short-stays, according to the Advisory Board. "No two micro-hospitals are exactly the same in their design or service mix, but one trend is becoming clear. Most health systems are using them as entry points into markets where demand would not be able to support a full-scale hospital," the Advisory Board noted in a recent report. 

"Micro-hospitals like this are more suited for large urban and suburban metro areas," he told the publication. "This model would probably be too large and complex for a rural market. It definitely is a trend, among many trends occurring in healthcare, to create more accessible, cost-effective access points and alternative delivery models." Driving this experiment is the desire to have highly efficient operations and specialized care giving. Industry is finding bigger is not always better and cost containment may more easily be achieved in smaller facilities.

Telehealth

FTC, DOJ back Teladoc in battle with the Texas Medical Board  

Teladoc is getting support from the Federal Trade Commission and the Department of Justice in its lengthy battle with the Texas Medical Board (TMB) over the latter’s face-to-face appointment requirement before a physician can prescribe medications via telemedicine.

Teladoc says that such a requirement limits and hinders use of telemedicine services within the state.

Last December, TMB was denied a motion to dismiss Teladoc’s 2011 antitrust lawsuit--the board then appealed that decision in January.

In an amici curiae brief, filed in the Fifth Circuit Court, the FTC and DOJ call that appeal an attempt to “evade the substance of federal antitrust law," and add that, basically, the court doesn't have jurisdiction over the appeal. 

The brief goes on to say that if the court does feel it has a right to jurisdiction over the appeal, "it should hold that the state action doctrine does not shield the TMB’s rules from federal antitrust scrutiny because the TMB did not carry its burden to show active supervision."

"There is no evidence that any disinterested state official reviewed the TMB rules at issue to determine whether they promote state regulatory policy rather than TMB doctors’ private interests in excluding telehealth--and its lower prices--from the Texas market," the brief says.

In conclusion, DOJ and FTC say that the appeal should be dismissed "for lack of appellate jurisdiction."

The FTC has shown support for telemedicine before, backing a telemedicine provisionpresented in March as part of legislation working its way through the Alaska Senate.

Remote televideo visits and screening

This ability will decrease non compliance for non ambulatory and/or non compliant patients. It provides a means of communication visually, with a nurse practitioner or medical assistant. Some insurance companies already reimburse for diabetic retinopathy screening at home for non compliant patients. The socioeconomic benefit has already been demonstrated. 1


'Micro-hospitals' offer alternative to urgent care model | FierceHealthcare

Help Preserve Our Privacy-Data Selling for Profit Epidemic |

It is your data, but are you sharing the profit ?


Each time I check my mail or bank statement I do not see any deposits coming from my health insurance company or hospital for the moneys they earned from selling my data, anonymized or not. This information is becoming more commonly known.

The larger question is it  still your data if your identifying information has been removed? Apparently so,  as this challenge has been rebuffed by powerful corporate interests. Profiteering from a sick or well person's data is now acceptable business practice.

This story is curated from an article by Barbara Duck in You Caring

The Story

I am an active consumer advocate and write about our data being sold frequently and we don't know to who, what kind of data they sell, and how it will impact us. We need a law to require all who sells data in the US to buy a license and disclose what they sell and to whom. Here's the reason why...(Think Anthem Breach)

This call was different as the caller proceeded to tell me that their records indicate that I am one who takes blood thinners.  They also had my name and address information which they disclosed at the beginning of the call.  So what's the problem here?

I don't take blood thinners, never been prescribed any and have not taken any in my life!  

Where did this information come from?  It was derived by the data sellers on the internet piecing together information they mine and some algorithm determined with making this match that "I take blood thinners"!  This is enough to make anyone mad as hell!  It made me mad as I used to be a data base person that did this kind of work too.  I have a pretty good idea on the data mechanics here.  

Now we hear that the hackers of Anthem came from China, do you want your records sold all over China and the US?  That's why they hacked to get data to sell, period.  Hackers can repackage our data, hide the original formats and bingo they have a money maker.  When this happens and being there's no licensing attached to identify origins, well companies will end up buying stolen data at some point, why we need licensing!!  Here's the rest of what happened to me..

Long and short of this, my data has been sold and I have been repackaged and who knows how many other places have this "flawed data" about me on file?  I'm not one who has ever taken blood thinners and I have no way to fix this.

I have no way to find who did this to get it corrected and remember this is all on my own dime and time too!  The data sellers don't care as flawed data gets the same price as good data, so I'm screwed and can't remove this and I don't know where and when it will appear again and I'm mad.  My hands are completely tied and I can't fix this.  This is why we need an index for this.

I have no way to find who did this to get it corrected and remember this is all on my own dime and time too!  The data sellers don't care as flawed data gets the same price as good data, so I'm screwed and can't remove this and I don't know where and when it will appear again and I'm mad.  My hands are completely tied and I can't fix this.  This is why we need an index for this.

Who in the hell are all these data sellers?  

Now when people do research about me to find what's on the web, I have no clue when this will pop up again and it will at some point, depends how many bought this information about me.  So I go apply for a loan as an example and guess what "I'm a person that takes blood thinners" shows up.  

With all the extensive data searching we do today, this person who could be the one approving the loan will see this!  What could be their next move?  Easy, look and purchase more data about me, like get an actuary report from another data seller that shows the risk of how long they think I will live!!  This happens folks and this an example with me here but it happens.  

So depending on what comes back if my risk of not living long enough has impact, well guess what, I get no loan.

More about other matters:

Here's some additional reference and information with more details about how this works against us with privacy and no transparency....

Did you know you are "secretly" scored? What is a score? Well think back to school if you will and remember how you were graded, and this is happening all the time today, but it's not a test you are taking to get scored, companies and buying and selling your data and you don't even know it. Worse yet, when there are errors, guess what, the score is wrong, but you have no way to even know you have a flawed score out there that people are using to make some kind of decision. 

Did you know that when you call most insurance call centers they are "scoring" your voice?When you hear "this call may be recorded..." what's really occurring is that millions of computer algorithms are listening to you and determining what your current state of mind is. You can read more here about how that occurs and the software used. 

Do you know that health insurers are buying your Visa and Master Card records? They sure are and those too are analyzed and used along with other data they may have on file about you. This is becoming more common practice all the time. They could be doing that, but they have a lot more than just clothes purchases and could be looking at anything including your grocery bill, and so on.  

Do you want your health insurer to know everything you buy and scrutinize it? You can read more here about how that works. 

There really are few ways to track your information once it  goes into a  server either cloud based or in your office. The cost of insuring your privacy is considerable and is another addition to health care costs.

The over-riding weakness of the system is that all of the data resides in one place (or more) It is not compartmentalized and a simple breach can result in massive data exposure.



Help Preserve Our Privacy-Data Selling for Profit Epidemic | Other - YouCaring