Patients and providers sometimes exhaust proven treatments for chronic disease and cancer treatments. The Food and Drug Administration approves drugs for human use only after the drug has passed a clinical trial.
Sunday, May 29, 2022
Wednesday, May 25, 2022
Gov. Newsom signs landmark MICRA modernization bill into law
Gov. Newsom today signed AB 35 into law, and in doing so put an end to a decades long political battle and ushered in a new era of stability around malpractice liability.
Since California’s landmark medical malpractice reforms – the Medical Injury Compensation Reform Act (MICRA) – were enacted almost 50 years ago, they have successfully struck a balance between compensatory justice for injured patients while maintaining an overall health care system that is accessible and affordable for Californians.
Since that time, California’s physician and provider communities have repeatedly defended MICRA through expensive battles at the ballot, in the courtroom and in the legislature.
This year, we were again facing another costly initiative battle. The so-called Fairness for Injured Patients Act, which had qualified for the November 2022 ballot, would have obliterated existing safeguards for out-of-control medical lawsuits and would have resulted in skyrocketing health care costs. This act demanded that patients who are injured have the right to seek compensation from alleged providers who 'injured' them. The original MICRA act of thee1970s limited compensation to $250,000.
But for the first time in a generation, we were met with an opportunity to achieve a meaningful consensus between competing interests through a revised framework that could protect both the rights of injured patients while keeping MICRA’s essential guardrails solidly in place for patients and providers alike.
“With today’s signing of AB 35, we have achieved what few thought was possible,” said California Medical Association President Robert E. Wailes, M.D
AB 35 passed through the California Legislature with nearly unanimous support, demonstrating broad bipartisan support. As part of the landmark agreement reflected in AB 35, proponents of the Fairness for Injured Patients Act have withdrawn the initiative. The initiative cannot be returned to the November 2022 ballot.
California’s new modernized MICRA statutes will provide predictability and affordability of medical liability insurance rates for decades to come, while protecting existing safeguards against skyrocketing health care costs. It will also bring greater accountability, patient safety and trust by making it possible for physicians and patients to have a full and open conversation after an unforeseen outcome.
Under the modernized MICRA law reflected in AB 35, which will go into effect on January 1, 2023, the underlying principles of MICRA were preserved – ensuring access to care and protecting our health care delivery system from runaway costs. Important guardrails of MICRA will continue unchanged, including advance notice of a claim, the one-year statute of limitations to file a case, the option of binding arbitration, early offer of proof for making punitive damage allegations and allowing other sources of compensation to be considered in award determinations. Furthermore, a new provision has been added to the law that protects expression of sympathy by a health care provider to an injured patient and their family, allowing physicians to express empathy, benevolence and even statements of fault after an unforeseen outcome without fear that such statements or gestures will be used against them.
The element that has garnered the most interest surrounds changes to the limit on non-economic damages in medical malpractice cases, which has been $250k since 1975. As opposed to the ballot measure, which would have effectively eliminated the cap on non-economic damages entirely, under the agreement:
Cases not involving a patient death will have a limit of $350k on the effective date of January 1, 2023, with an incremental increase over the next 10 years to $750k and a 2.0% annual inflationary adjustment thereafter.
Cases involving a patient death will have a limit of $500k on the effective date of January 1, 2023, with an incremental increase over the next 10 years to $1 million and a 2.0% annual inflationary adjustment thereafter.
Other critical MICRA guardrails that will remain in place with modest updates include the ability to pay awards of future damages over time and limits on plaintiff's attorney's contingency fees. CMA has prepared a publicly available fact sheet that provides additional details on this important legislation.
“CMA is proud to have been part of this landmark achievement for the benefit of all Californians,” said Dr. Wailes. “We look forward to a new era of long-term stability around MICRA that will allow California’s physician and provider communities to focus on other ways to improve access to care and public health for all Californians.
Sunday, May 1, 2022
Digital Health News - Digital Salutem
Digital Health came upon the scene in 2005, with a nationwide effort to transform health care with digital transformation. Anyone practicing medicine would not recognize how healthcare would transform between 20012 and today, 2022.
Scientific peer reviewed journals in medicine have a plethora of articles documenting the efficacy and efficiency for better cost effective medicine and evidence based information to sustain it's utility and further development, and proof of ROI.
In 2020 as the COVID 19 pandemic exploded across the globe digital health allowed for our health system to not implode, even when stretched to overcapacity.
Computing power allowed for data analytics, tracking and reporting of the pandemic.
The World Health Organization and Johns Hopkins University produced daily maps and statistics individualized to state, and nationality of the pandemic as it progressed. These were available on the internet in real time.
Daily Moving Average (in real time)
3 new trends in eHealth
Here are 3 recent innovations or trends in eHealth:
Virtual clinics: Virtual clinics let you see an expert doctor remotely at home on your computer instead of having to travel outside your home (or waiting in line). The idea behind this type of solution is that doctors can make appointments from anywhere in the world instead of having doctors based around your area (which means you can get more high quality health care). This is great for consumers because it allows them to see specialists or other specialists outside their area (for example as part of an emergency room) but less so for patients because remote care requires trained staff who are highly specialized and often expensive to get hold of.
Remote Clinical Care: A lot of people simply do not want or need access to an actual doctor when they need help with their health issues, especially if they live far away from an actual hospital (which is why there are so many virtual clinics available). But if we combine remote clinical care with virtual clinics then you can get high quality accurate care anywhere any time, be it at home or online, without needing access to an actual doctor at all! This allows patients who might not feel comfortable calling out sick or going into hospitals on their own but still need help with something like diabetes or heart disease can go online and see someone who has experience treating those issues remotely rather than having them deal directly with doctors at hospitals near them.
Virtual medical centers: are used to provide services easier and more cost-effectively when you call. A virtual clinic is a planned contact by the Healthcare Professional Responsible for Care with a patient for the purposes of clinical consultation, advice and treatment planning. It has been found to increase patient access to healthcare services, enhance health outcomes, improve patient experience and make optimal use of scarce medical resources.
Digital Health has made possible Precision Medicine whereby treatments can be specifically tailored to individual patients.
The University of California San Diego (as well as many others) has developed a Digital Health Lab, founded by Professor Edward J. Wang as a joint research laboratory of UCSD Design Lab and the Electrical & Computer Engineering department of Jacobs School of Engineering.
Saturday, February 19, 2022
Perspectives from the Frontline of the Fight for Public Health: A Live Q...
Leana Wen likes to say: “Public health saved your life today. You just don’t know it.” Join the conversation as she describes her experience on the frontlines of this critical—and often invisible—field.
Tuesday, February 15, 2022
FAKE NEWS ? Psilocybin treatment for major depression effective for up to a year for most patients - ScienceBlog.com
DISCLAIMER:
This information is neither a recommendation nor advice for treatment. The reader is cautioned to consult with their personal physician prior to using psilocybin for the treatment of any medical or psychiatric condition.
For readers who wish to dive deeper into the subject, read this
Psilocybin is not an FDA approved drug
Previous studies by Johns Hopkins Medicine researchers showed that psychedelic treatment with psilocybin relieved major depressive disorder symptoms in adults for up to a month. Now, in a follow-up study of those participants, the researchers report that the substantial antidepressant effects of psilocybin-assisted therapy, given with supportive psychotherapy, may last at least a year for some patients.
A compound found in so-called magic mushrooms, psilocybin produces visual and auditory hallucinations and profound changes in consciousness over a few hours after ingestion. In 2016, Johns Hopkins Medicine researchers first reported that treatment with psilocybin under psychologically supported conditions significantly relieved existential anxiety and depression in people with a life-threatening cancer diagnosis.A report on the new study was published on Feb. 15, 2022 in the Journal of Psychopharmacology.
The study was done under carefully controlled scientific studies by professional monitors who sat side-by-side with the patient.
Magic Mushrooms have been used for many decades by drug users. It is a powerful psychedelic drug produced by many different fungi, and ingested orally. Like LSD it has been proposed for treatment (Timothy Leary). Leary earned a PhD at U.C. Berkeley and was a psychologist at Harvard University and famous for a speech given "Turn up, turn in, and turn out ".
John Lennon and Yoko Ono were patrons of Leary, Lennon composed the song "Come Together" after meeting Leary.
L-R John Lennon, Timothy Leary, Yoko Ono
Johns Hopkins is one of the sites of a national multisite randomized, placebo-controlled trial of psilocybin for major depressive disorder.
The study was supported by philanthropic donors The Steven and Alexandra Cohen Foundation, Tim Ferriss, Matt Mullenweg, Craig Nerenberg, Blake Mycoskie, and Dave Morin; as well as by grants from the Riverstyx Foundation and the National Institute on Drug Abuse (T32DA007209, R01DA003889, K23DA035915).
Thursday, February 10, 2022
It isn't easy being green
"It isn't easy being green." Kermit, the frog
Why are some potato chips green? are some potato chips green?
This is how poisonous green crisps are - and why you still find them in your packetFew people will happily eat the green crisp - but here's the amount you'd have to eat to get ill, and what causes them.
Why are some potato chips green? — Tasting Table
Wednesday, February 9, 2022
Sunlight: Optimize Health and Immunity (Light Therapy and Melatonin)
Melatonin acts in many ways to maintain your health. Most of you use it to help fall asleep, however, it has many important other functions to maintain good health. Melatonin is produced in the pineal gland. There are receptors (ipRGCs) in the eye, intrinsically photosensitive retinal ganglion cells that are sensitive to infrared radiation. These retinal photoreceptors (nonvisual) send signals to the pineal gland which suppresses melatonin release.
There is another source for melatonin production, mitochondrion. Melatonin is produced as part of the mitochondrial oxidative chemistry. Melatonin serves to ' cool down' mitochondrial overheating. This pathway for NIR penetrates the skin and enters mitochondria stimulating melatonin release. Thus there are two separate paths for melatonin, 1.pineal gland 2. intracellular mitochondria.
Sunlight: Optimize Health and Immunity (Light Therapy and Melatonin)
Melatonin and the circadian rhythm play a pivotal role in rest, good health, and eliminating oxidative stress. The video by Medcram (Robert Seheult, M.D., UC Riverside School of Medicine
https://doi.org/10.32794/mr11250016
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