Medicine on Call – The Latest –8/30/09

 

The latest episode of “Medicine on Call” is here.  Check out Dr. Elaina George, as she breaks down the healthcare news you need.

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Medicine on Call – Dr. Elaina George Gives Advice

Dr Elaina George gives you the medical advice that other doctors won’t give.  Today she discusses alternative methods to treat chronic pain. The audio is below. 

 

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Julianne Malveaux: Why Black Folks Should Fight for Healthcare Reform

By Julianne Malveaux

Congress seems to be putting the final touches on health care reform legislation, arranging to provide health care, especially, for the uninsured. Anyone who has made the summer rounds of civil rights conventions understand that African American policy makers care about this issue. Still there seems to be no passion in advocacy for heath care reform.

Our presence in this debate is much needed - we have a dog in this fight. African

Americans are more likely than others to be uninsured, so the many ways our new legislation will make insurance available is important. And even when we are insured, the way that health problems hit us are most different. According to the Centers for Disease Control, African Americans and Hispanics "bear a disproportionate burden of disease, injury, and disability." African Americans, in particular, are more likely to be killed or to die of HIV than others are.

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A Doctor’s Take on the Michael Jackson Death

The following is a statement made by Dr. Elaina George, an Otolaryngologist out of Atlanta and advocate for physicians.

‘Michael Jackson did not have a chance’ was my first thought when I read the report that just came out about what caused his untimely and tragic death. I was unprepared for the absolute disregard for the first tenant of the doctors’ Hippocratic Oath – First do no harm.

There was no way that harm would not have come to Mr. Jackson. It was beyond negligent to give him a mixture of three different kinds of sedatives, a muscle relaxant, an antidepressant in addition to Propofol, a general anesthetic that is only used in an operating room setting (because it can stop someone’s breathing). Each of these drugs by themselves can be lethal, but together it is a recipe that will almost definitely kill someone. I can think of no medical scenario that would justify mixing these kinds of drugs. Hopefully, Mr. Jackson’s death will teach us that prescription drugs, though helpful are no substitute for doctors doing everything in their power to protect the health of their patients, including just saying no when it is appropriate.

Anna Nicole and Heath Ledger are two celebrities that died from drug interactions. The death of Michael Jackson and his relationship with Dr. Murray is the most recent example that highlights the danger of the ‘doctor on retainer’. This relationship is based on a contract that makes the doctor an employee, in essence changing a relationship that should be equal, to one where the patient can dictate the course of treatment. This shift in power can potentially blur the lines that must be maintained for a healthy doctor/patient relationship. It then can place a physician in a position where he/she may be prescribing medication in a way that is not clinically appropriate because the patient demands it. This needs to be examined and changed.

As a society we need to take a look at the culture of prescription medication as the cure all. There is a perception that we can treat anything by taking a pill. This concept has been fostered by the pharmaceutical industry and their constant advertising. There are pills to make you happy, perform better sexually, help your memory, make you feel younger etc… In reality all of these medications have one thing in common; they simply manage the symptoms instead of healing the problem. Perhaps the best thing that can come out of the tragedy of Michael Jackson’s death is the examination of our culture of disease. Maybe it will change the paradigm to prevention and to healing disease instead of managing it with an endless list of prescription medications.

MJ’s Doctor Had Serious Financial Woes

AP Photo/Houston Chronicle, Pool Photographer

Hmmm...maybe that's why Dr. Conrad Murray is being so cooperative with the Los Angeles Police Department. And the Las Vegas Police Department. And the Clark County Sheriff's Department. And the Drug Enforcement Administration.

It seems it's not the good doctor's first time at the rodeo.

A check of Michael Jackson's physician's legal past has revealed everything from domestic violence charges (of which he was acquitted) to financial woes (which at one point included a bankruptcy filing) to his latest headache (you know, other than that whole target-of-a-manslaughter-investigation thing), the possibility that his Las Vegas home could soon be foreclosed upon.

Let's hope the feds treaded lightly during yesterday's search. Depreciation can be a real bitch.

Documents filed July 23 with the Clark County Recorder reveal that Murray could face foreclosure on his gated country club estate as soon as November. Though the timing on the filing may seem a bit like kicking Murray when he's down, Jackson's doctor reportedly fell more than $100,000 into debt on the home, with his last payment, of $15,000, being made in January of this year. (Which may be why Murray was so keen to stay in Jackson's good graces and keep the $150,000-a-month salary that came with it.)

As for Murray's less current troubles, here's a rundown of his legal lowlights:

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Did Michael Jackson’s Doctor Give Him a Deadly Injection?

Singer Michael Jackson had lethal levels of the drug propofol in his blood when he died, according to court documents.

A search warrant filed in court showed toxicology reports found propofol in Michael Jackson's body.

Los Angeles' coroner Dr. Lakshmanan Sathyavagiswaran reached that preliminary conclusion after reviewing toxicology results carried out on Jackson's blood, according to an affidavit.

The drug Diprivan, known by its generic name propofol, is administered intravenously in operating rooms as a general anesthetic, the manufacturer AstraZeneca told CNN.

A source close to the investigation told CNN that Dr. Conrad Murray is believed to have administered the drug to Jackson within 24 hours of his death on June 25.

Investigators have searched Murray's home and clinics for evidence related to the anesthetic propofol, according to documents filed in court.

The drug works as a depressant on the central nervous system.

"It works on your brain," said Dr. Zeev Kain, the chair of the anesthesiology department at the University of California --Irvine. "It basically puts the entire brain to sleep."

 

 

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Black News: Are Doctors to Blame for the High Cost of Healthcare?

Dr. Elaina George, a prominent family practice physician in Atlanta, has a bone to pick with President Obama. During various healthcare town hall meetings and press conferences, the president has villified doctors as the cause of the high cost of healthcare. But Dr. George doesn't agree.

As one of the few black doctors in America who is taking the time to speak out in the current healthcare debate, Dr. George says that the culprits in the high cost of healthcare are The American Medical Association, hospitals, big pharmaceutical companies and insurance companies. Here is how she breaks it down.

1) Our country has gotten away from preventing illness and is instead engaged in the high cost of managing disease. Dr. George explains in the interview below that rather than actually curing illnesses or preventing them, we simply try to manage them. Her argument, as with many others in the healthcare profession, is that this attitude is driven by the fact that pharmaceutical and insurance companies only maximize profits when people stay sick. Symptoms tend to be treated instead of the underlying cause of the illness, making problems worse in the long-term.

2) According to some physicians, the public option on healthcare may not be as great as it sounds. When it comes to the public option (which is being heavily debated right now), Dr. George argues that while the option may provide health coverage for many Americans who don't have it, it may not cause insurance companies to pay their fair share of the cost of healthcare reform. "The argument that the public option will drive down costs is disingenuous," says Dr. George. "How can a program designed to cover about 10 million people (as per the Congressional Budget Office) really exert any pressure on the health insurance industry when a company like Blue Cross and Blue Shield has over 30 million members and United Healthcare is even larger?"

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Where is the Healthcare Debate Right Now?

 

by Dr. Elaina George

The debate on healthcare reform is in full swing, but no one is paying attention to the long term effects.

I am for universal healthcare in theory. As a physician, I believe that it is a fundamental right. Unfortunately, the way the debate and pending legislation has been crafted, the outcome will result in unintended consequences.

As a physician in solo practice, I am in a unique position to see the outcome if we continue on the path that Congress is proposing in HR 3200.

1. A single payer system that pays the same rate as Medicare or as the bill stipulates (5% above Medicare) will lead to LESS choice. People are overlooking the fact that most private physicians are currently NOT accepting new Medicare patients because they can’t afford to do so and stay open. There will be no reason for this to change if the reimbursement scale is adopted.

Unintended consequence: The network of private physicians would be smaller and more patients will be placed in a system of fewer physicians, less choice and longer waiting times to be seen. This would have the opposite effect – what is the point of universal healthcare if you don’t have quality physicians to provide it?

2. The proposed healthcare bill sets up a bureaucracy run by a National health insurance commissioner and sets up an insurance “self regulatory agency” – made up of national insurers, national agencies, and insurance producers. There are no physicians or patient advocates.

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Healthcare Reform 101

Walter Gaines Jr., left, who supports health care reform, confronts a man who opposes health care reform in Alhambra, Calif. (AP Photo/Jae C. Hong)

 

Dr Tyeese Gaines Reid – TheGrio.com.

 

With the bombardment of speeches, commentaries and rowdy town forums, many Americans are struggling to decipher the current state of health care reform. Understanding the ins and outs of over 1,600 pages of proposed law is daunting. Unfortunately, there is no politician or any crystal ball that can predict either plan's success at this stage.

To date, two bills have been proposed - the 1,017-page House bill (H.R. 3200) and the 615-page Senate Health Committee bill. A third bipartisan bill is said to be in the works from the Senate Finance Committee. Until September, when Congress reconvenes, we will continue to wait and debate on the limited information we do have.

Here is a summary of those bills, commonly-raised concerns and the debate as it now stands.

1) Problem: The Uninsured
Millions are uninsured and falling ill without insurance can be financially catastrophic. Many of these are working people, or recently unemployed, who can't afford to buy insurance plans. Others are self-employed or small business owners who also can't afford insurance. Some are between the ages of 55 (retirement age) and 65 (Medicare-eligible age), and thus have no coverage. In 2008, the Kaiser Commission reported that 41 million were uninsured, while another 35.8 million people had no insurance during part of the year.

Proposed Solution: "Health care for all." Both bills have outlined strategies to include all Americans in some form of a health insurance plan - whether Medicaid, Medicare, the private or the public/community option.

2) Problem: Pre-existing conditions
People with any history of medical problems ("pre-existing conditions") can be denied coverage by certain insurance plans because their condition makes them too high-risk.

Proposed Solution: Ban the pre-existing condition clause for all health insurance companies, including those in the private option. The hope is that as more young and healthy Americans have insurance and pay their premiums, that money will offset the costs of taking care of the sicker Americans.

3) Problem: The under insured
Some people with health insurance have plans that don't cover all basic health care needs (the "under-insured").

Proposed Solution: All health insurance plans will cover hospitalizations, outpatient hospital and clinic care, physician fees, equipment, prescription drugs, rehabilitation, maternity care, child care, preventive care, mental health, and marriage and family therapy. The addition of coverage for mental health and counseling is an added benefit not often covered currently.

 

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