Dr. Thompson's Blog

Dishonesty in Health Care

Almost daily in the news we see accounts of dishonesty in almost every type of health care. Today, there is an editorial in the New York Times about the gouging that occurs in Home Health care. I have seen many examples of this with patients and a family member. One agency in Las Vegas sent a speech therapist to see a relative who had severe dementia. Of course, the bill was charged to Medicare. In the San Francisco Bay area, I had frequent battles with one agency director who became angry that I would not authorize unnecessary vists to neuromuscular patients.

Dishonesty also occurs in the medical profession. Grants are written and the money not used as specified, professors don't declare their connections and payments from drug companies, unnecessary surgeries are performed and on and on. I would like to think that people who work in the health care professions are above this kind of greed and dishonesty. Unfortunately, this is not true. Thus, I think we all have to speak up when we see unethical, greedy individuals.  There are still some wonderful, caring members in the health profession, but the unethical, greedy ones greatly increase the cost of health care and give the profession a very bad name.

Saving Money On Medications

Kirby Horton, the CEO and Founder of Rx Help, kindly sent me a link to an article he wrote about saving money on medicines. The link can  be accessed in his comment to my Blog of 3/14/09. He gave me permission to summarize the main points. These are: 1. Talk to your doctor to see if there is a less expensive form of a drug, a different drug, or samples.

2. Shop around because different pharmacies may charge different prices for the same drug. 

3. Consider buying on-line.

 4. Look for four dollar generics that can be found in some Wal-Mart, Target, and Sam's Club stores.

 5. Be sure you know all the benefits of your insurance.

 6. Look for Patient Assistance Programs. ( I give some in the Blog of March 14th.)

7. Look for assistance for specific conditions. (I list a program for this in the March 14h Blog,)

There is help out there, but you may have to do some research to find it. Good luck!

Concern About Recent Account of Peanut Doses To Treat Allergy

If you have ever seen or had to treat a child or adult having an anaphylactic episode, you would share my concern about the article in the 3-16-09 New York Times. The title of the article is "Doses of Peanuts May help Blunt Allergy." The author is Tara Parker Pope. The article reports on a presentation at the American Academy of Allergy, Asthma, and Immunology. The number of children treated in the study was very small, just 33 kids.  Five stopped after two and one-half years because they could then have peanuts in their diet. (It was not noted that some children outgrow allergies, so the treatment may have  had no effect.) Four children dropped out of the program because they were not able to tolerate the treatment.

I cannot imagine any parent being willing to put an allergic child into such a study. There has to be a better way to treat peanut and other allergies. I was taught by a nationally respected pedatric allergist that with a family history of allergy the introduction of allergic foods should be delayed for as long as possible. My children never had orange juice and neither of them drink it even now. Their father was a severe asthmatic and I did everything I was taught to delay the introduction of eggs, chocolate, fish, nuts, and wheat. My two children were also breast fed which can make a great difference in the onset of allergy unless allergens go through the mother's breast milk. Both of my children have escaped the asthma, hay fever, and eczemthat their father had.  

I think nuts of any kind should be avoided with small children, not only becasue of allergy, but I have had to rescue kids with nuts stuck in their windpipes or tracheas. Popcorn can also be a problem this way, as can raw carrots, chunks of hot dogs, and raw apples.

Helpful Web Sites to get Medical Insurance and Good Care

I receive so many questions about ways to find good health insurance and medical care that I thought I would list some of the best resources I have found. They are also listed in the resource guide in my book, 101 Ways To The Best Medical Care.

I would first look at www.healthcarebluebook.com. The site lists  multiple resources.

To find health insurance, check out www.ehealthinsurance.com and also www.coverageforall.org.

If you need a patient advocate, a good Web site is: www.www.patientadvocate.org. If you have a disability, there is an excellent group at: www.protectionandadvocacy.com. For seniors you can look at www.medicareadvocacy.org

If you need help with paying for prescriptions, check out www.themedicineprogram.com. If you need financial help to pay for treatment, there is a good Web site at: www.patientaccessnetwork.org. Their telephone number is 1-866-316-7261.

If others have good Web sites to suggest, please let me know and I will pass them on.

 

 

Great News! Partial Lifting of Stem Cell Research Ban

If you have ever had to watch a child die from cystic fibrosis, leukemia, Duchenne muscular dystrophy, spinal muscular atrophy or a host of other progressive illnesses, as I have, you would be excited about the new possibilities President Obama has now allowed  by a partial lifting of the stem cell ban. The right-wing religious conservatives who oppose stem cell research have absolutely no idea what devastation the loss of a child can bring.

To oppose the use of human embryos that will be discarded anyway simply makes no sense. We already have hundreds of unwanted, abused, and mistreated children in this country. How can a lawmaker want to bring more children into the world when these kids may have no parents, no home, and no one who loves them. I wish these lawmakers could have seen some of the children I have cared for.

The Dickey-Wicker amendment should be repealed. It prohibits the use of federal funds for research involving the destruction of human embryos when stem cells are extracted.  Scientists should be allowed to do whatever they can to find answers to the many devastating conditions that can occur in children and adults. Watching a beautiful, healthy child suddenly become a paraplegic or quadriplegic takes all the strength, skill, and energy a  parent or doctor can muster. I hope lawmakers will begin to search their souls and allow our scientists to use their brains and training to work some miracles and find some answers to some of these terrible disorders.   

Is All Organic Food Safe?

With all the recent food recalls, many people have been turning to organic food. This is particularly hard now with the loss in money and jobs because organic produce and foods are usually more expensive. I have always assumed like everyone else that organic foods were safer. So when I read in the March 6, 2009 New York Times that the peanut plant,  which was the source of the salmonella outbreak, had federal organic certification, I began to wonder what was going on.

In reading further, I discovered that on March 27, 2008, an inspector gave the plant a Superior rating. The inspector had been paid, the article said by the peanut plant. This makes no sense when later pictures and inspections showed that there were serious public health problems. 3000 products have been recalled because of the salmonella scare, nine people have died, and 700 have become ill.

The government does not have the staff or money to do all the needed inspections, so companies pay private inspectors who may not be able to do a complete inspection or do not have the necessary background in a particular area. There is also no oversight of dietary supplements such as diet pills, herbs, and energy drinks. Last year there were reports of " 9 deaths, 64 life-threatening illnesses, and 234 hospitalizations." So for now, I guess the answer is to be careful about what we buy and eat and stay away from dietary supplements, herbs, and energy drinks.

Physicians Receiving Payments from Drug Companies

Not only are the CEOs of several banks and big corporations in the news almost daily because of their greed and dishonesty, but now there are  articles about physicians, both in private practice and medical schools, who have received very large sums from drug companies. (New York Times-3/4/09).

Harvard Medical School has always been considered one of the top medical schools. Now we are told that several professors have been accused of not reporting 4.2 million dollars in payments from drug companies between 2000 and 2007. I cannot understand why any physician, particularly in such a prestigious medical school, could be so greedy and have such minimal ethics. Receiving a grant to do specific work is different from a physician being given  money for his or her own use probably  to support a specific drug. What could these doctors possibly be thinking? I hope Harvard Medical School and local and state medical boards will look into the money that drug and equipment companies pay doctors. In the past, physicians had wonderful reputations, but these doctors are tarnishing the rest of us with their greed and lack of ethics.

Finding a Good Pediatrician

Almost weekly I receive a phone call or e-mail from a parent or grandparent asking how to find a good pediatrician. This seems to be getting harder and harder. Yes, many pediatricians are fine for treating illnesses, but what about teaching and helping with parenting? Is this not something any of them do these days? When I was in pediatric practice, I felt that was a very important part of what I did.

I have just finished reading an excellent book by Pamela Paul entitled "Parenting, Inc." As I put it down, I wondered how parents survive these days without large sums for consultants if there are no doctors to help and no extended family or grandparents close by. The author's answer was that parents who can afford it are turning to sleep coaches, nail biting coaches, potty training coaches, breastfeeding coaches, discipline coaches and on and on. Many of these individuals are self-taught, may not have children of their own, or are social workers.

I had a parent coach visit me one time and she said that two members of her class were pediatricians. They said they had not learned any well baby care in their medical school or residency training. I  have been told that in the three medical schools with which I am familiar,  no  practical pediatrics is taught, just training is given in treating diseases.

To find a good pediatrician, I would look for someone who has been in practice for a while and  has children. I would do lots of networking with other mothers, talk to nurses at the local hospital and then make an appointment with the pediatrician to find out if he or she sees all the patients, will respond to emergency calls, does not prescribe antibiotics over the telephone and does more than just care of sick children. Of course, you want to be sure the doctor is board-qualified or board-certified. Good luck!

Checking The Credentials of Medical Personnel

I am always amazed when people tell me that they are unhappy about medical care they have received and yet they have not checked the person's credentials. This is even more important if you are enrolled in an HMO and assigned to a specific doctor or therapist.

To check a physician's credentials you can go to the state medical board. If there is no listing for the physician, then I would call the board and ask for the information. Just because a physician has a wonderful personality does not mean that he or she is a good physician. Many people get along on their charm, not their knowledge or skill.

Remember that in many offices there are individuals who have on-the-job training, but have had no formal medical training. This is also true of therapy offices where there can be both licensed,  well trained physical therapists and also aides and technicians. I would want to be sure that anyone who is giving me physical therapy treatments has RPT after his or her name. This means the individual has had the required physical therapy training and passed the necessary examinations.

Remember in offices such as opthalmologists, (eye doctors), there are often untrained individuals who do the testing for glasses and then the doctor just signs the prescription. I think this is unethical, but it occurs very often. It has happened to me and I finally had to fly 600 miles to see my  previous eye doctor to get a correct Rx. He was appalled at the previous Rx  I had been given. It is your health and no one but you is responsible for checking out every single medical individual who treats you or your children.