Dr. Thompson's Blog

Senator Baucus and Senator Snowe Should Be Ashamed!

I was appalled to just read that Senator Max Baucus and Senator Snowe have voted against a public option in the health insurance bill. I know that Senator Baucus has recived over 3.9 million dollars from the health insurance companies. How can the Seantor show his face in public?  If he had seen the poverty and disease that I have seen, along with many other doctors, he could not possibly vote to increase the billions of dollars that the health insurance companies already make.

I spent a week in a rural part of Maine this summer ( Senator Snowe's state) and was amazed at the poverty. Doctors seemed to be few and far apart and one woman with a diabetic child said the child's care was by a nurse practitioner. The nurse took ten months to diagnose diabetes.  This mother had no health insurance and had to rely on a free clinic. I saw a news report last evening in which the executive director of the National Association of Free Clinics said their patient population had doubled this year as people lost jobs, houses, and health insurance.

We MUST have a public option. Otherwise, I sincerely hope that President Obama will veto the bill. Why should we as taxpayers put more money into the pockets of the greedy health insurance companies, the drug companies and the medical equipment companies?

Taxing Soft Drinks to Help Reduce Obesity

I think it would be a great idea to tax soft drinks. Not only could the money be used to help pay for some of those who are uninsured, but it could wean kids away from soft drinks. I've never understood our nation's addiction to soft drinks.I have never had them in my house and neither my children or grandchildren have any interest in drinking them.

When you look at the statistics about what obesity, diabetes and cardiovascular disease are costing this country, it is frightening. In a September 9/09/09 article by Michael Pollan in the New York Times, he lists the following amounts of money that  chronic illnesses cost:  $147 billion is spent on treating obesity, $116 billion to treat diabetes and "hundreds of billions more to treat cardiovascular disease."

Soft drinks should definitely be removed from schools. We did not have them when I was growing up and I was fortunate not to have any cavities until I went to college and the food was not great. I imagine dentists who have real concerns about their patients would also support a tax on soft drinks. Money can  be spent instead on real food, not big bottles of soft drinks high in sugar and calories.  

Health Care Costs and Preventable Chronic Diseases

I found an interesting article by Michael Pollan, a professor at U. C. Berkeley in the September 9, 2009 New York Times. He seems to think that if the governement regulated the food industry we could decrease the costs of health care caused by obesity and the disorders related to it.

I don't quite understand how the governement is supposed to control food production so people don't eat too much? It would seem to be the responsibility of each of us to get enough exercise, to not overeat and to eat foods that are not high in fat, sugar, or cholesterol. I don't see how the government can make people, who want to kill themselves by overeating,  change their eating habits.

I would suggest instead that education in the schools and in doctors' offices would be the place to make a difference. Few doctors I am told, discuss eating or diets and nutrition is also not part of most medical school training programs. When I talk to overweight patients about changing their diets, I often tell the story of a woman I saw in my very first job as a young M.D. This was with the San Diego Health Department where I had well baby clinics, school health exams, and prenatal clinics. 

My pregnant patient  was very much overweight and was developing  hypertension. I kept trying to get her to watch her diet and at her next visit she had not only lost two pounds but her blood pressure was down. When I asked her what had happened she said, " Dr. Thompson, every time I go to the refrigerator, I see your face."  So I would always laugh and suggest to an overweight patient that my face be on his or her refrigerator door or at least  my presence be felt near the refrigerator!

The Ugly Healthcare Debate

I cannot believe that a Congressman would have so little respect for our President and for us as a nation that he would call out "You lie" to the President of the United States. It seems that the discussion is no longer about about bringing healthcare to everyone. Instead those who are racist are trying in every way to destroy President Obama's reputation and bring down his administration. Is this really what we as Americans want?

I am embarrassed about what people in other countries are thinking of America. Are we really world leaders? When forty-seven million people have no healthcare coverage and 18,000 people die each year due to lack of medical care, we are in deep, deep trouble. I hope Congress either expells Mr.Wilson or severely censors him. We do not need people like this man representating anyone.

A friend asked me yesterday what I would do if I were in charge of healthcare. First, I would severely limit the power of the drug and health insurance companies, as well as the medical equipment companies. I would ban health lobbyists and contributions to our representatives in Congress from healthcare companies. The money that was saved from eliminating subsidies to drug and health insurance companies and decreasing the  administrative costs of health insurance companies could be used to pay adequate fees to hospitals, doctors, and other medical personnel. The payment to see a welfare or Medicaid patient is so low that few doctors (and hospitals) can afford to see these patients.

Medical schools need help to subsidize students who cannot pay  high tuitions fees. Some of the best doctors do not come from prestigious colleges and wealthy families, but from low income and middle class families. Often these students are much more in tune with the problems and worries of the ordinary American.

Swine Flu-Symptons and Treatment

A young mother asked me the other day if she should get swine flu shots for her children. They were all healthy and had infrequent colds and illnesses she said. In doing some research, I noted that most of the 36 deaths that have occurred in the U.S. to date because of swine flu were children who had cerebral palsy, muscular dystrophy or other disabilities. In general, swine flu seems to be attacking those with respiratory problems due to muscle weakness, very young children, or very old people.

Children receive so many immunizations these days that I would not want a child of mine to have the swine flu shot unless he or she had pulmonary or other underlying problems. However, each parent should talk to their pediatrician or family doctor. If there is a problem, then the CDC recommends one of two anti-viral agents, either oseltamivir or zanamivir. These should be started if a child is going to need to be hospitalized. THE CDC has a 24 hour call line if anyone has questions. The number is 1-800-232-4636.

If a child has trouble breathing, is vomiting, and very sleepy a  pediatrician or family doctor should be seen immediately. ER doctors and nurse practitioners usually have minimal pediatric training and should not be seeing little children, if this can be avoided. Thus a retail clinic, urgent care clinic, or ER would not be  places to take a child who is ill.

Commonsense is needed druing flu seasons. I just saw a mother with a tiny baby in a crowded airport. Strangers were touching and even kissing the baby. I wanted to stand up and say "STOP", but decided  the young mother would not appreciate my intervention. Staying away from crowds and keeping babies and small children away from people who are coughing is wise.

Getting Past Medical Gatekeepers

A friend asked me yesterday how you can get past the medical gatekeepers: clerks, secretaries, and nurses in medical offices, HMOs or insurance companies. My first suggestion was that you initially try to be very pleasant but firm and if that doesn't work then you need to use your "Big voice". If neither of these work, you can ask a doctor friend to intervene as I have done countless times. You  can also send a registered letter to the doctor, the CEO of the insurance company or the HMO. If none of these work then I would either change doctors, change HMOs or change insurance companies.

The whole idea of medicine these days seems to be to keep people out of offices, HMOs or to get any benefit from their health insurance. People with disabilities or chronic health problems have the worst problem because their care takes time and costs money. There is a wonderful national agency to help those with disabilities. It is Protection and Advocacy and they are great. They have attorneys who will help and they want to help, not keep you away. There are other advocacy groups which I list in 101 Ways To The Best Medical Care.

When you write a letter to a CEO of an HMO or insurance company, there is one sentence that will almost always get results. If you say  you are willing to consult an attorney unless you get the care that you need you will probably get fairly immediate action. The HMOs and insurance companies have had so many expensive law suits that the very mention of an attorney will usually light a fire under them. Medicine has come to a pretty bad place when this kind of statement is necessary to get adequate medical care. I hope the President and Democrats will ignore the Republicans and get a decent health care bill passed. I must admit that I don't see this happening unless we all start calling and writing our Congress representatives. They have wonderful health care so why should they care about the rest of us?

President Obama, Congress and the Health Care Mess

I have been talking to doctor friends across the United States the last few days and all are appalled at what has been going on with the various health care plans. The town meetings and the money being spent by the health care industry to stay in control of the U.S. health market are embarrassing.

I think President Obama needs to be very forceful about what he will and will not accept when he speaks to Congress next week. No plan without a public option is acceptable. He must stand up for the people who elected him and not allow the health care companies to tell him what to do. I worked hard to see that he was elected and will be greatly disappointed if he does not give the talk he is capable of giving. I think many other people will be greatly disappointed if he allows the health insurance and drug companies, as well as the medical manufacturing companies, to stay in control of our U.S. health care.

It was wonderful to practice medicine when there were no HMO's, no need for prior authorizations, and as physicians we were in control of our patients' medical care, not a clerk or nurse at a health insurance company. I realize that  as physicians we are at fault because we didn't speak out when the HMOs were started and the health insurance and drug companies became so powerful. I was too busy taking care of patients, as were many other physicians, to realize how badly medicine was going down hill. I'm not sure if it is possible at this late date to turn things around but for the 47 million without health insurance and those who have insurance but still lose their homes due to medial bills, somthing must be done.