Dr. Thompson's Blog

Choosing a Specialist

I am always amazed when an adult, even with an advanced degree, does not do more to check out any specialist they chose. Of course, if their health plan is an HMO they may not have a lot of choice.  I do not understand why anyone would get their health care from an HMO, unless financially that is all that is possible. Yet, often these same people spend money on things they could do without. 

Whenever I  have to check on a doctor, I want to see where he or she went to college, medical school, and if they are board-certified in their specialty. Now that nurses are getting doctor of nurse practitioner degrees, you want to be sure the individual you are choosing is an M.D., not a DNP, a neuropathic doctor, or an osteopath. It was a lot easier when I was growing up and we did not  have most of these specialties. Of course, even an M.D. graduating from a known medical school can be bad. I referred my teenage granddaughter to a woman M.D. who had graduated from the same medical school I  had gone to. I did not realize how badly the school was doing  with their students, which  I now know. The M.D. neither took a history and did not do a physical examination, but ordered a lot of lab tests. She did not order a urinalysis which would  have been important. Nor did she ever contact my granddaughter again. I  had to use a young voice and call for the results using my granddaughter's medical  number. 

I would check not only the things I mentioned, but also any reviews that are listed on the Internet. Asking a friend who is an M.D. can help but he or she may not know how the doctor practices. I  have had such an experience and it was not good. 

Terrible Drug Prices and Congress

Drug prices are outrageous and people are skipping needed medicines because they cannot afford them. The Biden bill, which has a section where Congress could negotiate drug prices, is not supported by three democratic representatives. One of them is Scott Peters who represents the area where I now live.  I  tried to send him an e-mail but his website does not accept e-mails to him. The facts are that CEOs of drug companies are making millions of dollars each year. For example the CEO of Roche makes $38.6 million each year. Yet he seems to  have no interest in the lives of the patients his company's medicines could help. 

Drug companies in the U.S. spend four and one-half million dollars on ads each year and hire 1200 lobbyists. The cost of drugs in the U S is far above that of any other country including Canada. Senators Bernie Sanders has taken groups to Canada to buy medicines. I think that is wonderful.

I do not understand why the 3 Democratic representatives are opposed to negotiating drug prices unless they have stock in drug companies or have wealthy wives or husbands. The other two opposing representatives are Kathleen Rice and Mr. Schrader. I hope they will change their minds and support negotiating with drug companeis. Drug prices must be reduced in the U.S.

What is Ahead for the United States?

I heard an excellent talk this weekend by Rick Steves, the travel writer and TV presenter. He talked about his concern in the many nations he had visited where the leaders worked hard to dumb-down their citizens, so they could become dictators.  As I listened I thought about how Trump tried to do this and is still trying. Not only Trump, but several of the Republican Governors. During thus awful pandemic several of the governors, who have strict vaccine requirements for kids in school, now are fighting President Biden about the vaccine mandate. That makes no sense. Not only do I see a lot of dumbing-down on TV, but I see it in our education system and sadly even in some U.S. medical schools. 

I had one doctor who never once looked at me on my visit to him but spent the whole time looking and typing on his computer. No, I never went back. Some medical schools are not teaching the art or love of medicine but it is all about clicking on computers.  Also the students are telling the heads of the programs want they will and will not do and what they will and will not listen to. It is truly amazing.  

I have great concerns about what children are learning today and their fixation  on their Smart phones and computers. I fear that many are not learning or being taught about history. One college sophomore, a friend told me, did not know who Hitler was. I was astounded.

The Cozy Relationship between the FDA and Drug Companies

There was a scary editorial today in the New York Times. It was about how some of the decisions made by doctors and others at the FDA are greatly influenced by drug companies. This does not bode well for those of us who need reliable medical experts to be sure the drugs we take are safe and appropriate.  The editorial notes that "Congress allowed the agency to collect fees from the industry it oversees to pay for the high cost of drug approvals. These fees pay much of the salaries of FDA drug workers responsible for the approval of new  drugs." Thus the FDA may be more of a partner rather than making responsible decisions about drugs. This is a scary thought. The other thing that is noted is that too many FDA personnel later go to work for drug companies.  Americans pay more for drugs than people in other countries. In other countries, prices are negotiated between governments and drug companies. This should happen in  America,  particularly for Medicare patients. 

The CEOs of drug companies, such as Roche, make enormous salaries. You would think they would respond to doctors like me who request special help for a drug  that can change the life for a spinal atrophy child. However, despite my request for one family with two spinal children, the CEO showed no interest in  having this happen. When I asked by e-mail if the CEO  had ever seen a child with spinal muscular atrophy, I got no reply. Some drug companies do set up special funds to help families that can not afford an expensive drug for a child with a disability. Roche does not seem to be one of those. 

Update on the Covid Virus

There are now 700 million vaccinated  people around the world.  Sadly, there are still a lot of false messages being given by people like Tucker Carlson and many on social media. The Pfizer vaccine has finally been given full approval which is great. Now hopefully some of the about 90 million people in the U.S. will get vaccinated. I had to change dentists because my dentist, who was also a friend, will not get vaccinated. I was appalled. Now there is the scary account in the news that some people are taking the deworming medicine which is for big animals. It can hurt people, not help, against the virus. 

The only way we are going to defeat this virus is by people getting vaccinated. If they want to die by not getting vaccinated, I guess that is their choice, but it is a selfish one because it can hurt their family members, friends, and children. Even little children are now dying or ending up in the hospital because someone spread the virus to them.

I am often the only one I see in this small beach town wearing a mask. I stay away from any gatherings because I know there are a lot of  unvaccinated  people in this community. I loved seeing everyone wearing a mask when I recently went to San Francisco on a business trip. I would not let anyone work for me who was not vaccinated. I hope many more people will insist on that in stores, offices, and big corporations. 

Resources for Children and Adults with Disabilities

There are some excellent resources for both children and adults with disabilities. If a child is found to have a disability early on, it is important for parents to get in touch right away with their state's program for these kids. I list them all  in my book, Raising a Handicapped Child, and I am sure you can find the telephone number for your state's program on the Internet. Each state offers special help such as special school exams, speech therapy, PT and OT. The earlier help is  given the better a child's life will be.

One of my favorite programs is Protection and Advocacy. They have lawyers who will answer questions about problems for those with disabilities. They have helped my patients many times and there is no charge. Their number is 1-800-776-5746. 

It is also important for parents to find a medical doctor who has training or interest in disabilities. The usual 15 minutes that most doctors seem to spend these days is not what you want. I always spent whatever was needed to help my patients. Not only are medical examinations important but there are also many forms that need to be filled out and calls to make if a child or adult has a disability.

Many adults seek help from sports' doctors. They do not have the needed training. A doctor who specializes in rehab medicine may be a good choice but you should check the doctor's training and reviews. Nurse practitioners, osteopaths, and chiropractors do not have the training you need. Many big hospitals have specialists who can be helpful.  Agencies connected with the type of disability a child or adult has can often be helpful. Some are not because they refer to doctors who are not qualified. 

I  have found two hospitals in the U.S. that do a wonderful job with patients with disabilities. One is Los Angeles Children's Hospital and the other is Cincinnati Children's Hospital. For children or adults with muscle weakness I use Dr. Selcen at the Mayo Clinic. She is outstanding.

 

 

Concern about Covid 19 Cases in Children

Covid 19 cases in children had risen 84% this last week in kids. Yet I still see many parents with children and most are not wearing masks. If they don't care about themselves, what about their defenseless children?  I had a pharmacist tell me today that she is appalled at the selfishness she sees in the U.S. A grandparent just sent me an e-mail saying she had looked up Governor de Santis and he has 3 small children. Yet he talks against vaccines and masks. What is wrong  with the man? Florida is teeming with new Covid cases and their health system and hospitals are overwhelmed. The latest statistics I  have seen are that 17,726 children are now infected in the U.S.

I do not understand the statement by anti-vacers that they want the freedom do to as they please and no person in authority is going to tell them how to live their lives.  But what about their families, older members and friends?  I certainly would not  have an employee or a parent of children I cared for who refused to get the vaccine against the Covid virus. That is selfish and ignorant. We were formerly a caring, concerned nation. Certainly during the wars and after 9/11 our nation seemed to care about all of us and not just themselves. I wonder if we will ever get back to that state or will our children and grandchildren live in a self-centered, uncaring country?

Non M.D.s Practicing Medicine

There are some wonderful MDs and healthcare workers, but I am seeing more and more non-MDs calling themselves doctor and trying to care for patients. I am worried that as health care gets more expensive and patients don't check on their "doctors" credentials we are going to see more non-medically trained people taking care of patients. We now have nurse practitioners who get a doctor's degree calling themselves doctor and caring for patients without the supervision of an M.D. Kaiser uses a lot of nurse practitioners. When someone in a white coat introduces himself or herself as a "Doctor" be sure you are talking to an actual M.D.  There are osteopaths, neuropathic physicians, chiropractors and neuropathic "doctors ".

I was in a doctor's office and saw a woman in a white coat and asked my doctor if he had a new associate. "No" he said, "she is a nurse practitioner, but I don't use her". If he did, I would not have gone back to him. I  have had very bad luck with several individuals who call themselves doctor.  They have never gone through medical school or received board certification. Thus, before you see a new doctor, please do check on the training they have had and if they truly  have gone to medical school, completed an internship and residency and passed board exams. 

Now the organization that is on charge of  physicians assistants wants to change their name to  physician associate. No, they still have the same limited training and should always work under a physician. I  hope they are unable to get the name changed.

Problems with Surgery in July and August

A friend e-mailed me that she was to have surgery at a university medical school hospital in August. She wanted to know my opinion of the surgeon and the hospital. I talked to my anesthesiologist son about her request and he reminded me of the problems with July and August in teaching hospitals. New interns and residents start their rotations on July first. I certainly remember walking up the front steps of Children's Hospital in San Francisco on July first wondering what lay ahead where I was to be a new interne.

Even though the surgeon has promised my friend that he would do her surgery himself, I would not count on that. Often a surgeon will let a new resident do all or part of a surgery even if he is in the room. In general, I would never plan a surgery in these two months if it can be postponed. I also would be particularly careful about university hospitals that depend on a big staff of new residents and interns. 

My experience at Children's was generally good, although there were some scary moments. One was when I had a resident who was never in the room during the polio year that left me to make decisions about when to put patients in iron lungs. Another was when my OB resident was never in the room and I had to  deliver babies by myself. Fortunately, luck and common sense were with me and I never had a major problem. 

The Amazing Double Standard at Fox News

I don't watch Fox News. but know the damage they do to their viewers. They  don't get Covid shots because Tucker Carlson and his group of co-anchors tell them not to.  Yet a recent news report said that no one can work at Fox News unless they have been fully vaccinated for the virus. I wonder if Tucker and his group realize that most of the Covid deaths are unvaccinated patients and probably their viewers? Are they trying to cut down on the number of viewers they have?  That makes no sense. 

Trump and his family have all been vaccinated and yet he tells the Big lie and also that vaccinations are wrong. If only he would tell the truth for once  it could save a lot of lives.  It is embarrassing, as a physician, to know that any leader of a country could care only about himself and not the country he represents. That would be like a physician telling his patients one thing and doing something else himself or herself. I hope the time comes when the Republicans and others who are not getting the vaccine come to their senses. I know how grateful I was when the Salk vaccine was available. Having seen both  children and adults die from polio, it was a blessing  when Dr. Salk and his group saved so many lives.