In The News 2020 - Sandweg & Ager PC

In The News 2020


Here we address interesting and important issues affecting the delivery of medical care and related topics from 2020.

We cover additional, related issues and discuss them in more depth on our blog.

In The News: 2020, 2021, 2022

 

December 29, 2020

To the list of questions you may want to ask your surgeon before scheduling surgery, add this.  “What is your birthday?”  Analysis of data relating to Medicare patients shows that surgeries performed on the surgeon’s birthday have a higher rate of complications.  Although there is no way to know for sure, the supposition is that the surgeon is more likely to be distracted by outside events on his or her birthday.

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December 28, 2020

2020 is on track to be the deadliest year in the history of our country.  Deaths are expected to exceed 2019 totals by over 400,000, primarily due to the Covid pandemic.  

Stay safe.  If you become ill and need to go to the hospital, there may be no room for you.  Don’t take a chance.

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December 4, 2020

Here is a follow up to yesterday’s post.  Europol, the police agency of the European Union, is warning that organized crime rings are going to be selling counterfeit Coronavirus vaccines.  Make sure you get yours from a source you trust.  Probably better to get it from a large chain than from an individual doctor.  Harder for criminals to trick a large chain than to trick an individual doctor.

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December 3, 2020

As I have observed on many occasions in the past, where there is an opportunity, there will be scammers attempting to separate honest citizens from their cash.  Such an opportunity is almost upon us in the form of the Covid-19 vaccines.  The federal government is already sounding the alarm.  There will be scammers offering to put you or your family at the head of the line for vaccination.  There will be scammers offering you “genuine,” government-approved vaccines.  Who knows what else they will offer, but it will all be based on limited supplies and fear of illness.  Be on your guard.

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December 1, 2020

High test volumes for the Covid-19 virus have highlighted a problem that has always existed but which most people never really considered.  Test results are often wrong.  There can be false negatives or false positives.  Some tests have a much higher error rate than others.  Treatment can be initiated on the basis of an erroneous result or can be withheld.  As always, be proactive about your health.  Don’t rely on test always being accurate.  Get second tests and get second opinions.

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November 23, 2020

A Mississippi doctor on trial in federal court for his alleged role in a health insurance fraud scheme has been acquitted on most of the charges against him.  The jury deadlocked on the last one.  The doctor was accused of writing unnecessary prescriptions for expensive compounded medicines in return for kickbacks from the pharmacies that prepared the medicines and delivered the prescriptions.  The doctor contended his signature on the many prescriptions was a forgery.  Guess the jury bought it.  The scheme is a real one and a number of participants have already pleaded guilty.

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November 17, 2020

Medical researchers are reporting what they refer to as a “breakthrough” in the understanding of Covid infections.  One of the major mysteries of Covid infections has been why some people do so much worse than others.  Researchers have discovered that many male patients who developed life-threatening infections have autoimmune antibodies, which disable key immune system proteins called interferons.  More study is needed but if this finding is supported by more research, interferon therapy to replace the disabled proteins may be a significant form of treatment.  Stay tuned.

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November 10, 2020

I have warned in the past about doctors, or those who claim to be doctors, taking advantage of the Covid pandemic to fleece the public.  When people are afraid and there is money to be made, there is always someone ready to try and make an extra buck.  Today’s New York Times has a story about a doctor in Westchester County outside New York City who performed Covid testing but charged insurance companies thousands of dollars for the testing.  Without telling the patients, he used their samples to test for a wide variety of other viruses and billed the insurance companies for each of them.  He even charged one patient’s insurer $480 for the phone call notifying her of her test results.  The doctor is not only unrepentant, he is angry that some insurance companies have the nerve to refuse to pay.  Be careful out there.

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November 9, 2020

Fantastic news on the Covid front.  Pfizer has announced that its vaccine shows 90% effectiveness in preventing infections.  A few weeks ago, Dr. Fauci said that we should be happy if we could get one that was 50-60% effective.  By the end of the month, Pfizer expects to be in a position to request emergency approval from the FDA.  It expects to have 1.5 million doses ready for distribution by the end of the year.  Keep your fingers crossed.

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November 2, 2020

Medicare has announced its annual list of hospitals that will receive reduced payments because too many of their Medicare patients have been readmitted after being discharged.  About half the hospitals in the country that are not exempt have readmitted too many patients and will receive reductions.  Hospitals which are the only hospitals in an area are deemed critical and are exempted from the program.  For example, here in Arizona, most of the hospitals on indian reservations are exempt.  Here is a list of the hospitals of Arizona showing who is exempt and who has received a penalty.  The larger the number in the box for a given year, the larger the penalty.  Larger penalties result from more readmissions.  The rate of readmission is widely considered to be a measure of the quality of care at a hospital.

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October 29, 2020

The FBI is warning hospitals and other health care providers that Russian speaking criminals are making ransomware attacks and that they need to take precautions.  Six hospitals have been attacked so far this week.  In a ransomware attack, the criminal hacks into the victim’s computer network and installs malware which encrypts all of the data on the system, making it inaccessible to the victim.  The criminal then offers to restore the system to function in return for payment of a ransom.  Most victims pay and the criminals usually keep their word to unlock the system.  Very scary.

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October 27, 2020

More evidence that antibodies to Covid-19 weaken over time giving more support to the theory that infection with the virus does not provide lasting protection.  A study from England that has not been peer reviewed showed rapid weakening of the Covid-19 antibodies over just three months.  They dropped most quickly in the over-75 population and least quickly in the 18-24 age group.  Additionally, those with the fewest symptoms had fewer antibodies and lost them soonest.  The results of the study are a blow to those who were hoping for some sort of herd immunity to develop over time.  The Covid-19 may be like the seasonal flu; you can get it year after year.

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October 26, 2020

If you are looking for an investment, consider stock in companies that make, sell or administer Botox.  According to an article in this morning’s Wall Street Journal, the use of Botox is increasing, especially in Brazil, in response to the Coronavirus pandemic.  It seems that the use of masks has concentrated attention on the eyes and the forehead so people want those areas to be wrinkle free.  Similarly, the regular use of Zoom meetings has caused many people to think about how they look on camera and to take steps to improve their appearances.  The pandemic won’t be over any time soon so there may be money to be made.

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October 22, 2020

In some good news on the Covid front, new polling finds more Americans wearing face masks when outside the home and not able to socially distance.  While there are still substantial differences among our citizens, often based on political party, mask wearing across the board is up.  

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October 20, 2020

There is a new procedure being performed on knees which have cartilage damage that typically leads to the need for a knee replacement.  It is a two-step procedure in which the patient’s own knee cartilage cells are harvested during the first step and then replaced in the second step after being grown on a matrix.  To allow the new cartilage to take hold and grow, the patient must remain bedridden for 6 weeks after the second procedure.  Full activity requires a year of gradual recuperation.  The procedure shows promise in the future for other joints, such as hips, shoulders and ankles.

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October 19, 2020

Here is a good piece on the myths associated with vitamins and supplements. Everyone wants to be healthy, to live a long life and to look like those models in the advertisements.  The sellers of vitamins and supplements know this and tailor their ads accordingly.  All is not as it seems.

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October 16, 2020

In 2017 and 2018 a nursing assistant at the VA hospital in Clarksburg, West Virginia, injected seven of her patients with fatal doses of insulin.  Although she has admitted her guilt, she has not offered an explanation for her behavior.  Needless to say, the families of the dead veterans have filed malpractice suits against the federal government for the care their loved ones received from the VA.  Now come reports that 6 of the 7 cases arising from this tragedy have been settled.  The final one will probably settle soon.  Hospitals, and VA hospitals in particular, are dangerous enough without the staff actively trying to kill the patients.

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October 15, 2020

Our increasingly germ-free environment may be bad news for our immune systems.  Those immune systems evolved over the millenia to protect us from a very germy environment.  In our somewhat antiseptic world, our immune systems with nothing much to do have turned to attacking our own bodies.  Autoimmune diseases are on the rise and their increased prevalence is blamed by some on diminished exposure to germs and other threats.

A small study in Finland brought forest soil and vegetation to preschool playgrounds.  The children exposed to the forest soil had increased diversity of skin bacteria and gut microbes than children not exposed.  These were perceived as beneficial changes.  Those exposed also had more anti-inflammatory proteins and fewer inflammatory ones.  Inflammation is a form of immune response which is believed to be harmful to the body.  Bottom line, let you children play in the dirt.

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October 14, 2020

The Coronavirus pandemic has affected us in many different and sometimes surprising ways.  One of the changes has been the increase in pet ownership.  Whether this is surprising depends on how you think of pets.  It seems people want a pet to keep them company in these difficult times when maybe we can’t go out of the house like we used to.  The increase in pet ownership has increased the business for veterinarians, has increased sales of doggie and other pet products and has made stocks in companies related to pet care more expensive.  Let’s hope that these pets continue to be loved and treated well after we are able to resume our normal lives.

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October 1, 2020

Contrary to recent assertions by someone who ought to know better, insulin is not as cheap as water.  Insulin, which is needed by Type I diabetics in order to live, has been a huge moneymaker for the drug companies that manufacture it.  Its price has increased by leaps and bounds since 2000.  Between 2002 and 2013, the cost of insulin rose 197%.  It’s meteoric price rise has continued since then.  Despite many politicians claiming to be ready to do something about it or even claiming that they already have, prices remain unaffordable for many diabetics.  Politicians, stop claiming to have done something about insulin prices and actually do it for a change. 

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September 30, 2020

As early as April of 2020, doctors began noticing that some young people with Covid-19 were experiencing large vessel strokes.  More recent analysis of the data found that in nearly half of the Covid patients under 50 who experienced a stroke, the stroke was the first sign of the disease.  These patients were asymptomatic right up until the moment they experienced their stroke.  They were diagnosed with Covid-19 after the stroke.  Scary business.

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September 29, 2020

In 1975, in response to a “medical malpractice crisis,” California passed a cap on non-economic damages in malpractice cases.  the cap was $250,000.00.  While that may have been a sizeable amount in 1975, inflation has eroded the purchasing power of money by 80% but the cap was never changed.  I blogged about the problem here.  Now a citizen initiative will place the question of the cap on the 2022 general election ballot.  The initiative proposes tying the cap to inflation, which would have the effect of raising the cap today to around $1.2 million.  In addition, the initiative would allow juries to exceed the cap in cases of death and catastrophic injury and to award attorney’s fees to victims.  Needless to say, opposition from the medical community will be fierce.

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September 23, 2020

Researchers are discovering that Vitamin D is even more important than they thought and they thought it was important before.   Especially as we age, we can develop Vitamin D deficiencies.  Low levels of Vitamin D have been linked to major age-related health problems, including osteoporosis (loss of bone mass), increased risk of death from cardiovascular disease, cancer, Type II diabetes and cognitive decline.  

A great source of Vitamin D?  The sun.  For us here in Arizona, the strong sun is a free source of lots of Vitamin D.  As always, don’t overdo a good thing.

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September 22, 2020

Uh-oh.  Now that three of the drug companies testing three different potential vaccines for Coronavirus have released their testing protocols, other scientists can now evaluate those protocols.  Here is an article from today’s New York Times, in which the author criticizes the testing as being too short and having the wrong endpoint.  It is the author’s position that the testing will not tell us if the proposed vaccine will prevent the most serious cases of Coronavirus or only mild ones because it will end and a winner will be chosen before we know its effectiveness against serious cases.  The author contends that preventing only mild cases is not worth either the effort or the risk of adverse consequences.  Good article and worth the read.

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September 21, 2020

A dentist in Alaska, who made a tape of himself extracting a patient’s tooth while balancing on a hoverboard, has been sentenced to a lengthy prison term.  His conviction was based, not only on the hoverboard incident, but on charges of embezzlement, fraud and unlawful dental acts.  This guy was stupid enough to make a tape and send it to others, which led to his exposure.  You have to wonder how many more are out there that are at least smart not to record their antics.

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September 19, 2020

Add AstraZeneca to the list of drug companies working on a Coronavirus vaccine that have released the protocols for their vaccine production and testing.  AstraZeneca had been under fire for its secrecy, especially in light of the fact that two women injected with its vaccine prototype developed serious neurological illnesses.

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September 18, 2020

Pfizer has joined Moderna in releasing its protocols for testing the coronavirus vaccine. Two down and a couple of more to go.

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September 17, 2020

Moderna is one of the drug companies engaged in the race to produce a Coronavirus vaccine.  Even people who are not Anti-Vaxxers have expressed concern about politicians pushing the vaccine makers to release a vaccine before it has been determined to be both safe and effective.  Today, Moderna attempted to quell those concerns by releasing a 135 page protocol detailing the steps it has taken and will take before releasing a vaccine.  Since these protocols are generally considered to be trade secrets, they are rarely released.  Let’s see if any of Moderna’s competitors choose to follow suit.

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September 16, 2020

This story is a little far afield but relates to a common theme: doctors who will violate their ethical obligations and the law to make a few bucks.  A German doctor is going on trial for setting up a large blood doping ring for cyclists and skiers.  Blood doping involves transfusing red blood cells, which increase the oxygen-carrying capacity of the blood, into athletes to increase their stamina.  He apparently was caught red-handed performing a blood transfusion immediately prior to a cross-country ski event.  American doctors are not the only ones willing to act unethically for money.

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September 15, 2020

Greedy drug companies are in the news again.  AstraZeneca, one of the largest of the big drug companies in the world, has raised prices on its best-selling drugs for the second time this year.  It has raised prices by 6%, when the rate of inflation is only 1%.  This action comes after it received hundreds of millions from the United States government to develop a vaccine for the coronavirus.  Poor AstraZeneca.  It made only $3.6 billion in operating profit in the first half of 2020.  You can certainly understand why they need a price increase.

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September 11, 2020

As the population of the United States ages, there is increasing attention being paid to the process of ageing and its effects on older Americans.  Here is a link to an article debunking a number of myths about ageing.  Among the recommendations are the obvious:  Be active, work on developing a positive mental attitude; eat healthy and get the sleep you need.  Do as many of these things as you can and you give yourself the best chance to have a healthy and happy life.

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September 10, 2020

AstraZeneca is one of the drug companies testing a vaccine for Covid-19.  It has paused its trials while it investigates a participant who has experienced a severe neurological problem.  While it is unclear at this time exactly what the problem is, it seems to be a form of transverse myelitis, a rare inflammation of the spinal cord.  It is also unclear whether the condition is related to the experimental vaccine or whether it is just a coincidence. 

This is a good time to remember that vaccines, while immensely important and strongly protective, can, in rare instances, cause unexpected and unwanted adverse events.  Should this happen to you, you should seek prompt medical treatment and then consider whether you have a legal remedy.  The United States government has established a Court of Claims procedure for people injured by vaccines.  Be sure to look into it, if you have had a bad reaction after receiving a vaccine.

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August 31, 2020

The FDA has granted emergency approval to an inexpensive Covid-19 test that can produce results in 15 minutes.  The test, marketed by Abbot Laboratories, only costs $5.00 and can be administered by nurses and techs.  Abbot hopes to sell millions of the tests and the federal government has already agreed to purchase 150 million of them.  The wide availability of an accurate, rapid result test will be a big help in controlling the pandemic and returning the country to a more normal state of affairs.

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August 27, 2020

About those high drug prices . . . .  Teva Pharmaceuticals, the largest generic drug maker in the world and one of the fifteen largest drug companies overall, has been charged by the United States Department of Justice with price fixing.  It is alleged that Teva participated in conspiracies with other drug companies to fix prices on a number of drugs, including drugs for lowering cholesterol, managing arthritis and preventing blood clots.  Teva is the latest company charged in these conspiracies.  A number of other companies alleged to have participated in the conspiracies and to have fixed prices have already admitted their roles.  You would think drug companies would be happy with the huge profits they make without having to resort to illegal conduct.

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August 25, 2020

In an embarrassing development, the head of the Food and Drug Administration, a cancer doctor before assuming control of the FDA, does not know the difference between absolute risk and relative risk.  This is a mistake that would get you an “F” on a medical school examination. 

A quick example of the difference.  If you buy a second lottery ticket, you have doubled your chance of winning the lottery.  Your relative risk of winning the lottery just went up 100%.  On the other hand, your absolute risk of winning the lottery only changed from 1 in a million to 2 in a million.  As you can see, there is a big difference and, when it comes to successful Covid treatments, the FDA chief needs to know the difference and be able to explain it to the public.

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August 24, 2020

Still too soon to tell what this means or how significant it might be but a Hong Kong man has been diagnosed with the Coronavirus a second time.  On the first occasion, he had very mild symptoms.  Four and a half months later, when he returned to Hong Kong from a vacation in Spain, he was tested again and found to be positive for a strain of the virus circulating in Europe.  He had no symptoms from the second round with the virus.  It may be that naturally acquired immunity is only short-lived.  It may be that this is the rare case that proves the rule.  It may be that any earlier exposure reduces the chance that a second infection will be serious.   Just another data point in what will be a many year investigation of the Coronavirus.

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August 20, 2020

Although it is not always the case, research of out the University of Southern California suggests that the flu usually begins with a cough while the Coronavirus usually begins with a fever.  Your mileage may differ.

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August 18, 2020

Bad news for those men who like to have a couple of drinks after work.  Previous guidance was that the overall benefits of two drinks per day for men outweighed the health risks posed by alcohol.  More research now shows that the benefits from alcohol on heart health are less than previously thought.  Now researchers believe that the health risks of drinking outweigh the benefits, if more than one drink per day is consumed.  They are taking all the fun out of life.

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August 7, 2020

The Department of Justice has rooted out another fraud on the taxpayers relating to Medicare.  As is often the case, the scheme required the cooperation of doctors who were willing to accept bribes and kickbacks to order tests made by the company committing the fraud.  The company was based out of San Diego and made a kind of DNA test.  Their marketing Vice President admitted to paying bribes and kickbacks of at least $3.5 million.  There may have been more.  The doctors who accepted the bribes in return for violating their oaths were not identified.  You better hope your medical care is not directed by someone willing to sacrifice you and your health in return for a bribe.

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July 22, 2020

A rare, life-threatening condition caused by Covid-19 has been found in children in Arizona.  The condition is called Multi-System Inflammatory Syndrome.  Symptoms include rashes, abdominal pain, fever, vomiting, diarrhea, fatigue and redness of the eyes.  It seems to come on about three to six weeks after a Covid infection.  Seek immediate medical help for your child, if you suspect he or she has this condition.

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July 22, 2020

During this pandemic with all the attention being paid to the Coronavirus, we should not forget our oral health.  Certain foods and behaviors make tooth decay, gingivitis and bad breath more likely.  Avoid sugary, highly processed foods.  Increase your intake of leafy greens, fatty fish and citrus.

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July 20, 2020

Hoping not to get caught short on drugs necessary to treat coronavirus cases in the event of a new surge, many hospitals are stocking up on those drugs.  This is having the unfortunate effect of creating a shortage in the very drugs that are most important.  The coronavirus bad news just keeps on coming.

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July 11, 2020

As if we needed more bad news about the Covid pandemic, it is becoming apparent to researchers now that, in addition to its many other bad effects, the coronavirus can cause the onset of Type 1 diabetes in previously healthy individuals. Type 1 diabetes, an autoimmune disease, has been increasing at an alarming rate in developed countries, likely as a result of exposure to environmental factors. Finding a new cause for even more Type1 cases is very disheartening.

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July 2, 2020

The big drug maker, Novartis, is pleading guilty to fraud charges in a kickback scheme. As part of its plea deal, Novartis is admitting that it has been paying bribes and kickbacks to doctors for years to prescribe its medications. It’s spent millions. Of course, it takes two to tango. The kickbacks and bribes only work if there are unethical doctors ready and willing to accept them in return for prescribing the Novartis products. It doesn’t matter if the Novartis product is the best for the patient or not. And if you think they have caught all of the unethical doctors out there willing to sell out their patients, I am afraid you are very naïve.

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June 28, 2020

Gene therapy is coming, gene therapy is coming.  Researchers at a stem cell conference reported encouraging results with gene therapy in monkeys to control high cholesterol and triglyceride levels.  Our livers follow instructions from our genes about making cholesterol and triglycerides. Researchers have discovered that some people have a gene mutation, which keeps the liver from making elevated levels of these two substances.  In the monkey experiment, the monkeys were given a shot which disables that gene directing creation of high cholesterol and high triglycerides.  So far it is working but it will be years before they know it has no bad side effects and it may be ready for human trials.

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June 24, 2020

Transparency is coming.  The federal government has ordered that hospitals disclose what they charge insurance companies for the treatment they provide to the company’s insureds.  This has been a closely guarded secret by the hospitals. The amount they agree to accept from the health insurer is almost always only a small percentage of what they claim is their usual bill. Not surprisingly, hospitals don’t want you to know what they actually charge if you have insurance because you may use that information to negotiate a better deal for yourself, if you are a cash payer.  Patients may also use that information to choose between hospitals providing like services. Patients may also see how unfair hospital bills are, if you do not have insurance.

 

The hospitals have been fighting this order in the courts. They recently suffered a significant setback when the court concluded that the order by the federal government was a reasonable one. I’m sure, however, that the battle is not over. The hospitals will continue to fight tooth and nail to keep you from learning this information, which is so important to an efficiently functioning healthcare system. 

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June 19, 2020

Fake doctors are a thing.  They are a thing in other countries and here in the United States as well.  We in Arizona are not immune to them either.  Back in March of this year, the Maricopa County Sheriff’s Office arrested a man who claimed to be a holistic medicine doctor and who was using this claim to defraud victims and to sexually assault women.  According to the MCSO, he had been doing this since 2013.  It amazes me that, with the resources available on line today, so many people can be fooled for so long a period of time.  Don’t be a victim.  Before going to see any medical provider, check his or her credentials with the appropriate state licensing board.  Even if your provider is properly licensed, you may find important information which affects your care.

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June 16, 2020

As part of this week’s blog post, I wrote about the breach of trust by nursing homes in the Covid pandemic.  Here is a similar story.  A veteran living in a leased facility on the campus of a VA hospital in Massachusetts went missing on May 8.  The staff reported him missing to the authorities.  Yesterday, the veteran’s body was found in a stairwell outside the lease premises, but still on the VA grounds.  He was wearing the same clothes he was wearing at the time of his disappearance.  An investigation is underway but the operator of the leased premises and the VA are blaming each other and each claiming the other has exclusive control over the stairwell.  In any event, it does not appear that anyone conducted much of a search of the premises when the veteran went missing.  Someone, perhaps many someones, need to do a better job of caring for their patients.

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June 15, 2020

In a couple of weeks I will be doing an longer blog post on problems with our supply chain for medical equipment.  In the meantime, the problem was acutely demonstrated by a story in the Wall Street Journal about Chinese medical supply manufacturers.   These manufacturers are required by U.S. law to have an agent in the United States to serve as a point of contact between themselves and the Food & Drug Administration, in the event of problems or just to schedule one of the inspections the FDA does of foreign manufacturers.  According to the Journal story, 1,300 of these manufacturers identified the same company as their agent and gave a Delaware address for the agent.  There were a couple of problems.  One is that there is no company by the name given.  The second is that the address was a private home where no one knew anything about the alleged agent.  Further investigation seemed to suggest that this was a misunderstanding by the Chinese manufacturers, that there was an agent and that they simply misidentified it en masse.  Even if this explanation is true, it shows a shocking hole in the FDA’s ability to monitor these manufacturers.  Given the number of defective medical products, including N-95 masks, that have been shipped out of China to protect our health care workers, we need all the oversight we can get.  These manufacturers apparently don’t give a damn.

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June 9, 2020

I am going a little off topic today.  I am writing about water safety.  I have grandchildren, who come over to the house often.  I also have a pool in my backyard, as do many Arizonans.  If you have ever been around toddlers, you know how hard it is to keep track of them.  You can turn your back for two seconds and they are out the door and into mischief.  If you have a pool that is not properly secured, that can lead to tragedy.  According to the Centers for Disease Control, after birth defects, drowning is the leading cause of death for children under four.  Here is an article about things you can do to make it safer for the little ones who may visit your home.   At my home, we have installed a removable fence with magnetic latches.  It is manufactured by Katchakid and I have been very pleased.  It is easy to set up and remove and has given me great peace of mind when my grandchildren visit.  Whatever you choose to do, do something.

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June 3, 2020

I didn’t realize it but medical professionals say there is a right way and a wrong way to breathe.  Breathing through the nose, when possible, is better than breathing through the mouth.  Breathing through the nose allows the nostrils to filter out allergens and bacteria, to warm air that is too cold, and to humidify air that is too dry.  There are some other tips that make this worth a read.

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June 1, 2020

Maybe you are not just scatterbrained.  Maybe part of the problem is your diet.  We have all heard that we are what we eat.  A recent study shows that, following a meal high in saturated fats, it is often more difficult to concentrate.  Researchers are not sure of the exact mechanism by which saturated fats affect concentration but they are confident of the relationship.  More evidence that a Mediterranean diet is a good lifestyle change to adopt.

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May 18, 2020

Keep it moving, keep it moving.  I don’t know where you are sitting out the coronavirus or if you are sitting it out at all.  For those of us who have been spending more time at home, the temptation to snack or have a quarantini is hard to resist.  This means excess pounds.  The solution, besides more willpower, is to keep it moving and exercise.  A good walk or run or some trips up and down the stairs can do wonders.  As a matter of fact, exercise is good for us, pandemic or not, so keep it moving.

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May 13, 2020

For many years, PSA testing has been the primary way of determining if a man has or may have prostate cancer.  Elevated levels of PSA (Prostate Specific Antigen) usually lead to an invasive biopsy.  All in all this is a terrible way to diagnose prostate cancer.

PSA tests fail to identify many men with prostate cancer and, on the other hand, return positive results for many men who do not have prostate cancer at all.  This means men who should be treated do not get treatment and men who should not be treated are, at a minimum, exposed to invasive biopsy procedures and unnecessary treatment.

The latest research shows that cancerous cells in the prostate produce molecules in the urine that can be detected.  Here is a link to a recent article on the subject.  The new testing is a step forward as it is accurate and non-invasive.

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May 7 2020

For those who are considering making their own face masks to address COVID-19 issues, here is an article suggesting some effective fabrics to use.

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May 5, 2020

There are news reports of a rapid, inexpensive but accurate test for COVID-19 using the Crispr gene-editing technology.  Epidemiologists have stated that we will need rapid, accurate and inexpensive tests in order to fully reopen the country.

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April 29, 2020

Here is an article on making a homemade mask and a material combination that is highly effective at screening out even very small particles.  A caveat, however, is that fit is critical.  If the mask is not properly fitted to the face and has openings at the sides or top or bottom, at least 50% of the effectiveness is lost.

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April 28, 2020

Even during the Coronavirus pandemic, we can be grateful that the Justice Department is continuing to prosecute those who would defraud the taxpayers by ripping off the Medicare system.  The latest is an orthopedic surgeon who agreed to reimburse the government $1.75M to resolve charges that he accepted bribes from a company that makes orthopedic medical devices.  According to the government, he is the sixth physician to pay money to resolve allegations that he accepted bribes.  Whenever there is money on the table, there will be doctors and others willing to forget their oaths and put their own interests ahead of those of their patients.

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April 27, 2020

We keep learning more and more about the things we already knew were bad for us.  Chalk up another bad consequence of obesity.  In addition to adverse effects on the cardiovascular system and Type II diabetes, it now appears that obesity makes you mentally slower and less able to mentally function.  Here is a story on recent research into this subject.

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April 20, 2020

Heart disease is one of the most significant causes of death in the United States.  We typically think of it as a disease of older Americans.  Years of bad living have a way of catching up with us as we age.  Younger people don’t need to worry about it as much.  New research suggests that is not true.

A study which recently appeared in the Journal of the American College of Cardiology, the researchers report that they found coronary artery disease progressed rapidly in a very substantial population of otherwise healthy adults in their 40’s.  The disease process was marked by the deposition of fatty plaques in the arteries.  Once those are present, it is extremely difficult to remove them and, should they rupture, they can cause a heart attack.  Word to the wise, take your cardiac health seriously, even in your younger years.

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April 10, 2020

This could be a game changer.  Researchers in Great Britain and the United States have developed a blood test that can detect 50 different cancers with a 90% accuracy rate and can tell where in the body the cancer originated.  Their results are reported in a paper in the Annals of Oncology.  One of the greatest diagnostic problems in cancer treatment is that detection often comes late in the disease process and this means the cancer has gotten a big head start on the doctors trying to treat it.  This blood test will allow doctors to discover cancer in its hiding places long before it would have been discoverable by the usual methods.

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April 2, 2020

Want some medical treatment but afraid to go to the doctor‘s office or the urgent care to get it? Maybe this is a good time to look into telemedicine instead. See the doctor online may be just the ticket. You are not alone.

According to the Wall Street Journal, telemedicine websites, which had been struggling to catch on, are being overwhelmed by patients.  It will be interesting to see whether this newfound popularity continues after the coronavirus crisis passes and people are once again willing to visit the doctor in person.

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March 30, 2020

Taking a break from Covid news today. In a finding that should be important to all older people facing the prospect of potential dementia, researchers in Great Britain have discovered that most forms of frontotemporal dementia are accompanied by brain inflammation. This discovery, it is hoped, will aid them in developing new treatments to prevent the onset of dementia by addressing inflammation in the brain. Keep your fingers crossed.

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March 24, 2020

Not all doctors are putting the health of the public ahead of their own or that of their family in this time of crisis.  In an apparent widespread practice, doctors are writing prescriptions for themselves and their families for drugs mentioned by the President as perhaps being effective against Coronavirus.  These drugs were being used successfully by people with proven medical conditions, such as lupus.  Because of hoarding by doctors, these people can no longer obtain the drugs they desperately need.  Some state pharmacy boards have issued orders to stop this hoarding.  They shouldn’t have to act to prevent doctors from  behaving unethically.

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March 23, 2020

In these difficult times, here is some good news you may be able to use.  Recent studies have found that daily meditation may slow the aging process in the brain.  If there was ever a time when a little meditation would be particularly good for us, this is it.  Commune with your inner self or your higher power.  It can’t hurt and, beyond the usual benefits of meditation, may keep your brain young.

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March 19, 2020

I try not to get political on these pages but today I am reminded of the importance of the vote.  In 2016, just a little over half of the people eligible to vote did so.  Many of those who did not vote took the position that their vote is meaningless since all the candidates are the same.  The Coronavirus crisis shows this is not true.  It also shows that the consequence of the vote for President goes far beyond the actions of the President himself or herself.  Far more significant are the actions of those who surround the President.  In the case of the current administration, there was a hostility to science and to expertise and an elevation of the importance of ideology and personal loyalty to the President.  As a result, many of our important health care institutions were hollowed out or were targeted for budget cuts.  We are all paying the price for the consequences of the last Presidential election.

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March 16, 2020

1918 not only brought us the last year of the First World War, it brought us what has been called the “Spanish Flu,” an influenza outbreak caused by a novel virus for which human beings had no acquired immunity.  Sound familiar?  It should.  It is very similar to the situation in which we find ourselves today with COVID-19.  We can learn a lot from the experience of 1918.  If nothing else, it should educate us about the risks inherent in a new virus.  Take this virus seriously.  It must be taken seriously by all of us because, if we don’t, we have the capacity to infect others through our carelessness.

It was less than two months ago that I wrote about the first case to arrive in the United States from China.  At that time, it had killed only 6 people in China.  That seems like a million years ago in terms of what has happened since.  The world has changed and so have we.  We still have a long way to go before this is even close to being over.

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March 10, 2020

Every day it seems as though there is another report on the benefits of exercise and activity on the human body.  We evolved as hunters and gatherers, always on the move.  The invention of the couch, the television and fast food came much later in our development.  We are meant to be active and, when we are not, we pay the price.  That said, it is never a good idea for a person who has been sedentary to suddenly take up high intensity interval training or any intense activity, for that matter.  Sudden, high intensity activity in a sedentary person increases the risk of a heart attack.  As one doctor put it, exercise is a medicine; too much or too little can be bad for you.  The moral of the story for those of us who have not been active is to start out slowly, but to be sure to start out.

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March 9, 2020

Wash your hands often and don’t panic is the good advice being given by knowledgeable health care professionals.  The same precautions we should be taking against getting the regular flu apply as well to the Novel Coronavirus (COVID-19).  Exactly how deadly is this virus is a question that cannot be answered until scientists have more date with which to work, especially more Western data.  Most of the cases so far have been in China and extensive, hard data from that country is not yet available.  Additionally, this disease usually kills through pneumonia, a disease which affects the lungs.  Many more men are heavy smokers in China than in the United States.  Does that make a difference in the mortality risk?  We don’t know but logic says it should.   Practicing good personal hygiene is good for you and for those around you.  We will make it through this together.

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March 4, 2020

The Feds are coming for bad nursing homes.  If you are fortunate, you have not had a loved one in a nursing home.  It is never a happy occasion to have to put a loved one in a nursing home, no matter how wonderful the home may be.  Some are not so wonderful.  They are understaffed, poorly maintained and uncaring about anything, other than the monthly charges.  We see bedsore cases, cases of abused patients and cases of extreme neglect.  Apparently, enough is enough.  The Justice Department has announced the formation of a task force to address abuse, neglect and financial exploitation of the elderly in nursing homes.  This is definitely a good thing.

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March 3, 2020

There are almost 200,000 children and adolescents in the United States living with Type 1 diabetes.  One of them is my 9-year-old grandson.  He is in his sixth year of living with the disease.  As a result, I am very interested in Type 1 treatment news.  Some good news just arrived.  Researchers have succeeded in developing a method to force pluripotent stem cells, which can become any cell in the body, to become insulin producing beta cells.  They have injected these cells into diabetic mice and have been able to return the ability of the mice maintain normal blood sugar levels for 9 months before the immune systems in the mice destroyed the new beta cells.  The good news, of course, is that more stem/beta cells can be implanted to keep the process of normal insulin production going and going.  Still a long way to go but very promising.

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March 2, 2020

There is an excellent story in the New York Times about the critical importance of medical examiners to public health and the many challenges they face due to underfunding and misunderstandings about their importance on the part of politicians and the public.  A related problem is that there are just too few forensic pathologists to do all the autopsies that ought to be done.  I strongly recommend you read the story and then see if your city or county is doing enough to protect the public by supporting this vital work.

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February 26, 2020

The coronavirus is coming.  It is a question of when and not if.  Here are some tips for protecting yourself.  Among them, wash your hands frequently, keep your distance from people who are coughing or sneezing, avoid touching your eyes, nose or mouth, practice good respiratory hygiene and, seek medical care if you get sick.

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February 25, 2020

We all suffer from what are called “cognitive biases.”  These are tricks the mind plays on us.  They are the result of the mind trying to make sense of the world around it and making up shortcuts to accomplish its many tasks.  Interestingly, we all suffer from the same cognitive biases, and that includes doctors.  The cognitive biases of doctors affect the decisions they make when treating patients.

One common cognitive bias is confirmation bias.  It refers to the tendency to look for and give greater weight to information that confirms something we already think.  For doctors, it means they may look for evidence that confirms a tentative diagnosis they have already reached while at the same time ignoring evidence that points to a different diagnosis.

Another common cognitive bias is the anchoring effect.  It involves the observer tending to give greater weight to the first piece of information he or she receives and less weight to subsequent information.  If the first test results a doctor sees are normal, the doctor may give less weight to other test results which are abnormal.

Left digit bias explains why we see gasoline priced at $3.99 per gallon and believe it is substantially cheaper than gas at $4.00 per gallon.  For doctors, seeing a lab result of 6.9 may be perceived as substantially less than a result of 7.1, even though the two are almost identical.  That can have a major effect on decision making.

The medical profession is aware of the existence of these biases and is trying to address them.  Some solutions are computer diagnosis programs with algorithms that push the doctor in the right diagnostic direction.

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February 20, 2020

I am not holding my breath but the Wall Street Journal reports that the big drug companies are losing the ability in Washington to block legislation aimed at reducing skyrocketing drug prices.  This is primarily occurring because Republican lawmakers, who have been the primary defenders of the industry, are feeling threatened by the growing public insistence that something be done about high drug prices.

Don’t think the rise of drug prices is solely a Republican problem.  The drug company lobbyists are equal opportunity influencers.  They donate to Democrats as well as Rebublicans.  Even when the Democrats controlled the White House and both houses of Congress ten years ago, the drug companies were able to block any meaningful legislation.  Despite my skepticism, let us hope that this is indeed the dawn of a new day on Capitol hill.

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February 13, 2020

As usual, your mother was right.  Washing your hands often is a good idea and one of the most effective means of preventing the spread of viral infections, such as the novel coronavirus sweeping China.  While a short wash with soap is better than no wash at all, a longer wash of about 20 seconds is the most effective and efficient.  Be sure to get the back sides of the hands and between the fingers too.  Hand sanitizers are helpful but no substitute for a thorough wash.

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February 11, 2020

“Eat more fish.”  That is the conclusion to be drawn from a large study seeking to compare the heart risks associated with eating processed meats, unprocessed red meats, chicken and fish.  All but fish increased the risk of cardiovascular disease, with processed meats leading the way.  The study has some limitations but is important, nonetheless.

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February 10, 2020

New imaging technology involving low dose x-rays permits full body x-rays which may eliminate the need for some autopsies or eliminate the need for certain steps in an autopsy.  This can be important for those religions that frown on the physical intrusion to the deceased that happens during a routine autopsy.   Here is a link to a story about this technology.

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February 6, 2020

File this under “What took you so long?”  A New Jersey oral surgeon was temporarily suspended in 2016 after multiple inspections of his office by the Department of Health found unsanitary practices.  He is in the news because he has finally agreed to a five year suspension and payment of $300,000 in fines.  During the time the health department was finding, documenting and warning about unsanitary practices, the doctor was allowed to continue to perform oral surgery.  During that four year time period, 15 of his patients developed heart infections, many of which led to heart valve surgeries, and one of which led to death.  None of the patients who developed bacterial endocarditis had a history of heart issues before becoming patients of the surgeon.  One of the patients who needed heart valve replacement was only 26.  Undoubtedly, this malpractice is the subject of multiple lawsuits but the question still remains, “What took so long to suspend this guy?”  How many times do you have to find him in violation of safety rules before you shut him down?  I respectfully submit that four years is too long.

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February 3, 2020

More bad news from China.  It’s not just the coronavirus.  As with so many products these days, most surgical gowns are manufactured in China.  A large surgical gown manufacturer in China has been discovered using factories that have not been registered with the Food and Drug Administration.  The factory has not been meeting cleanliness standards and at least some of the surgical gowns have been contaminated and are not sterile.  To make matters worse, the gowns are often packed along with other sterile items used in the operating room.  Millions of the surgical gowns have been recalled as have the packages containing the other surgical equipment.  This has caused substantial hardship at some hospitals.  Some surgeries have had to be cancelled or rescheduled because of the recall.  Here is a link to a CBS news story on the recall.

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January 31, 2020

I am not a coffee drinker but my wife sure is.  On top of that, my son owns one of the best coffee shops in Phoenix, Copper Star Coffee on 7th Avenue.  Caffeine is the most widely used psychoactive substance in the world.  Many people use it to fire up their brain and to get some extra energy.  According to a recent study, acute exercise can be just as good for the brain as it is for the body.  Acute exercise is as effective as caffeine in stimulating the brain, improving memory, and making you feel energetic.  Why not both?

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January 29, 2020

Researchers have discovered the secret to a longer, healthier life.  Guess what?  It isn’t a secret at all.  Avoid these five behaviors and you significantly increase your chances for an extra seven to ten years of disease-free life.  The bad five to avoid:  Smoking; Drinking too much alcohol; Not exercising; Being overweight; and Eating an unhealthy diet.  Now you know.

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January 21, 2020

The first case of the new Chinese coronavirus has reached our shores.  A gentleman who just returned to the United States from Wuhan, China, the epicenter of the disease outbreak, tested positive for the virus and is in hospital isolation in the state of Washington.  The disease has killed six and sickened hundreds in China so far.

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January 17, 2020

Disappointing news from a large test of whether active measures can keep the sickest patients from relapsing and returning to the hospital.  Five percent of the patients are responsible for about half of all health care spending.  One theory has been that if we could spend some money following up with these patients, making sure they are taking their meds, eating right, and getting appropriate preventive care, maybe we can keep them healthy enough to stay out of the hospital.  This test found that it was very difficult to keep these people out of the hospital and that all the interventions did not seem to make a difference.  Time to go back to the drawing board.

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January 16, 2020

Well there is good news and bad news on the economic and health fronts today.  The good news on the economic front is that the economy is nearing full employment.  People who want to work can find jobs and wages are rising as employers are forced to compete for employees.  The bad news on the health front is that, for every 1% decrease in the jobless rate, there is a 16% increase in the number of doctor visits because of the flu.  The speculation is that more crowded workplaces facilitate the spread of the flu from worker to worker.  Best advice is to get your flu shot, wash your hands often and stay home, if you are sick.

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January 15, 2020

In an unexpected finding, deaths due to cardiovascular disease are rising throughout the United States among middle aged people, aged 450 to 64.  By contrast, deaths due to cardiovascular disease are less among older Americans.  This was a finding made by the Wall Street Journal when it examined mortality statistics.  The future does not look good either as many elementary school children are obese and have high or borderline high cholesterol already.

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January 10, 2020

In what could turn out to be a very significant development in the delivery of affordable health care in the United States, California is looking into contracting with generic drug makers to produce drugs California could then sell/distribute to its citizens, many of whom are on Medicaid.  The investigation is said to be in its very earliest stage.  All I can say is that it is about time someone did something about runaway drug prices.

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January 6, 2020

A pair of San Diego ophthalmologists are paying the federal government nearly a million dollars to resolve claims of Medicare fraud.  A doctor who used to work at the practice filed a whistleblower complaint and will get a sizable check as a result of the settlement.  The doctors submitted bills to Medicare for treatment they claimed was performed by them but was actually performed by another doctor who was not qualified to treat Medicare patients.  According to the federal government, this constitutes Medicare billing fraud.  Here is a link to some local news coverage of the settlement.

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January 3, 2020

I read something today that really surprised me and may surprise you.  The most significant modifiable risk for developing dementia is hearing loss.  Hearing loss exceeds smoking, social isolation, high blood pressure and lack of exercise as modifiable risks for dementia.  And it doesn’t even have to be a big loss in hearing.  Even a small loss in hearing can increase the risk of dementia.  Here is a New York Times article on the subject.  One of the author’s recommendations is to use noise cancelling earbuds so that you don’t have to jack the volume up in order to be able to hear your music.  I am on my way to get a set of the new Apple AirPods Pro earbuds with noise cancelling.  I like my music and my brain.

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January 2, 2020

While artificial intelligence (AI) is not an unalloyed blessing, it does have the potential to improve our lives in many ways.  One of the ways is in reading x-rays.  Already, trained computers can detect lung cancers, eye disease and kidney injury better than most radiologists.  This is a good way to back up radiologists and improve the quality of care.  A recent article in the Wall Street Journal describes the successful use of  Google Health’s AI to detect breast cancer better than many doctors.  It also was reported to reduce the number of false positives.  A false positive occurs when a study is read as showing cancer or likely cancer.  It is a problem because it means more testing and perhaps a biopsy to rule the breast cancer in or out.  The new breast cancer algorithm is not yet ready for prime time but demonstrates the advances being made in this important area.