Here we address interesting and important issues affecting the delivery of medical care and related topics from 2021.
We cover additional, related issues and discuss them in more depth on our blog.
In The News: 2020, 2021, 2022, 2023
December 23, 2021
A San Diego plastic surgeon and his operating room nurse have been arrested and charged with involuntary manslaughter in the death of a patient who was undergoing a breast augmentation procedure in the doctor’s surgery center. According to prosecutors, the surgery was nearly complete when the patient went into cardiac arrest. Surprisingly, there is no suggestion in the charges that an anesthesiologist was present. Rather than call 911, the surgeon and nurse attempted to resuscitate the patient on their own. They were able to get her heart restarted, but she continued to deteriorate. The surgeon called other doctors for advice and more than one of them told him to call 911. He finally did call 911, but not until three hours after the patient’s heart first stopped. The patient survived for a few more days but never regained consciousness.
There are risks inherent in every surgery. When surgery is performed in an office setting without an anesthesiologist present, the risks are far greater than if the surgery is performed in a hospital operating room with an anesthesiologist present. Seems to me that the minimum you can ask for is that the surgeon call 911 for help when things go wrong. Looks like that is the way the prosecutors view it as well.
December 22, 2021
Our bodies don’t know it is almost 2022. They think we still live as hunter gatherers did 50,000 years ago. One of the ways that affects us today is that, when we attempt to lose a lot of weight, especially in a short period of time, our bodies react by greatly slowing our base metabolism to keep us from starving to death. Perversely, that lowered base metabolism stays low, even if we regain much of the weight we lost in the first place. Lessons to be learned are to reduce gradually and to combine caloric restriction with exercise. Good luck.
December 7, 2021
When choosing a hospital, you can add another question to your list: How likely is this hospital to sue me, if I can’t pay the full bill? According to a review of records from Wisconsin by the Wall Street Journal, some hospitals are much more likely to sue their patients than others. This is no small thing. People who are uninsured or who have insurance but high deductibles or co-pays, can find themselves stuck with high hospital bills and no way to pay. While most people are willing to try and work something out with the hospital and pay the bill over time, a hospital that uses lawsuits against its patients can ruin credit and make life very hard for those patients. Do yourself a favor, even if you have insurance, see if the hospital you are thinking about using is suit happy or not.
December 6, 2021
What’s in a name? Plenty, apparently. Physician Assistants claim that they get n0 respect because people figure they are nothing more than glorified nurses. They want to change their title to Physician Associate. That does not sit well with physicians, who claim that this will mislead the public into thinking that the Physician Associates are just junior doctors. This turf battle will undoubtedly go on for some time. Wake me when it is over.
December 3, 2021
I recently blogged about the practice effect for surgeons and how powerful it is. Here is a link. A recent story in U.S. News and World Report confirms the effect and its size. One statistic that struck me was that “routine” knee replacement procedures had a 24 times greater risk of death when performed at a rural Colorado hospital with 25 beds than the national average. The risk of death from hip replacements was three times as great.
December 2, 2021
Beware the scammers. They are seemingly everywhere trying to steal your money and your data. One of the more common scams at this time of the year centers around Medicare’s open enrollment period. Scammers sign Medicare beneficiaries up for Medicare Advantage plans without their knowledge or consent and then get commissions for doing so. Or scammers get your Medicare number and charge Medicare for treatment you never received. Don’t give out your personal information to anyone. Scammers can make it appear that the call or text you are receiving is coming from Medicare or from your local hospital or from your doctor. Don’t fall for it. Before giving out any data, hang up and call back at a number you have looked up yourself. It takes all of us to keep the scammers in check.
December 1, 2021
Another reason to get the COVID vaccine, if you need one. According to all the research, as we age, we lose some of our ability to smell things. More than half of all adults 65 to 80 have some degree of olfactory dysfunction. Researchers are not sure exactly why this happens, and it is probably multi-factorial, but it gets worse as we get older. One thing they know does make it worse is a COVID infection. According to new research, 1.6 million Americans have chronic smell problems due to COVID and it is worse among those who are older and who may have had some declines in this area even before they got COVID. Save your life and maybe even your sense of smell – get vaccinated and then get boosted.
November 30, 2021
Using a process they call “bar coding” scientists are learning new lessons about the behavior of cells in the body. The bar coding allows them to label a cell. Once it is labeled, all of its descendants will carry the same label. Using this method, which is only a few years old, they have already figured out why some cancer treatments work and why some don’t. The answer lies in the fact that the cells scientists believed were the sources of cancer and to which they directed chemotherapy were not in fact the source at all. The source was other cells, which were unaffected by the chemotherapy. Although bar coding of cells has not resulted in any new treatments yet, the increased understanding it is permitting will lead to new and more effective treatments for cancer and other diseases.
November 24, 2021
Hallelujah! It looks as though, after many, many years of diabetics being at the mercy of the big drug companies and their never ending price increases for insulin that Congress is going to pass legislation to cap insulin costs. The exact form this will take is still being debated but it appears this will finally get done. Congratulations to all those who worked so hard and for so long to make this happen.
November 17, 2021
Big Pharma is flexing its muscles again, this time over the possibility that Congress will allow the federal government to negotiate the price Medicare pays for prescription drugs. On the way in to work this morning, I heard a radio spot in which a couple was lamenting that, if Congress permitted price negotiation, the drug companies would not have enough money for research into new wonder drugs and how awful that would be. Trust me, the sky is not falling, if Medicare gets to negotiate drug prices. We pay more for the same drugs than any other country in the world. It is time to get past the drug industry’s scare tactics and let the market establish fair prices for drugs. Why is Big Pharma afraid of fair prices?
November 15, 2921
Medicare beneficiaries are about to experience the largest premium increase in program history. About half of the increase is due to the approval of a very pricy and controversial Alzheimer’s drug. The new drug is controversial because it does not cure Alzheimer’s. At best is slows it progression and yet it costs almost $60,000 per year to treat a patient. This once again highlights the abject failure of Congress to allow Medicare to negotiate drug prices with the manufacturers. Seniors are at the mercy of Big Pharma. When it chooses to raise prices, Medicare beneficiaries must either pay up or do without.
October 28, 2021
Here is another one, this one close to home. A doctor, who maintained what he called a mobile practice in Phoenix and Tucson, has been indicted for Medicare fraud. The allegations are the usual ones: billing for more services than were delivered, billing for services not provided, claiming a higher degree of complexity than the procedure justified. He is accused of billing Medicare for $33,000,000 of services. That sure seems like a lot and you have to wonder how he was able to escape detection long enough to bill that amount. I wish they were a little more vigilant.
October 25, 2021
Something is going on with younger women and pancreatic cancer. More and more younger women, especially between the ages of 15 and 34, are developing pancreatic cancer. The disease used to be more prevalent in men, but, if the current trends continue, women will have a much higher incidence than men in the not too distant future. Medical researchers are at a loss to explain why the rates for women are on the increase. Likely, there is something in the environment to which they are exposed and to which men are not.
The prognosis for pancreatic cancer patients is poor because the disease is usually discovered late in its development when surgery is no longer a viable option. The five year survival rate for pancreatic cancer patients is only 10%. That survival rate has barely budged over the last 20 years, despite the advancements in the treatment of other cancers. All of this points up the need to identify patients with pancreatic cancer earlier than we are able to do now. Genomic testing may provide a tool for early detection. Time will tell.
October 21, 2021
Privatization is the practice of using a private company to deliver services that would otherwise be delivered by the government. It is very popular with some politicians, who claim that private business is more efficient than the state so that taxpayers get more for their money. Sadly, it doesn’t always work out that way. The latest example of privatization failing to deliver comes from Iowa.
A few years ago, the governor privatized Iowa’s Medicaid program. It had been run by the state and would now be run by two private companies. After many complaints, the state auditor conducted an investigation, which showed that the two companies were improperly denying many Iowans the benefits to which they were entitled and were breaching their agreements with the state. Predictably, the companies say the state auditor just doesn’t understand how these things work. Unsurprisingly, it looks like our old friend money may be playing a role in the coverage denials by the private companies, which are still being paid for the care they are refusing to provide.
October 18, 2021
More evidence that our bodies were evolved to live in a certain environment and do not do well when taken out of that environment: Chemical tests have detected markers of brain damage in blood samples taken from astronauts returning from months in orbit in the international space station. The numbers of tests are small, of course, and the researchers admit there could be many reasons for the damage. It could be the result of prolonged weightlessness, the stresses of launch and recovery, or changes in brain fluid. The concern is that we cannot send people on long term missions in space until we understand the causes of brain damage and have a plan to address them.
October 14, 2021
Still another story in the news about a doctor misusing his position to gratify his sexual desires. This one in New York City. He abused women, some by addicting them to drugs and then trading drugs for sex. His hospitals allowed him to be in examining rooms alone with his female patients. When he would finally be caught at one hospital, he was allowed to move on to another without the new hospital being told that he was a predator. One more example of how the medical profession does a lousy job of policing itself. When are we going to wise up and make some changes?
October 12, 2021
Doctors are rethinking the prescription of low dose aspirin to men and women below 60 who are at risk of having a heart attack but have not had one yet. The latest research suggests that the risks associated with long-term use of even low dose aspirin in this group outweighs the benefits in preventing heart attacks. For that reason, this group should no longer take low dose aspirin on a regular basis as a prophylactic. This does not change the recommendations for older patients who have had a heart attack in the past. Their physicians may still prescribe daily low dose aspirin.
October 6, 2021
It seems as though every time you turn around there is another story in the news about a predatory doctor abusing his (why are they always men?) patients while those who were supposed to be protecting the public were looking the other way. The most recent story involves a pediatrician employed by the Indian Health Service to provide medical care to Native American children on reservations in Montana and South Dakota. This doctor worked for the Service for thirty years. During that time there were numerous complaints about him abusing young, male patients. Despite these complaints, senior employees of the service failed to document or investigate them. There is even evidence that whistleblowers who complained about the doctor were punished. For whatever good it does his victims, the doctor is now serving five life terms in prison. Can we please get someone to take seriously their responsibilities to the public?
October 5, 2021
Car makers and appliance makers are not the only manufacturers whose businesses are being affected by the shortage of computer chips. Makers of medical devices also rely on the availability of chips in the creation of their products. MRI machines, monitors, EKG machines, diabetes blood testing devices and many, many more need computer chips to operate. While the public can probably afford to wait for the new car or the new dishwasher, a shortage of medical equipment can be critical and life-threatening. Manufacturers of medical devices have taken to going directly to chip manufacturers and suppliers and asking for priority in getting the chips they need. So far, it appears chip suppliers have been sympathetic but delays and price spikes are a continuing problem.
October 4, 2021
As if we needed more proof that our system of pricing hospital services is broken. In today’s Wall Street Journal there is an article about how wildly different are the charges for treating Covid patients even in the same hospital. The hospital was New York-Presbyterian Weill Cornell Medical Center. For a similarly situated severe respiratory distress patient, the hospital charged patients insured by Aetna around $55,000. If the patient was insured by United Healthcare, the hospital charged around $64,000. If the patient was insured by Anthem’s Blue Cross Blue Shield, on the other hand, the charge was nearly $95,000. If you think this makes no sense, you are right.
September 28, 2021
Humans are not the only ones who are being put in harm’s way by the ability of bacteria, viruses, and other dangerous organisms to evolve so as to defeat existing medical treatment. Poor Fido is in the same boat. Hookworms are a common parasite in dogs. They have now evolved to the point that the existing drug therapies are no longer effective. A large part of the blame is being placed on dog parks, where dogs can be infected over and over with hookworms who have survived attempts to kill them. Hookworms are also a threat to humans. They can penetrate the skin and cause itchy, red rashes. Many vets recommend keeping your dog away from the dog park.
September 21, 2021
Here is a link to the first part of a two part story on CBS News about medical boards failing to protect the public by failing to discipline bad doctors. The story focuses on an OB/GYN, who also performs plastic surgery procedures. When a prospective patient looked him up on the web site of the California Medical Board, there was no record of discipline or problems, even though he had been previously disciplined for poor care and for having a sexual relationship with a patient. Although the doctor now is under a multi-count indictment for fraudulent billing, his medical license in California remains active as the board investigates him. The moral of the story is that medical boards often care more about what happens to the doctor than they do about what happens to the patient.
September 15, 2021
You didn’t think it was going to be easy, did you. When the Biden administration proposed allowing Medicare and other government programs to negotiate with drug manufacturers about price, it had the potential to save the taxpayers hundreds of millions of dollars. Of course, those savings would come at the expense of the drug manufacturers, who charge higher prices in the United States than anywhere else in the world. Well, all those lobbying dollars spent by the drug industry and all the political contributions made by it, are having their intended effect now. Some Democrats are joining all the Republicans in opposing the planned changes. This isn’t over yet, but it once again looks good for the drug companies. They tend to get what they pay for. Keep an eye on this story.
August 30, 2021
Even before the onset of the Coronavirus pandemic, there was a shortage of nurses in the United States. Since the pandemic began in earnest, that shortage has grown only worse. Not only do we need more skilled nurses to care for those becoming very sick due to the virus, many of the nurses who were working at the beginning of 2020 have left the profession due to age, illness or just plain, old burnout. This has big implications for everyone.
For one thing it means that when you go to the hospital, there may not be a skilled and experienced nurse there to care for you. Staff shortages are forcing more hospitals to place less-skilled, less-experienced nurses on the front lines. Staff shortages also mean that nurses are working longer shifts to care for the patients who are in the hospital. It also means that many shifts don’t have all the nurses they need to care for the patients they do have. All of this adds up to more mistakes in patient care due to inexperience, inadequate supervision, fatigue and just not enough nurses to meet the needs of patients.
Be careful out there. This problem is not going to be solved for a long, long time.
August 25, 2021
As if anyone should need more evidence that our health care delivery system is broken, here is an excellent article from the New York Times analyzing some of the price data that hospitals are being required to make available. You may recall that hospitals fought this disclosure requirement tooth and nail for decades. Now that they have lost, some hospitals just refuse to comply and have not posted the information or have made it extremely hard to find. Analyses like the one in the Times’ article shows why they continue to try and hide this information.
There is no rhyme or reason for why hospitals charge wildly different amounts for the exact same procedure. Health insurance companies negotiate rates with hospitals. Sometimes they have little incentive to get the best deal since they get paid a percent of the billings. In that case, high billings equal higher pay for the insurance company. In some instances, people with no insurance get charged less for a procedure than those with insurance. In some cases, hospitals charge the same insurer different prices depending on who the insured is or which of the insurer’s plans is involved. This makes a big difference for people with insurance, as they are being forced more and more often into plans with high deductibles and high co-pays.
Don’t let hospitals continue to get away with playing hide the ball when it comes to what they charge. Insist that they disclose their rates as required by law.
August 18, 2021
As with many other things in medicine, there is a lot of money to be made from orthopedic devices, the hardware orthopedic surgeons place in our bodies. They run the gamut from artificial hip joints, to knees, to plates and screws. Here is a link to one of a series of stories from the Kaiser Health Network on abuses involving these devices. According to the article, manufacturer’s representatives sometimes pressure surgeons to implant devices that are the wrong size or are defective. It is worth a read.
August 11, 2021
More on orthopedic surgeons who own stock or are otherwise paid by companies that manufacture or distribute the hardware spine surgeons put in patients. “Whistleblowers and government fraud fighters have argued for years that money passing from industry to doctors can corrupt medical judgment, inflate costs and lead to unnecessary operations or otherwise harm patients.” See more at Kaiser Health news.
August 4, 2021
More and more evidence is accumulating that sleep apnea is bad and can kill. As we become older and heavier, the incidence of sleep apnea increases. The tissue in the airway relaxes and blocks the airway as we sleep. Our body, deprived of oxygen, wakes us suddenly gasping for air. Once we have increased our oxygen levels, we fall back asleep and the pattern repeats over and over again throughout the night. In addition to being linked to a whole host of medical problems, the latest research suggests that those with untreated sleep apnea have a significantly increased risk of sudden death. While not all with obstructive sleep apnea snore, most do. If you snore, you should consider if you have sleep apnea and get tested.
August 2, 2021
A few weeks ago I blogged about the coming genomic revolution. One of the specific goals of the researchers in this area was the ability to test for the presence of cancer by simply analyzing a drop of blood. Well, last week some of the biggest hitters in the medical research industry revealed their new company that claims to be able to do just that. The new company is Grail, as in Holy Grail, and its offering is called Galleri. It claims that the test can detect the presence of more than 50 types of cancers and also identify the organ which developed the cancer. Among the heavy hitters associated with this offering are AstraZeneca, Amgen and Bristol Myers Squibb. Watch this space. Lots more of this to come.
July 22, 2021
I have written on many occasions about the benefits of an active lifestyle. Moving around is what we were made to do and it is good for us. Study after study has shown that being active confers benefits to nearly all parts of our bodies.
Researchers have wondered if the same benefits come from weight or resistance training. Turns out there are significant benefits but they are different. When the muscles are stressed by weight training or resistance training, they send messages to the fat cells telling them that it is time to turn some of that fat to energy. And we all want to lose some of that fat, don’t we?
Bottom line is that, in addition to whatever activity you choose to raise your heart rate and keep your body moving, it would be helpful to add some weight training. It can be as simple as pushups, or squats or using resistance bands. Give it a try.
July 20, 2021
Hospitals across the country continue to resist the rule requiring them to post their pricing data so that it can be reviewed and evaluated by the public. The idea is that, if a patient knows how much it will cost to get a certain treatment at a hospital, she can compare that cost to the same treatment at a neighboring hospital and perhaps choose the lower price. This will theoretically spur competition. Without price data, there is no way patients can comparison shop.
Surveys have shown that 32% of hospitals and hospital chains do not post usable price data on their web sites, despite the federal rule requiring them to do so. Many post the data but insert code into their web pages that prevent Google and other search engines from finding and displaying it. Another 10% post some data but fall short of the price data required by the rule. That means that close to half of all hospitals in the country are violating the rule.
The federal government is cracking down on these scofflaws by increasing the penalties for failing to comply. Hospitals with over 30 beds can now be subject to a fine of $2M annually for failing to comply with the rules. Let’s see if that gets their attention.
July 19, 2021
I wrote about the San Diego doctor who was selling Covid-19 “cure” packages for big money. He billed the treatment kits as “magic bullets” and “miracle cures.” He just pleaded guilty to attempting to smuggle hydroxychloroquine into the country for use in his “cure” packages, to misleading the public and to lying to the FBI when it came to investigate. He will be sentenced in a few months.
June 29, 2021
Good news, coffee drinkers. Drinking any type of coffee significantly reduces the risk of getting nearly any type of liver disease from cirrhosis to liver cancer. Three to four cups a day seemed to produce the greatest protective effect. Although all kinds of coffee were valuable in decreasing the risk of liver disease, coffee made from ground beans was the most effective.
June 28, 2021
Here is the latest example of our broken health care billing system. Like airlines, hospitals break treatment down into as many individual tasks as they can manage with a straight face and then bill separately for each one. The lucky recipient here was a young woman, who went to the emergency department with excruciating lower abdominal pain, which she was afraid might be appendicitis. At the hospital, she had an IV line placed. One CT scan and two doses of morphine later, it was determined that she did not have appendicitis and that the pain was most likely the product of a ruptured ovarian cyst. Good news: ruptured ovarian cysts are typically not a cause for concern and she was allowed to go home. Bad news: when the bill came, the young woman found that the hospital had billed her for each of the two times the nurse had injected morphine into her IV line. The process takes a matter of seconds. It is often even quicker than giving a shot into the arm. Each time, the hospital billed the young woman $700 for a total of $1,400 for maybe 30 seconds of nursing time. There ought to be a law against this kind of insanity.
June 18, 2021
The Centers for Disease Control is looking into reports that over 100 patients who underwent orthopedic surgery using a contaminated bone putty have developed tuberculosis from the contamination. The manufacturer has recalled the product but that is of little help to the poor people who developed TB.
June 15, 2021
Interesting story on the Kaiser Health News platform about start ups, and even Amazon, trying to make money by delivering primary care over the phone or the internet. Lots of room for these companies to grow and to save money for patients and for the employers who pay for their insurance.
June 4, 2021
Perhaps you have read about the fake reviews that appear on travel sites for hotels and restaurants. Those fake reviews also follow the money in health care where a fake review may cost you more than just the price of a bad meal. Glowing reviews and recommendations by “patients” on a doctor or hospital’s web site may not be real. Here is a link to a story in today’s Washington Post on the topic. There is a thriving business in selling fake reviews.
There is also little enforcement against those who sell the fake reviews or those who buy them. You have every right to be skeptical about Google and Yelp reviews and ratings.
June 3, 2021
“Antibiotic stewardship” is the latest step being taken to reduce our society-wide overuse of antibiotics. “Antibiotic stewardship” is a program intended to make doctors more mindful of the overuse of antibiotics and of the steps they can take to reduce that overuse. The CDC now recommends, for example, that when a patient has a bacterial respiratory infection, and the doctor writes a prescription, she should accompany it with the direction to wait a few days to fill it to see if the patient gets better without the antibiotic. Often they will get better on their own and the prescription will never be filled.
June 2, 2021
Our system of drug pricing is so broken. Many insurance plans which cover drugs hire pharmacy benefit managers to negotiate drug prices for them. These managers take a cut. Drug manufacturers blame high drug prices on these middlemen. The middlemen blame high drug prices on the drug manufacturers. Even more troubling, these middlemen apparently get less than the best deal for the insurance plan’s customers. According to a recent article in the Wall Street Journal, 30% of the time an insured person fills a prescription, she or he would have gotten a lower price from the pharmacy had they paid cash for their prescription and not used their insurance at all. The takeaway is to always ask the pharmacist if you can save money by paying cash.
May 28, 2021
Story today in the Wall Street Journal about the many scammers out trying to make money on the Covid pandemic. Medicare is a big target. According to the story, many scammers are billing Medicare for Covid tests and treatments that were never done, often billing into the millions. Scammer motto: “Never let a good crisis go to waste.”
May 19, 2021
From the health news writer at the New York Times on growing older:
“Without regular exercise, you can expect to experience a loss of muscle strength and endurance, coordination and balance, flexibility and mobility, bone strength and cardiovascular and respiratory function. In other words, a sedentary lifestyle is a recipe for chronic disease and decline.”
May 18, 2021
Over a year after hospitals were required to display their prices for services in an easy to find and easy to understand place on their web sites, many still play games and refuse to do so. According to a recent survey, half weren’t doing it at all and many of the other half were publishing their prices in a way that the general public could not understand. If you expected more from America’s hospitals, you have not been paying attention.
May 14, 2021
Covid-19 is the gift that keeps on giving. In addition to all the other woe and heartache it has caused, it apparently is also responsible for a spike in alcohol related hospitalizations. Many people turned to alcohol to alleviate their feelings of anxiety or out of boredom during the pandemic. Now many of them are experiencing gastrointestinal or liver issues from drinking too much. Let’s hope things get better soon.
May 11, 2021
Chalk up another win for the Mediterranean diet. Not only is it the best diet for heart health and for weight loss, there is now evidence that it prevents the build up of proteins in the brain that cause Alzheimer’s. Pretty impressive for pretty simple and pretty good tasting diet.
May 10, 2021
Our old friends at Big Pharma are back at it. Actually, they never left but have increased their lobbying efforts in Washington. According to an article in the Washington Post, the pharmaceutical industry is on track to spend more money lobbying this year than it has ever spent in the past. There are now more than two registered pharmaceutical and health care product lobbyists for every member of Congress. No other industry comes close to the pharmaceutical industry when it comes to spending money to lobby Congress. The industry makes huge profits and is willing to spend big on lobbying to keep it that way.
May 6, 2021
This week’s blog post was about the sale of continuous glucose monitors (CGM’s) to people with Type 2 diabetes. An article in a recent edition of the Wall Street Journal discussed the use of CGM’s by people who don’t have diabetes at all. These folks are health conscious people who just want to keep tabs on their blood glucose levels. One problem for these techies is that you still need a doctor’s prescription and just keeping tabs on your blood sugars when you don’t have diabetes is a problem for many doctors, who refuse to write prescriptions.
May 3, 2021
According to a report by Kaiser Health News, CVS and Walgreens have combined to waste more doses of Covid-19 vaccine that all the states and the federal government combined.
April 29, 2021
Lifestyles of the parents, both mother and father, likely affect health of their children in later life. Greasy diets and obesity by either parent = bad. Healthy diets by both parents and exercise by mom during pregnancy = good.
April 28, 2021
Researchers who study scarring in humans have found that the injection of a drug now used to prevent macular degeneration can prevent scar formation in mice and pigs. The skin of pigs is very similar to that of humans and human trials are now underway. The results are very promising. Keep your fingers crossed.
April 22, 2021
A chiropractor was sentenced to nine years in prison for a large and sophisticated scheme to defraud medicare and health insurance companies. The scheme involved hiring medical doctors to pretend to be the owners of his clinics, billing for services which were never provided or which were medically unnecessary. In these types of schemes, it is not just the defrauded payers who are hurt; patients are hurt as well.
April 21, 2021
Recent research with mice presents some strong evidence that icing muscles after a hard workout or after an injury does not speed healing and, in fact, may delay it. The study of the muscles of mice that had been exercised hard showed a pattern of inflammation which cleaned up and disposed of damaged cells. This was followed by a quieting process which ended the inflammation and rebuilt the damaged tissue. Return to full and strong function was slower in the mice whose muscles were iced and who delayed and reduced the inflammation. Once again, maybe Mother Nature knows best.
April 20, 2021
The importance of getting a good night’s sleep is being highlighted by recent medical research into the risk of dementia. The most recent study shows that getting less than 6 hours of sleep at night during a person’s 50’s is associated with a 30% increase in the risk of dementia in later life. Researchers think that sleep allows the brain to dispose of the toxic proteins that eventually lead to dementia. If a person does not get enough sleep, it allows these toxic proteins to build up in the brain. The presence of these proteins is thought to be a cause of dementia.
April 12, 2021
According to this article by Kaiser Health News, America’s largest hospital systems received the lion’s share of the federal Covid bailout money and many had banner years as a result. Small hospitals, got less and limped along.
April 9, 2021
Finally, some unalloyed good news. Drinking cocoa, as well as green tea, may improve blood vessel function and lower blood pressure, thereby protecting the blood vessels of those who are susceptible to mental stress. Any food having high levels of flavanoids, such as apples, blackberries, pears, black grapes and cherries, will have the same effect.
April 5, 2021
Here is a link to the page of the Arizona Medical Board which identifies the 81 medical doctors who were the subject of board action in the last year. It makes for some interesting reading. See what your medical board has been doing and to whom and for what reasons.
April 1, 2021
Not an April Fool prank. Scammers are not just preying on you and me. According to the Arizona Medical Board, scammers are calling doctor’s offices and making the caller ID look like the call is coming from the Medical Board. They may allege that opioids have been found and tied to the doctor. The scammers then try to get personal identity information or a transfer of money. It is important that all of us be aware of scammers and be careful not to click on unsolicited links and not to disclose passwords or other confidential information unless you are sure of the person asking for it.
March 31, 2021
Another entry for the “use it or lose it” file. For many years, researchers have known that exercise can improve blood flow to the brains of older people. Good blood flow to the brain is essential to good brain health and the development of new neurons. A new study shows that a little brisk exercise can actually improve memory and executive brain function in older adults who are already beginning to experience some cognitive decline. The exercise reverses the process to a degree. Get up off that couch and get moving.
March 30, 2021
A recent study found that black patients were more likely to be treated at lower quality hospitals than white patients with similar illnesses or medical conditions. As a result, black patients were more likely to be injured while in the hospital or to have a poor outcome. Being admitted to a high quality hospital made a big difference in safety outcomes, according to the study. The study did not examine why black patients were admitted more often to lower quality hospitals.
March 29, 2021
There is some bad news and some good news today for the carnivores among us. The bad news is that eating even a small amount of processed meats increases a person’s risk of developing dementia. The surprising good news is that red meat, which has not been processed, may offer some protection against dementia. Strange indeed.
March 26, 2021
Where there is money, there are fraudsters. I have warned about Covid fraudsters in the past. Here is a link to a story about the Justice Department’s cases against the Covid fraudsters they have been able to identify so far. They have brought charges against 474 individuals who have attempted to steal over $569,000,000 in your tax money. There are certainly lots more out there that have not been caught yet.
March 23, 2021
There is still so much to learn about the Coronavirus. The most interesting story I saw today came from of study in Denmark. It found that most people who recover from a bout of Covid have immunity for about six months. This is not true, however, for victims over 60, who are much more likely to be reinfected. Even if a Covid survivor is reinfected, the reinfection is likely to be affected by the residual immune reaction and be mild or even asymptomatic. The fact that natural immunity is not that strong or that long-lasting reinforces the need for everyone, even those who have already had Covid, to be vaccinated.
March 22, 2021
New research suggests that eating breakfast before 8:30 a.m. reduces the risk of Type 2 diabetes. The research did not consider what was eaten but it is assumed that a healthy breakfast is even better if eaten before 8:30 a.m.
March 19, 2021
Are you feeding your gut bacteria properly? This question has been raised by researchers who have found that older people with the greatest change in their gut biome are the healthiest and tend to live the longest. They believe that complex carbohydrates found in fruits, vegetables and nuts provide the nutrition needed for your gut bacteria to continue to do their jobs as you age. Stay away from processed foods to the extent you can.
March 18, 2021
We are barely halfway through the month of March and already the Department of Justice web site related to Medicare fraud cases has publicized fraud complaints, indictments, guilty pleas and convictions involving a total of over $400,000,000 in fraudulent billings.
As astonishing as these numbers may be, there are two things to keep in mind. 1) Many of the government press releases do not mention the amount of the alleged fraud, so there is lots more where that came from. 2) The government catches only a fraction of those who steal from the Medicare program.
March 17, 2021
In 2015, Pfizer took over operation of a drug manufacturing plant after acquiring its then owner. The plant at the time of the acquisition had a bad history of mold contamination, which apparently has continued despite FDA inspections. While this kind of contamination is always of concern, this plant is being used to manufacture Pfizer’s Covid vaccine, which places the FDA in a tight spot since it does not want to shut down vaccine production. Here is a link to a story about the plant.
March 16, 2021
They are definitely out there. A south Florida woman was recently arrested for performing plastic surgery on a man without going through the lengthy and expensive requirement of attending medical school. It is highly unlikely this was her first and only “patient.” Remember, just because someone says they are a doctor does not mean that they are in fact a doctor. Be careful about whom you let touch your body much less perform surgery on it. Not surprisingly, the plastic surgery did not go well.
March 10, 2021
Here is a link to a New York Times story illustrating the insanity of our patchwork health insurance and healthcare system. This gentleman went to the hospital with possible coronavirus just before he became eligible for Medicare and just after he had cancelled his other health insurance coverage. Because the doctors were not sure he had coronavirus, they did not diagnose him with it so he was not eligible for a fund for coronavirus patients. He makes just a little too much to be eligible for other programs which assist the poor. He is now saddled with a bill for over $22,000.00, which the hospital is threatening to send to collections. As one person observed, it is crazy that your diagnosis can make the difference between a bill being paid and one which sends you into bankruptcy. We need to do a better job providing health care and health insurance to our citizens at affordable prices.
March 6, 2021
State prosecutors in New York have taken the unusual step of charging a medical doctor with the second degree murder of five of his patients. The charges were based on the allegation that the doctor prescribed large amounts of opioid medications to patients, who were struggling with addiction issues. He was also charged with recklessly endangering another eleven patients through the same behavior. This is one of the first cases ever to charge a licensed physician with murder in connection with the prescription of opioids. The doctor, 75, no longer practices medicine, having turned in his license in 2019.
March 5, 2021
Add this to the “Keep it moving” file. A study of sedentary African-Americans in their 60’s found that even a little bit of regular aerobic exercise improved brain function and memory. The brains started acting like they were much younger. Among the many takeaways, it is never too late to start being more active.
March 2, 2021
Confused about which vaccine to choose? Don’t be. Often you won’t have a choice anyway. What you get will depend on where you are getting your shot(s) and from whom. Best advice appears to be that when offered the opportunity to get a vaccine shot, take it and don’t worry about which vaccine it is.
March 1, 2021
Here is a good story about how diets high in fructose can damage the immune system by increasing inflammation. Fructose, a natural form of sugar, is found in many fruits and some vegetables. A sensible diet including these foods is healthy. The problem occurs when we eat too much fructose. Many products we see on the supermarket shelves have added sugars. We should stay away from those as much as possible.
February 24, 2021
I have written a couple of pieces on sepsis and the novel treatments being tried to derail this deadly condition. Recently there had been a lot of buzz about the possibility of Vitamin C along with some other vitamins and steroids as a treatment. While there had been some early promise, a large study failed to show any consistent, positive effect. The researchers who originally reported good results are going back to the drawing board in an attempt to figure out why things looked good at first and if there is still a role for Vitamin C in the treatment of sepsis.
February 4, 2021
By coincidence, CNN has a story up about how to avoid Covid-19 vaccine scams. Markers of vaccine scams are offers to help you cut the line to gain a priority, requests that you pay for the vaccine, requests for personal information to register you for the vaccine, offers to ship the vaccine to you for a price, and insisting that you take additional tests before being vaccinated. Be careful out there.
February 3, 2021
Although it took no particular skill to do so, I correctly predicted fraudsters would be out in force to take advantage of the Covid-19 pandemic. What I did not foresee, but perhaps should have, was that elected officials would get in on the act too. The feds have indicted a Missouri state legislator for fraud in the marketing of stem cell treatment for Covid-19 in her health clinic. The fluid she claimed contained stem cells, contained no such thing. In the great tradition of snake oil salespeople everywhere, she marketed the “stem cell” treatments as good for whatever ails you from Chronic Obstructive Pulmonary Disease to erectile dysfunction. The treatments were pricey too. Keep your eyes open and one hand on your wallet whenever you are around politicians.
February 2, 2021
Artificial intelligence continues to make contributions to science and to medicine. The latest news is the use of AI to predict which people with normal cognition will develop Alzheimer’s disease in the future. The experiment involved people who did not have Alzheimer’s. They were asked to describe the scene in a drawing they were shown of a boy reaching for a cookie while his mother dried dishes and the sink overflowed. The computer was able to detect subtle differences in sentence formation on the part of participants who five or ten years later developed Alzheimer’s. The ability to predict the development of Alzheimer’s will allow physicians to direct treatment toward these patients which may delay the onset of symptoms.
January 12, 2021
Finally, the Covid vaccinations have begun for front-line health care workers and residents of nursing homes. Close behind are teachers, law enforcement and those over 75. There is still so much to learn about the vaccines and their effects. One of the questions addressed by today’s Wall Street Journal was whether vaccinated people can still spread the virus. The answer, unsurprisingly, is that no one knows. For that reason, medical experts are urging that even those who have been vaccinated continue to wear masks, socially distance and wash their hands well and frequently until we reach herd immunity and the virus dies out. When we will reach herd immunity, if ever, is also an open question. Welcome to the new normal.