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Archive for July, 2007

Soldiers’ War Injuries = Pre-existing?

This story from NPR caught my eye this morning. Even those who think I go a bit off the deep end when it comes to casting dispersions on insurance and other payor programs that should be paying for our healthcare and don’t… this will make you think twice.

The story concerns American soldiers who have fought in Iraq and have been injured, in this case, by bombs or rockets. They return to the States with long term effects from those injuries ranging from headaches to bleeding ears to insomnia, symptoms which never existed before they left and clearly result from their war injuries. Heck, some of them have been awarded purple hearts for those injuries.

If I understand the story correctly, if the soldiers are diagnosed with post-traumatic stress (PTSD) then the VA will continue to care for them. This is important because most of them don’t stay in the service past their original enlistment, so the PTSD diagnosis establishes that they have suffered from the effects of war. That ensures their care once they leave the service for the injuries suffered during service to our country.

That’s fair. And that’s the point being made by the injured veterans who testified before the US Congress yesterday. But, according to Paul Towns, who runs an organization called Veterans for Common Sense, there may be tens of thousands of soldiers who aren’t receiving that fair care they deserve.

Unfortunately, those tens of thousands are being denied care because, instead of being diagnosed with PTSD, the VA “discovers” that they had a “pre-existing personality disorder” after they return. Never mind that these soldiers passed all their physical and mental tests and exams before they entered the service. Never mind that they didn’t get blinding headaches, bleeding ears or suffer from insomnia before they went to Iraq.

Are you kidding me?

This seems like a travesty to me. That these soldiers fought on our behalf, to help America retain its freedom… and we would deny these men and women who stood on the front lines the healthcare they deserve?

And this is the government doing the denying – not a private health insurance company. That means it is our tax dollars that would need to be spent to take care of these soldiers. I, for one, think that it is a small price to pay to take care of these soldiers who have put their lives on the line to protect me.

Even aside from dishonoring these men and women in this way — for the government to be so underhanded, for the government to strip the possibility of care from these soldiers, establishes a precedent for other payor entities to do the same. Afterall, if a private insuror did the same thing and was sued, all their lawyers would have to do is point out that the US government denied care first!

It’s wrong. I’ll be interested to see what the outcomes of the congressional hearings are. If you have the opportunity to contact your congressional representatives, please do:

Contact information for US Congress Members

Covering the healthcare costs for injured American soldiers is only fair.

………………
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………………

Soldiers’ War Injuries = Pre-existing?

This story from NPR caught my eye this morning. Even those who think I go a bit off the deep end when it comes to casting dispersions on insurance and other payor programs that should be paying for our healthcare and don’t… this will make you think twice.

The story concerns American soldiers who have fought in Iraq and have been injured, in this case, by bombs or rockets. They return to the States with long term effects from those injuries ranging from headaches to bleeding ears to insomnia, symptoms which never existed before they left and clearly result from their war injuries. Heck, some of them have been awarded purple hearts for those injuries.

If I understand the story correctly, if the soldiers are diagnosed with post-traumatic stress (PTSD) then the VA will continue to care for them. This is important because most of them don’t stay in the service past their original enlistment, so the PTSD diagnosis establishes that they have suffered from the effects of war. That ensures their care once they leave the service for the injuries suffered during service to our country.

That’s fair. And that’s the point being made by the injured veterans who testified before the US Congress yesterday. But, according to Paul Towns, who runs an organization called Veterans for Common Sense, there may be tens of thousands of soldiers who aren’t receiving that fair care they deserve.

Unfortunately, those tens of thousands are being denied care because, instead of being diagnosed with PTSD, the VA “discovers” that they had a “pre-existing personality disorder” after they return. Never mind that these soldiers passed all their physical and mental tests and exams before they entered the service. Never mind that they didn’t get blinding headaches, bleeding ears or suffer from insomnia before they went to Iraq.

Are you kidding me?

This seems like a travesty to me. That these soldiers fought on our behalf, to help America retain its freedom… and we would deny these men and women who stood on the front lines the healthcare they deserve?

And this is the government doing the denying – not a private health insurance company. That means it is our tax dollars that would need to be spent to take care of these soldiers. I, for one, think that it is a small price to pay to take care of these soldiers who have put their lives on the line to protect me.

Even aside from dishonoring these men and women in this way — for the government to be so underhanded, for the government to strip the possibility of care from these soldiers, establishes a precedent for other payor entities to do the same. Afterall, if a private insuror did the same thing and was sued, all their lawyers would have to do is point out that the US government denied care first!

It’s wrong. I’ll be interested to see what the outcomes of the congressional hearings are. If you have the opportunity to contact your congressional representatives, please do:

Contact information for US Congress Members

Covering the healthcare costs for injured American soldiers is only fair.

………………
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EveryPatientsAdvocate.com
………………

Doctors are Human, too

A report from the AP last week, and reported by the Washington Post, Fox News and others, describes a survey of more than 3,000 doctors in both the US and Canada about their reactions to their own mistakes.

The survey was developed and issued by the Joint Commission (JCAHO), the body that accredits hospitals and other health care facilities. It asked doctors whether they had affected any near misses, minor medical errors, or serious medical errors which may have caused permanent or potentially life threatening harm.

92% admitted they had been involved in errors. And those involved also reported that after they made the errors, they felt increased anxiety about the potential for future mistakes, less confidence in their abilities, they reported sleep problems and a loss of job satisfaction.

Yes, doctors are human, too. No matter what kinds of egos some doctors may have, no matter that we put them on pedestals and expect them to be all-knowing, and regardless of their extensive educations — they are still human.

But the survey conclusions, and the news reports, fail to draw a few conclusions I think are important for sharp patients:

  • I appreciate the fact that these doctors were so candid. Among the survey questions, the doctors were asked what kinds of help they were offered for dealing with their mistakes (counseling? further education?) and almost no help was offered. Hospitals, in particular, don’t want doctors to admit or discuss problems because they feel like they are open to lawsuits. I see both sides — but my sense tells me that helping these doctors deal with their mistakes in positive ways would perhaps prevent future problems.
  • The number is huge — 92% !! We all make mistakes, granted, but our mistakes don’t usually cause harm to other lives. That’s 92 of every 100 doctors. We know that translates to almost 100,000 deaths per year, too. I don’t know how to do that math, but those numbers are huge.
  • I can’t help but think some (not the majority, but some) of these doctors were affected less because they had caused harm to patients and more because they have huge egos. You’ll remember my blog post last week about the word “ego-dystonic” — a doctor who thinks he is omnipotent could be traumatized by making a mistake because he doesn’t think it’s possible for him to make. So their depression and sense of failure could be more self-indulgent than the reports or statistics might indicate. Further — there is a good chance that many of those egos didn’t report any errors; meaning, the other 8% who said they didn’t experience any errors are really just covering them up.

Medical mistakes are a lot like car accidents — everyone thinks they happen only to someone else. But when we learn to drive, we are taught to drive defensively. We are taught about how accidents happen, and we are taught the rules of the road.

No one teaches us defensive patienting. No one teaches us to watch out for the others on our patient road. No one teaches us how to read the signs or signal our intentions. We’re just expected to know these things.

So perhaps the biggest takeaway from this report is that we patients need to internalize is the sheer numbers of doctors who make mistakes. And we patients need to practice defensive treatment seeking.

Because at least 92% of our doctors are making errors and we are the ones paying the price.

………………
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………………

Lymphoma Patients’ “Secret” Option

Before you read this blog post, I’ll beg you to be patient with me. Having been diagnosed with lymphoma myself, and reading the article I’m about to cite, my disgust and anger can’t be bridled…

If you have been diagnosed with non-Hodgkin’s lymphoma, there may be a cure for you that your oncologist hasn’t even mentioned to you. Yes, I said a CURE. Not just a treatment. A cure.And the reason you don’t know about it is because your oncologist won’t make any money from it. Since he can’t profit, you won’t be cured. Seriously.

Here’s the article I’m referring to, and when you read it, you’ll see why it angers me so. It’s from the New York Times.

It regards numerous patients, all late-stage non-Hodgkin’s lymphoma patients, all of whom had already suffered through chemo, and were then given a shot of either Bexxar or Zevalin, and never needed treatment again.

Both drugs are FDA approved. Both are readily available. So why don’t oncologists give them to their patients? Because they don’t get paid to do so. The only place a patient can get a shot of either drug is through an academic medical center, and not at a private oncology practice.

I’ve blogged previously about oncologists and profits from their drugs. To remind you, oncology is the only specialty I know of that directly profits from the sale of drugs.

Ding! Ding! Ding!! Can you spell c-o-n-f-l-i-c-t-o-f-i-n-t-e-r-e-s-t?

My jaws are clenched because…. My own misdiagnosis revealed the truth. At the end of my debacle, I accused my oncologist of insisting I begin chemo (for a cancer I didn’t really have) because it was the only way he could profit from me. He never even responded.

And from the article, I quote:

“One reason is that cancer doctors, or oncologists, have financial incentives to use drugs other than Bexxar and Zevalin, which they are not paid to administer. In addition, using either drug usually requires oncologists to coordinate treatment with academic hospitals, whom the doctors may view as competitors.”

Then, quoting Dr. Oliver W. Press, a professor at the University of Washington and chairman of the scientific advisory board of the Lymphoma Research Foundation, “Oncologists use everything in their cupboard before they refer,” Dr. Press said. “At least half the patients who get referred to me have had at least 10 courses of treatment.”

So let me review to this to be clear:

If you are a non-Hodgkins lymphoma patient (or a caregiver or advocate for one) then get in touch with the oncology department of your closest academic medical center. That will be a university or medical center or hospital that is aligned with a medical university. Here is a list. Request to be seen by an oncologist on its staff, and take copies of all records regarding your diagnosis and treatment. As you discuss options they can provide to you, ask them specifically about Bexxar and Zevalin and whether or not either drug can help you.

Then let me know if you make progress, please!! I’d love nothing more than to know this blog helped you…. because even though my diagnosis of non-Hodgkin’s lymphoma turned out to be wrong, I still feel such a comraderie with other lymphoma patients…. and while news like this angers me, it also provides me with hope that YOU will find relief.

  ………………
Want more tools and commentary for sharp patients?
Sign up for Every Patient’s Advocate once-a-week or so email tips
Or link here to empower yourself at
EveryPatientsAdvocate.com
  ………………

Lymphoma Patients’ “Secret” Option

Before you read this blog post, I’ll beg you to be patient with me. Having been diagnosed with lymphoma myself, and reading the article I’m about to cite, my disgust and anger can’t be bridled…

If you have been diagnosed with non-Hodgkin’s lymphoma, there may be a cure for you that your oncologist hasn’t even mentioned to you. Yes, I said a CURE. Not just a treatment. A cure.And the reason you don’t know about it is because your oncologist won’t make any money from it. Since he can’t profit, you won’t be cured. Seriously.

Here’s the article I’m referring to, and when you read it, you’ll see why it angers me so. It’s from the New York Times.

It regards numerous patients, all late-stage non-Hodgkin’s lymphoma patients, all of whom had already suffered through chemo, and were then given a shot of either Bexxar or Zevalin, and never needed treatment again.

Both drugs are FDA approved. Both are readily available. So why don’t oncologists give them to their patients? Because they don’t get paid to do so. The only place a patient can get a shot of either drug is through an academic medical center, and not at a private oncology practice.

I’ve blogged previously about oncologists and profits from their drugs. To remind you, oncology is the only specialty I know of that directly profits from the sale of drugs.

Ding! Ding! Ding!! Can you spell c-o-n-f-l-i-c-t-o-f-i-n-t-e-r-e-s-t?

My jaws are clenched because…. My own misdiagnosis revealed the truth. At the end of my debacle, I accused my oncologist of insisting I begin chemo (for a cancer I didn’t really have) because it was the only way he could profit from me. He never even responded.

And from the article, I quote:

“One reason is that cancer doctors, or oncologists, have financial incentives to use drugs other than Bexxar and Zevalin, which they are not paid to administer. In addition, using either drug usually requires oncologists to coordinate treatment with academic hospitals, whom the doctors may view as competitors.”

Then, quoting Dr. Oliver W. Press, a professor at the University of Washington and chairman of the scientific advisory board of the Lymphoma Research Foundation, “Oncologists use everything in their cupboard before they refer,” Dr. Press said. “At least half the patients who get referred to me have had at least 10 courses of treatment.”

So let me review to this to be clear:

If you are a non-Hodgkins lymphoma patient (or a caregiver or advocate for one) then get in touch with the oncology department of your closest academic medical center. That will be a university or medical center or hospital that is aligned with a medical university. Here is a list. Request to be seen by an oncologist on its staff, and take copies of all records regarding your diagnosis and treatment. As you discuss options they can provide to you, ask them specifically about Bexxar and Zevalin and whether or not either drug can help you.

Then let me know if you make progress, please!! I’d love nothing more than to know this blog helped you…. because even though my diagnosis of non-Hodgkin’s lymphoma turned out to be wrong, I still feel such a comraderie with other lymphoma patients…. and while news like this angers me, it also provides me with hope that YOU will find relief.

  ………………
Want more tools and commentary for sharp patients?
Sign up for Every Patient’s Advocate once-a-week or so email tips
Or link here to empower yourself at
EveryPatientsAdvocate.com
  ………………