Like herpes, the Democrat's health care insanity is back again.  The Obama administration and radical leftists in congress know they are about to lose their majorities in congress, and before that happens they want to complete the largest governmental power grab in American history.  They want to take control of your health care.

We can defeat them if we stand up the way we have done in the past.  It is time for another round of protests at the offices of Democratic members of Congress around the country.  Telephone calls and faxes aren't enough.  We have to show up in person, and let them know that their jobs are on the line.  Vote for Obamacare, and we will throw you out of congress.  Let's make sure they hear us loud and clear! 

An internal debate is raging within the FDA about Avandia.  Should it remain on the market?  Is is too dangerous?  Do other drugs offer the same advantages with lower risks of cardiovascular side-effects?  It appears that the FDA itself can't reach a conclusion, but a large contingent of these government scientists want to take it off the market.  You can read about the debate here:  http://www.nytimes.com/2010/02/20/health/policy/20avandia.html?no_interstitial

I don't pretend to know whether or in what cases Avandia is an advisable drug.  The bureaucrat-scientists at the FDA who want the drug banned are pretending to know.  They've decided to believe one set of studies, disregard another set of studies, and use the force of government to remove a choice from doctors and patients.

I don't know of any drug that can't kill the person taking it.  Yes, that's right:  every single drug you put in your body has the potential to kill you!  When you take a drug, you're making a bet.  You're betting that the drug will do you more good than harm.  Doctors spend years studying so that they can help you make a good bet.  Here's the crux of the issue:  it is your bet, because the stakes are your body and your life.  It is an outrage that the FDA is even considering banning Avandia.  The only moral course of action is to leave the decision about its use up to doctors and patients.  That is the American way.

The last month or so has been one of the happiest months of my life.  Why?  For the first time in my life, I'm directly involved in patient care!  I am certain now more than any time in the past that I am on the way to leading a happy life as a physician.  There is something intensely personally rewarding about making a difference in the life of someone in need. 

The patients I've been treating are almost all terminally ill.  At first, this really bothered me.  I'd lay awake at night thinking about their suffering, and about their families.  One day, though, something changed.  I can't pinpoint exactly when it was, but I started to think about how I could make patients smile when I went to see them, and about how my attention to their cases had in many times improved the quality of their care and therefore the quality of the last weeks of their life.  Rather than feeling like an observer of a cruel process of nature that robs human beings of everything, I started thinking of myself as someone who could take what my patients have left and help them make the most out of it.  I can help make a mother's last days comfortable, so she can share them with her children in the best way possible. 

Much of what I write on this blog is intensely negative.  Unfortunately, we live in a world full of malignant politicians who are intent upon destroying the quality of care we can give to patients.  My postings on this blog have been an attempt to fight that.  It is important, though, that we all take a moment to be thankful for our profession.  Lots of doctors and even medical students are bitter about the way their profession is going.  I'm not happy about the government's filthy hands being involved in patient care.  Medicine, however, is a joy to practice.  I know that I have a wonderful, happy career ahead of me doing what I love, and I know that I will make a profound difference in the lives of my patients.  It is for precisely this reason that I will remain involved with the AAPS, and do everything in power to preserve this noble profession.  The future of medicine is bright, as long as we keep politicians as far away as possible!



This week I heard the stories of 3 family practice doctors who have dropped insurance and quit participating in medicare and medicaid.  Two were AAPS leadership via a webinar hosted by this site and one was a local physician Dr. Glick, www.thehealthquest.com, that our student club hosted to speak with us.  All of these doctors had a few things in common.

1) They love what they do. This is extremely rare in the primary care world as frustration with administrative burdens, restrictions to time and care, and a relatively low pay leave many primary care doctors burnout and regretting their career in medicine.

2) They know their patients well.  They take the time to talk with their patients and do complete history and physicals. This allows they to make better diagnosis, make fewer mistakes (less risk to patients and less malpractice), order fewer unnecessary tests, they can address behavior health issues, patients get more education- better understanding, and better compliance with therapy.

3) Patients save money - Doctors make more money. Cash practice fees are very reasonable, often less than the billed charge of managed care doctors. Some of these doctors have their fee schedule on their website so you know exactly what to expect. They can charge less and make more because there is little to no staff that has to be paid to manage the red tape of insurance and medicare/medicaid. These doctors had take home pay similar to that you would expect of a specialist.

Patient question: But what about my wonderful insurance that I had to sell my kidney to pay for? Your insurance is still good, the doctor simply gives you a receipt of services, pre-addressed to you insurance company which you mail in and you receive the refund for the covered charges sent from the insurance company directly to you. This process is more economical if you have and HSA plan, but works with you normal employer based insurance as well.

4) They were able to provide free/charitable/pro bono care.  Something I find funny is that if you accept medicare/medicaid/insurance it is actually illegal to provide services at reduced prices or for free - you are required by law to bill for your services. These doctors all provide a considerable amount of medicine at reduced or no charge at all. One treated all her patients over 90 for free. I thought that was neat and shows a lot of respect.

Isn't this what everyone wants? (ok maybe not  the insurance company shareholders, or control loving politicians) It's as simple as doctors saying no to 3rd party payer contracts and patients looking up doctors that operate

Is this something you want in your doctor? here are two websites that might help

http://www.medibid.com/consumers,

http://www.simpd.org/findphysician, or Google "cash doctor and your city"



Today Dr. Conrad Murray was formally charged with manslaughter in the death of Michael Jackson.  We don’t have a lot of facts in this case, but in today’s criminal courts that really doesn’t matter.  Dr. Murray will almost certainly be convicted because in our perverted system someone, anyone, must pay for Jackson’s death.

As we watch the proceedings in this Kangaroo Court, let us keep in mind:  we have no way of knowing the truth.  Everyone:  the police, the public, the prosecutor, the judge, the jury, will be out for blood.  They loved Michael Jackson’s music, and now they’ll want revenge.  If you are a doctor, and some opportunistic prosecutor brings charges against you, innocence is no defense.  Especially when the alleged victim is the “King of Pop!”

The case will probably go something like this:  prosecutors will argue that Dr. Conrad should have known that the dose of Propofol that he administered to Jackson was likely to kill him.  To make this point, they’ll argue that Conrad’s use of Propofol was unconventional.  The jury, which will likely have a mean IQ of 60, will not understand the nuances of the case.  They’ll buy into the retarded notion that the unconventional use of a drug amounts to knowledge that the drug will likely kill the patient.  Dr. Murray’s life will be destroyed, and the Jackson family will get the blood they want.

The facts of this case will likely never come to light.  This trial will be a show, and a doctor will be crucified by an opportunistic prosecutor.  Unfortunately, this happens on a regular basis in America, because if you’re a doctor, innocence is not a viable defense.