Articles Posted in Military Medicine

shulkin-240x300More than 100,000 patients in the area surrounding the nation’s capital rely on a flagship hospital for what should be blue-chip care. They deserve better than the continuing scandal that envelops not only the VA Medical Center in Washington, D.C., but also its parent Department of Veterans Affairs.

Investigators have excoriated the VA and its leader for failing to address problems in the agency’s medical facilities nationwide but especially in Washington, because officials, as USA Today reported,  “had been informed of the issues repeatedly since 2013.”

The news organization added that investigators concluded “a culture of complacency and a sense of futility pervaded [VA] offices at multiple levels,” such that, “In interviews, leaders frequently abrogated individual responsibility and deflected blame to others. Despite the many warnings and ongoing indicators of serious problems, leaders failed to engage in meaningful interventions of effective remediation.”

AR-15_Sporter_SP1_Carbine-300x120When partisans refuse to deal with deadly gun violence as a public health crisis and to support and fund rigorous research to guide  law-making, it’s unsurprising that extreme and outlandish notions rush to occupy a noxious space in public discussions — a condition one think tank has labeled “truth decay.”

Let’s not stoop, though, to useless bickering about our respective “thoughts” on guns, but rather stick to facts and credible evidence to figure how the nation can better prevent mass shootings.

Exhibit A:  A South Florida radiologist’s essay on the lethal results of wounds inflicted by high-powered battlefield weapons like the AR-15 used in the recent mass shooting at a Florida high school.

banyan-300x173Federal officials offer a glimmer of hope in caring for head injuries, especially the sharp, repeated, and often damaging blows that  afflict athletes and which millions worldwide are witnessing, yes, as part of the Winter Olympic Games.

The federal Food and Drug Administration has announced that it has approved a long-awaited blood test that can help doctors determine the severity of traumatic brain injuries. This test will provide a cheaper, easier, more convenient, and likely faster way to handle the rising health bane of concussions, rather than relying on computed tomography or CT scans using big machines and a form of X-rays.

As the New York Times reported:

fitzgeraldWhat’s going on at the Centers for Disease Control and Prevention?

It’s a federal agency with a $7 billion budget and more than 12,000 employees working across the nation and around the globe on everything from food and water safety, to heart disease and cancer, to infectious disease outbreak prevention. Its work and guidance on health matters long has been heeded and well respected.

But the Washington Post — in a story that sounds like it might have leaped from the satirical pages of The Onion or from a monologue by the late comedian George Carlin — has reported that CDC experts have been banned from using seven words in any upcoming communications with Congress about the 2019 budget.

traumatower2-300x205In the torrent of the relentless 24/7 news cycle, let’s not allow a new normal to prevail. We can’t forget that just days ago, a madman opened fire on a church in a small town south of San Antonio, Texas, killing at least 26 and wounding 20 or so. It was the worst mass shooting in the Lone Star State’s history, and it added to a horrific and growing toll for recent such gun-related outbreaks.

These incidents not only devastate the communities in which they occur. They also put giant strains of doctors, nurses, emergency medical technicians, and hospitals. All respond in ways that deserve a major salute, as well as empathy, compassion, and shared grief for the victims, their families, and those who seek to save and protect lives in chaotic situations.

The killing in Sutherland, Texas, posed its own unique stresses, with medical experts heaping praise on EMTs and first-responders for their heroic work at the scene, and then speeding those in need to care at hospitals at least 35 miles away.

LV100117-300x215Caregivers and the community in Las Vegas, Nev., deserve a salute for their response to the gun violence last week, which could have overwhelmed a less-prepared community’s medical system.

Las Vegas  isn’t a giant metropolis (pop. 2 million in its metro area), and, due to the high costs to operate such a facility, it has just one Level 1 trauma center. That’s a facility staffed and equipped to provide a “gold standard” of emergency care. In the state of Nevada, the only such center is at the 541-bed University Medical Center of Southern Nevada.

It was slammed with more than 100 critical patients, many with life-threatening or fatal gunshot wounds.  A torrent of patients also was routed to the hospital, some for treatment of injuries they suffered while fleeing Stephen Paddock’s rampage. First-responders soon were flooding another facility, Sunrise Hospital and Medical Center in Las Vegas—a Level II trauma facility—with hundreds more. the barrage of terrible headlines about reported problems in its care, the VA, aka Veterans Affairs, “continues to perform as well as, and often better than, the rest of the U.S. health-care system on key quality measures [including] patient safety, patient satisfaction, care coordination, and adherence to evidence-based medical practices,” a new study of the embattled agency concludes.

The work, issued by the American Legion and conducted by health care journalists with affiliations including Johns Hopkins University and the University of California, San Francisco, is part of a growing, continuing, and urgently needed re-examination of one of the nation’s major medical providers.

The VA’s struggles, past, present, and into the future, are driven in part by its size and the scope of its mission and commitment, as a recent, detailed article in Foreign Affairs points out:

mdmaMental health experts aren’t suffering Sixties flashbacks. But they are seeing a new day for Molly (aka MDMA, Ecstasy, or 3,4-Methylenedioxymethamphetamine) and magic mushrooms (psilocybin). These hallucinogenic drugs are getting serious consideration in helping those with post-traumatic stress disorder (PTSD) and depression and anxiety due to cancer.

The federal Food and Drug Administration, which won’t comment on the matter, has approved Phase 3 clinical trials (large-scale human research) of MDMA for treatment of PTSD, according to  Multidisciplinary Association for Psychedelic Studies (MAPS).  

MAPS is a nonprofit research and educational organization that “develops medical, legal, and cultural contexts for people to benefit from the careful uses of psychedelics and marijuana.”

38_Special_mushrooming_side_viewA lethal epidemic is sweeping Baltimore neighborhoods, costing taxpayers millions of dollars, as well as demoralizing caregivers who struggle with its casualties daily. Researchers, tragically, are barred from developing detailed data about this scourge to try to curb its increasingly deadly harm.

Kudos to the Baltimore Sun and reporter Justin George for investigating for a year the gun violence that torments the city, sending at least 200 patients to area hospitals already just in 2016. The Sun says hospitals in the poor city have spent in five years more than $80 million caring for patients involved in gun crimes. Hospitals have seen their gunshot caseload double, and the costs of this care increase by 30 percent. Taxpayers end up footing most of the bill under Medicaid, the federal-state insurance for the poor.

The Sun’s multi-part series looks at gun violence from many aspects but the violence’s effects on the city’s health care is tragic and distressing.

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
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