Articles Posted in Primary Care

azar-235x300Members of Congress have scattered back to their districts for Thanksgiving, giving the nation a bit of a break from the health policy turkey shoot that has besieged the nation’s capital. The health- and medical-related actions have piled up so fast and furious that it can be daunting.

But let’s not overlook:

  • The hot mess that’s supposed to be a GOP wish list of tax changes has, instead, turned into yet another attempt to gut the Affordable Care Act, aka Obamacare, this time by eliminating the “individual mandate” that requires Americans to show through their tax returns that they have health insurance coverage. Tax policies invariably are complicated. Let’s simplify this one: Partisans want to slash the ACA, so they can take money from it — $300 billion or so — to help “pay for” $1 trillion or more in tax cuts for giant corporations and the wealthy. This legislative legerdemain will mean 13 milllion Americans will lose health coverage and insurance premiums for millions will rise 10 percent, according to the independent Congressional Budget Office.

bp-300x169Did you feel yourself just get less well? U.S. heart experts have just issued new guidelines on what Americans’ optimal blood pressure should be—effectively and suddenly shifting just under half of the adults in the nation younger than 45 into an unhealthful status as hypertensive.

Doctors say there’s no doubting data that shows that blood pressure readings exceeding 130 over 80 can be detrimental to patients’ health. That’s down from the previous warning level of 140 over 90.

But what exactly has the medical establishment wrought with this sweeping metric? Have they deemed so many of us unwell in this way that we’re about to see public doubt and confusion—even profiteering—as has surrounded the description of tens of millions of Americans as “prediabetic?”

alcohol-248x300When topics like booze and health flow together, common sense seems to disappear. So let’s give credit to the context-restoring efforts of Aaron Carroll— a pediatrics faculty member at Indiana University medical school, a health policy researcher, and a writer for the New York Times’ “Upshot” column—and healthnewsreview.org, a health information watch dog site.

Both addressed a “panic” in certain quarters generated by a new caution issued by the American Society of Clinical Oncologists. The respected organization of cancer medical specialists said that even light alcohol consumption can add to drinkers’ cancer risks.

As Carroll summarized the cancer experts warning:

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.

northam-300x228Millions of Americans may qualify for federal help in paying for the health insurance, but they must sign up for coverages on exchanges set up under the Affordable Care Act, aka Obamacare, by Dec. 15. Doing so, starting with a visit to healthcare.gov, has become a surprisingly popular and perhaps a strongly political act.

That’s at least one way to look at it after voters, led by Virginians, sent a big electoral rebuke to President Trump and congressional Republicans over their failed congressional assault and continuing efforts to repeal and replace the ACA, especially its increasingly popular expansion of Medicaid. Its programs benefit the poor, young, old, chronically and mentally ill—and growing numbers of working poor and middle-class Americans, too.

The punditry has flowed since Tuesday’s elections in Virginia, New Jersey, Maine, and elsewhere. Virginia voters not only trashed Ed Gillespie, the Republican candidate who was supported by Trump, and elected Ralph Northam, a Democrat, a pediatrician, and a veteran who was the state’s lieutenant governor (see photo), they also churned the membership of the state legislature. Control of the House is up to recounts in a few tight races.

epipen-300x119Big Pharma’s rapacious profit-seeking can seem to hit no bounds, even if it afflicts millions: Just consider what federal and state regulators are mulling about the makers of a popular anti-allergy therapy and those who supply a critical diabetes medication.

The federal Food and Drug Administration has replied to Bloomberg News Service that, so far, in 2017, it has recorded 228 reports of EpiPen or EpiPen Jr. failures, and the failure of EpiPens to deploy correctly has been cited in seven deaths through mid-September.

The agency said it is monitoring closely these “adverse event complaints.” These are unconfirmed reports that do not necessarily tie a product to a harm. But they might constitute sufficient grounds to investigate further and to potentially order product recalls, though, so far, the FDA says it believes patients can keep using EpiPens on the market without worry.

bowser-240x300Even as District of Columbia officials struggle with deepening woes at the United Medical Center (UMC), advocates from a national, independent, and nonprofit group have offered a dim review of hospitals in the DC area.

The bad news keeps piling on at UMC, a leading provider of medical care for communities of color in the District’s Southeast area and in Prince George’s County, Md.

To its credit, the sometimes locally slumbering Washington Post has put out a disturbing, well-documented report about the death of a 47-year-old HIV-AIDS patient in UMC’s nursing home care. As others witnessing the scene clamored for them to help, UMC nurses, the Post says, let the patient fall to the floor, where he sprawled in his own waste for 20 minutes while his caregivers argued with a security guard. When the patient finally was returned to his bed, he was dead.

GWU-seal-150x150Elmo-150x150Elmo and the Colonials won’t make it as a new Saturday morning hit cartoon show. But the colorful characters might play a tangential part in some important lessons for consumers and some supposedly serious institutions on preserving the public trust in published, medical-scientific research.

Healthnewsreview.org, a nonprofit and independent watchdog of health information, rightly has taken George Washington University to task for issuing a Pollyannaish, inaccurate news release on a Colonials’ study on whether text messages could help curb expectant moms’ smoking. The hype from the school, about research from GWU’s Milken Institute School of Public Health, first proclaimed:

Text messaging program may help pregnant women kick the smoking habit

reuters-300x153Although countless doctors and nurses put in untold blood, sweat, and tears to provide quality care to their patients, health care profiteers can undo these good works in an instant with shameful plundering. Here is a roundup from multiple fronts.

The nonprofit, nonpartisan Kaiser Health News Service deserves credit for its painful reporting on the rising problems in the once much-admired area of hospice care.

Reporters JoNel Aleccia and Melissa Bailey have written, in a story carried by Time Magazine, that they “analyzed 20,000 government inspection records, revealing that missed [hospice worker] visits and neglect are common for patients dying at home. Families or caregivers have filed over 3,200 complaints with state officials in the past five years. Those complaints led government inspectors to find problems in 759 hospices, with more than half cited for missing visits or other services they had promised to provide at the end of life.”

choosing-wisely@2x-300x197Up to a third of medical spending goes for over-treatment and over-testing, with an estimated $200 billion in the U.S. expended on medical services with little benefit to patients. But getting doctors and hospitals to stop this waste isn’t easy, nor is it a snap to get patients to understand what this problem’s all about so they’ll push their health care providers to do something about it.

Which is why kudos  go to Julie Rovner, of the nonprofit, independent Kaiser Health News Service, and National Public Radio for the recent story on how older women with breast cancer suffer needlessly and run up wasteful medical costs due to over-testing and over-treatment.

Rovner and Kaiser Health News worked with a medical benefit management company to analyze records of almost 4,500, age 50-plus women who received care for early-stage breast cancer in 2017. She found that just under half of them got a medically appropriate, condensed, three-week regimen of radiation therapy. Research has shown this care is just as effective as a version that’s twice as long, costs much more, and subjects patients to greater inconvenience, especially with more side-effects.

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
Washingtonian Top Lawyer 2011
Avvo Rating 10.0 Superb Top Attorney Best Lawyers Firm
Contact Information