Patients Are Powerful

I know full well that my Costa Mesa Chiropractic is so buried in paperwork that I have very little time to keep up with the latest technologies.

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When Dr. Lee Sacks was in a private practice with two other family physicians, he said, they were so busy with time-consuming insurance paperwork that it was difficult to keep up with trends in patient care.

Most Americans receive their care from practices of fewer than five doctors.

As the top administrative physician at the largest provider of medical care in Chicago, Sacks is lending resources to the more than 3,200 independent doctors, largely in small practices, affiliated with Advocate Health Care in hopes of improving quality of care.

If doctors in small practices don’t get funds and support to equip their offices with the latest technology and quality data, Sacks said, there will be little hope for President Barack Obama and Congress to effectively implement health-care reform that is high-quality and cost-effective.

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“Unless you create an organization among all of these small practices, there is going to be a great disconnect because a lot of the [health-care reform] plans are predicated on organized groups,” said Sacks, executive vice president and chief medical officer at Advocate, which operates nine Chicago-area hospitals.

“Some of that is coaching and training, and some of that is infrastructure, data and feedback.”

Advocate says its efforts to help individual doctors and those in smaller practices are paying off. Over the past two years, Sacks said, smaller practices that once scored in the 60th or 70th percentile on measurements of quality are routinely in the 90th percentile, much like large practices.

Ways to improve quality of care and patient outcomes can be as simple as paying for doctors and their staff to attend a daylong workshop or providing physicians with e-prescribing technology, which reduces errors. These are among Advocate’s efforts to improve patient care, which Sacks thinks could work more broadly across the country.

Under the stimulus package approved by Congress and signed by Obama in February, doctors will receive more than $40,000 from the Centers for Medicare and Medicaid Services over a five-year period beginning in 2011 for the electronic conversion of medical records.

“Physicians are faced with an unprecedented offer from the federal government to essentially pay them to automate their practices and provide better care for patients with electronic records,” said Glen Tullman, chief executive of Allscripts Misys Healthcare Solutions Inc[.], the nation’s largest publicly traded electronic health record firm. “Advocate is offering them a relatively easy first step that’s both a simple solution to a key public safety issue and an on-ramp to the complete electronic health record.”

Sacks expects hospitals to be called on to reduce costs, improve patient outcomes and reduce errors.

“We know we have to do more with less,” he said. “I can’t imagine that additional money is going to be enough to offset the additional coverage.”

Technorati Tags: Patient Rights

As a Colorado Spring chiropractor I am very familiar with the issue of patient privacy. This is a summary of a news story out today.

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WASHINGTON — The push for universal electronic health records, a long-simmering issue in the healthcare debate, is gaining fresh momentum with the new administration and Congress, but privacy concerns continue to confound policymakers.

President Obama has set a goal of digitizing every American’s health record by 2014, and he included $19 billion to that end in the economic stimulus package.

But the question remains, how do health IT providers ensure that patients remain in control of their most sensitive personal data in a digital healthcare regime?

At the Computers, Freedom and Privacy conference today, a panel of experts took up that question, acknowledging that it doesn’t really have an answer at this point.

“This is one of those issues that has been going round and round and round for years,” said Joel Slackman, managing director at the BlueCross BlueShield Association.

But in the case of the stimulus money, that debate is going to be cut short.

“The time in which things have to be done is incredibly compressed,” Slackman said.

The IT provisions in the stimulus bill amended the Health Insurance Portability and Accountability Act, broadening its scope to cover tech firms offering personal health portals.

“I don’t know if we’ve gotten there yet,” Torres said.

The advent of the Web-based personal healthcare portal was greeted with significant privacy concerns.

“At Microsoft we decided very early on with our HealthVault product that consumers should control what goes in, who sees it going out,” Torres said.

Torres said that patients can control the information that is entered into their files, as well as which doctor gets to see it.

The appropriate granularity of these controls is one of the thorniest issues facing policy-makers as they set privacy rules for e-health records.

“Consent is the 800-pound gorilla for medical privacy,” said Ashley Katz, executive director of the advocacy group Patient Privacy Rights.

The prospect of bringing IT firms into the business of managing medical records can also introduce a significant challenge in ensuring compliance with a bewildering complex of state laws.

“You don’t even know that a law’s conflicting until it smacks you in the face, sometimes,” Slackman said.

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Technorati Tags: patient Advocacy, patient privacy, Patient Rights

When the body is looked at from behind, a normal spine is straight without much deviation from one side to the other.Scoliosis is a disorder that is generally associated with a lateral, or side-to-side, curvature of the spine.The disorder shouldn’t be confused with poor posture, even though it often gives the appearance that the individual is leaning to one side. Scoliosis is a troublesome deformity that is defined by both lateral curvature and rotation of the vertebra often causing a symptomatic “rib hump” in the mid or thoracic spine. This is created by the vertebrae in the area of the major curve rotating toward the concavity and pushing their fastened ribs posterior hence producing the characteristic rib hump seen in thoracic scoliosis. The pulmonary and cardiac functions can be obstructed if the thoracic curve and rib rotation exceeds 70 degrees. Often later in life in untreated severe idiopathic infantile and juvenile scoliosis patients, this amount of curve and resulting cardiac and pulmonary changes can be life threatening.

Anatomy

The spine reveals four normal curves: the cervical, thoracic, lumbar, and sacral, all of which are observable from a side view of the trunk. The thoracic, in the chest vicinity, has a normal round curve, “reversed C,” called a kyphosis, while in the lower spine there is a healthy “C” curve, known as swayback or lordosis. Increased kyphosis in the thoracic area is called hyperkyphosis, while increased swayback is termed, hyperlordosis. Scoliosis changes regularly accompany diversions from normal on a side view. A few round back deformities are simply due to poor posture and can often be resolved with postural exercises. A small percentage of people with kyphosis have more rigid deformities than the postural type, which are coincidental with vertebral deformity. This kind of deformity, called Scheuermann’s kyphosis, is much harder to treat than postural kyphosis, and it’s cause is unknown.

 

Even a layman can help to identify a child or fully-grown individual with scoliosis just by viewing the person in a standing position, preferably with no shirt and in shorts, and observing the following:

 

• One shoulder may be raised than the other.

• One scapula (shoulder blade) may be raised or more prominent than the other.

• With the arms hanging loosely at the sides, there may be more area between the arm and the body on one side.

• One hip may look to be raised or more conspicuous than the other.

• The head is not centered over the pelvis.

• When the person is analyzed from the rear and asked to lean forward until the spine is horizontal, one side of the back seems higher than the other.

The child or adult should be sent to a healthcare professional, such as a chiropractor, for further evaluation once scoliosis is suspected. your chiropractor would be happy to help.

The most prevalent type of scoliosis is, by far, Idiopathic, and though there are various origins and many types, Idiopathic Scoliosis accounts for about 85% of all cases. “Idiopathic” means “no known cause” and is observed with equal prevalence in boys and girls in the mild or low curve magnitudes. Depending on the age of onset, this condition can be sub-classified into infantile, juvenile and adolescent cases. Idiopathic Scoliosis may be linked to genetic or hereditary influences as it commonly runs in families. Though it is unknown why, girls are five to eight times more likely than boys to have their curves increase in size and require treatment. The most general time for the development of Idiopathic Scoliosis is during adolescence when children are finishing the last major growth spurt. Unfortunately, at this age young people are reluctant to allow their body to be looked at by parents and other adults, so it is very important to have this age group examined on a regular basis.

If a scoliotic curve is observed in the growing adolescent, it is very important that the curves be monitored for advancement by periodic examination and from time to time standing X-rays. In ninety percent of instances, the scoliosis is mild and does not require active treatment, however increases in spinal deformity necessitate evaluation to ascertain if a brace or other management is required. In a small number of patients, surgical treatment may be required.~Surgery may be necessary for a small number of patients.

Brace treatment (orthosis) is recommended for newly-identified symptoms of moderate scoliosis or abnormal kyphosis, as well as when an increase in scoliosis or kyphosis is discovered in both juvenile and adolescent children. There are a number of types of braces, all created to prevent curves from increasing by acting as a buttress for the spine during active skeletal growth. Bracing is effectual in preventing curve progression in a very large portion of skeletally-immature adolescents. Nevertheless, braces generally won’t make the spine completely straight, and cannot always keep a curve from getting bigger.

Scoliosis has no simple resolution. The majority of cases, even though often monitored, are not actively treated. The standard medical treatment for moderate cases is a brace, whereas severe cases in some cases are treated surgically. You may want to see your local chiropractor first.

Along with bracing, many other therapies have been used successfully like specialized exercise, electric stimulation of spinal muscles, nutritional programs, and chiropractic treatments. It seems like the most effective results have been sustained with a multi-faceted approach to the management of this condition.

There are chiropractors, that have expertise treating scoliosis conditions.

 

Technorati Tags: back pain, chiropractor, scoliosis

As an Orlando Chiropractor, I felt a sinking feeling when I read this NY Times story. One can only hope that patient interests are truly being taken into account.

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A back-pain researcher, Dr. Richard Deyo, recalls the uproar the last time federal officials tried to suggest how doctors should practice their craft.

It was in the mid-1990’s, when Dr. Deyo helped develop federal guidelines urging surgeons not to perform spinal fusions to treat acute pain.

Spine specialists quickly attacked the report, calling it flawed. One medical device maker, Medtronic, sued unsuccessfully to block its release.

Now, 15 years later, the Obama Administration is entering this same medical minefield.

The Administration plans to spend $1.1 billion over the next few years on studies like the one conducted by Dr. Deyo, to compare the effectiveness of competing treatments for common conditions like back pain, heart disease and prostate cancer.

Supporters include many medical researchers, consumer groups, unions and insurers.

The New England Journal of Medicine, published several articles Wednesday supporting the federal effort and rebutting arguments raised by critics.

But potential opponents — which include medical products companies, some doctors and their political allies — warn that the comparative effectiveness movement could lead to inadequate treatment for some patients and even the rationing of health care.

“It is not difficult to see how you can get on a slippery slope very easily,” said Tony Coelho, a former Democratic Congressman who is head of a new industry-backed Washington group called the Partnership to Improve Patient Care, formed to lobby on the comparative effectiveness effort.

Among others, the group is backed by the major trade organizations that represent producers of drugs, medical devices and biological treatments.

Critics like Mr. Coelho also point to a British government agency, the National Institute for Health and Clinical Excellence, or NICE, which considers costs in judging a treatment’s effectiveness.

Whether cost should be a factor in this country was a hot-button issue during the Congressional debate in February, when the comparative-effectiveness funding was approved as part of the economic stimulus package.

Despite that assurance, even supporters of the effort say one goal in identifying effective medical treatments is to stop wasting money on those of little value.

For now, proponents and critics are warily circling one another, as the first administrative steps of the process unfold.

A panel of government health experts is holding a series of public hearings at which people can suggest medical conditions for comparative effectiveness reviews.

“If this research is done in a rigorous way and doesn’t pull strings, then a lot of pressure will come to bear,” on the process, said Dr. Deyo, a professor at Oregon Health and Science University in Portland.

Some conservative and libertarian think tanks, as well as commentators like Rush Limbaugh, have attacked the comparative effectiveness effort as a step towards socialized medicine.

But for now, both Mr. Coelho’s opposition group, as well as drug and device makers, are using more measured rhetoric.

Coelho, a former House Democratic leader who resigned in 1989 over a controversial junk-bond investment, says his organization does not oppose the concept of comparative effectiveness.

His organization includes patient advocacy groups like the National Alliance for Hispanic Health and the National Alliance on Mental Illness, which also receive funding from medical products companies.

Coelho, who was a driving force behind the Americans with Disabilities Act, points to his own experiences with epilepsy, which he has had since he was a teenager, as an example of how patients need to be treated individually.

Under the comparative effectiveness program, the Department of Health and Human Services and two agencies under it –the National Institutes of Health and the Agency for Healthcare Research and Quality — will fund studies that will look at various treatments as well as pay for the development of information -gathering tools like databases of patients being treated for a certain condition.

Right now, “there is no place that helps you sort through a specific option and how that compares to another,” said Dr. Carolyn M. Clancy, the director of the Agency for Healthcare Research and Quality.

The agency, back when it was known as the Agency for Health Care Policy and Research, was the federal body Dr. Deyo worked with in drafting the back pain guidelines in the mid-90’s.

More recently, officials of the Oregon Evidence-Based Practice Center, began producing reports a few years ago comparing the effectiveness of competing drugs, both brand name and generic, in treating specific conditions.

Wherever they went, Dr. Helfand said, he and his colleagues met resistance from drug makers and some patient groups that had rallied to the companies’ side, who raised the same arguments that critics of comparative effectiveness are raising today. The Practice Center’s research, which is continuing, is now used by 14 states.

“Ironically, the motivation for comparative effectiveness is to see what works in practice,” he said, “rather than over generalizing from a few unrepresentative studies.”

 

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Full article: http://www.nytimes.com/2009/05/07/business/07compare.html?hpw

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Technorati Tags: comparing medical treatments, consumer groups, medical treatment

Great article with tips for patients below. As a San Diego Chiropractor I feel it is important for patients to learn how to navigate the current healthcare system as it leaves much to be deisred. Good luck Ms. Boden and Dr. Hallisy.

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by Victoria Colliver, Chronicle Staff Writer

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Adriana Boden was a healthy 33-year-old woman until one day in March 2007 when she felt like an explosion went off in her head. Although she went to her doctor immediately, it would take nearly a year of doctor visits, diagnoses of everything from migraine headaches to encephalitis, unnecessary drugs and treatments before a physician finally figured out what was wrong with her.

It was a relatively simple test - one that Boden, through her own research, suggested and was eventually ordered by a physician who listened to her - that led to her diagnosis of epilepsy.

Boden, a sales manager at Google Inc. in Mountain View, wants to take what she’s learned and use her technological know-how to help other patients better navigate the fragmented health care system.

Along with San Francisco dentist and author Julia Hallisy, she founded a nonprofit organization and Web site called the Empowered Healthcare Community, which will officially premiere at a conference in San Francisco on May 16.

Many Americans - even those with insurance and access to care - are frustrated by the U.S. health care delivery system.

Boden said there were many things she wished she had known at the onset of her illness that could have helped or shortened her search for a diagnosis and cure.

She formed the organization in part because most of the patient advocacy and networking groups she found were specific to certain diseases or didn’t offer her the kind of help she needed.

“I want to give people confidence and help them find the courage to help themselves,” she said.

Hallisy, the group’s co-founder, spent virtually her daughter’s entire life - from the time she was diagnosed with cancer at five months until her death in 2000 at age 10 - pursuing the treatment her daughter needed.

Hallisy last year published “The Empowered Patient” to give patients practical tips about their rights and safety issues.

“Our goal for the organization is to give patients an unprecedented level of information they don’t have access to,” she said.

Boden’s physician, Palo Alto internist Darren Phelan, said patients and doctors need to work together now more than ever due to the information age.

Doctors, he said, have a tendency to get stuck in the patterns they know.

“You can search on the Internet and find a study that will support or refute a lot of things,” he said.

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The conference is open to the public and registration is $80.

Have a health advocate.

No news is not necessarily good news.

A second - or third or fourth - opinion is appropriate at any time during your treatment, not just in the early stages of diagnosis.

Be aware that federal law guarantees patients access to their medical records.

Always check your medications for drug interactions.

If you need surgery, find out information about your hospital at the U.S. Department of Health and Human Services site at hospitalcompare.hhs.gov.

If you are having surgery, ask your hospital to use the World Health Organization surgical checklist.

 

Technorati Tags: health, health care, patient Advocacy, Patient Rights

Post from Healthcare300.wordpress.com

As health care providers we are always taught to not let our emotions regarding any particular subject interfere with our ability to treat a patient.  Easy enough concept perhaps, but actually following through with that thought is sometime difficult.  What happens when a health care provider, a nurse or a doctor lets their feelings about a patient or patient’s actions drive their care decisions?  Well, typically it plays out against the patient’s best interest.

Patients that present to local emergency departments that are suspected of drug seeking are often ignored by providers in hopes that they will become so frustrated with waiting that they will just leave the ER. Other times care will be purposely delayed for patients that are rude, “whiny”, or in some other way annoying.  Providers will often minimize a patient’s level of pain and health and not offer analgesics even though they are told by the patient that they hurt.  This is often seen when patients come in to an ER setting in a histrionic state.

Letting value judgments about patients or patient’s actions drive care decisions in most cases would be considered counterproductive.  Health care providers must continually evaluate their own biases and look beyond the realm of their own perspectives and focus on treating the patient appropriately.  Frequently the only way to combat this prejudice is to have a patient advocate.  Family members are often advocating for their loved ones with health care providers. In several other instances nurses play a huge part in patient advocacy. The issue here is that providers are not always in tune with the needs of their patients.  Call it being human, call it something else. The fact remains that whether or not providers have biases toward patients should be irrelevant when it comes to making care decisions.

Technorati Tags: ER, health, health care, patient Advocacy

Yoga practitioners have discovered that consistent yoga exercises awaken both mind and body! As you unburden your mind to give your undivided attention to each pose, you stimulate your “inner body” awareness of the present moment.

Patience is not only a virtue, it is the “key” to mastering a yoga pose, specially when combined with ample time and commitment.

Choose a clean, graceful space for your practice area, and if you can, one with a bare floor and an accessible wall. Remove any distractions from your yoga environment.

Be consistently mindful of how your body feels, and stop or pause if you feel any pain or discomfort while undertaking a pose.

Yoga props and yoga accessories, such as yoga mats, yoga bolsters, yoga straps, yoga blocks, yoga mat bags, and even yoga towels are perfect for aiding you in moving deeper into a pose, in performing a flawless pose, and in practicing in a wholesome way.

High on the list of the many benefits of using yoga props is that most are designed to to aid in the relief of any pain or discomfort you may feel while a yoga pose is being perfected.

On occasion we all “push” instead of “ease” into a yoga pose, and injury sometimes occurs.

Doing yoga releases tension, and using props assists with stress relief by giving the support necessary for you to relax (but not be lazy) in your practice.

As we mentioned earlier, yoga practice is about unifying the mind, body and spirit through the development of a deeper awareness and the augmentation of mindfulness.

Technorati Tags: mind-body, stress relief, yoga exercise

Honolulu Chiropractor: It is unbelievable to me that it is legal to  prescribe psychiatric drugs that have not gone through clinical trials for children. I was so glad to read this article and see some states starting to take action.

States focus on limiting psychiatric drugging of kids

The Texas legislature is considering a bill that would require doctors to get prior approval before prescribing atypical antipsychotic drugs like Zyprexa, Risperdal, Invega, Abilify, Seroquel and Geodon to children under 11 who are covered by Medicaid in that state, the Dallas Morning News reported on April 1, 2009.The reports on Texas foster childrenin recent years provide evidence to support such a bill.

The atypicals are the most expensive psychiatric drugs on the market and children all across the US have become the target of the off-label marketing campaigns of their makers.

The atypicals are being prescribed more often than antidepressants to children in foster care for everything from ADHD to depression to sleep problems. A report on Texas foster children for the year 2005 has a list of the top ten drugs prescribed to children ages 6 to 12, and Seroquel and Risperdal combined beat out the two antidepressants on the list.

In the three-year-old toddler age group, Seroquel and Risperdal combined were prescribed 115 times.

With infants, age 0 to 2, Risperdal and Seroquel prescriptions had a combined total of 28.

In May 2008, a group of New Hampshire legislators wrote to the state’s attorney general asking for a criminal investigation of the atypical makers after learning about the increasingly large amounts of spending by Medicaid for children on the drugs.

Atypical antipsychotic drugging “of children in the Granite state has skyrocketed from under $300,000 in 2000 to nearly $4 million in 2007,” the letter states.

“As you are likely aware, antipsychotics are psychiatry’s most powerful medications with very little FDA approval for children and include side effects ranging such as early death, diabetes, heart failure, psychosis, permanent muscle spasms and more,” the lawmakers pointed out.

They noted the $515 million civil settlement the DOJ entered into with Bristol-Myers Squibb for illegally marketing Abilify for off-label uses and the settlements between private plaintiffs and Eli Lilly for “causing diabetes in 28,500 people with Zyprexa.”

“Any ordinary citizen would minimally be charged with manslaughter or second degree murder for such criminal negligence,” the letter advised.

“It is very important to take such criminal actions as the civil actions merely appear to be write-offs as business expenses to drug manufacturers in cases like Vioxx, OxyContin, Neurontin, Paxil and those mentioned above,” the lawmakers pointed out.

“A criminal deterrent is needed to protect our children and others placed on powerful medications,” they stated.

Last September, attorney Jim Gottstein, the leader of the patient advocacy organization, PsychRights, filed a lawsuit against the state of Alaska seeking to bar the state from paying for off-label prescriptions of all psychiatric drugs to children covered by Medicaid in Alaska.

Evelyn Pringle

(Evelyn Pringle is a columnist for Scoop Independent News and an investigative journalist focused on exposing corruption in government and corporate America)

Technorati Tags: children, off label use, psychiatric drugs

As a former Michigan resident and current California resident, this Santa Barbara Chiropractor, while I’m happy with the decision to allow medical marijuana, I am concerned that patients will not be able to get access to marijuana when needed. This is the current situation.

State health officials are finalizing rules and regulations for the Michigan Medical Marijuana Program.

Step one: issuing picture ID cards for those on the marijuana registry; they should begin arriving by the end of April.

Caregivers, who can supply marijuana to a maximum of five patients, will also have to pay $100 for ID cards under a program the state hopes will be self-supporting and require no taxpayer dollars.

One thing the state won’t do is provide the marijuana or even tell patients how to acquire it on their own.

And possession of marijuana remains a federal crime, although the Obama administration has said that it likely won’t prosecute users in states where the drug’s use for medicinal purposes has been approved by voters.

To get on the confidential marijuana registry, patients must get a letter - not a prescription - from a Michigan-licensed physician certifying that pot could benefit their medical condition.

The law covers people with “debilitating” medical conditions, including cancer, glaucoma, HIV/AIDS, hepatitis C, amyotrophic lateral sclerosis, Crohn’s disease, Alzheimer’s disease, and chronic diseases, or their treatments that produce wasting syndrome, severe pain, severe nausea, seizures or severe muscle spasms, such as those caused by multiple sclerosis.

Greg Francisco, executive director of the nonprofit patient advocacy group Michigan Medical Marijuana Association, said some doctors are refusing to go along with the new law.

“Many doctors are skeptical and reluctant to get involved in this,” said Francisco, whose wife mixes marijuana into brownies that she bakes to ease his back pain from atrophied muscles, the result of childhood polio.

“The larger, mega corporation health clinics associated with hospitals are refusing, based on corporate policy,” said Francisco, whose group is based in Paw Paw, in southwest Michigan.

The Michigan State Medical Society, which opposed the ballot proposal, has sent out a “legal alert” to its 16,000 physician members advising them that “a physician should use his or her best judgment whether they want to recommend that a patient get a registry card,” said David Fox, spokesman for the group.

The new law shelters participating doctors from arrest, prosecution or any professional penalties for recommending marijuana use.

Doctors cannot write prescriptions for marijuana since the U.S. Food and Drug Administration classifies it as an illegal, controlled substance like heroin and LSD, with no medical use and a high potential for abuse.

The Michigan doctors’ group does favor more research to establish what, if any, medical use marijuana may hold.

More problematic is the question of legality.

The U.S. Drug Enforcement Administration regards marijuana users, even in states that have medical marijuana statutes, as lawbreakers.

But as a practical matter, the feds have not gone after medical marijuana users in states with those laws.

Francisco said that when he was a federal law enforcement officer with the U.S. Coast Guard, “we didn’t bother with nickel-and-dime drug use by recreational boaters.

“Sheriffs and prosecutors are telling us that like it or not, they will go along with the new law,” he said. “It’s like the speed limit.

Shanon Akans, spokeswoman for the Michigan State Police, agreed.

“It’s not going to have a huge effect on us,” she said. “As long as medical marijuana patients comply with the law (limits on amounts and not giving or selling marijuana to people not on the state registry), they won’t have an issue with law enforcement.”

Despite the law, it’s up to employers to decide whether to prohibit medical marijuana users from smoking in the workplace.

The new law bans pot use in public places. And it will remain illegal for patients to use marijuana while operating a motor vehicle, aircraft or motorboat.

Unlike a constitutional amendment that can only be undone by a vote of the people, the medical marijuana law is a citizen initiative.

That means the Legislature is free to modify or outright repeal the law after two years.

Meanwhile, Francisco said his group is planning an application rally at the Michigan Department of Community Health on Monday.

“We’re asking patients to come to Lansing and caravan to hand-deliver the applications,” he said. “We’re planning on a mass turnout so we can turn this into a media event.”

For the full article, see Charlie Cain, “Michigan readies for medical pot use: Up to 50,000 may qualify for legal smoking”, Detroit News, April 1, 2009.

Technorati Tags: medical marijuana, Michigan, patient Advocacy

As a Fort Worth Chiropractor I am concerned that this budget situation in Washington State will soon be affecting us here in our state.

Washington State Budget Cuts Endanger Registry for Living Wills.

What good is your living will if your doctor can’t get to it in an emergency?

That dilemma spurred Washington in 2007 to create a free electronic registry of health-care directives, legal documents containing a person’s end-of-life wishes. In little more than a year, nearly 600 state residents have registered at the site so that physicians can quickly look up whether a patient has opted to refuse respirators, feeding tubes and other life-prolonging treatments.

Gov. Chris Gregoire has proposed slashing the registry’s $180,000 annual budget by 80 percent. That won’t leave enough money, patient advocates fear, to keep the registry viable. In fact, registry supporters argue the proposed cuts could well cost the state more money in the long run if patients are given expensive treatments they did not want. Miller said registry sign-ups have accelerated since the passage of Initiative 1000, which legalized physicians prescribing lethal doses of drugs to people with less than six months to live.

In the five months since Washington voters approved the so-called Death with Dignity Act, the pace of enrollment in the registry rose by 18 percent compared to the previous five months. In case of accidents or a coma, patients may be unable to alert medical professionals that they do not want CPR, artificial ventilation or other treatments, Miller said. “Doctors are reluctant to make a decision that’s going to result in the death of a patient.”

People who enroll in the living-will registry carry wallet cards with an identification number that allows qualified medical professionals to look up their directives on a secure Web site. Miller said even one critically ill patient who is revived against her wishes and ends up in intensive care could rack up more needless treatment costs in a few days than the registry’s annual budget. Kate White Tudor, a lobbyist for Compassion & Choice, said $70,000 a year would enable the registry to continue accepting new registrants, although customer support would have to be cut back.

Source: Seattle Times

Kyung Song: 206-464-2423 or ksong@seattletimes.com

 

Technorati Tags: fort worth chiropractor, patient Advocacy, Washington State budget cuts