Archive for April, 2009
The Empowered Patient: Making the Health Care System Navigable
April 26th, 2009 | 
Author: 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
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.
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.
Posted in patient advocacy | 
Tags: health, health care, patient advocacy, patient rights | 
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Health Care, Treating Patients, Feelings Can Get in The Way!
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.
Yoga Exercises For Your Health
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.
Finally, Some Action on This Insane Drugging of Our Children.
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)
Medical Marijuana and Patient Rights A Michigan Quandry
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.