February 6th, 2010 by drval in Health Policy, Opinion
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Dr. Rich recently posted a 3-part series on the shortcomings of medicine’s new ethics. While I personally find Dr. Rich’s writing style both nuanced and entertaining, there is no doubt that his posts require some focused attention. And so I thought I’d provide a “Cliff’s Notes” version for my regular readers (since Google analytics tells me they are unlikely to spend more than 2 minutes here at a time).
Advances in science and technology have provided us with valuable new treatment options for many diseases and conditions. Unfortunately, these new drugs, devices, and procedures are so expensive that we cannot (as a country) afford to make them accessible to everyone who could benefit from them. Medical technology has outpaced our ability to pay for it. This leaves us with an ethical dilemma: how do we ration access to modern medicine? Read more »
February 6th, 2010 by DrRich in Better Health Network, Health Policy, Opinion
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A few days ago Mr. Doherty (who is also the ACP’s Senior Vice President of Governmental Affairs and Public Policy), graciously agreed to engage in this discussion, and promised to do so after consulting with the ACP’s Committee on Ethics, Professionalism, and Human Rights.
DrRich had hoped that Mr. Doherty would reply with a post on his ACP blog, which (since it likely has a vastly greater readership than the CRB), would more effectively give this topic some much-needed airing - and in particular, might engage some of the ACP’s membership (specialists in internal medicine) in this important discussion. DrRich was disappointed, then, when the reply came today in the form of a comment, which was tacked on to a long queue of reader’s comments at the end of DrRich’s posting.
DrRich was also very disappointed by the content of the reply which, fundamentally, was: This is a non-issue, and even if it was an issue, it’s now a settled issue. (So go away.) Read more »
*This blog post was originally published at The Covert Rationing Blog*
February 6th, 2010 by DrRich in Better Health Network, Health Policy, Opinion
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In his last post, and not without some little trepidation over the propriety of doing so, DrRich offered to enter into a “constructive dialogue” with Bob Doherty of the ACP Advocate Blog, regarding the important topic of medical ethics. What occasioned this offer was the fortuitous selection of each of us as finalists in the 2009 Medical Weblog Award Competition, in the category of Best Health Policy/Ethics Blog.
Ever since the inception of the Covert Rationing Blog (and even before that, in his book) DrRich has taken strong exception to the new code of “medical ethics for a new millennium,” formally promulgated in 2002 by the American College of Physicians and several of its equally respected sister organizations (a grouping DrRich has termed the Millennialists). And when he saw that the ACP Advocate Blog (an official publication of a principle component of the Millennialists) had become a co-finalist for a Weblog Award in the category of medical ethics, DrRich could not resist offering to engage in a discussion over same. Read more »
*This blog post was originally published at The Covert Rationing Blog*
February 6th, 2010 by DrRich in Better Health Network, Health Policy, Opinion
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Yesterday, DrRich noted (with his usual affecting humility, modesty, self-deprecation, &c.) that the Covert Rationing Blog has been named a Finalist in the 2009 Medical Weblog Award Competition, in the category of Best Health Policy/Ethics Blog. He now calls to his readers’ attention the fact that, among the other two finalists - both of which are of very high quality and undoubtedly are more deserving of this award than DrRich - is none other than the ACP Advocate Blog.
The ACP Advocate Blog, written by Bob Doherty, is a publication of the American College of Physicians, and its purpose is to explain, elaborate on and advocate for the ACP’s positions on important matters related to health policy and medical ethics that affect its members, namely, internal medicine specialists. Doherty - who DrRich does not know, but of whom he has heard many very complimentary things - is an insightful analyst of matters related to healthcare policy, and to boot he is an excellent writer. DrRich is a loyal reader of the ACP Advocate Blog, which in fact has habitually led off DrRich’s blogroll.
Here’s why this is interesting. While both the ACP Advocate Blog and DrRich’s blog are finalists in the medical ethics category, it so happens that DrRich and the ACP are far apart on that very issue. Read more »
*This blog post was originally published at The Covert Rationing Blog*
February 3rd, 2010 by drval in Audio, Expert Interviews, Health Tips
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February is National Heart Disease Awareness Month, and so I invited Dr. Bill Kussmaul to make me aware of some of the hottest controversies in cardiology. His tips and insights are invaluable to busy primary care physicians looking for the bottom line on thorny issues. Dr. Kussmaul is the Associate Director of the Cardiac Catheterization Laboratory at Hahneman Hospital in Philadelphia and an Associate Editor of the Annals of Internal Medicine. You can listen to our conversation or read my transcript below:
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Controversy #1: Cholesterol and Statin Therapy
Dr. Val: Who should receive high-dose statin therapy? Read more »
January 11th, 2010 by RyanDuBosar in Better Health Network, News
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ACP Internist’s wrap-up of current events continues with ping-pong for health care reform, how the recession curbed health care spending and how legislation preventing patient-dumping can hurt the physicians required to provide treatment.
Health care reform
Negotiations for health care reform will avoid the formal conference procedure and instead negotiate directly. The “ping-pong” talks, which don’t have to be public, will send the bill back-and-forth between the House and Senate until both chambers agree. C-SPAN wants to televise the negotiations. The goal is to pass the legislation by a State of the Union speech scheduled for February. (Los Angeles Times, C-SPAN, Baltimore Sun)
The recession did what Congress has struggled to do–slow spending for health care. Spending on physicians and services rose by 4.4% in 2008 over the previous year, the slowest increase in 50 years of tracking by the Centers for Medicare and Medicaid Services. Still, spending totaled $2.3 trillion, or more than 16% of the entire economy. The credit freeze in the most recent recession may have dissuaded people from paying large deductibles. (AP, USA Today) Read more »
*This blog post was originally published at ACP Internist*
January 8th, 2010 by drval in Audio, Expert Interviews
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Over 10,000 Americans (mostly young) have already died of H1N1 flu, and yet we’ve only vaccinated 10-20% of those who need protection. January 10-16 is National Influenza Awareness Week, and the American College of Physicians is doing its part to raise awareness of the ongoing need to protect Americans from the next wave of influenza.
I interviewed ACP President, Dr. Joseph Stubbs, about the current influenza season and Americans’ vulnerabilities to the virus. Please enjoy the audio of our conversation or read the transcript below.
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September 29th, 2009 by DrRob in Better Health Network, Health Policy, Opinion
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Please allow me to coin a new term:
Medical Homelessness – Not having access to a consistent familiar medical setting. Not having a care location where one is known or where the medical information is accurate.

credit
I think medical homelessness is one of the main problems in our system.
Read more »
*This blog post was originally published at Musings of a Distractible Mind*