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Latest Posts

The Not-So-New Problem Of Drug Shortages

Crucial drugs are running in short supply and patients are dying as a result.

Much of the problem stem from manufacturing problems that interrupt production. There may be only one or two companies making a drug, and when something happens such as contamination, it creates huge gaps. As a result, there’s been 213 drug shortages so far this year, or two more than all of the previous year.

The shortages have forced hospitals to resort to gray market purchases. These involved third parties that may corner the market on some drugs, and resell them at exorbitant mark-ups. The practice then fuels further shortages.

And this “new” crisis has been occurring for a decade. ACP Internist ran an article 10 years ago that could run in its pages today. Read more »

*This blog post was originally published at ACP Internist*

Medical Tourism: A Lot Of Sellers But Not Many Buyers?

I must confess that I have a weakness for medical tourism. Patients have always been ready to go on a pilgrimage to find the world’s leading expert (we call it ‘key opinon leader’ now) hoping to find a cure. As long as traditional leaders in the field of Medicine have been the Germans, the French and the English -with some occasional Austrian and Spanish name in the mix- traffic of wealthy patients across Europe is nothing new.

Since we entered the antibiotics era, these leaders started to be located mainly in the United States, the cradle of modern, technology-driven Medicine. Thus hi-tech centers got ready to welcome foreign patients, building strong International Customer Support departments. A random example -by no means the only one- would be the Mayo Clinic. On their website you can see that their wealthy patients speak Arabic or come from Latin America. These healthcare services have a long tradition of client-oriented work because they work for private clients that pay for their treatment (sometimes the client is not the patient himself but his family). The important thing was never the price, but the patient. Read more »

*This blog post was originally published at Diario Medico*

Surgeons Criticize Medical Tourism: You Can’t Sue If Things Go Awry

In an earlier post, DrRich offered several potential strategies for doctors and patients to consider should healthcare reformers ultimately succeed in their efforts to make it illegal for Americans to seek medical care outside the auspices of Obamacare. To those readers who persist in thinking that DrRich is particularly paranoid in worrying about such a thing, he refers you to his prior work carefully documenting the efforts the Central Authority has already made in limiting the prerogatives of individual Americans within the healthcare system, and reminds you that in any society where social justice is the overriding concern, individual prerogatives such as these must be criminalized. Indeed, whether individuals will retain the right to spend their own money on their own healthcare is ultimately the real battle. The outcome of this battle will determine much more than merely what kind of healthcare system we will end up with.

DrRich, despite his paranoia on the matter, is a long-term optimist, and believes that the American spirit will ultimately prevail. So, to advance this happy result DrRich (in the previously mentioned post) graciously offered several creative options that could be employed to establish a useful Black Market in healthcare, which will allow individuals to exercise their healthcare-autonomy against the day when such autonomy again becomes legal. His suggestions included offshore, state-of-the-art medical centers on old aircraft carriers; combination Casino/Hospitals on the sovereign soil of Native American reservations; and cutting-edge medical centers just south of the border (which would have the the added benefit of encouraging our government to finally close the borders to illegal crossings once and for all).

As entertaining as it might be to imagine such solutions, a readily available, though much more mundane, option exists today, which is to say, medical tourism. Read more »

*This blog post was originally published at The Covert Rationing Blog*

A New Superbug?

newNYCfashion 300x199 New Superbug AlertScientists have discovered a new, highly-transmissible gene that could, quite easily in fact, open a frightening new front in the ongoing global war against superbugs.

The antibiotic-resistant gene, NDM-1, was first identified in 2008 a Swedish patient that had received hospital care in New Delhi. NDM-1 produces an enzyme that allows bacteria to destroy most antibiotics. It exists on plasmids, which are pieces of genetic material that are easily shared between bacteria including E coli and other species that can cause pneumonia, urinary tract infections, and blood stream infections.

NDM-1 probably evolved in parts of India where poor sanitation and overutilization of antibiotics provide a perfect environment for the creation of antibiotic-resistant bacteria.

The gene has been identified in three U.S. patients. All had received medical treatment in India, and all recovered from their infections. It has been found sporadically in Britain, Australia and nearly a dozen other countries as well. Most affected patients were “medical tourists” — that is, people seeking less expensive medical care in India.

“We need to be vigilant about this,” said Arjun Srinivasan, an epidemiologist at the CDC told the Washington Post. “This should not be a call to panic, but it should be a call to action. There are effective strategies we can take that will prevent the spread of these organisms.” Read more »

*This blog post was originally published at Pizaazz*

Patients Are Avoiding Healthcare Because Of Costs

One in five Americans didn’t seek medical care for a recent illness or injury, often because of the cost, according to a survey of adults polled by a healthcare consulting firm, and the number of people who saw a doctor fell as well.

Four out of 10 adults said the cost was the main reason not to seek care, a trend that be driven by unemployment and health insurance costs, said a survey by the Deloitte Center for Health Solutions. They surveyed more than 4,000 adults. Also, 79 percent of respondents sought medical attention from a doctor or other health care professional in 2010, down from 85 percent in 2009. Read more »

*This blog post was originally published at ACP Internist*

Latest Interviews

The Surprising Economic Burden Of ADHD (Attention-Deficit Hyperactivity Disorder)

If you can read this you need to download a more recent browser It is estimated that as many as million U.S. adults have ADHD Attention-Deficit Hyperactivity Disorder A recent research study publication-pending suggests that the economic burden of ADHD on America could be as high as billion annually. I…

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Is The Adderall Shortage A Harbinger Of Future Drug Supply Problems?

If you can read this you need to download a more recent browser Today most- if not all- Doctor’s offices are strained by the shortage of some prescription medication or vaccine. A month ago President Obama signed his executive order directing the FDA to take steps to reduce drug shortages…

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Latest Book Reviews

Book Review: The First Step To Improve Health Care Is A Close Examination Of How It’s Delivered

My friend and former Chair of the CFAH Board of Trustees Doug Kamerow has written a book that I think you will like. Besides being a mensch and witty as heck Doug is a family doctor and a preventive medicine specialist. In his new book Dissecting American Health Care Commentaries…

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“Your Medical Mind” Explores Factors That Influence A Patient’s Medical Decisions

Recently I had a conversation with Shannon Brownlee the widely respected science journalist and acting director of the Health Policy Program at the New America Foundation about whether men should continue to have access to the PSA test for prostate cancer screening despite the overwhelming evidence that it extends few…

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Book Review: Food Truths, Food Lies

Food Truths Food Lies written by family physician Eric Marcotte M.D. may be the most refreshingly evidence-based diet book of the decade. You will not find a single mention of super-foods magical berries or supplement must-haves in the entire book. What you will find is the cold hard truth about…

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