A recent stir was created regarding a California pediatrician Dr. Bob Sears. Dr. Sears is sympathetic to parents who do not want their children vaccinated. Apparently, Dr. Sears got in trouble with the California State Medical Board for not producing medical records to support a parent's claim that their son could not take vaccines because of adverse reactions, including "loss of urinary function and going limp,” and instead, just taking ...

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Physicians do not have a lot of power these days. But if you know when, where and how to look, we can, on occasion, score some victories. Case in point: hospital bylaws that every physician is required to acknowledge and sign before being granted privileges. It is always a good idea to carefully read before signing anything, and I did the just that before signing my hospital's bylaws. I asked a ...

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Have you ever had a prescription altered? I have, several times — all opioids. Despite making copies of every prescription to prove what I actually wrote for, dealing with everything from patients who threatened to sue me for false accusations to time spent with the DEA was a real pain. The good news is that during the pre "pain as fifth vital sign" era at least — since my prescribing ...

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It was a typical weekend on call. The usual number of surgeries, ER calls and consults. I was called to consult on 47-year-old female who had been admitted with four days of left shoulder pain. She had gone through a cardiac workup and was cleared by her internist. So now, a consult was called to see if there was an orthopedic cause for the patient's pain — not an uncommon ...

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There are a lot of TV commercials for structured settlement companies these days. You know, the companies that say if you are cash-strapped but have a structured settlement they will be happy to buy your settlement and give you "cash now." Some of the commercials are quite clever and catchy featuring everything from operettas to boy bands. After seeing so many of these, one has to conclude that there has ...

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Whether by design or by necessity, it appears that single payer is inevitable. Economic reality demands it. Some external force needs to be applied to counter the cost of rapidly expanding medical technology coupled with the political and legal pressure to make that technology available to as many people as possible, regardless of their ability to pay. The problem is certainly not new, but we are at the point of having ...

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Years ago, our government had a problem with health care. Medicare and other health care costs were spiraling out of control. It was clear that the problem was rapidly advancing technology and pressure to provide that technology to everyone who was demanding it. But the government, as usual, choose a politically motivated solution. They went after the one group involved who was the most disorganized, least clear on its desires and ...

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A friend of mine recently underwent a total knee replacement. Although he did well and was pain-free, he did say that he felt he was on an assembly line. I asked him what he meant. As he was talking, I flashed back 30 years, back to a time when by today's standards I would be considered a “good old country orthopedist.” Thirty years ago, I moved to a small community to ...

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The main justification for single payer seems to be that access to affordable quality health care is a right. Nowhere in our constitution does it say that anyone has a "right" to individual services or property. Housing, food, health care, even cell phones have become "rights." What our constitution does say is that each citizen does have the right to equal protection under the law, equal access to the courts ...

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Although I am now working part time, I still get my academy's monthly newsletter. I pretty much ignore the ads and any clinical studies that do not directly affect the work I am doing now, but I still find myself drawn to stories with a political bent. Namely, those stories that reflect the latest health reform controversy. The vast majority of these stories do not mention anything really new, just ...

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To listen to all those desperate to reform health care, you get the impression that physicians are pretty horrible people. We are all sexist, greedy, money grubbing tyrants who will perform unnecessary tests and procedures just to make money. We don't care about quality or cost. We are killing off 250,000 patients every year with our ignored "errors." We purposely keep our patients in pain, or we addict them to ...

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During my salad days, I — like a lot of physicians — thought I could take on the world. Despite working in a smaller, community hospital, our ER saw a lot of the same type of orthopedic trauma I saw during residency. And my young partners and I took virtually every case that came in except spinal trauma. We did this whether we were on unassigned ER call or not ...

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Sometime during my medical training in the early 1980s, a wise, old attending orthopedist taught me this about pain management:

"Pain is a message that something is wrong, a red flag that corrective action is needed. Narcotics should only be used when the cause of the pain is determined and corrected (Post-op or post injury), all other pain management tools have been tried and failed, and it is determined that nothing ...

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While I was in full-time practice, as far as I can tell, I received one bad anonymously written online patient review. It was on one of the numerous sites that exist but allows written reviews. The star rating is not much better since here you have no idea what the complaint is. However, the weight these reviews carry will increase, so we better take heed. Plus, given the fact that ...

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I started my career in the late 1980s and retired just recently. I am very grateful that I caught at least a few years of the "golden age" of medicine because those years made all the difference. Over my career, I witnessed many different efforts at health care reform proposed, attempted and failed. DRGs, Hillarycare, private insurance capitation, "To Err is Human,” Medicare fraud crackdowns, Global and Bundled payments, general reimbursement ...

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Anyone watching daytime or late-night cable TV has to notice that every third commercial is for a toxic tort. As my wife had breast cancer, one, in particular, caught my eye. In it, the claim was made that: "If you suffered from permanent hair loss due to chemotherapy, you might have a claim because less toxic treatment was available." This struck a chord with me because my wife was in ...

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The year was 1976. I was graduating from a small branch of my state university with a bachelor's in chemistry when I first applied to medical school. I was living at home and paying my own tuition. There were no physicians in my family, but I became interested in medicine after I was impressed with a surgeon who had operated on my shoulder. I had a better-than-the-medical-school-acceptance-rate average on my ...

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Dear President-elect Trump, You have stated that one of the first things you will do in office is to overturn Obamacare. You state that you will keep coverage for pre-existing conditions and children to age 26 but beyond that is unclear. Speaker Ryan said it would be "patient centered" but what that means remains to be seen. You now have a former surgeon as head of HHS. If I may, I would ...

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"If you do not cooperate, doctor, we will have no choice but to label you as being 'disruptive' and take whatever steps are necessary to remedy the situation." What physician does not dread hearing these words? Over the past several years, the term "disruptive" has been increasingly used to characterize and intimidate a physician who is perceived as not being a "team player." With hospitals increasing the difficulty in navigating a ...

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One of the latest trends in health care is “patient choice,” meaning the patient is in charge of their own care. Our job as a physician is to educate patients about the diagnosis, discuss the various treatment options, go over risks and benefits, then allow the patients to choose the best course of action. Of course, this assumes that patients always make the right choices and are solely motivated to ...

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