Angels Protect Chinese

Hospitals in Beijing will recruit 1,500 "guardian angels" to protect their doctors from violent attacks by patients.

In recent years, angry patients have killed a number of Chinese doctors, often citing frustration at how they have been handled by the healthcare system.

In the latest case, a 45-year-old man from Jiangsu province stabbed his doctor to death on Tuesday because he was unhappy with a circumcision operation. "(He) was dissatisfied with the treatment outcome and the medical expenses," the state media reported.

Doctors and nurses in hospitals are violently attacked every two weeks on average, the state media said, by patients angry at long waiting times, high medical bills and haughty or uncaring doctors. Many hospitals now have security officers on their premises.

The campaign in Beijing will recruit volunteer students, medical staff and other patients to act as buffers between doctors and patients, defusing arguments and smoothing tensions, suggested Xinhua, the state news agency.

"Patients will understand doctors better after talking with our volunteers," said Feng Guosheng, the head of the Beijing Municipal Administration of Hospitals. He added that the "guardian angels" would provide "hospital guidance" and "psychological intervention".

He said 21 hospitals had already begun training the volunteers and assigning them to patients. He added that hospitals should also listen to the volunteers about any systemic problems they uncover.

Han Meng, a representative for the project, said it would allow doctors and nurses to focus on their work without fear.

The government has promised to root out corruption in the healthcare system, and the Health Ministry said in February it would target patients who bribe doctors for better treatment.

In 2012, the Lancet, a medical journal, wrote that "China's doctors are in crisis". A letter to the journal from a Chinese medical student, Li Jie, said "the deteriorating relationship between doctors and patients has turned medical practice in China into a high-risk job".

Physicians Going Bankrupt

As many doctors struggle to keep their practices financially sound, some are buckling under money woes and being pushed into bankruptcy.

It's a trend that's accelerated in recent years, industry experts say, with potentially serious consequences for doctors and patients. Some physicians are still able to keep practicing after bankruptcy, but for others, it's a career-ending event. And when a practice shuts its doors, patients can find it harder to get the health care they need nearby.

Chapter 11 bankruptcy filings by physician practices have spiked recently, noted Bobby Guy, co-chair of the American Bankruptcy Institute's health care committee, who tracks bankruptcy trends tied to distressed businesses. Guy said there were at least eight filings in recent weeks, which he said was "very unusual."

Five years ago, Plantation, Fla.-based bankruptcy attorney David Langley didn't have a single doctor as a client. Since then he's handled at least six bankruptcy cases involving doctors. Two current clients -- an orthopedic surgeon and an OB/GYN -- also are in bankruptcy.

None of his physician clients had malpractice lawsuits that landed them in dire financial straits. All are "top-notch doctors," he said.

The weak economy has taken a toll on doctors' revenue, as consumers cut back on office visits and lucrative elective procedures, said Guy, a bankruptcy attorney in Nashville with Frost Brown Todd LLC.

Doctors also blame shrinking insurance reimbursements, changing regulations, and the rising costs of malpractice insurance, drugs and other business necessities for making it harder to keep their practices afloat.

Related Story: Doctors going broke

Oncologist Dr. Dennis Morgan had a profitable solo practice in Enfield, CT, for years. Revenues began to fall, he said, when reimbursements for treatment and drugs to oncologists started shrinking. He made cutbacks, but he began having trouble meeting expenses, and his business debt grew. Critical chemotherapy drug and medical supplies providers "eventually cut me off," Morgan said.

In June 2011, his practice, in a medically underserved area, filed for bankruptcy. It had hundreds of chemotherapy patients at the time.

For the next two years, his role became "that of a captain of a sinking ship managing the allocation of life boats until rescue arrived," he said. He redirected patients to other doctors and area hospitals. Early last year, he stopped practicing medicine.

Having a cancer practice close can be "debilitating" to a community, said Morgan. "If you have to travel one or two hours to get treatment and you have no one to go with you, it becomes a matter of getting care or not getting care," he said.

Unlikely Shortage

SACRAMENTO — As the state moves to expand healthcare coverage to millions of Californians under President Obama's healthcare law, it faces a major obstacle: There aren't enough doctors to treat a crush of newly insured patients.

 

Some lawmakers want to fill the gap by redefining who can provide healthcare.

They are working on proposals that would allow physician assistants to treat more patients and nurse practitioners to set up independent practices. Pharmacists and optometrists could act as primary care providers, diagnosing and managing some chronic illnesses, such as diabetes and high-blood pressure.
"We're going to be mandating that every single person in this state have insurance," said state Sen. Ed Hernandez (D-West Covina), chairman of the Senate Health Committee and leader of the effort to expand professional boundaries. "What good is it if they are going to have a health insurance card but no access to doctors?"

Hernandez's proposed changes, which would dramatically shake up the medical establishment in California, have set off a turf war with physicians that could contribute to the success or failure of the federal Affordable Care Act in California.

Doctors say giving non-physicians more authority and autonomy could jeopardize patient safety. It could also drive up costs, because those workers, who have less medical education and training, tend to order more tests and prescribe more antibiotics, they said.

"Patient safety should always trump access concerns," said Dr. Paul Phinney, president of the California Medical Assn.

As the nation's earliest and most aggressive adopter of the healthcare overhaul, California faces more pressure than many states. Diana Dooley, secretary of the state Health and Human Services Agency, said in an interview that expanding some professionals' roles was among the options policymakers should explore to help meet the expected demand.

Only 16 of California's 58 counties have the federal government's recommended supply of primary care physicians, with the Inland Empire and the San Joaquin Valley facing the worst shortages.

In addition, nearly 30% of the state's doctors are nearing retirement age, the highest percentage in the nation, according to the Assn. of American Medical Colleges.

Physician assistants, nurse practitioners, pharmacists and optometrists agree that they have more training than they are allowed to use.

"We don't have enough providers," said Beth Haney, president of the California Assn. for Nurse Practitioners, "...so we should increase access to the ones that we have."

CANCER SURVIVORS

Long Term Side Effects

by Alex Hutchins

4% of Americans have

some type of cancer and the

numbers continue to escalate…

Heart  problems,

are common long-term side effects of chemotherapy drugs.

Others include,

osteoporosis, nerve damage, early menopause, infertility, leukemia, and the recurrence of cancer.

According to the Mayo Clinic,

Late effects are side effects of cancer treatment that become apparent after your treatment has ended. Cancer survivors might experience late effects of cancer treatment years later.

Late effects of cancer treatment can come from any of the three main types of cancer treatment: chemotherapy, radiation and surgery. As newer types of cancer treatment are developed, doctors may find that these treatments also cause late effects in cancer survivors.    To view list of long term side effects, click here

According to the American Cancer Society,

For many people with cancer, chemotherapy is the best option for controlling their disease. You may be faced, however, with long-term side effects related to your chemotherapy treatments.

In some cases, side effects related to specific chemotherapy drugs can continue after the treatment is over. These effects can progress and become chronic, or new side effects may develop. Long-term side effects depend on the specific drugs received and whether you had other treatments, such as radiation therapy.  Read more,

As reported by Debra Sherman, Reuters, in June of this year,

CHICAGO - Mario Alberico got his education in oncology the hard way. He has lived with cancer and the long-term effects of his treatment for most of his life.

At 51, Alberico has finally assembled a team of doctors near his home in suburban Chicago to manage his care. Before that, he saw one doctor after another who failed to recognize serious health problems that stemmed from radiation and chemotherapy drugs used to treat his bone cancer decades earlier.

During his senior year of high school, Alberico, the seventh of nine children supported by his widowed mother, got radiation and rotated through 4 different chemotherapy drugs at high doses that eradicated the cancer. Each one of those drugs can have grave long-term effects.

As Alberico and many other cancer patients have learned, most doctors outside the oncology  community never learned about the impact cancer treatment may have on the longer lifespan they fought to achieve.

That has deep implications for the ranks of U.S. cancer survivors, which have quadrupled to nearly 12 million people since the 1970s, according to the National Cancer Institute.

A survey of 1,072 primary care doctors (PCP), which include internists and family practitioners, showed that 94 percent of them were unaware of the long-term side effects of four of the most commonly used chemotherapy drugs used to treat breast and prostate cancer.

Better treatments and an aging population are expected to fuel this trend in the coming years. At the same time, many health insurance plans will only cover oncology visits for a limited period of time, eventually pushing patients back to family doctors or internists.

Dr. L. Nekhlyudov

 "Oncologists didn't know as much as one would think either. That was surprising," said Dr Larissa Nekhlyudov, a general internist who is the director of Cancer Research in the Department of Population Medicine at Harvard Medical School and lead author of the study.

"There's no way a PCP can know all the late effects of these drugs. There's too much and they keep changing," Nekhlyudov said. "This will become more important as a discipline of study. This needs to be taught in medical schools. There's some movement, but very little."

For those of you who do not have cancer, this posting may not “strike home” or mean much; but, for those people who do have cancer or have survived cancer, like my blog partner and I, this knowledge and awareness is very important. 

For example, at the time I was diagnosed with Lymphoma, I also discovered that I had experienced a severe heart attack that permanently damaged my left heart muscle substantially reducing my heart’s ability to pump blood out to the rest of my body.  Even without chemo, I will experience chronic fatigue for the rest of my life.  Now, coupled with the aggressive chemo treatment I had for Lymphoma my heart’s (and lungs) ability to function properly is seriously reduced the older I become.

It is difficult for me to accept because up until I was diagnosed with heart disease and cancer, I had NEVER been sick and only had visited the doctor for routine annual check-ups; but my life was turned upside down in 2009.

 

There are millions of potential cancer victims coming behind me and their plight needs to be understood, accepted, and managed by the rest of us, so that they can have the best quality-of-life possible. 

We have not even touched upon the
 long term psychological side effects . . .

Thank you for reading!

SHERPAA

A New Idea in Healthcare

by Alex Hutchins

What is Sherpaa?

Sherpaa is around the clock email and phone access to our friendly, NYC-based doctors (or Guides as we call them). Whenever you have a health question or concern, we're here for you. And we play nicely with the insurance you've got. Our Guides are well connected, in-the-know local doctors. Sometimes they can solve everything for you right away, and other times they’ll collaborate with other New York City specialists to arrange the most appropriate care for you. They make your health simple.

Dr. Susan Scharf

Board Certified in Internal Medicine, Fellowship in Functional Medicine

Susan is not your typical physician. She likes to think holistically. She conscientiously tailors care for the whole person, working as an open-minded and dedicated partner in designing personalized health plans. And she’s currently trying to master the Warrior Pose.

Dr. Bobby Buka

Board Certified in Dermatology

Bobby did more residencies and fellowships than we can list. He’s been voted the best dermatologist in NYC. Both he and his offices are very zen-like. Not only that, they’re the most efficient offices we’ve seen.              Read more 

When you’re sick or hurt, figuring out exactly who and what you need and when you need it is difficult. You need an accessible, friendly doctor you can call and email 24/7 who will either solve the problem right then and there or guide you to the highest quality, health professionals with the best personalities who will provide exactly the care you need.

Here is how it works, suppose you cut your finger:

1.      You call your Guide

2.      You snap a photo of the cut and email it to Sherpaa

3.      Sherpaa looks at it and it looks like something that can be handled outside the ER

4.      Sherpaa gives you instructions on what to do in the meantime as we schedule a stitch up

5.      Sherpaa calls Dr. Sung (their plastic surgeon)

6.      You are free to meet Dr. Sung in his office in an hour

7.      You are on the road to recovery

Without Sherpaa, you spend 8 hours in the ER at a cost of $8000 but with Sherpaa your cost is $1000 and you spend 30 minutes in Dr. Sung’s office.

Do you think this will catch on?