Real medicine is better

By now everyone knows that I have a fairly low opinion of doctors and most modern medicine. But, I have to note that there are worse things- the alternative “therapies” that are, in fact, entirely non-therapeutic. These “therapies” rely on you, the general public, to be gullible enough or desperate enough to hand over money in exchange for, well, nothing.

One of the best documented cases is an Australian woman named Carissa Gleeson. Gleeson had a cancer, sarcoma actually, a fairly nasty tumor. Initially she embarked on some seriously foolish naturopathic treatments. Eventually she came around to the realization that chemo and living might be a better idea than dying broke from a potentially curable cancer.

But naturopathic quackery is not the only type for gullible patient. Another of my favorites is Anthony William  who calls himself the Medical Medium. The breadth of his quackery- and outright fabrications seems endless. Some of his advice is quasi-useful. He encourages consumption of fruits and vegetables- hardly a bad idea. But he encourages it because:

Because they grow from the earth and are showered by the sun and sky, enduring out in the elements day after day as they form, they are intimately connected to the holy forces of nature. They don’t just contain the building-block nutrients we need to function. They contain intelligence from the Earthly Mother and the heavens that we desperately need about how to adapt.

Perhaps the best reason to accept William as a full-fledged quack is that Gwyneth Paltrow likes him! Yes, that Paltrow- the purveyor and peddler of unscientific, potentially lethal items and devices and other gunk (ironically sold at goop.com). It’s not terribly dissimilar different from two Klansmen  endorsing each other.

Others that make my “favorites” list:

Geoffrey Ames whose license was appropriately revoked after he was finally found responsible for the death of a patient. But theWashington Department of Health Medical Quality Assurance Commission. Ames initially came to attention because of his use of something called The Life Information System Tens, or LISTEN. The device allegedly tested the patient’s muscle resistance using low-voltage electricity. Eventually Ames abandoned the device because he could obtain the same information “simply by touching the patient.” This form of hoax electrodiagnostics is fairly common.

Clare O’Nan an acupuncturist in Mississippi. Her website claims:

Clare’s focus is primarily on pain and ophthalmologic conditions, including macular degeneration, retinitis pigmentosa, dry eyes, and more. She is the only licensed acupuncturist in Mississippi who specializes in vision treatment and one of a few in the country.

She has a new website now. Her claim to be able to “treat” macular degeneration caught the eye of the Mississippi State Board of Medical Licensure (MSBML), which licenses acupuncturists. O’Nan noted that she doesn’t treat macular degeneration (for which there is no recognized effective, scientifically valid treatment). She treats the “symptoms.” MSBML took no action.

State medical boards will not reliably protect you from bad care or quacks. You must take an active role in your care and be cautious. Unscrupulous “practitioners” will gladly separate you from your money.

 

 

http://scienceblogs.com/insolence/2017/08/03/carissa-gleason-embracing-real-medicine-after-fake-medicine-failed-her/

Opioid Epidemic

Every one’s excited about the “epidemic.” Recently I posed the question, “who cares?” As it turns out not very many people.

Let’s look first at the epidemic. Using CDC data we can see the rise in deaths from opiates:

opiate deaths

Wow, it seems that no one thought this was a problem until WHITE PEOPLE started dying. People of color either no how to use recreational drugs or simply don’t. The epidemic is a problem because it’s affecting the white middle class. Gosh, no we gotta do something. The death from opiates is widely expected to top 55,000 for 2016. That’s the equivalent of SIX people every hour, every day. What did the Federal government do? The CDC issued “guidelines” for prescribing. Many states have issued similar guidance- but it’s mostly voluntary. Prosecutions are rare and the penalties vary widely. State medical boards routinely fail to take meaningful actions.

The bottom line- doctors continue to be treated “special.”  They’re subjected to some additional scrutiny and “guidance” now that their actions have begun killing white people but they’re largely immune to discipline.

 

Who cares about opiates?

There’s an opioid epidemic. Oops. Maybe that should be a question. There’s an opioid epidemic?

Even if there is, who cares?

Doctors care. Not because of patients but because addiction pays. I can say with complete certainty that without payment no physician would be offering addiction treatment. The newest rage is Suboxone for “medication assisted treatment (“MAT”).” Suboxone, like methadone before it, is not a cure for addiction- no matter what The American Society for Addiction Medicine may say. These addicts are not recovering they are exchanging one addictive narcotic drug for another one. A different drug for which they need a prescription which can only be obtained by a licensed provider (physician, physician-assistant, or nurse practitioner).  The idea behind MAT is substituting one addiction for another. To put it in perspective it’s like treating an alcoholic with limited supplies of prescription beer. It’s like treating crack addicts with methamphetamine.

Doctors also care because they make money from each and every visit at which they write prescriptions. The price for a “suboxone visit” may be as high $500 and some providers only take cash. The rise of “pill mills” has occurred, not because doctors altruistically want to ease the suffering of people but because it pays. In short, cutting back prescribing cuts into business. Medical boards are hesitant to intervene because they are frequently run by doctors- the same doctors who make money prescribing. For example, Mississippi, with great fanfare announced the “Governor’s task force” on opioids in December 2016. Eight months later the task force has 41 recommendations. The few recommendation that have been released so far are similar to what other jurisdictions already have in place. It’s worth noting that the Governor specifically indicated that “here have been 95 overdoses to date this year in Mississipp.”

“Pain doctors” frequently run cash-only businesses with waiting rooms and parking lots filled to capacity with “unsavory” individuals. Pill mills are enough of a problem that there are instructions for how to recognize them. It’s not hard. See here, here, here, and here.  Some of my favorites:

334baa96-d56c-47eb-b128-40c018db4f64-large16x9_Capturepillmills-splash

 

Recent occurrences may cause doctors to re-think whether the income from opiate prescriptions is really worth it. South Bend, IN now has “groups working together to fight the local opioid epidemic.” It remains to be seen what “working together” will actually mean. It is, after all, only the providers (mostly doctors) who can stop the flow of unnecessary prescriptions.

More on the “opioid epidemic” later.

 

Academic Corruption

Many patients are skeptical of their physician- you probably should be too.  contributed a piece over at the Diet Doctor. The Diet Doctor states this on the “About” page:

Regaining health in a sick world requires thinking and acting differently. It requires trusting not in corporate propaganda or old misinformation, but in nature. In the power of your own body to return to its natural state, given the right environment.

Our mission is to find the truth about health and supply tools for those who want to free themselves. Thus empowering people everywhere to revolutionize their health.

Dr Fung highlights some of the most egregious conflicts of interest many physicians labor under. Money is the cause. You doctor is swayed by payments. You can (and should) check your physician at https://projects.propublica.org/docdollars/.

Almost all doctors acknowledge that physicians can be swayed by payments. However, they limit that persuasive effect to other doctors. No physician admits that a few bucks, or a golf trip, or a free lunch might cause him/her to compromise a patient’s care.

But let’s look at a specific example- Charles “Sam”Fillingane, DO from Jackson, Mississippi (how appropriate that he hails from the state that is routinely number last in everything good).

Wall Street Journal article cited the case of one doctor, Charles “Sam” Fillingane, as “the most prolific test prescriber among 296 doctors who referred patients to HDL.” He may have earned as much as $23,000 in six months on P&H fees at one point. In 2010, according to the Journal, he received $3,000 a month for serving on HDL’s medical advisory board. By 2012, as the former HDL employee told me, Fillingane received $6,000 a month to serve on the advisory board. This was on top of the P&H fees and his fees for speaking on behalf of the company. Despite all these revenue streams, the company gave him $100,000 in unsecured loans “because he was struggling in his business.”

If you do a quick google search for “Dr. Fillingane” in addition to his distinction as one of the highest referrers to the operations of HDL he can be found on several websites. On his own website he notes this:

Dr. Sam Fillingane is a board certified family practitioner whose practice is totally dedicated to “Cardiovascular Risk Reduction.” Dr. Fillingane has had a passion for CV Risk Reduction for years which has led him to develop a treatment protocol for cardiovascular disease that has had great success in reducing cardiovascular events in a high risk patient population.

Dr. Fillingane has been teaching courses related to cardiovascular risk reduction all over the country for many years. Recently Dr. Fillingane has become the TV host of a national television show related to cardiovascular risk reduction, “Straight To The Heart,” which can be seen weekly on My Family TV Network. Dr. Fillingane utilizes his experience and knowledge of cardiovascular biomarkers to identify patients at risk for cardiovascular disease and how to remove that risk from each patient.

Dr. Fillingane has been a sought after speaker for multiple topics related to CV disease. He has also assisted in the training of multiple medical students and residents throughout the years. Dr. Fillingane was selected as the AOA Mentor of the Year in 2009.

Dr. Fillingane is a medical director for Jackson Sleep Laboratory, and assists with the care of numerous cardiovascular patients with sleep abnormalities. Dr. Fillingane has laser surgical training that includes many years of experience treating obstructive sleep apnea with LAUP (laser assisted uvulopalatopharyngoplasty) when conservative treatment with CPAP or BiPAP are not an option.

Dr. Fillingane is a graduate of Kansas City College of Osteopathic Medicine and Biosciences. Dr. Fillingane also did his rotating internship in Kansas City at Lakeside Hospital, which included cardiology training at St. Luke’s Hospital. Dr. Fillingane is the founder and CEO of Fillingane Medical Clinic in Jackson, Mississippi.

He also has another website here, which also make many of the same self-serving claims. Ironically, it also touts his relationship with the now defunct HDL.

All of the websites indicate Dr. Fillingane practices here:

Fillingane Medical Clinic
1021 North Flowood Drive
Jackson, Mississippi

Yet this location is closed. The bank has taken possession of the property. Dr. Fillingane has abandoned the building, his patients, and his practice. Yet he still has a Mississippi license and has acquired, miraculously, a Florida license as well.

The public is right to be skeptical of “academic” credentials. The public- you included- should carefully check out whether you doctor’s credentials are real or simply bogus “puffery.” Licensure doesn’t help as a screening tool (ask Mississippi and Florida). At least Alabama had the good sense to deny “Dr. Fillingane” a license.

What’s wrong with healthcare?

Basically, it’s not very good but it’s very expensive. Yet another round of studies confirms what we should probably know. But we’re not just worse than other industrialized countries, we’re worse than Cuba. Basically, we kinda suck.

Insurance is a racket basically redirecting the spending of money “donated” by healthy people for the care of less healthy. Its the only insurance system we have wherein the really good risks are forced to subsidize the really poor risks.

Imagine, if you will, what your insurance auto premium would look like if your premium depended on how well your alcoholic, multiply convicted, thrice bankrupt, wife-beater neighbor drives. Right, that’s what modern health insurance does. We’re all in the same pool. Your premiums are driven up specifically so that unhealthy patients can have lower premiums and third-party payers can still make a profit.

But that’s what happens when healthcare is primarily a business designed for the enrichment of providers rather than the maintenance of patient welfare. The problem isn’t insurance. The problem is healthcare.

 

Could it be dumber?

Nancy Pelosi says “In America, health care should be a right for all, not a privilege for the wealthy few. ”

The woman who referred to herself as “a master legislator” displays an enormous lack of understanding of “rights.” Most of the right in the US are negative rights- against the government. These rights protect us from unreasonable search and seizure, self-incrimination, and the like. One of the rare rights not involving the government is the abolition and prohibition of slavery.

13th Amendment:

Neither slavery nor involuntary servitude, except as a punishment for crime whereof the party shall have been duly convicted, shall exist within the United States, or any place subject to their jurisdiction.

There are a few affirmative rights- national security, police protection, public education. In each of these cases the government provides the service through collecting taxes and subsequently hiring the individuals to provide the service. Does anyone really want healthcare run like the army? The police? The public schools? The only way that healthcare can be a right is if we, consumers- also known as patients- allow the government to take over care.

It might be a good idea. But then again it might be as effective as the TSA. If you think your healthcare is bad now- wait until Pelosi makes it a right.