Part 5 – Bricks in The Wall

This entry is part 5 of 5 in the series UNWANTED - Dead, or Alive

In 1992, emergency physician Dr. James Keaney (under a pseudonym “The Phoenix”) wrote a seminal book entitled The Rape of Emergency Medicine. In this semi-fictional work he described how the specialty of Emergency Medicine was born in the 1970’s, and how it quickly came under corporate control. Since ER’s had to be staffed with doctors 24 hours a day, 365 days a year, hospital administrators found that hiring staffing companies was a lot less hassle than trying to arrange physician coverage themselves. Plus there was – and undoubtedly still is – the potential for financial gain for administrators with the power to award exclusive contracts using the old “you
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The Forest? Or The Trees…

I was saddened to hear that one of my favorite Libertarians, the wonderful journalist John Stossel, has taken ill. True to form however, he’s taking it in stride (he nonchalantly quipped “seems I have lung cancer”), and I want to take this opportunity to wish him very well indeed. I enjoy his reporting and writing, and have learned a great deal from Mr. Stossel over the years. But that doesn’t mean he’s always right. In a great piece about his recent diagnosis and workup at one of America’s “premier” hospitals, Stossel goes to great lengths to praise the quality of medical care he’s received throughout his
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Part 4 – Comfortably Numb

This entry is part 4 of 5 in the series UNWANTED - Dead, or Alive

Brain death is defined as the irreversible loss of all brain function, and as far as the law is concerned means that a person is dead, no matter what: “Someone who is medically declared brain dead — meaning there is zero brain activity — is legally considered dead.” So when it comes to deciding whether a patient is brain dead or not it’s crucial to make the right call, because the human brain is susceptible to all kinds of injury. Low body temperature, drug overdoses, and severe head trauma are but a few of the conditions that can mimic brain death, and fool even the
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Part 3 – Proof of Death

This entry is part 3 of 5 in the series UNWANTED - Dead, or Alive

As an Emergency Physician, I learned the criteria for pronouncing death at the bedside early on in my training, and it is a rather straightforward process, conducted easily – and rapidly – with no special tests or tools required. While there are several, for-sure signs that death has occurred, in essence, the best way to determine a patient’s demise is to consider a combination of three things: if there is no pulse, no respiratory effort, and the pupils don’t respond to bright light, then after a few minutes that patient can safely be pronounced dead. But of course, if all three are not true then
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Black Rose

Part 2 – A Rose By Any Other Name…

This entry is part 2 of 5 in the series UNWANTED - Dead, or Alive

In putting the finishing touches on this post this morning I came across a chillingly ironic report just filed by local NBC affiliate KXAS, that revealed how a Dallas area hospice provider is under investigation by the FBI. The Feds are claiming that the owner of Novus Health Services – a 34 year old accountant with no medical background – “regularly told nurses to overdose hospice patients” with morphine to “speed up their deaths.”  This was apparently done in the never ending quest for profits – since “reimbursement” by Medicare and other insurance providers apparently goes down significantly after the first day of hospice care. The FBI raided the offices
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Thumb Over Endotracheal Tube

Part 1 – How Messed Up Is That?!?

This entry is part 1 of 5 in the series UNWANTED - Dead, or Alive

The corporate practice of medicine is, not to put it too mildly, a horrible idea. So much so that most states have laws that define and then restrict, if not prohibit it. In fact, my home state of Texas has some of the strongest bans against the model of doctors working for non-doctors, with court decisions that go all the way back to the 1970’s. And yet, the corporate practice of medicine is alive and well, and has now become the rule, rather than the exception, of medical practice throughout the land. The following true story is intended to illustrate the perils of corporate healthcare;
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It’s time that everyone have a stake in the health insurance game, and recipients of employer-funded programs are no exception. But it’s going to take a seismic shift in attitude from employees who enjoy such perks. Which won’t be easy, given how ingrained is the idea of comprehensive health benefits as a part of one’s overall compensation package. I have five words for workers who still enjoy so-called “Gold” health insurance plans paid for by their employers – Enjoy That While It Lasts.   Recently I had the opportunity to sit down to an early dinner with a woman who works as an
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A Guide to DFW Metroplex School Districts’ 2015 Health Insurance

The cover of the 2015 Scott & White Health HMO Plan’s Summary of Benefits asks ‘Who thinks school employees should get lower health insurance deductibles?’ To put it bluntly – not I. Please don’t think me cruel, but I happen to know that deductibles are just marketing tools used by health insurers to sell lucrative policies to folks. A lot of them. Don’t believe me? Would you spend $3,276 more in premiums, just to take $1,500 off your deductible? How about $6,768 more in premiums, just to save $2,000 in deductible? No way? Well, It happens every day, and I would wager it’s happening right now, too because once again, hundreds of
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The Texas Senate Has No Heart

Last month House Bill 767, that would have required electrocardiogram (ECG) screenings in Texas students participating in UIL athletic activities, was passed by the Texas House and sent to the Senate for consideration. Today, five Republican Senators from the Senate Education Committee voted to kill the bill. The Dallas Morning News recently published two pieces that attacked the bill. The first was a May 11 article by sports writer Corbett Smith, and on May 15 the paper printed an editorial imploring lawmakers to “follow science, not emotion,” and to not pass a law designed to mitigate risk and save lives. To support the bill, I wrote the following rebuttal
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A Matter of the Heart

Last week, the Texas House of Representatives Public Education Committee voted unanimously to pass a bill requiring students to undergo EKG screenings before participating in UIL events, The bill leaves the burden of paying for the testing up to the parents, and under our current system an EKG can cost hundreds of dollars. But how much does an EKG really “cost,” anyway?  Adapted from my upcoming book, Your Money AND Your Life, or American Healthcareonomics: “THAT one, Daddy,” said my daughter, pointing to a glossy black, ultramodern bedroom set. I didn’t agree with her choice, but it was her 12th birthday and for months, she had complained about the embarrassing
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