Big hospitals forget who is important - the patient

A while back I read an article about how surgeons at Mass General were double booked for surgery and the hospital policy was okay with this. Double booking is when the surgeon is responsible for two surgeries going on at the same time. A follow up was published yesterday to show the results of this expose and whistle blowing by Dr. Dennis Burke.

"Burke was at the center of the Globe Spotlight Team’s report in October about the propriety and safety of a fairly common practice called concurrent surgery, or double-booking, in which doctors work on more than one patient at a time."
And as long as the doctor is within 1/4 mile of the hospital during both surgeries this is okay. And that's the new policy instituted by MGH as a result of the story. Really? I don't consider this that okay at all. I would not want the patient where the surgeon wasn't even in the room. I assume the surgeon is responsible for the surgery should be in the room at all time.

Burke is uncompromising on the issue. He called it unsafe and unethical, embracing a cautious approach that I think most of us expect from the doctor wielding the scalpel.The hospital's response to this article was appalling. They fired the man who spoke up about this issue. He was a physician at the hospital and ended up moving on to a new hospital, and all his patients followed him.

The hospital disagreed. MGH said it has taken careful steps to assure patient safety. The hospital accused Burke of violating hospital rules and perhaps federal privacy laws by supplying the Globe with copies of some internal records.
Being a whistle blower is a hard thing to do. And by being fired by the hospital, he has become a hero to others. 

"Burke thinks MGH and its advisers blundered by terminating him. “Probably the stupidest thing they did was to fire me,’’ he said. “If they didn’t, this wouldn’t be such a big story.’’

But it is. And that may explain why nearly 300 people turned out at the Fairmont Copley Plaza on Friday afternoon during a risk management seminar sponsored by Harvard Medical School to hear Burke’s version of events and why he believes concurrent surgery is unacceptable.

When he was done, the audience stood as one amid resounding applause." 

Who do you want for your surgeon? One that is up to 1/4 mile away while you are in the OR or the one who said this was wrong? The patient is the most important person here and their safety should be utmost.

Comparing notes

Yesterday I had lunch with a high school friend who has MS. She is the one person I know who can relate to many of my health issues. While she hasn't had cancer, she has had chemotherapy - it is used for MS as well as other ailments besides cancer. Its safe to say we can compare a lot of notes.

As we graduated from junior high and high school together, we both are 37 and holding. And our respective healths (I am not sure healths is a word but I'm using it) are in the toilet. We discussed exercise options - she is an avid hand cycler - and I go to the gym.

We also talked pain management and siblings. Pain management is big for both of us. Pain management while functioning like a normal human being is even more important. There is a fine line between the two. And siblings? Need I say more. We got to argue about who got the better handicapped parking space. I got there first and left her a closer van accessible space... that someone else took before she arrived.

I have many cancer friends these days but I don't know as many people with other chronic conditions. And my friends with rheumatoid don't seem to have anywhere as many symptoms as I do.

Some books still hit too close to home

I have always been a bookworm (hiding under the blankets with a flashlight as a child). I read lots of different types of books. After my first cancer diagnosis I found I would have problems with books on young women with life changing medical issues. I would stop reading them, get upset, and put them down. Some I never finished reading.

I have thought I have had this under control from time to time through the years but then again my angst rears its lowly head. I got a pile of books out of the library last week and was looking forward to reading them. I got through one and put it down to move on to the next.

Red alert! I didn't catch the full plot when I read through the blurb in the library. A woman has to figure out how to tell her best friends that she is dying of breast cancer.

I resisted the urge to immaturely throw it across the room and put it down. It sounded like a great book except for that tiny little detail on an impending death from cancer.

I have pet peeves about book reading. For some reason I don't really like books written in the first person but sometimes I will read one. I'm not sure why the first person bugs me but it does.

I don't mind books with highs and lows, emotional tension, or twisting plots. I sometimes wonder what is the real difference between a romance novel and a military novel. Sometimes I think that its just the amounts of lovey dovey mixed in with car chases, shoot outs, or high drama and a few dead bodies.

But its the causes of death which get me. Bullets, poison, large animals don't bother me. But cancer gets me every time.
 
It would be nice if it would someday I could get a handle on that.

Please, patients not profits

I know I can sound like a broken record sometimes (a very badly scratched record) but this stuff just really irks me. A new report came out recently that said Gilead, manufacturers of that ultra expensive Hepatitis C drug,

"The 18-month Senate committee investigation reviewed more than 20,000 pages of company documents.

Of course it takes a Senate committee...

'The documents show it was always Gilead’s plan to max out revenue, and that accessibility and affordability were pretty much an afterthought,' said Senator Ron Wyden, Democrat from Oregon, who co-led the investigation with Senator Charles Grassley, an Iowa Republican, in a press conference.

Its all about the revenue. Their pricing strategy also caused patients in several areas of the country to be limited in their access to the potentially life saving medication because of the cost alone.

In a statement released Tuesday, Gilead disagreed with the conclusions of the report, saying that the price was ‘‘in line with previous standards of care.’’ The company noted that it has programs in place to help uninsured patients and those who need financial assistance to access the treatments. More than 600,000 patients around the world had been treated with Gilead’s hepatitis C drugs since 2013, according to the company." 

Of course they were not happy about criticism. And yes they have programs to help uninsured patients and ones in financial need. But maybe they wouldn't need such expansive programs if they hadn't priced it so high in the first place.

"The report suggests that the factors Gilead used to set its price were not based on the research and development needed to bring the drug to market, or on the $11.2 billion it paid for Pharmasset, the company that developed Sovaldi. Instead, Gilead executives looked at what previous treatments had cost and the effect of future waves of competition on the revenue it could bring in.

Instead of using their industry's standard line of the R&D to bring it to market, they decided to get as much money as they could and then set themselves up for future high priced medications.

‘‘Company officials surmised that its drug had a ‘value premium’ because of increased efficacy and tolerability, shorter treatment duration, and its potential to ultimately be part of an all-oral regimen,’’ the report states.

In its statement Tuesday the company said, ‘‘We stand behind the pricing of our therapies because of the benefit they bring to patients and the significant value they represent to payers, providers, and our entire health care system by reducing the long-term costs associated with managing chronic [hepatitis C virus].’’"
Admit nothing, deny everything. And screw the patients.

Can I be a person not a patient?

I often feel I spend a good portion of my life going from medical appointment to medical appointment. My calendar is full of doctor appointments, reminders to call different doctors, or notes on prescriptions.

My schedule is set for the rest of my life by medical appointments. Yesterday I wanted to go to the gym in the morning but had to wait until after the eye doctor for my dry eyes, which force me there twice a year. Those dry eyes, along with dry mouth, are a 'benefit' of my rheumatoid. Which is followed by a dentist appointment on Friday morning, which will also delay my getting to the gym. Or force me to get up early to go to the gym first.

I used to work with a woman who scheduled all her doctor appointments for the year in one week. I'm so jealous.

Normal people don't go to the doctor as often as I do. Their calendars are filled with friends, fun, and adventures. I get to go to the doctor.

Aggravations

My little world is feeling very aggravated this morning. First of all my damn laptop is having way too many technical issues. I have been working on it for days. It keeps running too slow. It is running a little faster but still has hiccups. I need to pull some more tricks out of my sleeve to fix it.

Also, my damn prescriptions are aggravating me. A few weeks ago, I had prescription issues when it took weeks to get one filled. Last Tuesday I called in another prescription and today I had to call again... I have 1, yes ONE, pill left. Which means I have until tomorrow at about 6 pm before I completely run out. Just damn aggravating.

Then I read in this morning's paper (yes I read the paper newspaper every day - the comics are better in the paper than online, and if you don't read the comics, life would be too boring) about how many unvaccinated children there are these days.

Who knew that most children do not get their vaccinations before their second birthday? Vaccinations are one of the greatest advances in modern medicine and people don't get their kids vaccinated. I don't get this. People who stop eating fast food to be healthier but then don't get their kids vaccinated? They would have their children's best interest at heart if they got the shots.

I just don't understand this. Its the same for people who go macrobiotic and skip going to the doctor. Maybe I'm just good and aggravated already before I read the paper

How Generous!

Back in September, I blogged about the lovely 'gentleman' who bumped up the price of a drug from $3.50 per pill to $750 because they felt like it essentially. Because of a bit of ensuing 'bad press', they then announced they would reduce the price but never said how much.

Now they have finally made a decision on their price decrease. It will be a generous 50%. So since they raised the price somewhere around 5000%, the 50% decrease will really be about 2500% increase from the original price.

"Still, even a 50% discount would only bring the price for hospitals down to $375 per 25 mg pill.
The typical Daraprim dosage is between 50 mg and 75 mg a day for one to three weeks and can be followed by an additional 25 mg a day for four to five weeks if needed, according to the FDA. So even with the discount, a normal course of treatment for toxoplasmosis could cost between $5,200 and $36,700."

I still don't like this guy and don't think he's generous.