Enjoy our most current issue of the most popular medical e-newsletter on the internet.
Blogs and Thoughts for April 11th to April 17, 2019
Here is what we had this past week:
The Story Behind the King of Medicine Name
Alexa is HIPAA Ready!
Quick, Someone Call the AAP! by Pat Conrad MD
The AAFP Loves the ABFM and Sleeps Right Along Side Them
Friday Funny: Penmanship
Quote of the Week: Tony Bennett
1. The Story Behind the King of Medicine Name
April 17, 2019
Sometimes I forget how long I have been doing this blog. I realized that I have been through a few generation of doctors since the King of Medicine nickname began. Some people who see it now think it is pompous or egotistical. I find that funny since it started around the year 2000 as a goof to poke fun at our broken healthcare system. At that time I wrote an editorial to the Boston Globe claiming that the system is so ludicrous that a king should run it and I should be that king. And they printed it!
When I started my Placebo Journal (2001-2011), I just continued the nickname. It seemed fitting for the only humorous medical journal out there. Yes, before Gomerblog and before ZDoggMD there was the Placebo Journal. Once again, it was all a spoof. The above picture was from an article written about me over a decade ago and the below images are from one issue of the Placebo Journal.
In these times of healthcare insanity, where insurers, hospital administrators and Big Pharma rule the land, isn’t it time we have something or someone so stupid like “King of Medicine” be in charge.
I thought so.
Now please lighten up and smile. And let me take over from here.
2. Alexa is HIPAA Ready!
April 16, 2019
Remember how scared you were when you heard about HIPAA? Remember how you were going to get sued, fined or lose your license because you may mention a patient by name or talk to them in the supermarket with the possibility of someone listening? Well, in another example of double standards:
Alexa can now transfer sensitive, personal health information using software that meets health-privacy requirements under federal law. Five companies, including insurer Cigna Corp. , diabetes-management company Livongo Health Inc. and major hospital systems, said they developed new Alexa features for consumers using the federal protocol. The features let Alexa perform tasks such as scheduling urgent-care appointments, tracking when drugs are shipped, checking health-insurance benefits or reading blood-sugar results.
No worries, right? We can trust Amazon, Cigna, Livongo, and so on to be private but doctors? No way. Just another example of how big money talks and the power some companies wield.
Here is the funny part. Not long after the first article there was this one:
Amazon.com Inc. employs thousands of people around the world to help improve the Alexa digital assistant powering its line of Echo speakers. The team listens to voice recordings captured in Echo owners’ homes and offices. The recordings are transcribed, annotated and then fed back into the software as part of an effort to eliminate gaps in Alexa’s understanding of human speech and help it better respond to commands.
So…..no chance of this going bad, huh? I am sure all medical information is safe.
But let’s hammer the doctors for any mistakes they make. That’s fair.
3. Quick, Someone Call the AAP! by Pat Conrad MD
April 15, 2019
Anyone with half a brain knows very well that sodas contain a lot of sugar. And consuming a lot of sugar can cause all sorts of tooth rot and will make you fat, the latter leading to bad joints, diabetes, heart disease, and only a very tiny, miniscule shot as ending up in the latest Sports Illustrated Swimsuit Issue as a “body positive” model. Of course, excluding those without at least half a brain still sets the bar to high, and invites in the entire nanny do-gooder industry and state to protect you from yourself.
Enter the doctors, spearheading a polyglot of concerned acronyms all focused on forcibly keeping the rest of us healthy because, presumably, we all fall below that half-brain bar.
“In its scientific statement on the role of added sugars and cardiovascular disease risk in children, the American Heart Association (AHA) concluded that strong evidence supports the association of added sugars with increased cardiovascular disease risk through increased caloric intake, increased adiposity, and dyslipidemia” (somebody call CNN). In what has to be the strongest argument in favor of geopolitical isolationism yet, “the European Society for Paediatric Gastroenterology, Hepatology and Nutrition called on national authorities to adopt policies aimed at reducing free sugar intake in infants, children, and adolescents.”
And stateside, our own American Academy of Pediatrics (AAP) advocates warning parents about the demon sugars, advising its members to limit consumption of fruit juices to no more than 4 oz per day in children 1-3, and “recommended that children and adolescents avoid all energy drinks and the routine consumption of carbohydrate-containing sports drinks and instead drink water.” Which makes one think that the average AAP-sanctioned first-grader’s birthday party of kale chips and water would be not as eagerly attended as once thought. But hey, pound your drum…
Except now the AAP and AHA are doing what these tiresome groups always do, which is to take their good advice and try to shove them down everyone else’s throats, presumably if they aren’t blocked by a logjam of carrots sticks. ” On the basis of lessons learned from tobacco-control efforts”, the AAP and AHA want to push for legislation at state and federal levels to implement taxes on sugary beverages to curb consumption. They cite successes of such initiatives in Chile, Mexico, and Berkley, California, three countries that surely warrant no emulation in a free society. Many major U.S. cities have soda excise taxes, defended thusly: “Although people of lower socioeconomic status bear a greater burden from taxation, they also disproportionately benefit from the health and economic benefits from prevention of cardiovascular disease and type 2 diabetes mellitus.” And with the applause of the white-coated arbiters of taste, these good monies may be doled out for better purposes: “For example, the Philadelphia tax has been used to fund prekindergarten programs that are of direct benefit to underserved communities.” These noble doctors also want more federal and state regulation of sugary drink marketing, because I suppose, misery loves company. They even want hospitals to ” disincentivize” the purchase of sugary drinks. Would one soda machine over the federally approved allotment be justification to withhold 2% of Medicare / Medicaid reimbursements on the ground of not meeting community health promotion guidelines?
The point is that for all the dumb or apathetic people roaming the streets, we have more than an overabundance of arrogant, insufferably self-important nagging doctors who detract from the seriousness of what should be their profession by forcing themselves into everyone else’s business.
4. Medicare Fun
April 14, 2019
The Medicare Payment Advisory Commission is exploring options for moving further away from fee-for-service reimbursement that include allowing beneficiaries unrestricted choice of health care providers while incorporating bundled and site-neutral payments as well as new quality incentives. Here are the models:
- Scenario 1: Traditional FFS continues and incorporates reforms such as bundled payments, site-neutral payments and new quality incentives. Beneficiaries continue to receive their choice of “any willing provider.”
- Scenario 2: Traditional FFS option is removed. Providers must join ACOs to be eligible for FFS payments and Medicare assigns all FFS beneficiaries to ACOs. The Centers for Medicare and Medicaid Services (CMS) pays claims for ACOs using FFS rates. Beneficiaries retain the option to enroll in Medicare Advantage (MA) plans.
- Scenario 3: Traditional FFS option is removed. MA plans and ACOs pay providers for all services, but CMS continues to release the FFS fee schedule. “ACOs effectively become capitated health plans,” according to MedPAC briefing documents.
- Scenario 4: Total elimination of FFS program. CMS would not maintain the FFS fee schedule. MA plans and ACOs pay providers for all services.
My thoughts? Thank god for Direct Primary Care. I will never deal with this stuff. Ever.
5. The AAFP Loves the ABFM and Sleeps Right Along Side Them
April 13, 2019
Doctors have to get CME each year to keep their state licenses up to date. Unless you have been under a rock, you know that the ABFM has been controlling the board certification process forever. They also invented the MOC (maintenance of certification) in order to capture all that CME money. Wes Fisher MD has been getting traction in suing the ABIM but the force is strong with the ABFM. Their newest trick is to not call it MOC but instead the “Longitudinal Assessment Self-Study Package”. The AAFP, who makes a ton of money off this same process, is in bed with the ABFM. And guess what? They have the “All-in-one FMCLA companion”. FMCLA =Family Medicine Certification Longitudinal Assessment. The cost to you is only $995 ($1195 for non-members).
Do the members of the AAFP still want the MOC? It has NEVER been proven to do anything other than make them, and the ABFM, money. Do we need live and work by evidence?
Here is my twitter conversation (public) with the current president of the AAFP in January:
Feel free to ask the AAFP why they support the ABFM and the corrupt MOC, or whatever name they want to give it.
6. Friday Funny: Penmanship
April 12, 2019
This comic strip is great. Bizarro.com
7. Quote of the Week: Tony Bennett
April 11, 2019
“If my life is just about winning championships—if it’s just about being the best—then I’m running the wrong race,” he said. “That’s empty. But if it’s about trying to be excellent and do things the right way, to honor the university that’s hired you, the athletic director you work for and the young men you’re coaching—always in the process trying to bring glory to God—then that’s the right thing.”
Tony Bennett, UVa Basketball Coach
Congrats to my alma mater!