Poor pieces of Flesh!

             Foreign buyers are flocking to Canada to find surrogate mothers now that Asian countries have cracked down on this practice.  These narcissistic folks are using Canadian Health Care resources to satisfy their desires and their longing for immortality and for the most part are not interested in offering a good life to some baby waiting to be evacuated out of  the womb.  I see their mission as a purely selfish  one, which I resent subsidizing with my health care dollars.   I  would be surprised if most Canadians didn't share my views.   Canadian surrogates should not be covered by medicare and if the practice is allowed at all, should be paid for  by the people buying  the babies.  Many developed countries ban surrogacy outright.  Surrogacy, catering as it does to the whims of the purchaser may take an ugly and immoral  turn.   Recently a Nova Scotia woman who was 'commissioned' to have a child for an  overseas couple found herself carrying triplets.  Although she wanted to carry all three, the 'would-be' parents insisted one of  the fetuses be killed off.  The woman was told that the couple could cut off expense payments if she insisted on keeping all the babies.  The surrogate agreed to  one of the fetuses being killed off.  One of the two remaining fetuses died too.   Apparently, the remaining baby is surviving its hazardous intrauterine journey for the moment.  If it does one has to wonder about the environment into which the poor thing will be born.    If Canada's medical ethicists and other self professed protectors of patient health don't have something to say about this, they certainly are not doing their jobs.                                                        

                                      Perhaps  they just don't understand it. 

 

The Elecronic Medical Record.

Physicians Use of EHR Systems 2014

The survey on Physician Use of EHR Systems 2014 found that close to, or more than half of all respondents, reported a negative impact in response to questions about how their EHR system improved costs, efficiency or productivity.

Physicians have become increasingly unhappy with EHRs. We really did not need a survey to document this.
The real question is why? I think logical thinking can reveal the answer.
Why do we use information technology in general? We use smartphones, pads and computers when they improve our lives. No one makes me buy a computer. I buy the computer because of the value it gives me. I buy software (or apps) because I find them helpful.
Throughout our economy, information technology must provide value. Developers have to demonstrate value to those who spend money on systems.
Electronic health records are being imposed on health care systems. They are not being sold as helping physicians do their work. In addition to this problem, the government has mandated meaningful use (a term that physicians often ridicule). When you impose technology on users, then an important development piece is missed – user friendliness. Every system that my friends describe has made the user’s (physicians, nurses and other health care workers) charting more difficult. No one asked the physicians how they work. No one has designed a system to be health care worker friendly. We are expected to figure out the system, rather than the way most computer programs are developed.
Bob Wachter, in his important book Digital Doctor, explains the care that goes into developing airplane computer systems. No one thinks the same processes occur in health care.
How does this matter? EHRs add time to the physician’s day. EHRs contribute to physician burnout – a major problem that negatively impacts patients. We should all speak out about this problem.

Medicine gone crazy!

             A Canadian forensic psychiatrist says he regularly treats sex offenders for impotence with Viagra like drugs and advocates the practice as a way to actually keep them out of trouble.
             Dr. Paul Fedoroff’s comments come as a new American study raises legal and ethical questions about helping convicted sex criminals overcome erectile dysfunction (ED).
              Authors of the paper worry that doing so might help some perpetrators re-offend, while American law bars government health-insurance from covering the treatment’s cost.
But in a response to their article, Fedoroff says prescribing Viagra-type drugs or delivering other ED treatment can be part of a strategy to shift offenders away from criminal behaviour — such as assaulting children — and toward more normal sex.
            I have to wonder if Dr. Fedoroff would like his daughter to be exposed to such an offender fortified with Viagra as part of his treatment to steer him in  the direction  of 'normal sex'.   Come off it, Doc.  Further, our contention that pedophiles often target children only because they’re afraid they will not be able to perform if they try to have sex with an adult partner is nothing short of absurd.  He further asks, “Which sounds like the more dangerous person a person who is engaged in fulfilling, healthy sexual relations with a consenting partner, or someone who has no legal sexual outlets?”  He does not seem to grasp, that if the person  was capable of having the sort of relationship that the learned doctor describes it is unlikely that he would be in jail serving a sentence for pedophilia in the first place.                                                                   
            The issue was raised recently, though, in a study by three Boston-based urologists, who noted in the Journal of Sexual Medicine that coverage for anti-impotence drugs by the United States’ Medicaid program was banned in 2005 in the wake of public “outrage” that tax dollars were used that way..                               
            The doctors say they are not in favour of denying care to all sex offenders, but suggest it is possible in some cases that “treating their sexual dysfunction may increase the risk of sexual recidivism.”
          Still, they say the science is unclear, and complain that urologists lack the training to know whether treating the offender’s impotence is appropriate or not.
“Virtually everyone has some improvement,” the psychiatrist said. “Most find a girlfriend, boyfriend or appropriate partner.”
             Most pedophiles engage in inappropriate touching, kissing or genital contact, and an erection is irrelevant.  Castration would probably be a more appropriate treatment than viagra.
             Just another 'politically correct' misconception by the LWLs, until one of their kids are molested.
             Go figure!!

Social Sickness

                         "Pigs in a blanket- fry 'em like bacon!'
            If that's not hate speech, what is?  Hate speech is not free speech, it's anarchy! 
           America is a dangerous place and rapidly becoming more dangerous.  Violent crimes are escalating and a sizable segment of the population, instead of walking softly and carrying a big stick, are walking as loudly as possible and carrying a Smith & Wesson.  When the police are a major target of the violent crimes, anarchy is not far away.  I'm prepared to bet a hefty sum that a police call these days has a longer response time than has been normal  in recent years and if things continue in the present manner, there may well be cases when there is no response at all.  Not good for the nation.  Until someone takes charge, conditions will deteriorate and the mental and physical health of the nation can only decline.  As long as every malcontent can walk around with a gun in his pocket, the health resources required to deal with gun violence will continue to soak up an extravagant part of the health care and the legal systems budget. 
       When I was growing up, long, long ago in a land far, far away, my mother told me while quite a little  lad, "son, if you are worried or afraid of someone or something, just go up to a policeman and tell him what you're worried about and he will see that you are safe".  And that's the way it was.  There was something pretty healthy about that.  Both mentally and physically.  The police were perceived as friend and protector and they usually were.  They didn't need a gun and the truncheon they wore on their belt rarely came out of its sheath.   My parents didn't have to worry when we kids went out for the day and the greatest danger we could imagine was being home late for supper.   
       We are all proud of the fantastic advances that have been made in individual and public health in conquering and preventing disease in recent years.  Unfortunately, during the same time anarchy has been gaining momentum in our society and resulting in more mortality and morbidity than ever.  If we don't elect leaders who have the courage and integrity to deal with this, we will deserve what we are going to get..  Social sickness may now be a greater threat than physical disease.
      

Doctors reluctant to Kill Patients.

      Following up on my previous blog,  the second headline reads as follows:
"Doctors divided on assisting dying:Poll.
CMA says willing minority enough to meet the demand "
    According to the poll most Canadian doctors are reluctant to help end a life.    The article alleges that the results of a survey by the CMA suggests that thousands of doctors would be willing to prescribe a fatal drug overdosage for a patient whose suffering was purely psychological.  Phew!  I was afraid the poor patient might get appropriate medical help and get better before the lethal dose was administered.  Dr. Jeff Blackmer, vice-president of professionalism (gimme a break!) at the CMA reassured the CMA gathering that there would be enough terminators to go around, with the statement, "you are talking tens of thousands of Canadian physicians that are now saying,'I will participate'".
     A CMA on-line survey asked, "if a physician refuses to provide medical aid in dying, what should they be required to do?   The most popular response was, "they should not be required to do anything". 
      I find it encouraging to note that the majority of physicians still embrace the traditional principles of the medical profession.  There will always be enough who feel otherwise to ensure that those patients who wish to end their own lives will have adequate help without forcing those who find termination repulsive to perform the deed.
    

Medicine in the Headlines - again.

         Now that I am retired, I have time to peruse what is really happening in Medicine and it isn't a pretty picture.  Over a leisurely breakfast I have time to page through the national paper that I prefer and hardly a day goes by  without some sort of medical  headline.  Often it is trivia, sometimes not.  So  let me tell you about the last two days 'Medlines'.
          August 25th. -  
         "Weak MDs blamed for opioid epidemic", sub heading - 'We kill  more people now than cars do'. 
        At a CMA Meeting in Halifax the CEO of the College of Physicians and Surgeons of Halifax opined that physicians don't understand narcotics and that he frequently sees undisciplined, unstructured and arbitrary use of these medications, by weak-willed, uninformed physicians!   Hello Dr.  Grant, what's your job?   Isn't a main function of the College to protect the public from just such issues as you are criticizing?  What are you getting paid for, because if what you say is true and you haven't addressed it, you are not doing your job.   Grant went on to say "The number of lives ruined by drugs is a problem of enormous magnitude that is killing people".  Well, Dr Grant, if you were not as weak and ineffective as the physicians you are thus labeling, you would have taken this matter in hand, long ago.  You don't know how?  Well let me tell you, but you do have to  be prepared to take responsibility for what you have to do..   When I was a young physician, long long ago and in a place far away, when physicians prescribed inappropriately, they got a warning from the College.  If they did it again, their license to prescribe narcotics was taken away.  If they offended again, their license to practice medicine was taken  away.  Simple.  Effective.  But you have to have guts to implement such a policy.   It is always easy to criticize (particularly one's colleagues), there is a solution, but it takes conviction and effort to remedy the situation. 
         I'll save the next Medline for the next blog. 
 Your comments are welcome.

The Pink Pill!

          The impotent male has had the Blue Pill for a long time now.  How much joy, delight and satisfaction it has brought to that group is questionable, but erections, like elections, are an essential part of our social culture.  But why should these droopy males, have all the advantages.  Legions of women who have derived little satisfaction from sex (after the wonder months or years) want to pop a pill just the way that those lucky, privileged, males have done for years now and find instant gratification!    And indeed, why shouldn't they?    I think, the very political correctness of the situation will make it an instant winner and barring any unsuspected side effects, above and beyond those already documented, will make a fortune for those bold enough to invest heavily in it.  

         Flibanserin (Addyi) is classified as a 5-HT serotonin receptor agonist and a dopamine D4 receptor partial agonist. It is a Non-Hormonal agent that increases dopamine and noradrenalin while reducing Serotonin in the brain.  It was being developed as a new antidepressant  and  a large number of women noticed an unexpected positive side effect from Flibanserin. Many woman were reporting more sexual interest and overall satisfying sexual experiences than before. One of the  main  side-effects of antidepressants is loss of libido, so  this provoked much interest.  Apparently some woman in the trials didn't want to stop the testing based on this fact alone.    This led the company to clinically testing this new compound for this exact reason. Can it actually increase a woman's desire for sex?
           Side effects that were reported by some of the users where usually low to moderate. These were dizziness, anxiety, fatigue, dry mouth, insomnia, nausea. Not everyone who partook in the study had any of these but there were more occasions of these being reported compared to the placebo group and due to the fact that this compound is fairly new, there have not been nor could there have been any long term studies on side effects
          Flibanserin (Addyi®) 100mg has been approved by the FDA. It is anticipated that it will be available by October 17th 2015.