Non-Compliant Patients and the AMA

This is a note traveling the e-mail forwarding loop that I believe is worthy of sharing - for those of you who don't have that 1 or 2 obnoxious friends who believe every e-mail is meant to be forwarding. ;-) FYI - It wasn't an obnoxious friend who shared this one with me, though this wasn't the first on in my inbox.  It was a friend who knows my interest in such topics.  And, this friend also sent me the most user friendly version of the e-mail.

****Begin Email*****
"The following is page 102 of 134 pages of the American Medical Association's Annual Meeting Report. Essentially, physicians are requesting a "code" enabling them to identify, label, and recognize "non-compliant" (READ: "autonomous") patients. (Bold emphasis added.)


SOURCE: http://www.ama-assn.org/ama1/pub/upload/mm/475/refcomg.pdf

AMERICAN MEDICAL ASSOCIATION HOUSE OF DELEGATES
Resolution: 710 (A-09)
Introduced by: Michigan Delegation
Subject: Identifying Abusive, Hostile or Non-Compliant Patients
Referred to: Reference Committee G

(J. Leonard Lichtenfeld, MD, Chair)

Whereas, Many patients are becoming more abusive and hostile toward physicians for many reasons not limited to the economy, increasing co-pays and deductibles, unreasonable expectations and demands, a lack of instantaneous cure, arrogance and/or the belief that they “own” their physicians; and

Whereas, There are decreasing numbers of physicians both in primary care and specialties especially in terms of access; and

Whereas, Increasing noncompliance with treatment can reflect negatively on physicians during black box audits by insurance companies and oversight governmental agencies; and

Whereas, Abusive, hostile, and noncompliant patients result in increasing office resources adding to office overhead and added stress on all of the office personnel, which can lead to potential ill health; and

Whereas, The stress of dealing with ungrateful patients is adding to the stress of physicians leading to decreased physician satisfaction; and

Whereas, Any complaint to any oversight investigative regulatory body leads to uncompensated expenditure of time, resources, and monies to defend physicians or the “guilty until proven innocent” principal; and

Whereas, Physicians need to own the data to simplify patient collection and identification to defend themselves as well as alert outside investigating agencies to the potential nature of the patient’s records; therefore be it

RESOLVED: That our American Medical Association ask its CPT Editorial Panel to investigate for data collection and report back at Annual 2010 meeting: 1) developing a modifier for the E&M codes to identify non-compliant patients and/or 2) develop an add-on code to E&M codes to identify non-compliant patients. (Directive to Take Action)

Fiscal Note: Staff cost estimated at less than $500 to implement.
Received: 05/06/09" *****end e-mail*****

Be ye not ungrateful, or you may find those physicians who are already impossible to communicate with getting even more impossible because of the Code 666 attached to your file - since you were ungrateful when you went to the last MD, who didn't do anything but empty your pocketbook.  It's a shame we can't all be sheep led to the slaughter I guess.  Another reason we just don't do MDs unless we need to save someone from bleeding to death or set a bone. 

 

Topical Yeast Infection

It was a long, hot, sweaty summer, as usual. It wasn't last summer, and it isn't the one coming. It was actually 2007. I found that any time I went outside to work, I sweated. When I sweated, a burning, itching rash would present itself at the same location my bra strap wanted to sit. I can only tell you how uncomfortable this is, but you can't imagine unless it has happened to you. It would be akin to sticking your hand in a nest of fire ants, and leaving it there. Most of that summer I sat inside, not knowing what to do for this torture. Jay suggest Gold Bond powder. That would soothe, but not eliminate the problem. Summer went, and cooler temperatures came. But, I would still notice some itching and rash on occasion.

Well, 2008 summer came with a vengeance, as they all do here, and it started again. Somewhere inside me, an answer rose up. I'd actually love to take credit for the genius thought, but am sure it was the Holy Spirit in response to my prayers of pain. YEAST. We'd been fighting yeast, and winning, with Ross - mostly respiratory. But, I had never imagined that yeast might be my enemy too. A quick test would be to dilute some Grapefruit Seed Extract and wipe it on the affected area. If it was yeast, it should reduce, if not eliminate, it. IT DID!! I did this a couple more times over the next week, and then just completely forgot about my personal nightmare.

Summer 2009 is quickly approaching. It brought it to mind when I noticed I was sweating from the excessive humidity. I decided that this was an overdue post to my health blog. I have reason to believe I'm not the only person in the world who suffers from topical yeast infections. We may think they are bacterial, or allergic reactions, but they may just be yeast.

Yeast is very easily treated with Grapefruit Seed Extract. You can find it at http://www.iherb.com - Nutribiotic is the brand. If you have never ordered there before, use coupon code KES097 to get $5 off your first time order. I prefer the liquid, since direct application in diluted form is quick, easy and makes it less necessary to take more pills. But, you can take it in pill form and it is effective. We use a 10 drops to 6 oz of water dilution rate. You can mix up more or less depending on your need. For a douche, I actually triple the GSE in the dilution.

We've also recently discovered that our youngest daughter's frequent breakouts are actually yeast acne. She noticed that sugar increased breakouts, so stopped doing so much sugar. I put 2 and 2 together and came up with yeast. She started taking 2 GSE pills at night before bed, then a probiotic pill in the morning before breakfast, and her acne has improved tremendously. She even ran out of her Clinique cleanser, and the acne is still improving.

Ross's frequent throat infections were also yeast, treated with diluted GSE gargle.

So, yeast is more than an internal enemy. It is also a topical enemy. Next time that strange rash gets you down, think yeast, and try some GSE wipe. It may not help, but it won't hurt to try. If it does help, you know you are battling Yeast.

Just a word on the H1N1 virus

Yup, that's about all the air time it deserves in my opinion. So the word is - "ignore"

(FYI - I'm taking lightly the effect it has had on people's lives, but AIDS, cancer and many other ailments require much more thought than this one. Don't believe the hype, just stay healthy and you'll be fine.)

The Feet Have It – Part I – Chilblains

I think this is the oddest of my foot entries. This was also not my problem, but my teenage daughter's. At first, we thought it was a rash, or topical affliction. But, it really didn’t ever blister. Her toes just kept looking redder, bothering her more – pain and itching – and then started to swell and turn purplish. It actually looked pretty disgusting.

I knew it wasn’t fungal, since we tried Grapefruit Seed Extract dilution on it to no avail. She actually soaked in the dilution and said it made them itch more. So, somehow the heat was affecting it.

I got online and started looking. It was an interesting search that ended at Chilblains. It was because her feet got cold I guess. But not just her feet needed to be warm, her whole body. Though her ever-helpful parents had constantly reminded to put socks and long sleeve shirts on in the winter house, she would rather complain about the cold than do that. When she got her diagnosis from mom, along with several web pages to peruse, she took great interest in putting on more clothes to keep warm.

The treatment I decided looked most effective was actually to keep the whole body warm. Being adventurous though, I added a warm Epsom salt foot bath to the list of do’s. I had her sit a couple hours with her feet in the Epsom salt bath, and keep herself very warmly clothed. I did my part by stocking the wood stove hotter so the temperature in the house was around 75 or higher. She spent most of the day in her room, at the end of the house, doing school work though. It was harder to keep her room warm with the wood stove, so I suggested she move to the room the wood stove was in.

Her brother and I dressed more lightly, and it took a few days, but eventually the Chilblains disappeared almost as suddenly as it showed. The color in her toes went back to normal, but the stretched skin still looked odd and grotesque. Most of the improvement was, oddly enough, after soaking her feet. I didn’t use very hot water, mostly just lukewarm. I think that helped. From the reading I did on several different sites, it sounded like a circulation issue and extreme temperatures aggravated.

Therefore, the feet have it on this one. My “odd foot affliction” award goes to the Chilblains. Surprisingly, it wasn’t my feet that had it either.

I believe this is probably the final installment in the Feet Have It series. I hope you found our oddities amusing and a bit informative.

Good luck with your feet and your health!

The Feet Have It – Part 2 – Vaso-Spastic Disorder

I can’t even begin to tell you about the discomfort of this one. It felt like 1,000 needles sticking into each individual nerve in my toes and upper foot. The heat was extreme also, like a fever localized to just the toes and ends of my feet. I rarely seek medical advice or diagnosis, but this was one time I did.

Since it was the feet, and obviously not fungal or anything I could figure out, I headed to the Podiatrist. This was 24 years ago now, shortly after my first child I believe, though time slips from my memory banks. I was doing work overnights taking inventory for stores all over the state, and spent quite a few hours on my feet and driving to remote locations. The drive is when it seemed to bother most.

The podiatrist was stumped, but suspected nerve problems, so referred me to a neurologist 3 hours away. Great, another long drive. I saw the neurologist, don’t remember any tests, just an office visit. At the office visit he confidently announced “Vasospastic disorder.” Then, as if reading from a copy of his medical school text, rambled off, “It affects mostly young women in their early 20s, bla, bla, bla, and has no known cure. We also do not know the cause. We can prescribe a drug to keep them calm and relieve the discomfort. You will take it for life. It does cause birth defects, so you can’t become pregnant while on it.” Well, if you know me, you know what I said as I ran screaming from the office!! NO THANK YOU.

It was nice to know what they didn’t know, though, you know? I didn’t bother trying to find any more out. I just limited long drives, put my feet up more, etc. Then a few months later I noticed that I was no longer having symptoms. I thought about changes I’d made – diet, exercise, work, etc. Nothing there. But, then I went to put on my size 12s. They were new. I was so excited to find them too. They were the first pair of women’s size 12s I’d ever seen in a store. It was so nice to not have my toes crammed into the end of my shoe. . . . .hmmmmmm. . . I think I’m on to something here. This was the first pair of shoes I’d purchased that actually fit in about 5 years, since my feet had reached their size 12 proportion. I had also mostly gone barefooted since I didn’t work outside the home, until I got that job doing inventory which required me to be in shoes for hours on end – including long drives through the state. Now, we know why mostly young women are affected with this I thought. You ever try to find a nice fitting pair of women's shoes in the 1980s?

Mystery solved. Did I contact the neurologist and podiatrist and let them know the mystery was solved? No. I didn’t even think of it. Probably should have though. Well, maybe they will stumble upon this blog and find out that I’m doing fine, and so are my feet. . .for now.

The Feet Have It – Part I – Ganglion Cysts

Well, yes, if my feet can, they will – Have it. And, if my feet don’t get it, surely, on of my family members’ feet will. In doing my part to keep the world on its feet, I’m doing a multi-part series on odd foot ailments and what we have done for them. Part I – Ganglion Cysts is about thinking outside the box, or boot as it were.

A ganglion cyst can be very annoying. It is a weakness in membrane walls that causes lubricating fluid to fill it like a balloon. While not at all life threatening, it is indeed a pain in the foot, though it can manifest in the hand area also. Not only can you not get this knot on the top of your foot into your usual shoes, it also aches. It is a dull ache, not an earth shattering, ear splintering ouch. But, it is that kind of pain that just lingers and says “Here I am!”

One of these creatures showed up on my left foot after I had been painting at my daughter’s new house. I noticed the step stool I was using was rather uncomfortable for my size 12s, so I swapped with someone else, not that they had any smaller feet to put on it, but I am the elder after all. I did not think anything else about the foot pain using the more narrow stool had caused until the next day. Hmmmm. . . .why was my foot so sore, I thought. Well, figured it was the painting, ignored it and moved on.

You see, I don’t usually wear shoes, and examining a sore foot I guessed was beyond me, so I didn’t. It was still sore the next day, so I got out my Topricin (if you decide to buy some, use code KES097 at checkout for $5 off) and put some on. While rubbing, I may have noticed my foot was a bit swollen. Due to the estrogen dominance I was yet to know I was dealing with, swollen feet and water retention wasn’t abnormal, so I just wrote it off. Wow, that felt nice, the Topricin, massaging, pain relieving and all. Over the next day, we would do the reminder pain – Topricin application. After another 48 hours I really thought no more about it for a day or two.

Then, I noticed a dull ache, and instead of just reaching for the Topricin, I happened to actually look at my foot. I will admit a bit of shock flooded me, but not really panic. What I saw, I hadn’t witnessed before. There was a BUMP on my foot, just back of my smaller toes, where normally the bones show. I felt it, thought about it, put some more Topricin on, and figured like all things it would go away.

Next day, it was still there, so was the dull throb, and now a new friend, a second bump. Okay, if my foot is going to start looking like a mountain range, I guess I should figure out why, I thought. Online I went, to many sites, checking symptoms, stories, people blogging about foot bumps, etc. Finally, I found a name – Ganglion Cyst. We all know cysts can be naughty, nice or just irrelevant. I started looking to see which bugger this was. Well, it was mostly irrelevant other than the disturbance it caused shoe wearing.

Treatment: Ah, lovely treatment lists. They are never correct. For ganglion cyst there were two proposed treatments. The first, you guessed, was surgery, which according to all sites was mostly helpful in the short term yet very ineffective in the long run. The other treatment was called the “Bible Thump.” This is why another name for this ailment is “Bible Cyst.” Just like it implies, you smash the cyst with a Bible or other large book. That sounded a bit painful and ineffective to me. But, it did explain why massaging the foot made it feel better. The idea behind the Bible thump is to push the fluid back out of the weakened area. Massaging was a kinder, gentler method of doing so.

A strange thing happened on the way to treatment though. I decided that since the Topricin made it feel better, I’d continue that approach. It had to be as effective as the two medically proposed options, and certainly was less barbaric. So, for about a month I continued. I discovered my estrogen dominance in this time, started USP progesterone treatment, and now, 8 months later have no sign of swelling, pain or Ganglion Cysts.

Stay tuned for the next installment of “The Feet Have It” when I tell you about my experience with the mysterious vaso-spastic disorder which strikes women in their early 20s and is totally incurable . . . right.

Dr. Mercola and The Town Of Allopath Video

Hate mail to Dr. Mercola? Okay, yes I can believe it. He doesn't really seem to follow the party line. I remember reading that this video generated more hate mail. I can't imagine it. My husband and I love it. Every once in a while I pop in to view it again. I decided today that I really should share it. The Town of Allopath

I also thought of it today because I have noticed a new buzz-phrase that the "modern medicine" quackbusters clan is trying to get us to adopt - Evidence Based Medicine. HUH? What could be more evidence based than thousands of years of real life success with herbs, manipulations, massage, etc. Sure homeopathy is a fairly new thing, but I have heard more successes coming out of homeopathy than I have "modern medicine."

Now about calling it "allopathic." I hadn't heard that term until about 10 years ago. I looked into that some, and it would seem that may be where the friction between "allopathic medicine" and homeopathy began. I guess the MD crowd doesn't like being called allopathic, so they want to be called "evidence based" now. Allopathic medicine defined on Wikipedia (bastion of reliability it is) says that the founder of homeopathics actually coined the term from Greek meaning "other than the disease" since MDs don't treat based on symptoms of the disease. I won't try to explain it all here, but it does seem that the MDs might have been a bit upset with the attitude that they were harming patients. Okay, we know they are; they still don't like it when we say that.

Suffice it to say, at our house, the new terminology for those MDs who are a bit touchy is "skidmarks disease." Hope you enjoy/enjoyed the video!

Qualification: Just FYI - I don't hate allopathic medicine, just don't like it much. Have had little reason to use it since evidence based medicine usually helps us much more quickly, effectively and with fewer side effects. We do visit the MDs if a bone is broken or there is an immediate life threatening situation. Once stabilized, we then look into mean of evidence based medicine to help us recover.