Saturday, May 26, 2012
Busines of Medicine: Encouraging News
PGY 39, Day 331
Re-Humanizing Health Care
I am happy to report encouraging news for Patients and Doctors. The American College of Physician Executives (I am a member, and encourage all physicians to join this organization) hosted a very fine webinar on Re-Humanizing Health Care, which I participated in, largely because I was encouraged to do so by Charisse Jimenez. Our email exchange that preceded this webinar will be abbreviated and included on future blogs, because it reflects my fundamental belief that The Profession of Medicine is driven by the Power of Love, and put to work in accordance with The Hippocratic Oath. This webinar was outstanding, encouraging and heartwarming, for several reasons. They include, but are not limited to these facts:
1. The topic is very timely. It reflects a growing recognition among physicians (and patients) that the business of medicine is routinely failing physicians and patients
2. Technology enabled a broad audience from across the country (around the world?) to participate.
3. This "boots on the ground" member was encouraged to participate and
4. was able to participate from my rural location in Maine,
5. "Important" People are listening,
6. I was encouraged and able to share my views on the need to realign Medical Care and "Health Care Institutions" in the USA to the needs of the patients, by focusing on our professional obligations and primary mission as it is outlined in the Hippocratic Oath for Patients and Physicians. Specifically, I was able to make this statement at the end of the webinar.
"The Organizations appear to be confused. In some cases, they have become so preoccupied with money that they have completely lost sight of their Mission, and realignment is essential. Our Mission is based upon Love and Care. The Oath is our practical guide."
Dr. Rubin's response was ... beautiful. Through this, I see hope, that the ACPE will truly facilitate moves in the direction that will at least encourage reconstruction of the Doctor-Patient Relationship and use of The Hippocratic Oath, as the Doctor-Patient Relationship, as it is defined in the Hippocratic Oath is the foundation of any proper fix for America's Health Care "System". My bias is toward development of Non Profit Doctor-Patient Cooperatives, but most models can work, if they are rational and based upon the Hippocratic Oath ... Not money ... Patients ... not Profit.
Here ... for now, is the email that was sent to me after the conference. There are links to the details of the meeting, which may, or may not work for you. If you need further information, please feel free to talk with me. Email works best.
Feel the Love and Enjoy!
Dr. Mike
From: Charisse Jimenez
Date: May 25, 2012 9:02:57 EDT
To: Michael F. Mascia, MD, MPH (dr.mike@ihealsolutions.com)
Subject: ACPE - Post webinar evaluation and links.
Michael Mascia,
I found yesterday’s webinar, Physician Leaders: Their Unique Perspective Re-Humanizing Health Care fascinating and I appreciate you sharing an interest in this topic. A link to the slides and an audio recording appear below. Many of you requested a copy of the references and citations so Dr. Rubin is collecting these and I will send them to you next week. If you were able to listen to the whole session, would you take one minute to complete this post-webinar evaluation? Thank you in advance for your feedback as ACPE continues to work to support your work as a physician leader.Links:
· Slide deck: http://net.acpe.org/webinars/rehumanizing.pdf · MP3 recording: http://net.acpe.org/webinars/rehumanizing.mp3 Enjoy your Memorial Day Weekend,
Charisse Jimenez
Director, Membership
800-562-8088
Friday, May 25, 2012
More On Love
Heavenly Love
But Ahhh ...
the crumbs that fall from the table of the gods ...
so delicious ...
a taste ...
wants more.
That ...
craving ...
desire ...
power ...
charge ...
heart and soul.
And ...
mutual ...
when mutual ...
a heavently crescendo ...
lifting toward their feast.
But ...
we never reach the table ...
rather ...
drifting up ...
and
down ...
with the Power.
When one fails ...
a sudden fall ...
and painful ...
crash.
Veritas est!
Enjoy!
Dr. Mike
But Ahhh ...
the crumbs that fall from the table of the gods ...
so delicious ...
a taste ...
wants more.
That ...
craving ...
desire ...
power ...
charge ...
heart and soul.
And ...
mutual ...
when mutual ...
a heavently crescendo ...
lifting toward their feast.
But ...
we never reach the table ...
rather ...
drifting up ...
and
down ...
with the Power.
When one fails ...
a sudden fall ...
and painful ...
crash.
Veritas est!
Enjoy!
Dr. Mike
Friday, May 18, 2012
Disaster Preparedness: Lightning Strikes Twice
PGY 39, Day 323
Lightning Strikes Twice!
For those who think, "It won't happen to me.", think again. Disasters can and will happen to you, to someone you love, or someone you know. So, be prepared for yourself, your family, your friends, your community, or the larger community. And, if it does not have a directly impact on you, be prepared to help others.
Katrina taught me a few things about Disasters and Disaster Preparedness ... she burned these things into my brain, and made it a part of my blood. Consequently, I was somewhat prepared ... for just about anything. But, at the time of the storm, disaster management was the farthest thing from my mind. I was in a "chillin'" mode, and mesmerized by the beauty and power of it all. The storm was booming around me, then ... crack ... I was literally blown out of my trance.
This is not the first time my home has been struck by lightning. There was a strike before, with destruction of the original alarm system. This time, for better or worse, I was home and right in the thick of things. It has taken me a few days to get my wits about me ... mostly going through the motions ... figuring out exactly what had happened. Perhaps part of it was a sort of "blast injury" ... I don't know. The thing did slap me on the left side of my face and the blast was strong enough to blow a basement window in. Or, it may just be the overwhelming gravity of it all ... coming to grips with the damage, and truly appreciating my good fortune ... having sustained no significant personal injury(?) and little property damage. It could have been much worse, so I do consider myself to be fortunate ... to have learned more. Still learning ...
Now that my wits are back, I am compelled to share the story for those who might like to learn with me, by seeing the near real time account of my experience after the strike ... through the eyes of a Katrina Survivor and seasoned physician. I will try to keep it in chronologic order and give it to you as it evolved and is evolving over time ... a luxury I did not have after Katrina.
Day Zero: Struck on Wednesday, May 16, 2012 at about 8PM
The Storm: Mesmerized by Power and Beauty
I was actually sitting outside, relaxing, enjoying the storm and writing this (unedited) email at the time of the strike.
"Sitting in darkness ... Oil lamp flickers ... outside on the porch ... Crickets sing the day's swansong. thunder rumbling in over the mountains ... far away ... echoes grumbling ... sky flashes w lightning ... Trees silhouetted ... Drop in and out of the black night. Great horned owl calls ... Rain starting ... Hushhhhh ... Calling for silence to no avail ...
The symphony continues ... Crescendo now ... Then decrescendo ... Up and down and up again ... Crescendo ... Up ... Up ... Fortissimo ... Now over me ... Lighting brighter than day ... booming close ... Closer ... CRACK ...
To my left ... I am shaken out of my trance ... Smell the smoke check the house. It was struck. Just to my left. Wires burned out in the basement ... A window blown in."
In the Aftermath of the Storm
Assessing the Damage
Day Zero: Wednesday, May 16, 2012 @ 8PM
Actually I had had initially assumed that the smoke was from a nearby tree ... hiding in the darkness, but that was not correct.
Alarming ... I go inside ... "what is that beeping?"... "lights working" ... follow the sound into the kitchen ... Control panel from alarm system reads, "Open Crt" ... "what the hell does that mean?" Open circuit, I figure, and assume that the alarm system is out. "Does it work at all? Did it send a signal to the monitoring center? What signal did it send?" Lights work. No smoke upstairs, the basement ... full of smoke. I don't want to stay there, but quickly determine that there is no obvious fire. "Open the broken window" I do. ... some windows and doors, and went back up stairs, to avoid smoke inhalation. Finish my email (Blackberry still works), drink some coffee, and sit outside while the storm is moving on, and smoke is moving out.
After a bit, I went back to the basement. Smoke was diminished, but still thick. Another quick look showed that the strike had not only blown in the basement window (a direct blast effect?) but as the electricity traveled into the house, it blasted and destroyed part of the cellar door frame (blast caused by vaporized water?) and adjoining wall. From the door frame to the aluminum weather stripping, and up to the alarm sensor for the door. It blew that out with the frame around it, vaporized the sensor and much of the wire. "Get out of the smoke. It is probably toxic." I do.
Back upstairs ... the hard wired phone does not work. "Still alarming", I call the alarm monitoring folks. They tell me that no signals have come in. I tell them what is going on. "Do you want us to call the fire department?" "No, thanks, I think I am OK." They guide me through trouble shooting, but the best we can do is to shut off the alarm. They give me the phone number of the local guys to call about the alarm system. I call and leave a message.
I wander around a bit ... check basement again ... "no fire and less smoke". Shut the (broken) window, shut things down, and go up to bed. "Nothing else I can do now." Have power, Blackberry, I pad and "My Fi" working, I get into bed and drift off to sleep.
Day One: Daylight, Thursday, May 17, 2012
Make a bunch of phone calls, the alrm guy calls and schedules a ...
Update: Writing now Saturday, May 26, 2012
Day One: Thursday, May 17, 2012
Activities ...
Discoveries: Went to make coffee ... no water comes out of the kitchen faucet. "the well pump is out". I use the water I had collected and bottled water for routine activities (two gallons in reserve, a case of 500ml Pellegrino sparkling water) and can't flush the toilets, and dishwasher and washing machine are out of commission.
Blown out basement window, door frame and general reconstruction issues: Call HB Wood Company. Leave a message. Call back. Will come and evaluate on Friday Morning.
No land line: Call Fairpoint Communications. Schedule service before the end of Friday.
Disrupted Schedule: Meeting Friday through Monday in Boston. Must delay my participation. Luckily, my presentation is on Sunday, so I can go in on Saturday.
Water Pump and Living Room Light Circuit Out: All breakers intact, Call All Service Electric. Call back, scheduled a visit for Thursday PM. Evaluation of circuit and well pump. Bulbs and dimmer switch are out in LR, and pump motor is burned out.
Water Pump: Call Hodgdon Well Drilling. Leave a message
Alarm System: WAM Alarm calls back and schedules a visit for today. Evaluation shows vaporization of most of wires and sensors around the area that was struck and around to the front of the house.
Insurance: Call USAA, tell them the story and they say, "you are coverd. $500 deductable. go ahead with repairs."
To be continued ...
StepWisely®© Enjoy! Dr. Mike
Lightning Strikes Twice!
For those who think, "It won't happen to me.", think again. Disasters can and will happen to you, to someone you love, or someone you know. So, be prepared for yourself, your family, your friends, your community, or the larger community. And, if it does not have a directly impact on you, be prepared to help others.
Katrina taught me a few things about Disasters and Disaster Preparedness ... she burned these things into my brain, and made it a part of my blood. Consequently, I was somewhat prepared ... for just about anything. But, at the time of the storm, disaster management was the farthest thing from my mind. I was in a "chillin'" mode, and mesmerized by the beauty and power of it all. The storm was booming around me, then ... crack ... I was literally blown out of my trance.
This is not the first time my home has been struck by lightning. There was a strike before, with destruction of the original alarm system. This time, for better or worse, I was home and right in the thick of things. It has taken me a few days to get my wits about me ... mostly going through the motions ... figuring out exactly what had happened. Perhaps part of it was a sort of "blast injury" ... I don't know. The thing did slap me on the left side of my face and the blast was strong enough to blow a basement window in. Or, it may just be the overwhelming gravity of it all ... coming to grips with the damage, and truly appreciating my good fortune ... having sustained no significant personal injury(?) and little property damage. It could have been much worse, so I do consider myself to be fortunate ... to have learned more. Still learning ...
Now that my wits are back, I am compelled to share the story for those who might like to learn with me, by seeing the near real time account of my experience after the strike ... through the eyes of a Katrina Survivor and seasoned physician. I will try to keep it in chronologic order and give it to you as it evolved and is evolving over time ... a luxury I did not have after Katrina.
Day Zero: Struck on Wednesday, May 16, 2012 at about 8PM
The Storm: Mesmerized by Power and Beauty
I was actually sitting outside, relaxing, enjoying the storm and writing this (unedited) email at the time of the strike.
"Sitting in darkness ... Oil lamp flickers ... outside on the porch ... Crickets sing the day's swansong. thunder rumbling in over the mountains ... far away ... echoes grumbling ... sky flashes w lightning ... Trees silhouetted ... Drop in and out of the black night. Great horned owl calls ... Rain starting ... Hushhhhh ... Calling for silence to no avail ...
The symphony continues ... Crescendo now ... Then decrescendo ... Up and down and up again ... Crescendo ... Up ... Up ... Fortissimo ... Now over me ... Lighting brighter than day ... booming close ... Closer ... CRACK ...
To my left ... I am shaken out of my trance ... Smell the smoke check the house. It was struck. Just to my left. Wires burned out in the basement ... A window blown in."
In the Aftermath of the Storm
Assessing the Damage
Day Zero: Wednesday, May 16, 2012 @ 8PM
Actually I had had initially assumed that the smoke was from a nearby tree ... hiding in the darkness, but that was not correct.
Alarming ... I go inside ... "what is that beeping?"... "lights working" ... follow the sound into the kitchen ... Control panel from alarm system reads, "Open Crt" ... "what the hell does that mean?" Open circuit, I figure, and assume that the alarm system is out. "Does it work at all? Did it send a signal to the monitoring center? What signal did it send?" Lights work. No smoke upstairs, the basement ... full of smoke. I don't want to stay there, but quickly determine that there is no obvious fire. "Open the broken window" I do. ... some windows and doors, and went back up stairs, to avoid smoke inhalation. Finish my email (Blackberry still works), drink some coffee, and sit outside while the storm is moving on, and smoke is moving out.
After a bit, I went back to the basement. Smoke was diminished, but still thick. Another quick look showed that the strike had not only blown in the basement window (a direct blast effect?) but as the electricity traveled into the house, it blasted and destroyed part of the cellar door frame (blast caused by vaporized water?) and adjoining wall. From the door frame to the aluminum weather stripping, and up to the alarm sensor for the door. It blew that out with the frame around it, vaporized the sensor and much of the wire. "Get out of the smoke. It is probably toxic." I do.
Back upstairs ... the hard wired phone does not work. "Still alarming", I call the alarm monitoring folks. They tell me that no signals have come in. I tell them what is going on. "Do you want us to call the fire department?" "No, thanks, I think I am OK." They guide me through trouble shooting, but the best we can do is to shut off the alarm. They give me the phone number of the local guys to call about the alarm system. I call and leave a message.
I wander around a bit ... check basement again ... "no fire and less smoke". Shut the (broken) window, shut things down, and go up to bed. "Nothing else I can do now." Have power, Blackberry, I pad and "My Fi" working, I get into bed and drift off to sleep.
Day One: Daylight, Thursday, May 17, 2012
Make a bunch of phone calls, the alrm guy calls and schedules a ...
Update: Writing now Saturday, May 26, 2012
Day One: Thursday, May 17, 2012
Activities ...
Discoveries: Went to make coffee ... no water comes out of the kitchen faucet. "the well pump is out". I use the water I had collected and bottled water for routine activities (two gallons in reserve, a case of 500ml Pellegrino sparkling water) and can't flush the toilets, and dishwasher and washing machine are out of commission.
Blown out basement window, door frame and general reconstruction issues: Call HB Wood Company. Leave a message. Call back. Will come and evaluate on Friday Morning.
No land line: Call Fairpoint Communications. Schedule service before the end of Friday.
Disrupted Schedule: Meeting Friday through Monday in Boston. Must delay my participation. Luckily, my presentation is on Sunday, so I can go in on Saturday.
Water Pump and Living Room Light Circuit Out: All breakers intact, Call All Service Electric. Call back, scheduled a visit for Thursday PM. Evaluation of circuit and well pump. Bulbs and dimmer switch are out in LR, and pump motor is burned out.
Water Pump: Call Hodgdon Well Drilling. Leave a message
Alarm System: WAM Alarm calls back and schedules a visit for today. Evaluation shows vaporization of most of wires and sensors around the area that was struck and around to the front of the house.
Insurance: Call USAA, tell them the story and they say, "you are coverd. $500 deductable. go ahead with repairs."
To be continued ...
StepWisely®© Enjoy! Dr. Mike
Tuesday, May 15, 2012
Business of Medicine: About to Implode?
PGY 39, Day #320
Arnold Relman recently wrote an Essay that was published in the British Journal of Medicine, and I saw some commentary on it today in Physician's First Watch for May 15, 2012. From what I have been able to dig up so far, I agree with his observations, but don't think his fix is the best solution. I will share what I have found so far, and follow it with my reaction. You know up front, that I am an advocate for Non Profit Doctor Patient Cooperatives, but let's see what Dr. Relman, professor emeritus of medicine and social medicine, Harvard Medical School, Boston, Massachusetts, USA, had to say.
First directly from
Physician's First Watch for May 15, 2012
David G. Fairchild, MD, MPH, Editor-in-Chief
After 30 Years, Still Warning About the Direction of U.S. Healthcare
Dr. Arnold Relman, who first warned in a 1980 essay against the rise of the "new medical-industrial complex," offers another warning, this time in BMJ. (Clinical Conversations has an interview with him. Listen via the link below.)
While Relman's 1980 essay called for more study of an emerging situation in which market forces were distorting the U.S. healthcare system, he now describes a system headed inevitably toward bankruptcy and in need of major reform. Physicians, fully aware of what their reimbursements will be, have strong incentives to be "overly generous" in recommending services, he writes, but they remain mostly "unfamiliar with the charges made to insurers [and others] for the services they recommend."
He recommends, among other things, the reorganization of the U.S. system into "private, non-profit, multispecialty group practices, in which physicians are paid largely or entirely by salary." He predicts "fierce resistance" to reform "from all those with vested financial interests in the status quo."
This commentary had three links
BMJ article (Free abstract)
Clinical Conversations interview (Free)
NEJM 1980 article (Free abstract)
Below is the BMJ abstract of the essay ... I did listen to his interview, but have not yet read the complete essay.
"Why the US healthcare system is failing, and what might rescue it
BMJ 2012; 344 doi: 10.1136/bmj.e3052 (Published 9 May 2012)
My Readtion ...
I appreciate the fact that I am not the only Doc who sees the inevitable implosion of the "Business of Medicine" as we know it, and I would like the pleasure of reading your entire article, so that I may comment on it in a comprehensive way.
As a participating observer for over 30 years, from my "front lines and boots on the ground" perspective, the "Business of Medicine" has hijacked the Doctor Patient Relationship to take Profit away from patient care, without benefit to patients or providers. Pushing toward $$$ = assembly line care, return on investment, care lines, product lines, reimbursement for technical and categorical (reimbursable) services has made it impossible to give HUMAN care ... as we now only pay for "indicated" procedures "proper" diseases. Clearly, business only cares about those things that bring $$$, consequently, much of what real people need, the stuff we used to do for free, or on a fee for service basis, or in trade, or for love(personalized care) is left to fall through the cracks. And, that says nothing about the people who have no care, because the monster providers just ... do not care ... except for money.
Of course, they don't care, because there is no money in it ... if it does not have a code, or $$$ return attached to it, forget it. "Dysintegrated care" or "Disintegrated care" (my pet phrase) IS the current "health care system". And, as it has become progressively more complicated and progressively deteriorated over the years, IT continues to promote ITSELF (the third parties) to the detriment of Patients and Doctors. Yes, disintegrated cafe is promoted by the "business of medicine" ... of course, because the focus on technical stuff and disease works for the third parties. Precisely because it consistently fails Patients and Doctors, the third parties get more money in the process. Yes, the "Business of Medicine" just does not work and can not work ... ever ... for Patients and Doctors. And, I don't see that the bandaids will work either, because they enable, endorse and foster the current mess. For that reason, I advocate a paradigm shift ... back toward the Doctor Patient Relationship.
For the last decade, or so, I have been advocating the formation of Non Profit Doctor-Patient Cooperatives ... building greed and third parties out of it as much as is possible. My hope is to set one up by the end of this year. We will see how it goes. Most Doctors seem to be quite content to follow the money ... they seem to be blinded by it, as they can't see they are about to fall off a cliff and drag all the patients with them.
Join me in working toward the New Paradigm in Healthcare: The Non Profit Doctor Patient Cooperative
Respond to this blog, or email me at dr.mike@ihealsolutions.com and thanks for your support. We are all patients at one time or another and who wants to be left flat by greedy business people?
Dr. Mike
Arnold Relman recently wrote an Essay that was published in the British Journal of Medicine, and I saw some commentary on it today in Physician's First Watch for May 15, 2012. From what I have been able to dig up so far, I agree with his observations, but don't think his fix is the best solution. I will share what I have found so far, and follow it with my reaction. You know up front, that I am an advocate for Non Profit Doctor Patient Cooperatives, but let's see what Dr. Relman, professor emeritus of medicine and social medicine, Harvard Medical School, Boston, Massachusetts, USA, had to say.
First directly from
Physician's First Watch for May 15, 2012
David G. Fairchild, MD, MPH, Editor-in-Chief
After 30 Years, Still Warning About the Direction of U.S. Healthcare
Dr. Arnold Relman, who first warned in a 1980 essay against the rise of the "new medical-industrial complex," offers another warning, this time in BMJ. (Clinical Conversations has an interview with him. Listen via the link below.)
While Relman's 1980 essay called for more study of an emerging situation in which market forces were distorting the U.S. healthcare system, he now describes a system headed inevitably toward bankruptcy and in need of major reform. Physicians, fully aware of what their reimbursements will be, have strong incentives to be "overly generous" in recommending services, he writes, but they remain mostly "unfamiliar with the charges made to insurers [and others] for the services they recommend."
He recommends, among other things, the reorganization of the U.S. system into "private, non-profit, multispecialty group practices, in which physicians are paid largely or entirely by salary." He predicts "fierce resistance" to reform "from all those with vested financial interests in the status quo."
This commentary had three links
BMJ article (Free abstract)
Clinical Conversations interview (Free)
NEJM 1980 article (Free abstract)
Below is the BMJ abstract of the essay ... I did listen to his interview, but have not yet read the complete essay.
"Why the US healthcare system is failing, and what might rescue it
Cite this as: BMJ 2012;344:e3052
The US healthcare system seems headed for bankruptcy because of its ever increasing and unsustainable costs. These costs will be effectively controlled only by legislative reforms in the insurance and payment for medical care, but the prospects of such legislation will depend on a more favourable political climate and stronger public support. However, legislation will accomplish little unless the organisation of medical services also changes. The recent movement of US physicians into large multispecialty groups suggests that this reorganisation of medical care may already be under way. If this trend continues, it could not only facilitate the enactment of legislation, but also help to make our medical care much more affordable and efficient.
At present, most US physicians are in solo practice or belong to small, single specialty partnerships, but new social and economic forces are beginning to make employment in large multispecialty groups a more attractive option. About a quarter of all US practitioners are now employed in such groups, which are being formed by independent physician organisations and by hospitals. If their number continues to increase and if they eventually represent the great majority of practising physicians, a wave of legislative reforms could be initiated that transforms our currently dysfunctional healthcare system. But before I say more about this move towards group practice and how it might improve prospects for reform, readers need to understand how and why our health system … "
My Readtion ...
I appreciate the fact that I am not the only Doc who sees the inevitable implosion of the "Business of Medicine" as we know it, and I would like the pleasure of reading your entire article, so that I may comment on it in a comprehensive way.
As a participating observer for over 30 years, from my "front lines and boots on the ground" perspective, the "Business of Medicine" has hijacked the Doctor Patient Relationship to take Profit away from patient care, without benefit to patients or providers. Pushing toward $$$ = assembly line care, return on investment, care lines, product lines, reimbursement for technical and categorical (reimbursable) services has made it impossible to give HUMAN care ... as we now only pay for "indicated" procedures "proper" diseases. Clearly, business only cares about those things that bring $$$, consequently, much of what real people need, the stuff we used to do for free, or on a fee for service basis, or in trade, or for love(personalized care) is left to fall through the cracks. And, that says nothing about the people who have no care, because the monster providers just ... do not care ... except for money.
Of course, they don't care, because there is no money in it ... if it does not have a code, or $$$ return attached to it, forget it. "Dysintegrated care" or "Disintegrated care" (my pet phrase) IS the current "health care system". And, as it has become progressively more complicated and progressively deteriorated over the years, IT continues to promote ITSELF (the third parties) to the detriment of Patients and Doctors. Yes, disintegrated cafe is promoted by the "business of medicine" ... of course, because the focus on technical stuff and disease works for the third parties. Precisely because it consistently fails Patients and Doctors, the third parties get more money in the process. Yes, the "Business of Medicine" just does not work and can not work ... ever ... for Patients and Doctors. And, I don't see that the bandaids will work either, because they enable, endorse and foster the current mess. For that reason, I advocate a paradigm shift ... back toward the Doctor Patient Relationship.
For the last decade, or so, I have been advocating the formation of Non Profit Doctor-Patient Cooperatives ... building greed and third parties out of it as much as is possible. My hope is to set one up by the end of this year. We will see how it goes. Most Doctors seem to be quite content to follow the money ... they seem to be blinded by it, as they can't see they are about to fall off a cliff and drag all the patients with them.
Join me in working toward the New Paradigm in Healthcare: The Non Profit Doctor Patient Cooperative
Respond to this blog, or email me at dr.mike@ihealsolutions.com and thanks for your support. We are all patients at one time or another and who wants to be left flat by greedy business people?
Dr. Mike
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