Doctor

• A ? for those in favor of national healthcare - sm
  • I believe him and I'm scared. - LRS
  • I think - Kaydie
    • too many people = higher premiums?! - mk
  • You could find out you have cancer and need - treatment now, but with National Health Care
    • But what if you didn't have any insurance...sm - blondie_1147
    • cancer and national health - mk
    • I have Blue Shield, and can hardly get them - to pay for anything, hence no doctor visits for me
    • What is the difference, all the doctors - are leaving or quitting and there will be
      • and once you do get an appt., you're lucky if they - spend even 8 minutes with you.
        • my doc is so awesome -- sees me for free - XanaX
          • I have an awesome deal right now too (sm) - Just the big bad
          • Maybe he has a crush on you. n/m - Stardust
          • Oh you are blessed...nm - blondie_1147
          • Doctor - woofer
  • Obama's plan is not based on - European models...sm
    • The long lines and months of waiting for tests - with HIS plan are still predicted.nm
      • What are you talking about? - Why would that happen?....sm
      • and where does this come from? Never heard that before now - nm - Amanda
  • healthcare - mk
    • Ditto. - nm
    • I'm with you MK....(sm) - Just the big bad

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The health-care reform debate is in full roar with the arrival of Michael Moore's documentary Sicko, which compares the U.S. system unfavorably with single-payer systems around the world. Critics of the film are quick to trot out a common defense of the American way: For all its problems, they say, U.S. patients at least don't have to endure the endless waits for medical care endemic to government-run systems. The lobbying group America's Health Insurance Plans spells it out in a rebuttal to Sicko: "The American people do not support a government takeover of the entire health-care system because they know that means long waits for rationed care."

In reality, both data and anecdotes show that the American people are already waiting as long or longer than patients living with universal health-care systems. Take Susan M., a 54-year-old human resources executive in New York City. She faithfully makes an appointment for a mammogram every April, knowing the wait will be at least six weeks. She went in for her routine screening at the end of May, then had another because the first wasn't clear. That second X-ray showed an abnormality, and the doctor wanted to perform a needle biopsy, an outpatient procedure. His first available date: mid-August. "I completely freaked out," Susan says. "I couldn't imagine spending the summer with this hanging over my head." After many calls to five different facilities, she found a clinic that agreed to read her existing mammograms on June 25 and promised to schedule a follow-up MRI and biopsy if needed within 10 days. A full month had passed since the first suspicious X-rays. Ultimately, she was told the abnormality was nothing to worry about, but she should have another mammogram in six months. Taking no chances, she made an appointment on the spot. "The system is clearly broken," she laments.

It's not just broken for breast exams. If you find a suspicious-looking mole and want to see a dermatologist, you can expect an average wait of 38 days in the U.S., and up to 73 days if you live in Boston, according to researchers at the University of California at San Francisco who studied the matter. Got a knee injury? A 2004 survey by medical recruitment firm Merritt, Hawkins & Associates found the average time needed to see an orthopedic surgeon ranges from 8 days in Atlanta to 43 days in Los Angeles. Nationwide, the average is 17 days. "Waiting is definitely a problem in the U.S., especially for basic care," says Karen Davis, president of the nonprofit Commonwealth Fund, which studies health-care policy.

All this time spent "queuing," as other nations call it, stems from too much demand and too little supply. Only one-third of U.S. doctors are general practitioners, compared with half in most European countries. On top of that, only 40% of U.S. doctors have arrangements for after-hours care, vs. 75% in the rest of the industrialized world. Consequently, some 26% of U.S. adults in one survey went to an emergency room in the past two years because they couldn't get in to see their regular doctor, a significantly higher rate than in other countries.

There is no systemized collection of data on wait times in the U.S. That makes it difficult to draw comparisons with countries that have national health systems, where wait times are not only tracked but made public. However, a 2005 survey by the Commonwealth Fund of sick adults in six nations found that only 47% of U.S. patients could get a same- or next-day appointment for a medical problem, worse than every other country except Canada.

The Commonwealth survey did find that U.S. patients had the second-shortest wait times if they wished to see a specialist or have nonemergency surgery, such as a hip replacement or cataract operation (Germany, which has national health care, came in first on both measures). But Gerard F. Anderson, a health policy expert at Johns Hopkins University, says doctors in countries where there are lengthy queues for elective surgeries put at-risk patients on the list long before their need is critical. "Their wait might be uncomfortable, but it makes very little clinical difference," he says.

The Commonwealth study did find one area where the U.S. was first by a wide margin: 51% of sick Americans surveyed did not visit a doctor, get a needed test, or fill a prescription within the past two years because of cost. No other country came close.

Few solutions have been proposed for lengthy waits in the U.S., in part, say policy experts, because the problem is rarely acknowledged. But the market is beginning to address the issue with the rise of walk-in medical clinics. Hundreds have sprung up in CVS, Wal-Mart (WMT ), Pathmark, (PTMK ) and other stores—so many that the American Medical Assn. just adopted a resolution urging state and federal agencies to investigate such clinics as a conflict of interest if housed in stores with pharmacies. These retail clinics promise rapid care for minor medical problems, usually getting patients in and out in 30 minutes. The slogan for CVS's Minute Clinics says it all: "You're sick. We're quick."

There are so many ways to cut food costs and eat healthy.

Cook, repeat cook oatmeal for breakfast. Eggs anyway

One pound of ground turkey, chopped onion sauteed, mix with 1-2 cans of diced tomatoes, 1-2 cans of beans (pinto, black, etc.) seasonings like cumin, chili, etc. serve over brown rice that you cook - or over a small pasta, or in a tortlla.

Soup - homemade - diced tomatoes, onion, celery, carrots, any type of beans, frozen cut okra, etc. add water and seasonings - add Butterball smoked turkey sausage cut into half slices

I make a pot of soup every week and eat until gone, then a new one.

I also cook my beans from dry - very inexpensive and very nutritious

Hope you think this is helpful for that is what I want to be. Your present eating program is soooo unhealthy. I would be glad to share any of my other low-cost recpies with you.

Best wishes.

landerson@theadvocate.com

Advocate staff writer

In the midst of administering chest compressions to a dying woman several days after Hurricane Katrina struck, Dr. Mark N. Perlmutter was ordered to stop by a federal official because he wasn't registered with the Federal Emergency Management Agency.

I begged him to let me continue, said Perlmutter, who left his home and practice as an orthopedic surgeon in Pennsylvania to come to Louisiana and volunteer to care for hurricane victims. People were dying, and I was the only doctor on the tarmac (at the Louis Armstrong New Orleans International Airport) where scores of nonresponsive patients lay on stretchers. Two patients died in front of me.

I showed him (the U.S. Coast Guard official in charge) my medical credentials. I had tried to get through to FEMA for 12 hours the day before and finally gave up. I asked him to let me stay until I was replaced by another doctor, but he refused. He said he was afraid of being sued. I informed him about the Good Samaritan laws and asked him if he was willing to let people die so the government wouldn't be sued, but he would not back down. I had to leave.

FEMA issued a formal response to Perlmutter's story, acknowledging that the agency does not use voluntary physicians.

We have a cadre of physicians of our own, FEMA spokesman Kim Pease said Thursday. They are the National Disaster Medical Team. ... The voluntary doctor was not a credentialed FEMA physician and, thus, was subject to law enforcement rules in a disaster area.

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A Coast Guard spokesman said he was looking into the incident but was not able to confirm it.

Perlmutter, Dr. Clark Gerhart and medical student Alison Torrens flew into Baton Rouge on a private jet loaned by a Pennsylvania businessman several days after Katrina hit. They brought medicine and supplies with them. They stayed the first night in Baton Rouge and persuaded an Army Blackhawk helicopter pilot to fly them into New Orleans the next day.

I was going to make it happen, the orthopedic surgeon said. I was at Ground Zero too, and I had to lie to get in there.

At the triage area in the New Orleans airport, Perlmutter was successful in getting FEMA to accept the insulin and morphine he had brought. The pharmacist told us they were completely out of insulin and our donation would save numerous lives. Still, I felt we were the most-valuable resource, and we were sent away.

Gerhart said the scene they confronted at the airport was one of hundreds of people lying on the ground, many soaked in their own urine and feces, some coding (dying) before our eyes. FEMA workers initially seemed glad for help and asked Gerhart to work inside the terminal and Perlmutter to work out on the tarmac. They were told only a single obstetrician had been on call at the site for the past 24 hours.

Then, the Coast Guard official informed the group that he could not credential them or guarantee tort coverage and that they should return to Baton Rouge. That shocked me, that those would be his concerns in a time of emergency, Gerhart said.

Transported back to Baton Rouge, Perlmutter's frustrated group went to state health officials who finally got them certified -- a simple process that took only a few seconds.

I found numerous other doctors in Baton Rouge waiting to be assigned and others who were sent away, and there was no shortage of need, he said.

Perlmutter spent some time at the Department of Health and Hospital's operational center at Jimmy Swaggart Ministries before moving to the makeshift Kmart Hospital doctors established at an abandoned store to care for patients. After organizing an orthopedics room and setting up ventilators there, Perlmutter went back to the Swaggart Center and then to the LSU Pete Maravich Assembly Center's field hospital to care for patients being flown in from the New Orleans area.

We saw elderly patients who had been off their medicine for days, diabetics without insulin going into shock, uncontrolled hypertension, patients with psychosis and other mental disorders, lots of diarrhea, dehydration and things you would expect. I slept on a patient cot there every night until I came home.

Gerhart said he felt the experience overall was successful and rewarding, although frustrating at times. You don't expect catastrophes to be well organized. A lot of people, both private citizens and government officials, were working very hard.

Perlmutter did not return home empty-handed. He brought a family of four evacuees back with him and is still working with Baton Rouge volunteer Hollis Barry to facilitate the relocation of additional hurricane victims to Pennsylvania.

He also returned with a sense of outrage. I have been trying to call Sen. Arlen Specter (of Pennsylvania) to let him know of our experience.

I have been going to Ecuador and Mexico (on medical missions) for 14 years. I was at ground zero. I've seen hundreds of people die. This was different because we knew the hurricane was coming. FEMA showed up late and then rejected help for the sake of organization. They put form before function, and people died.

Both FEMA and the Coast Guard operate under the U.S. Department of Homeland Security, which has been widely criticized for its disjointed, slow response to the devastation caused by Katrina. Federal officials are urging medical personnel who want to volunteer to help with disaster relief to contact the Medical Reserve Corps or the American Red Cross for registration, training and organization.

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Both sides should have a choice, on both sides, pregnant woman and doctor...nm
bm

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