Author Archives | Richard

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What Is Your Left Ball Worth $$$???

June 27, 2017



$870,000. As shown in this article, that is what a patient received in compensation for a surgical error that resulted in his left testicle being removed when it was the right one that should have been. But that includes $250,000 in punitive damages, so maybe the real value is only $620,000!!! Guys? Ladies? What do you think???

Bottom Line. Luckily, such surgical errors are extremely uncommon, and techniques exist for further minimizing the risk. When I had my cataract surgeries several years ago, I discovered that only one eye gets done at a time with the other eye being done about three weeks later. AND. I also discovered that in order to keep things straight, my surgeon had one operative day on which he ONLY did right eyes, and one on which he only did left eyes. 

That sort of struck me as tactical overkill at the time, but having read the wrong testicle report, it seems that anything that can be done to reduce the risk of surgical problems probably should be done.

Actually, isn’t that true of a lot of the things that we do?

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The Mind Boggles!!!

June 26, 2017



Check out this piece. Apparently, all it takes is a good pricing scandal to get a competitor for EpiPen to market.

I know that the URL above only gets you to the first paragraph of the WSJ article unless you are a subscriber. BUT. That’s really all you need to learn:

  • That a generic alternative for the EpiPen is finally going to be available.
  • That no specific pricing information is being publicized at this time.
  • That the trade name selected for the product, Symjepi, has got to be one of the strangest I have ever seen. (I am sure it is just because I don’t understand . . . )

Bottom Line. With the amount of ire that has been raised about EpiPen pricing, and specifically price increases, over the past year, it should be very interesting to see what happens in this market once the generic hits the street. Maybe (?) we will finally get some indication as to what the public thinks is a fair price for a life-saving drug that you usually don’t have to take. We know $400 a year was seen as too high, but . . . 

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Amazon Buys Whole Foods! So?

June 23, 2017


Whole Foods

I frankly don’t know what to make of this. But I am betting Jeff Bezos does!

Check out this post. In it, you will see the blogger opine that through this acquisition, WF will have the opportunity to function as a broader-based delivery system for healthy foods for America, rather than as a gentrified store for the well to do. (We have a WF on Hilton Head Island. Many locals call it “Whole Pay Check!”)

Bottom Line. What will Amazon actually do with this interesting acquisition? Will it serve to get Bezos into bricks and mortar at a time when others are exiting? Will the stores be launching points for Amazon drones? Will there be health and wellness implications?

Keep a close eye on this one. Somehow, I think this acquisition is going to be important in general, and for health and wellness in particular.

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The Insurance Companies Did It!!!

June 22, 2017


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Check out this piece. In it, you will read that healthcare became such a mess because of the machinations of insurance companies and, behind them, the political workings of the AMA. You will also see the perspective that Obamacare and the latest Republican attempts at a healthcare bill are doomed to fail because they don’t overturn the insurance company model, but rather attempt to work around it with “jerry rigged” tactics.

Bottom Line. Interesting, and rather fatalistic stuff here. One is left to ponder when someone will get the guts to overturn the insurance company model in the U.S., and what the replacement should look like.


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Not Funny!!!

June 21, 2017



You know ZDOGGMD. I’ve frequently shared his videos, which display his rapping style used to communicate important medical messages. Typically, they are both profound and humorous.

But this time there is no humor. The “incident” that ZDOGG is reporting here, in narrative rather than rapping style, is the recent story of a nurse who was raped at gunpoint by an inmate at the hospital at which she worked. The video lasts 20 minutes. Spend the time to watch it!

ZDOGG makes several key points here. First, he believes that people have to understand that healthcare practitioners are on the front lines in more ways than one. They often deal with volatile people in volatile situations. We need to understand this. For example, in my home state of South Carolina, one of the places where the holder of a Concealed Carry Weapon (CCW) permit is not allowed to carry a gun is anyplace where “healthcare is being delivered.” I often wondered why. This piece gives me a better understanding of this exclusion.

Second, he proposes that healthcare institutions must do everything in their power to protect their practitioners. Whether or not that was done at the hospital at which this attack occurred is now the subject of a civil suit filed by the two nurses who were involved.

Finally, he requests that other healthcare practitioners reach out to show support for those who actually do become victims of violence in the workplace.

Bottom Line. All of that sounds right! Think about it!!!

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June 20, 2017

1 Comment

Health Care Blog

We have previously written, probably ad nauseam at this point, about the raging battles in many healthcare fields concerning the rights and roles of “care extenders.” Dental Therapists, Physician Assistants, Nurse Practitioners, etc.

BUT. Here is an especially cogent piece specifically addressing Nurse Practitioners.  Read it.  I think that there are at least three major takeaways here.

  1. The differences in training between physicians and NP’s is huge, consequential and should not be ignored.
  2. Nurse Practitioners, like every other professional group, should recognize their limitations and know when to call in the heavy artillery.
  3. Even if they have a Doctorate in Nursing Practice, an NP calling herself “Doctor” can be confusing and misleading to patients.

Bottom Line. The message here is a clear one. In order for healthcare to work efficiently in the future, it will be necessary to make increasing use of non-physician practitioners. BUT. Such increased utilization needs to be approached with great care.

Guiding principles, such as those set forth in this piece, can help.

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I Hate My Job!!!

June 19, 2017


Healthcare websites

Here is a really depressing piece that lists, in good old David Letterman (remember him?) fashion, the 10 reasons that people don’t like working in the pharmaceutical industry. Given the critical importance of the Bio-Pharma space to healthcare, I find this list to be both accurate and especially troubling.

And here is the worst part! This list hasn’t changed significantly in recent memory.

Bottom Line. Come on folks! All of these problems have relatively straightforward solutions. Let’s take a fresh look outside our industry at companies that aren’t bedeviled by these problems, and figure out what we need to do differently. Seems to me that an industry with a bad PR image and bad internal moral requires a rather major makeover.  


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Speak Your Mind, But…

June 16, 2017


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Check this out. Here you will find a blog post from a Canadian physician that sort of speaks for itself (pun intended.). The question wrestled with here deals with the extent to which medical professionals are “free” to speak their minds on social media.  Interestingly but not surprisingly, the blogger reported that those who are “employees,” i.e. of a hospital, are likely to face significantly more constraints than those who are in private practice.

Bottom Line. There is, of course, a bigger issue here. Loosely translated, I often ponder the amount of crossover there is now, and will be in the future, between our “private lives” (?) on social media and our careers/jobs. Checking social media posts of job applicants, for example, is now becoming standard operating procedure for many HR departments.

Two questions: How much crossover is there/will there be here, and how much crossover should there be?

 Think about it!

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June 15, 2017


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Check this out! What you will see are guidelines for creating healthcare apps that people will love. More difficult, the blogging physician believes, than one would think.

Why? Priorities! For example, many apps for hospital use are created with the priorities of the clients, i.e.,  hospital administrators, in mind. Their priority? Efficiency!

Unfortunately, these apps have to be used by physicians. Their priority? Quality!


Bottom Line. There is a general learning here. In virtually any endeavor, failure to take priorities into consideration can lead to major disconnects. Project failure. Make sure to consider the priorities of all of the key players in an any venture before deciding how to proceed.

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How 101 Words Helped to Fuel the Opioid Crisis

June 12, 2017


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Check this out. What you will see is a fascinating analysis of how only a few sentences, under certain circumstances, can take on a life of their own and wreak major havoc.

More specifically, what you will see is the impact felt from a 1980 Letter to the Editor of NEJM. Just a few sentences summarizing the findings of an analysis that seemed to indicate that the use of opioids in the treatment of pain carried with it virtually no risk of abuse or addiction. Wrong!

As the story got spread, a couple of key factors got left by the wayside. The fact that the patients studied were in a hospital environment, for example. And the fact that patients included in the analysis were those who had taken an opioid “at least once.” Etc. Leaving out these “little details” convinced physicians that it had been demonstrated that opioids carried little risk of addiction in the treatment of chronic pain in ambulatory patients. Wrong again!

Bottom Line. This piece taught me a new term. Bibliometric Analysis. A rigorous procedure used for counting how many times this letter was cited by other scholars. Over 600 times! In articles read by untold thousands of physicians. 

 The moral of the story. When information is put “out there,” it can take on a life of its own. It can morph significantly in terms of meaning, and get (mis)quoted ludicrous numbers of times. 

 So. Be careful. As a writer. And as a reader.

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