08.31.09
Indelible Footprints
I was glued to the TV this weekend, saying farewell to an American patriot. I know the end of human life is inevitable but oh how I wished Senator Ted Kennedy could have remained just a little bit longer.
Like most Americans, I admired the Kennedy family from afar and their compassion had far-reaching effects. President John Kennedy sent troops to the Deep South and protected the civil rights of my relatives. Senator Robert Kennedy transformed my beloved Bedford Stuyvesant Brooklyn community into a successful economic empowerment zone that created jobs and stability. We always looked forward to the annual ice skating party that was organized by Mrs. Ethel Kennedy even after that horrendous assassination. Because of Kennedy’s vision, the price of a Bed Stuy brownstone in today’s market begins at one-half-million dollars.
My introduction to the magic of Senator Edward Kennedy began in medical school during the early eighties when my former Assistant Dean, Dr. Van Dunn, resigned from BU to become the senator’s Senior Policy Advisor. Senator Kennedy was full engaged and committed to healthcare reform and Dr. Dunn had the privilege of helping him. Kennedy’s name re-emerged during the early nineties when I was working in a small southwest Louisiana community. Towns were buzzing for miles around about the marriage of Kennedy and a Cajun woman named Victoria Reggie.
I love walking through the congested WIC (Women, Infant and Children) department at work and beam with pride at the sight of beautiful, healthy babies and children. They are truly Kennedy’s legacy. If you’ve ever received a Medicare benefit, a WIC check, SHIP benefits, a Family Medical Leave, the right to vote or a COBRA benefit, you can thank Senator Ted Kennedy. He served “the least among us” nobly.
I hope more legislators and physicians will do the same.
08.27.09
A Sweet Job if You Can Get It
- Image via Wikipedia
I was lamenting about the passing of our beloved Senator Ted Kennedy and then I received an e-mail that made me smile. Democracy for America is hiring state-level Public Option Field Organizers for an intense three-month pressure campaign to pass a public option as part of healthcare reform. They’re upping the ante and are looking to put full-time, hired, grassroots field organizers, on the ground to pressure elected leaders to pass healthcare reform with a public option in your state.
You can see the entire job description here: DemocracyForAmerica.com/PublicOptionApply
What better way to honor the memory of Senator Kennedy AND serve our country.
Go for it!!!
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08.26.09
The Death of Quality Healthcare
Quality healthcare is dead. And it was murdered by penny-pinching administrators.
An ultrasound report came across my desk the other day that made me scratch my head. On the first page, the fetus was listed as head down and on the second page it was listed as breech (feet first). Well, what was it? The patient was almost ready to have her baby and I needed accurate information in order to make a clinical decision. It wasn’t the first time I had received a conflicting report of that nature and I was becoming highly annoyed.
A few days later I received two PAP reports printed in large font that included an apology for the “discrepancy” of the original reports. A technician had originally read them as “normal”, but after they were re-read by a physician, they were in fact, abnormal. I had the unpleasant duty of reporting to my patients that they were now at risk for developing cancer.
In an effort to “cut costs”, professional standards are cast to the wind. The radiology department in question reverted to a voice-recognition system, eliminating transcriptionist jobs. Because the computer can’t recognize certain words the ultrasound reports are often riddled with mistakes. The problem is further compounded by a revolving door of radiologists who are hired as temps and read the reports remotely (outside of the hospital). As a result of an absence of physician leadership, the radiology technicians have inadvertently “taken over.”
Yes, you can nickel-and-dime health care services, but you will also get what you pay for. Voice-recognition software can never replace qualified human beings and neither can improperly trained technicians replace pathologists. Physicians love to scream about tort reform, however how about putting some of these hospitals in check? I wish my colleagues would get their complacent heads out of the sand and DO SOMETHING to promote patient safety.
I’m tired of fighting this battle alone.
08.24.09
A Pregnancy Dilemma!
Get the Facts!
I don’t care how many times you repeat the same refrain some patients still don’t get it. A significant number of pregnant women begin prenatal care at the eleventh hour because they’re waiting for insurance approval but others simply procrastinate without rhyme or reason. As a public health physician, I can’t reject difficult patients like my counterparts in private practice. I am obligated to see them for better or for worse. Obstetricians usually steer clear of women who begin prenatal care late and for good reason: they usually present with a host of problems. Quite often I can foresee these problems but on rare occasion, I get duped.
A patient came to see me in her early third trimester and there was nothing unusual about her medical history. She appeared pleasant, cooperative and all of her labs had returned normal, including her fetal ultrasound. Two weeks later, during a routine visit I was unable to hear her baby’s heartbeat. When she stated that the baby had not moved for over a week, my heart sank.
Exhaling a sigh of frustration, I wrote the order for an emergency ultrasound and warned her that things did not look good. Two hours later, a stillbirth was confirmed.
The on-call physician who had delivered the baby gave me an update the next day. The baby had multiple abnormalities and the patient’s lab tests were positive for cocaine. And of course, she initially denied taking it. Her previous ultrasound was allegedly “normal” and although I’m far from being naïve, I would have never suspected the possibility of drugs.
She subsequently refused consent for an autopsy so the official cause of death remains unknown. Earlier prenatal care and a level of honesty might have changed the outcome of this pregnancy. Do I now have to resort to performing drug screens on ALL late prenatal registrants?
What do you think?
08.19.09
President Obama, Please Rock the Boat
- Image by Getty Images via Daylife
President Obama, don’t even try it. If you think that eliminating the public health option would enhance healthcare reform, please think again. There IS no reform without the public health option despite the deceit and spin. First you eliminate the single-payer plan, then the universal health plan and now Secretary Sebelius states that the public health option “is not essential”? This is where we draw the proverbial line. I stand in full support of Congresswoman Maxine Waters and Senator Nancy Pelosi who are adamant about maintaining the public health option. You have no idea what it’s like to practice medicine with one hand tied behind your back.
I had to contact a hospital administrator prior to leaving for vacation a few weeks back because one of the radiology technicians refused to give my patient an ultrasound. My order allegedly did not have a diagnosis (which in fact, it did) and the order was not “dated” so (God forbid), the hospital might not get paid. When the billing codes takes precedence over patient care and technicians are practicing medicine without licenses, you know that our healthcare system is in deep trouble. This was not the first time that I had to contend with the technician’s overreaching behavior so I have opted to send my patients to the hospital’s competitor.
Having recently celebrated yet another year added to my life, I’ve come to the conclusion that despite our best efforts, there will be people who will never like you. Therefore accept it and move on. Hillary and Bill buckled under pressure of the insurance lobbyists thirteen years ago and look at the mess we’re in.
Sometimes you may have to rock the boat to shift the course of progress but fear not, Mr. President. We’ll be in that boat right beside you.
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08.18.09
In Memory of Paulie
- Image by Getty Images via Daylife
Yesterday was my birthday, but I wasn’t in the mood to celebrate. The deeper I get into the fifth decade of my life, the more reflective I become.
My cousin, Pearl (“Paulie”) Ford Colon left us on August 8th and to say that I’m devastated is an understatement. She was not only my cousin, but one of my dearest friends.
Paulie and I were considered the “good” daughters in our extended family. The daughters who never gave their parents grief; that played by the rules even when others didn’t; who finished college got the “good” job and was the family support (both financially and emotionally) in the midst of a crisis. We both walked the perennial tight-rope in corporate America while maintaining our family culture and traditions. Paulie was my greatest cheerleader and “in-house” comedian. How I lived for her e-mails that made me howl!
We were scheduled to meet in New York this week so that she could finally meet my children. We both held the undesired distinction of being childless until the adoption of my sons last year. Paulie was previously married and had miscarriages. If only I had been in practice during the time of her pregnancies.
Paulie briefly mentioned that she was having foot surgery but I never gave it a second thought. In retrospect, I wish I had. She ultimately had two foot surgeries within a two-week period although the first surgery allegedly had not healed.
The smell of smoke alerted her neighbors who called NYPD on that fateful night. Upon forced entry, a frying pan burning on the stove was discovered along with her lifeless body. The cause of death was a blood clot to the lungs and I have a million unanswered questions for her podiatrist. Did he obtain medical clearance from her family physician? Did he prescribed anticoagulants (blood thinners) upon her discharge and did he have to do the second surgery so soon?
The “business” of healthcare has claimed yet another victim. When is it going to stop?
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08.07.09
A Peek Into the Future
And so it begins.
For those who want “more of the same” regarding healthcare insurance, here’s a peek into the future. Open enrollment begins for most companies in less than two months. The employees of a local health department have already been informed that their premiums will be increased by six hundred dollars and they will have to sign an affidavit attesting that they do not smoke. If they smoke, their premiums will be increased even more dramatically.
The handwriting’s on the wall. If you have a chronic illness such as diabetes, hypertension, or a heart condition, be prepared for your premiums to rise. If you are obese, be prepared for your premiums to rise – substantially.
Promoting personal responsibility and lifestyle changes is one thing. Forcing the issue is quite another. To all those who are tired of the status quo but afraid of healthcare reform, let me share the infinite wisdom of the late Dr. Benjamin E. Mays, President Emeritus, Morehouse College:
“The tragedy of life is not found in failure but complacency. Not in you doing too much, but doing too little. Not in living above your means, but below your capacity. It is not failure but aiming too low that is life’s greatest tragedy.” –
Aim high, America. Aim high.
Dr. Linda Burke-Galloway will return from vacation in one week.
08.05.09
The Soundtrack of Ignorance
Disrupted town hall meetings. Congressmen lynched in effigy. Haters in full bloom. The reason for the discourse? Healthcare reform. If special interest groups are that desperate to disrupt legitimate town hall meetings through premeditative protests and Rent-A Mobs then I say please, call Security.
We have been down this road before. The Brooks Brother Thugs descended on Florida eight years ago and turned our election system into a banana republic. Most of the dissenters were rewarded with cushy jobs during the Bush II Administration but they didn’t live happily ever after.
As a physician, I am committed to fighting unethical insurance companies on behalf of my profession and the patients that I so humbly serve. The bogus groups who have emerged such as Citizens for Patients Rights (CPR) read like a hall of shame. Its leader, Rick Scott, is a former hospital executive, who was terminated for fraud and cost his hospital 1.5 BILLION dollars in punitive fines. He does NOT speak on behalf of America’s patients and should be ashamed to be seen in public. The fact that he never spent a day in jail gives me much reason to pause.
I urge the American people to raise one unified voice to drown out the soundtrack of ignorance. The train to progress has already left the station in the form of a public health option. The safety of your health is at stake. The price of your insurance premiums is at stake. The quality of your healthcare is at stake. The economic and professional future of your physicians is at stake. The integrity of medicine is at stake.
The Bogeyman is dead. There is no reason to resurrect him.
08.02.09
Channeling Eleanor Roosevelt
The American people are not descendants of the infamous Chicken Little so please stop telling us that the sky is falling.
The reckless tales spun by those who want “more of the same” regarding healthcare reform make me want to reach for an emesis basin and regurgitate my lunch. There IS no agenda to withhold care from our precious elderly or send them off to die. All dastardly lies.
Everyone who enters a hospital for an admission (regardless of race, gender or age) is asked whether they’ve signed an Advanced Directive, commonly known as a Living Will outlining their desires in the event of an emergency, a terminal illness or catastrophic event. President Obama does not have a patent on this directive. It was started by the Euthanasia Society of America and Euthanasia Educational Council in 1967.
Fear is a terrible disease, whose effects are long-lasting and at times, fatal. It has reared its ugly head again as Congress heads home for a month leaving the business of healthcare reform undone.
Heck yes, we need a sense of urgency. One hundred thousand unnecessary deaths committed annually in a dysfunctional healthcare system is a compelling argument to move forward with speed.
And I would love to return to the practice of medicine.
I should not have to battle insurance clerks who refuse to admit my pregnant patients with emergency conditions because they don’t have the “right insurance plan;” or fight my local hospital that charged me $78.00 for a $4.00 generic drug and overinflated my hospital bill by 1000%. A public health option would put these people in check.
And increased taxes? You’re paying for them anyway every time an uninsured patient shows up in the emergency room for routine medical treatment.
Eleanor Roosevelt once said, “You must do the thing you think you can not do.”
America, are you listening?
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