February 23, 2012
Rick Santorum: Stop Using Pregnant Women as a Stepping Stone to the White House
A lie unchallenged becomes the truth. While I admire GOP candidate Rick Santorum’s decision to raise a special needs child, I certainly wish he would keep his political agendas out of my exam room. Yes, it takes love and courage to raise a child with Trisomy 18, a genetic disorder that’s associated with severe physical and mental challenges. However, this does not make Santorum an expert on prenatal tests and to say anything to the contrary, is both reckless and immoral.
Prenatal tests, especially those that tests for chromosomal abnormalities, are optional. A woman can decline the tests if she chooses to do so and I’ve had patients who have exercised that perogative in the past. But first, let me tell you why these genetic tests are so important. If a woman discovers that she has a baby with Trisomy 21, commonly known as Down’s syndrome, both she and her pediatrician will have time to prepare for possible complications. Many genetic disorders are associated with heart conditions and require immediate surgery after birth. There are instances where the baby is born with a pediatric cardiologist in the delivery room who then whisks the baby away to have a life-saving cardiac procedure. This cannot happen if you don’t have the prenatal test.
In my 25-year career as a physician, I’ve only had 2 confirmed cases of Trisomy 21 and both mothers decided to keep their pregnancies. However, please be aware that there are some genetic disorders that are incompatible with life and the baby expires shortly birth. Most mothers do not want to experience that type of emotional trauma.
Mr. Santorum, please stop using Women’s Health as a stepping stone to gain entrance into the White House. If you can’t campaign for President based on truth and merit, then perhaps you’re not cut out for the job.
October 31, 2011
Politicians: Please Don’t Bully Our Patients for Your Personal Agendas
I normally refrain from discussing the subject of abortions. In my humble opinion, it’s a private matter between a woman, her physician and her God. Have I ever performed a termination of pregnancy? No, I have not. But would I judge a woman who had one? No I would not. And let me tell everyone a quiet little secret. When a baby is supposed to be born, Fate steps in and handles the situation. I recall an acquaintance that was scheduled to have a termination. She developed pneumonia before the procedure, it was cancelled and she went on to deliver a healthy set of twins who are in middle school thriving. So you can imagine the shock I experienced when a friend sent me an article from Time Magazine, entitled The Next Abortion Battleground: Fetal Heart Beats, by Adam Cohen. It appears that certain politicians are proposing a law that would force a pregnant woman to have an ultrasound and listen to the fetal heart beats before she terminates a pregnancy. I would hope that our political candidates would make better use of time than to attempt to practice medicine without a license.
I’m not going to discuss the issue of Roe vs. Wade or whether the fetus has rights or if those rights take priority over the rights of its mother. I will yield to the American Civil Liberties Union and other advocacy groups regarding those issues. However, I cannot and will not allow politicians to tell me what I should or should not do in my own examination room. Nor should they bully my patients by dictating policy and procedures. Perhaps we need to review the definition of coercion. According to the Legal Dictionary, coercion means: The intimidation of a victim to compel the individual to do some act against his or her will by the use of psychological pressure, physical force, or threats. Psychological pressure. Has it come down to that?
Auscultation or listening to a fetal heart beat is a clinical examination, not a political tool. Please keep your political agendas out of my exam room.
May 16, 2011
Keep Politics Out of Pregnancy
“But for the grace of God go I.” My late aunt drilled that value into my six-year old head and it has never left. An article regarding a New York politician recently caught my attention. When New York State enacted a bill to ban the shackling of pregnant prisoners, a New York State Assemblywoman objected. The article goes on to discuss the case of Jeanna M. Graves, who, in 2002 was arrested on a drug charge and began a three year sentence. Graves was pregnant with twins and while in labor, was handcuffed during her entire C. Section. How utterly ridiculous.
Before a C. Section begins, a patient is usually given either an epidural or spinal anesthesia. On rare occasions, she is put to sleep with general anesthesia if the baby must be delivered emergently. On all accounts, the patient’s legs will either be numb from anesthesia or she will be sleeping. Why then does she need shackles? She’s certainly not in a position to run. Although I addressed this issue last August, it needs to be revisited again.
Women’s health and pregnancy should not be political agendas. I recently tweeted about another controversial article that blamed the reduced workforce in Memphis on teen pregnancy. Yes, it’s true that 49% of teen pregnancies are unplanned and unwanted but somehow the teens eventually mature and become productive human beings for the sake of their children. Our workforce problems stems from the outsourcing of U.S. jobs overseas, not teenage pregnancy.
Jeanna Graves was not perfect but neither did she commit a heinous crime. She used drugs and had a self-inflicted disease. In the course of my professional career, I have witnessed the most egregious acts corruption, fraud, deception and medical negligence, all under the rouse of helping the poor yet not one administrator ever left the building in shackles or seen the inside of a county jail.
Here’s a question for New Yorkers: Would you really elect someone who approves of shackles on pregnant to be your congressional representative?
March 20, 2010
A Love Letter to My Congresswoman Suzanne Kosmas
The Russians have a saying: “One who sits between two chairs may easily fall down.” Representative Kosmas, as a constituent in your 24th Congressional District and as a public health physician, thank you for having the courage to vote for healthcare reform. I know this was a difficult journey and that your professional career is on the line. However by voting for healthcare reform, you will be remembered in history as a pioneer who gave the American people a beacon of light and returned the “care” back in healthcare.
The healthcare bill is not perfect, I actually cried when I first read it. As a physician, I have witnessed the devastation that insurance dynasties have created by placing profit before people and billing codes before treatment. They thought they could marginalize physicians and nurses by referring to us as “providers.” They ignored our years of expertise and training. They annihilated the profession of medicine.
I know that the pharmaceutical and insurance lobbyists were bombarding you with temptation that would have been easy to deposit into the bank of future favors. However as a very wise man once said “What good does it profit a person to gain the whole world but forfeit his soul?”
Tomorrow, you will cast your vote and change the course of history. You have pushed through your fears and stepped into greatness. As your constituent, please rest assured that I will have your back. You have earned both my trust and my vote in the next election. I will knock on doors for you. I will volunteer for you. I will be there for you in your time of celebration but also in your time of need. You are now the crown jewel of my congressional district. May God continue to bless you.
December 22, 2009
Questions You Should Ask About the Senate Healthcare Bill
On Christmas Eve in 1981, my father died of a heart attack in a Brooklyn emergency room while waiting for a hospital bed that never manifested. Dad died because he didn’t have private insurance or a cardiologist who would have advocated on his behalf.
Christmas Eve of 2009 marks an historical moment and a first-hand view of American politics. The Senate and House of Representatives will convene to decide whether to pass a unified bill on healthcare “reform”. To vote on Christmas Eve is not a coincidence: there will be pressure to simply gloss over the bill so that everyone can rush home for Christmas.
The House had the mettle to include a public health option. However, sixty dealmakers in the Senate did not. They plan to have the foxes continue to watch over the chickens, then had the temerity to call it reform.
Thank you, Victoria Kennedy. I desperately needed to know how your wonderful husband would have responded. I was so despondent at the shenanigans of both Democrats and Republicans that I was ready to relinquish my voter’s card.
No, it is not practical to abandon this grossly imperfect healthcare bill and start anew but we definitely need to have protective measures in place. Sui Generis (self-regulation) will not and should not be the order of the day. It didn’t work in the past and it certainly won’t work in the future. Insurance companies are NOT going to do the right thing once politicians stop looking. If Americans are forced to remain with private insurers then we need an enforcer of strict regulation. An Insurance Czar is definitely needed; an Elliot Ness or an Elliot Spitzer will do just fine. We also need answers to the following questions:
- Will the premiums for people with pre-existing conditions be higher and by how much?
- Will there be some outside regulatory agency to govern the insurance companies in the event of misdeeds?
- Will there be co-pays and deductibles and by how much?
- Will there be a limit of services provided by these so-called state regulated insurance plans, i.e., will the poor receive less services based on the type of insurance they have?
- How much assistance will the middle class receive regarding insurance premium payments? 10%, 20%, or 30%?
- Is there a cap on how much an insurance CEO can earn?
- Will there be reductions in payments of Medicare and Medicaid to physicians?
- Will these plans be taxed to people who earn above a predetermined income?
No one wants a perfect plan, just a fair one. That is not too much to ask. President John F. Kennedy said it best: “If a free society cannot help the many who are poor, it cannot save the few who are rich”.
I hope the politicians are listening.
September 30, 2009
Dedicated to My Congresswoman Susan Kosmas: The Ultimate Fence Sitter
I politely ask my readers to please indulge me while I have this private rant.
You see, every day I go to work within a challenging healthcare system while my Congressional representative plays games on Capitol Hill.
The good congresswoman to whom I elected appears to be sitting on the fence. Yes ma’am, I’m talking about you. I warned you that if you did not answer my e-mail then you WOULD read about it in my blog. Yes, I saw you in the TV commercial espousing “working to make a better healthcare system” and noted the sponsor: a pharmaceutical “foundation.” Pulleease. You were the first elected Democrat within my district since Noah launched his Ark and you have yet to commit an opinion regarding the public health option. Obviously you had an agenda when you entered public office and it did not include the constituents of your district.
What is it with Florida politicians that make you so ethically-challenged? The debacle of the 2000 election. Instant replay in 2004. Representative Mark Foley and his predilection for White House pages. Tom Feeney and the Abramoff scandal. And on and on and on. Is it something in the water?
They say the worst thing that anyone could ever witness is the making of political decisions and the way that sausages are made.
Well, please pass the sausage. I’ll take them over politics any day.
Dedicated to My Congresswoman Susan Kosmas: The Ultimate Fence Sitter
I politely ask my readers to please indulge me while I have this private rant. You see, every day I go to work within a challenging healthcare system while my congressional representative plays games on Capitol Hill.
The good congresswoman to whom I elected appears to be sitting on the fence. Yes ma’am, I’m talking about you. I warned you that if you did not answer my e-mail then you WOULD read about it in my blog. Yes, I saw you in the TV commercial espousing “working to make a better healthcare system” and noted the sponsor: a pharmaceutical “foundation.” Pulleease. You were the first elected Democrat within my district since Noah launched his Ark and you have yet to commit to an opinion regarding the public health option. Obviously you had an agenda when you entered public office and it did not include the constituents of your district.
What is it with Florida politicians that make you so ethically-challenged? The debacle of the 2000 election. Instant replay in 2004. Representative Mark Foley and his predilection for White House pages. Tom Feeney and the Abramoff scandal. And on and on and on. Is it something in the water?
They say the worst thing that anyone could ever witness is the making of political decisions and the way that sausages are made.
Well, please pass the sausage. I’ll take them over politics any day.
P.S. A picture’s worth a thousand words. Here’s what Will Ferrell and friends have to say about insurance companies: http://bit.ly/4k5QU
September 14, 2009
Who Else Wants Affordable Healthcare?
Did you see it? The makings of history? Oh what a joyful sight! After sixty years of several failed attempts, maybe we’ll finally get it right. It took the courage of a leader to venture down the road less traveled. Despite the hate, propaganda and vitriolic behavior, President Obama stood firm, like many of us prayed he would.
Obama delivered on his promise: a public health option. The party is over for the insurance company monopolies and I’m not shedding a single tear.
The rights of passage I endured during my eight years of training were never meant to be used for the benefit of greed. It was for the exclusive benefit of my patients. I often lament on how physicians arrived at this ungodly juncture and to a certain extent, it’s our own fault. Most of us were too afraid to organize for fear of being in violation of anti-trust. Of losing precious hospital privileges. Of being disenrolled from insurance plans. Of being labeled a “trouble maker.” So instead, we did nothing and the unscrupulous took over.
Some of us threw in the towel and retired. Others added “spa boutiques” to compensate for shrinking revenue. The desperate (and greedy) ones added additional volume to their office schedule and almost killed patients in the process. Some whined about “Obamacare” in the “physician-only” chat rooms and called him every name in the book. But deep within the recesses of their hearts, they knew they were witnessing a hero. Our profession was a bumbling mess, yet no one had the courage to fix it. It was the nurses (God bless them) that stormed the senate hearings in protest so that our voices could finally be heard.
When the smoke clears and the dust finally settles it is the patient-physician relationship that must be held sacred. Med school taught us the standards, the ethics and the integrity of our profession. Let us NEVER allow it to be compromised again.
September 8, 2009
“It’s Flat-Out Stupid”
“It’s flat-out stupid” said renowned author Thomas Friedman on last Sunday’s Meet the Press and I couldn’t agree with him more.
The firestorm regarding President Obama’s speech to school children is tragic. I guess some people would rather see their children dig ditches or flip hamburgers than pursue an education that would unshackle chains of generational ignorance.
Those of us who have traveled globally know how much our president is well loved and respected. It would be nice to see citizens of his own country respect him in that manner as well. I saw “Obama” bumper stickers half way around the world in Ethiopia during the adoption process of our sons and it gave me great hope. The world wanted to breathe again, and the election of Obama allowed that to happen.
One of my proudest moments as an American occurred on election night of 2008. I thought the pettiness was finally over. I guess I’ll continue to dream. Meanwhile for the agitators and conservative pundits who are stuck on stupid, here’s a rude awakening:
- The United States is no longer the world leader in secondary education. http://www.upi.com/Top_News/2008/11/19/US-slipping-in-education-rankings/UPI-90221227104776/
- 93 percent of high school students in South Korea graduate on time compared to only 75 percent of American high school students
- The United States has failed to raise student achievement in science over the past decade while Singapore and other Asian countries continue to score higher in both subjects
- Students in Singapore and Taiwan scored 40 points higher than American eight graders
- U.S. teens in math and science trailed their international peers on a math and science exam http://www.usnews.com/blogs/on-education/2008/12/09/study-us-trails-asian-countries-in-math-and-science.html
It’s obvious that our children’s future bosses are going to come from Asia.
“A mind is a terrible thing to waste.” Need I say more?
September 2, 2009
Invoking the Miraculous: A Case for the Public Health Option
If JT had private insurance and not Florida Medicaid, her baby would probably be dead.
JT’s pregnancy was miraculous, considering she had conceived with only one fallopian tube and ovary and she had no prior children. Things went well until her 27th week when she developed vaginal spotting. She went to a local hospital and was discharged home with a clean bill of health although they never ordered an ultrasound.
Bleeding during pregnancy is not a normal phenomenon. When I saw JT three days later during a routine prenatal visit, I ordered an ultrasound although the bleeding had stopped. A few hours later, the radiologist emergently reported that the placenta completely covered the opening to her womb and the baby’s umbilical cord was wrapped tightly around its neck three times. JT had a complete placenta previa and someone at the local hospital had regretfully missed the diagnosis.
I discussed JT’s case with a high-risk obstetrician and we both agreed that she should be admitted to the specialty hospital if only for observation. Thankfully, JT had state-sponsored Medicaid insurance because a commercial insurer would have made us jump through hoops. They would have required pre-authorization, endless forms and an inappropriate premature discharge home where she would have subsequently returned to the hospital with a dead baby.
What was supposed to be a 24-hour admission turned into a sixty-four day hospital stay because JT bled on a weekly basis. The cord remained around the baby’s neck and the prognosis was guarded regarding successfully carrying the baby until it was full term.
At 35 weeks, JT had an amniocentesis to make certain that her baby’s lungs were mature. She was subsequently delivered by cesarean section with the umbilical cord STILL wrapped around her baby’s neck. Because of skill, compassion and medical expertise, both mother and baby are just fine.
Marie Curie once said, “Nothing in life is to be feared. It is only to be understood.”
Please do not let fear cloud your judgment. Support the public health option, America. We need these miracles to continue.
