Kudos to the California Association of Physician Groups (CAPG)...

... and its President Mr. Donald H. Crane for the recent decision by CAPG’s Public Policy Committee to support AB 374, the Compassionate Choices Act.

The Committee was strongly drawn to the proven, seven year experience of a very similar law in Oregon.

By giving patients facing imminent and inevitable death the option of self-administering life ending medication, the law ushered in a host of important improvements to end-of-life care: increased referrals to hospice care; improved pain management services; a rise in comfort care teams and high attendance at end-of-life seminars for physicians.

Most importantly, a marked increase in the difficult task of physicians and families of engaging in frank conversations about end-of-life options.

The Committee acknowledged that a minority of physicians may oppose this bill, but observed that the participation by physicians was strictly at their option and that this bill
presented a real opportunity to genuinely improve patient care.

CAPG decides, we do NOT gripe, you decide.

Be Well!

Kaiser Permanente Arraingment...

...is being held today in a Los Angeles court.

In adherence to its motto "Customer is always wrong", Kaiser is charged with dumping a confused homeless person in the downtown skid row upon her release from a Kaiser hospital.

In addition to sending some of the Kaiser executives to jail and imposing sky-high fines (to benefit health services for the homeless), the court should sentence the remaining Kaiser national and regional executives to 48 hours sentence by walking around downtown dressed only in a hospital gown without money, food or shelter.

State of California must revoke Kaiser's license to operate, unless and until dumping of patients is thoroughly investigated and prevented from happening in the future.

It's about time we speak with Kaiser in their own language-profits!

Kaiser dumps, we gripe, you decide.

Be Well!

Dr. Sokolov's 378 Thousand Reasons...

...for not-caring about the patients and for his "green outlook" on health carING.

To be more specific, there are more than 377,952 reasons for Dr. Sokolov to care more about his clients than he cares about patients/health consumers.

In it's eternal wisdom, the Editor of Modern Healthcare elected to ignore our posting "Health Consumers & Mr. Inlander v AMGA & Dr. Sokolov" of March 6, 2007.

$377,952.16 is just the face value (of 03/13/2007) of Dr. Sokolov's 9,622 shares of Hospira Pharmaceutical that he owns as a Director.

Modern Healthcare editor's core value reflect his allegiance to his advertisers, and their core values (profit) divergent with that of health consumers.

Once a throw-away publication, always a throw away publication.

We gripe, you decide.

Be Well!

Health Consumers & Mr. Inlander v AMGA & Jacque Sokolov, MD

Excerpted from Michael Romano's article in the latest edition of Modern Healthcare :

"It’s hardly a secret that the doctors and managers who run the nation’s biggest multi-specialty group practices...firmly believe that their model of integrated delivery is the very best way to provide patients with quality health carING.

Despite the traditional belief, doctor does not always know best! Especially a doctor-turned-consultant-turned-executive-turned investor.

Last week, the Alexandria, Va.-based American Medical Group Association, the trade group for all those large medical groups, held its annual conference over four days at the luxurious Westin Kierland Resort & Spa in Scottsdale, Ariz.

The self-satisfied (God-like) attitude of many AMGA members took a (bit) serious and fully deserved beating from Charles Inlander, noted naysayer (read patient/health consumer advocate) and the outspoken president of the People’s Medical Society since the consumer-advocacy group was founded 24 years ago".

“... the reason you’ve (AMGA) been losing the war (health care policy) is because the focus hasn’t been on the patient. It’s been on the delivery system.”

"For some reason—token, balance, perhaps—the conference organizers invited the consumer gadfly to join a panel discussion.

Panel participants, of course, were the button-down industry veterans to Inlander’s version of a tie-dyed radical about to storm the gates and bring down the system.

After suggesting that universal healthcare is inevitable sometime in the next several years because the public will demand it, he reinforced his point about the industry’s lack of sincere concern for patients by mentioning a keynote address one day earlier by Jacque Sokolov, a physician-turned-consultant and an impressive speaker"

"But, according to Inlander, this highly regarded expert never mentioned the P-word. “Jacque never once mentioned the word ‘patient’ in a 50-minute speech..."-noted Inlander.

Dr. Jacque J. Sokolov is indeed a highly experienced and accomplished expert on most aspects of health care.

I have personally known Dr. Sokolov since early 90-s, and had the distinct privilege of associating with him on a number of projects, as well as on health care panels, forums, and on the speaker circuit.

Dr. Sokolov practically invented employer-directed managed care as Vice President and Medical Director at Southern California Edison Co—HealthFlex, and, thus became one of the co-authors of the "mangled health carING"---see this blog archive ("Mangled Healthcare" for All).

Unfortunately for then Edison employees, they were not considered to be part of the equation. Otherwise, Dr. Sokolov would have bypassed the archaic "patient-centric", and would have gone straight to the appropriate "health consumer (payors)-directed".

Fortunately for Dr. Sokolov, that position made him a national name in health care and helped launch his worldwide consulting business.

In the ensuing years, Dr. Sokolov served as top executive with Advanced Health Plans Inc. and AHP Development Corp. to "develop, finance and implement advanced, integrated health systems." He is a savvy investor in health care.

His clients included: physician organizations, hospital systems, insurance companies, managed care plans, and vendors in 100 markets in 40 states, plus three foreign countries.

Dr. Sokolov is no stranger to pharmaceutical and medical device industries either. He serves on the Board of Directors for Hospira, Inc., the global specialty pharmaceutical and medication delivery company since Hospira’s spin off from Abbott Labs in May, 2004.

He also serves as a Director of MedCath Corporation. Please see this blog archive ("NEW Presciption for Pharma Marketing).

He is best remembered for presiding over the decline and, final demise of the Coastal Physician Group, Inc., after a protracted proxy battle with Dr. Steven Scott, founder of Coastal Physician Group, and much-publicized law suit (Scott v Sokolov, 1996, NCBC 2, Durham, North Carolina).

In-fighting under Dr. Sokolov’ tenure as Chairman of the Board & Vice-President for Healthcare, resulted in Coastal Physician Groups' stock price sinking from a high of $42 to around $13.

Fortunately for Dr. Sokolov, he was able to walk away from Coastal (which later became PhyAmerica Physician Group, Inc) with a sizable “chunk-of-cash”.

Currently he is Chairman and Senior Partner for SSB Solutions, Inc. His bio on the company’s website states: “…. Over the past 15 years, he has led consulting engagements with top-tier physician organizations, hospital systems, and managed care organizations in virtually every major market in the country…”

Curiously, but not surprisingly, the patient/health consumer is not mentioned. Is it because patient/health consumers do not pay exorbitant consulting fees, speakers’ honorariums or luxury hotel and airline accommodations?

The long of it:

Mr. Inlander is absolutely correct;

Dr. Sokolov, a former cardiologist, works for "...top-tier physician organizations, hospital systems, and managed care organizations..."

AMGA is absolutely wrong and was caught "red-handed";

Mr. Inlander "has a heart" & works on behalf of Patients-Health Consumers;

Dr. Sokolov does NOT work for patients/health consumers;

AMGA either knew, or should have known the content of Dr. Sokolov's presentation.

Dr. Sokolov could have removed the "patient-centric" slides to stay within the allotted time.

AMGA is in "damage to its real image" control spin;

Mr. Inlander will not be invited back by the AMGA, but he is always welcome on my blog!

The short of it:I am pointing out the obvious to the obviously blind!

Be Well!

Italian Doctor Enforces Patient's Rights.

In a major victory for right-to-die advocates in Roman Catholic Italy, prosecutors on Tuesday cleared a doctor of wrongdoing after he switched off the life support of a terminally ill patient who had asked to die, as reported by the Yahoo News.

Anaesthetist (in US, Anesthesiologist is a MD; Anesthetist is a Certified Registered Nurse Anesthetist-CRNA), Dr. Mario Riccio removed the respirator of muscular dystrophy sufferer Piergiorgio Welby in December to end a life that the paralyzed patient had repeatedly described as torture.

Supporters have called Riccio a hero for ignoring a court ruling that rejected Welby's high-profile request to have his respirator removed. He is a hero for "walking the walk" despite all adversities and for not abandoning his patient in a time of extreme need, and when his patient ran out of other options.

Opponents, including in parliament, said Riccio was a criminal who should go to jail. Real criminals are legislators, judges, prosecutors and other officials that willingly and maliciously denied the patient his right to self-determination.

The Roman Catholic Church went as far as to deny Welby a Catholic funeral and Pope Benedict joined the national debate by saying life was sacred until its "natural sunset."

"Natural sunset" is to be determined by each individual, not by an overpaid and overdressed figurehead such as Pope.

Within the various uses of the word today, "nature" may refer to the general realm of various types of living plants and animals, and in some cases to the processes associated with inanimate objects – the way that particular types of things exist and change of their own accord, such as the weather and geology of the Earth, and the matter and energy of which all these things are composed.

This more traditional concept of natural things which can still be found today implies a distinction between the natural and the artificial, with the latter being understood as that which has been brought into being by a human or human-like consciousness or mind.

By the same token, Pope can argue that cancer, heart disease, pregnancy, stroke, coma, and even hemorrhoids are "natural" conditions and should not be interfered with.

Not shying away from double standards, the previous Pope was kept alive by the miracles of modern artificial (not natural) technology.

Dr. Riccio is correct in his assertion that "...even under the law, it's confirmed: there's been no crime of euthanasia, just a patient who refused treatment..."

Italian prosecutors, after more than two months reviewing the case, said Riccio had done nothing wrong since he was acting in the spirit of Welby's constitutional rights and in strict adherence to Hippocratic Oath--an important procedural step that makes future criminal prosecution highly unlikely -- and could be seen as setting a precedent in other right-to-die cases.
"Doctor Riccio's behavior does not appear to be censurable for not having reinserted the artificial mechanical ventilator when the respiratory crisis occurred," the prosecutors wrote in their request to shelve the investigation".

Still, neither Riccio nor the medical panel and prosecutors described what Riccio had done as euthanasia, which is illegal in Italy and carries a 10 to 15 year jail term.

Only Switzerland, the Netherlands, Belgium and the state of Oregon (and Australia, Northern Territory) permit assisted suicide for the terminally ill.

Former Italian President Francesco Cossiga formally demanded magistrates consider Riccio a murder suspect last.

But Riccio's supporters have noted that Welby, lucid despite his illness, had asked to die and that his treatment held no hope of improving his condition. Prosecutors noted those facts in their request to shelve the case.

Riccio, who gave Welby a cocktail of sedatives when removing the respirator, had already been cleared of wrongdoing by a medical panel last month. He said the prosecutors' decision was a major step toward strengthening patients' rights in Italy.

"The only one who can ultimately decide on the therapy is the patient," Riccio said.

Let this case serve as a lesson to all California proponents and supporters of patients right to privacy and unimpeded ability to exercise their rights of self-determination.

California does not have to engage in euthanasia, physician assisted suicide, "physician assisted death" or any other "verbology".

California simply has to reaffirm individual patents" right to refuse any treatment, including the life-sustaining one.

We gripe, you decide.

Be Well & Exercise Your Rights Freely & Frequently!

City of Santa Monica promotes promiscuity...

...among ground squirrels by providing them with free birth control, subject to Santa Monica residency requirements, Mr. P. Lamont Ewell presiding!

In an unprecedented display of poor judgement, even for Santa Monica "standards", the City of Santa Monica does it again.

Here we were griping about healthcare-impotent Los Angeles BOS, while the public health masterminds in Santa Monica have come up with a plan to administer inmmuno-birth control to ground squirrel population of Santa Monica at a cost of up to $10.00 per squirrel.

I called the City of Santa Monica today to get a guesstimate of ground squirrels in the city limits and was refused a coherent or substantive answer.

Santa Monica "leadership", probably does not know the exact number of infectious diseases that were transmitted from squirrels to humans over the past 10 years, outcomes and costs of such alleged transmissions?

City of Santa Monica is not interested in protecting its residents and hundreds of thousands of visitors to the city from Hepatitis A in restaurants, farmers' markets, catering companies, bars, wholesale and retail markets.

Instead of pursuing an imaginary zoonatic threat, they could have considered handing $10.00 to each homeless person in Santa Monica in exchange for a pledge not to urinate on the Promenade!

We gripe, you decide, if you want to eat in Santa Monica.

Be Well!

"Board of Stupidvisors" (BOS)?

If one Googles "Board of Stupidvisors" one will come up with over 600 mass media references for a number of counties.

Why do residents of so many counties appear to be "lees-than-tickled" with our elected "servants"--members of the respective counties Board Of Supervisors (BOS)?

Maybe, it's because mine (BOS representative), for example, is more interested in watching himself on TV surrounded by men/women in uniform and flashing lights, than protecting the health of county residents.

Even though in Los Angeles County the final responsibility for health care services, public health, and emergency preparedness rests with the Committee of the Whole (meaning all persons elected to the BOS), there are definite "champions":

Gloria Molina, the first latina elected to BOS in 2/1991 distinguished herself in the health arena by protecting county library services whenever there was a fiscal problem with health services. A former smoker, she voted to re-appropriate (take away) $60 million in Tobacco Securitization towards County USC Replacement Project to be opened 11/2007. A "4 vote" item stuck in a budget request eliminating possible objections and/or discussions. Maybe she should use her quilting skills to patch up county's health system that's falling apart.

Zev Yaroslavsky, my BOS representative and a budget "expert", has been re-directing Master Tobacco Settlement Funds to non-tobacco related activities since 1998. Being in charge of the County Fire and County Sheriff departments allows Mr. Yaroslavsky ample media exposure. I wish he was as interested in provision of emergency health service in medically under served Malibu. Yes, MELibu, that does not have a single medical facility open after hours. Similarly, he does not seem to be interested in emergency preparedness, and did not support Malibu Medical Reserve Corps (MMRC).

Yvonne Braithwaite Burke--Member of the BOS since 1992-- continues to preside over the slow and painful demise of the King Drew Medical Center. Under her l"eadership" the BOS and its appointees failed to hire required number of outside doctors and nurses to roam the hallways to protect patients from medical mishaps. Burke proclaimed she: "... would not allow hospital to shut down, no matter how bad its problems and over my dead body..." She, and her colleagues, hired Navigant, an outside firm to turn around King Drew Hospital, spent hundreds of thousands of taxpayer dollars, but did not accomplish what they said they would.

Smartvisor Don Knabe is responsible for the Department of Consumer Affairs and leads the health carING by example--he is the Vice Chairman, Health Sub-Committee, National Association of Counties.

Smartvisor Michael D. Antonovich (also responsible for the office of the Coroner and Mental Health Services) reacts quickly and appropriately to the recent case of Hepatitis A in a cook with a major catering company. He states, that the case: "... demonstrates the major impact that this food-borne disease can have on restaurants, catering companies and consumers..."

Despite the fact that LA County Public Health Department took appropriate action to inform those who were at risk, and to offer prophylaxis for those for whom it was still potentially effective, it is still a prevalent serious disease.

His motion, scheduled to be heard on Tuesday March 6, 2007, which if passed, will instruct the Director of Public Health to review the relevant public health literature, and report back to the Board in 30 days with an analysis, including cost-benefit calculations concerning the question of whether Hepatitis A vaccinations should be required for food service workers in restaurants, catering companies, and in wholesale markets.

In the presence of abundantly clear and convincing evidence of the Hepatitis A vaccine safety & efficacy, it's really a matter of dollars and sense. Sense of doing the right thing to protect residents of and visitors to our great County of LA.

The non compliant restaurants, catering outfits, wholesalers and retailers must be fined severely to generate additional revenue for Hepatitis A vaccination of their employees.

Mandatory multilingual education, when monitored and enforced, can be as effective as vaccinations in preventing the spread and outbreaks of this serious disease.

Talking about proper hand washing techniques, recent studies have demonstrated the effectiveness of 6-step technique, as part of the safe hand washing is extremely effective in preventing the spread of the Avian Flu.

In our humble opinion, an ounce of prevention is better (faster and cheaper) than a pound of cure. Which box are you in LA County BOS Members.

We gripe, you decide!