wmed.com Blog

The current flu pandemic is caused by a virus from the Influenza A family and further identified as H1N1.  Influenza A is a specific genetic type of virus found in birds, swine, and humans.  It is the most common cause of flu in humans.

There are two specific chemical compounds found on the surface of the influenza virus. The first compound “Hemagglutinin” locks the virus to the cell surface so that the virus can enter the cell and cause infection.  The second compound “Neuraminidase” helps release the virus from a previously infected cell so that the virus can spread.  There are 16 known types of hemagglutinin and 9 known types of neuraminidase.  These number types are used to subclassify the flu virus such as H1N1.  Drugs that inhibit neuraminidase are used to treat influenza.

The severe flu pandemic of 1918 was of type H1N1.  The current flu virus appears to lack the virulent features that produced an over reaction of the immune system causing widespread illness and death.

There has been much media attention about the death of a 17-year-old girl with relapsing leukemia denied insurance coverage for a liver transplant.   This tragic event should offer an opportunity for an intelligent discussion of transplant policies.  Instead there has been the threat of criminal charges against those involved in the transplant decision process.  Another big problem is those people with knowledge; experience and perspective are remaining silent because of fears of being drawn up in an irrational debate.  Politicians have jumped into the debate with little knowledge of transplant issues but offering lots of draconian and impractical solutions. Read the rest of this entry »

There is no question that a medical education is a rigorous experience with tough mental and physical challenges. The training period is great preparation for the real world life of a physician. Working long hours compacts years of experience into the training period. There is also no question that many physicians in training are chronically fatigued and overtaxed beyond the point of diminished performance. No one can argue with the adverse effects of fatigue on performance. Experts point out the impressive safety record achieved by the airline industry that limits pilots to about 80 flight hours a month. In an effort to combat the negative effects of fatigue on the training experience, academic medicine has now limited physicians in training to 30 consecutive work hours and an 80-hour workweek.

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For many years people gather at a place to live, work, and have mutual protection and support. Eventually a group of people at this place gets unhappy. They have ideas that could make things better. They start causing trouble. This new group either leaves voluntarily or they are driven out.

The new group moves away and starts a place using new ideas. Most of the time this new group fails but sometimes they are successful and the new place becomes much better than the old place.

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Many people now equate a doctor with a health care provider. Indeed, bureaucracy has forced most doctors to function as health care providers even though they were trained to be doctors. The following points help remind everyone of the difference.

1. A doctor has a name.
.. A health care provider has a number.

2. A doctor makes decisions based on years of training and experience.
.. A health care provider must call for authorization and approval.

3. A doctor attends those in need.
.. A health care provider requires a valid insurance card.

4. A doctor prescribes the best drug available.
.. A health care provider must use the insurance company formulary.

5. A doctor brings comfort to the patient and family.
.. A health care provider cannot bill for these services.

6. A doctor does what’s best for the patient.
.. A health care provider must follow insurance company guidelines.

7. A doctor delivers care exceeding expectations.
.. A health care provider delivers the services specified in the
.. contract.

8. A doctor is rewarded by the patient.
.. A health care provider is reimbursed by the fee schedule.

9. A doctor is chosen.
.. A health care provider is assigned.

———— The Editor

The first dedicated hospital in the United States opened in 1751 in Philadelphia. Started by the Quakers, and headed by Benjamin Franklin and Dr. Thomas Bond, Pennsylvania Hospital’s mission was to care for the sick who lacked proper home care. Today, there are about 7000 hospitals in the United States delivering general and specialized health care. Half of these hospitals have less than 100 beds. In addition to this primary mission, many hospitals offer education and training for medical personnel, and conduct vital medical research.

Visit Pennsylvania Hospital

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Its hard to find fault with the authors of the Constitution of the United States. Even in retrospect they did an amazing job outlining in a few pages the structure of a government that has been successful for over two hundred years. Its hard to blame them for a lack of emphasis on health care in the organization of the new country. The people of 1787 cared no less about health than we do, but had pitifully few tools to use. Only primitive knowledge was available about sanitation, disease and nutrition. Health care consisted of a few basic items; a varied diet, fresh air, water, and sanitation. The humoural theory of disease was still in vogue (it was 1881 when Louis Pasteur established the germ theory of illness). Government involvement in health care consisted of only a few people caring for sick and injured sailors. The Public Health Service would evolve from this agency but much later in the history of our country.

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You’ve been feeling sick lately, bedridden at home and unable to work. Your doctor diagnoses a serious illness but luckily he is able to prescribe a medication, which controls the disease and can return you to a normal life. He explains its benefits and the low risk of side effects.

After having the prescription filled, your pharmacist asks if you want to purchase the supplemental “Pill Insurance”. Noticing your confused look, he offers the following explanation.

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Palm Beach County Florida is a great place to live and work. Many of the best doctors in America have been attracted to the area to practice medicine. The area’s neurosurgeons treat a variety of diseases including brain and spinal trauma, tumors, vascular disease, and back problems. Several limit their practice to special areas such as pediatrics or diseases of the spine.

Neurosurgeons are considered by their colleagues to be the “Green Berets” of medicine. They have one of the longest training programs and perform some of the most technically difficult surgery. Neurosurgeons frequently operate against long odds for success. The nervous system is vulnerable to trauma and damaged tissue has only a limited ability to heal. Many of their cases meet the category of “medical disasters”. Thankfully these cases are interspersed with many patients who have a complete and amazing recovery. Because of the characteristics of their specialty, neurosurgeons are among the most frequently sued doctors in America.

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