My letter to a grant recipient at OSU

Today I noticed in OnCampusToday you’ve received a handsome grant of $2.27 million from NIH for “patient engagement.” Congratulations.  I’ve read through your publications, and you have had an impressive career. Although I don’t know what “concept map to define capacity for engagement” means, I would like to comment on patient portals as a means to engage patients in their own care.

I hate them.

My husband has 2 doctors, 3 if you count the cancer specialist whom he rarely sees, and I have 3, family, ophthalmologist and cardiologist. We share the family doctor. Each practice uses a different portal system for finding our lab results, asking questions, tracking meds, etc.  But the worst feature is their sending us advertisements! I don’t know until I’ve made the effort to get in—not easy—why I’m being contacted. What a mess! Fortunately, I don’t think my ophthalmologist uses one, because he’s the one I see most frequently. When I ask him to send a record to my family doctor, he uses a fax.

Recently we received a notice from our financial advisor suggesting we have our own “portal” for his financial services, and I fired back, Absolutely Not. Face to face is always better. I’ve not had eye-contact with a doctor since Obama imposed the horribly expensive EMR system, which had never been tested for improved care or cost reduction. One of the Emanuel brothers just thought the tech industry needed a pay off. My medical records could be transported faster by carrier pigeons from Riverside Hospital to Dr. Jennifer Bush, 2 miles away. And I hold no hope that patient portals will improve my care, at least not the ones in use by any of our doctors.

And by the way, how secure are these portals? Who designs them to be unworkable? Are they more secure than large medical practice records? Two years ago my husband’s urologist’s practice was hacked, and thousands of records exposed with all the personal data that goes along with that.

I have 9 blogs, I’m on at least 4 e-mail discussion lists, I’m on Facebook, I read a lot of medical, political, technology and religious information web sites, and I’m a retired librarian (veterinary medicine) who formerly taught classes in data base searching and information skills.  I used to teach “older learners,” which is anyone over 25.   You need a system that is easy for 80 year olds or admit this technology does not have the capacity to engage.

Norma J. Bruce

OSU Libraries faculty, retired

Megyn Kelly interviews Dr. Emanuel twice on Fox

If you wanted to throw something at the TV watching Megyn Kelly's interviews with Zeke Emanuel, you'll love what he said in 2008--his audacious views and rationing beliefs were all out there, and he was Obama's main advisor on this death trap called PPACA. Oh yes, and he claims it's Fox News and Republicans' fault. Sorry, Zeke, but as you blame, your own words point 3 fingers back to you and the advice he got from you.

http://online.wsj.com/news/articles/SB10001424052970203706604574374463280098676

http://therightscoop.com/round-2-megyn-kelly-interviews-ezekiel-emanuel-again-and-hes-blames-fox-news-for-failure-of-obamacare-rollout/

It’s not a failed “roll out;” it’s a terrible law.

Fudge phrases—rich, thick, gooey

“Experts agree. . . “

“The new model recognizes that. . .”

“While data are limited. . . “

“The answer probably has to do with. . .”

“While outcomes data on alternatives are limited. . . “

“Consistent with this proposal, . . .”

“It is also possible. . . “

These were all in Dr. Ezekiel J. Emanuel’s (Rahm’s brother and Obama’s house doctor) first third of a paper arguing for shortening medical training by 30%.  I have no opinion on this. However, once he’d warmed up to the topic with vague generalities, he then became very dogmatic and authoritarian about values and ethics.  On that, I do have an opinion.  It’s dishonest.  It should be noted that these are his opinions not based on data or a high power from which ethics flow.

“Efficiency has its own value.”

“Waste, especially wasting the time of some of society’s most highly educated and talented people, is unethical.”

“Changing the structure of training would force medical leaders to eliminate unnecessary and repetitious material and emphasize training physicians to become part of a care team.”

In the first half of his article he lists 3 medical schools, University of Pennsylvania, Duke University, and  Harvard, that have rearranged different parts of medical training, and one, Texas Tech that offers a 3 year program.  Then at the conclusion, he confidently states, “many medical schools and residency and fellowship programs have already shortened their training in various ways. . .” 

You can tell he’s worked in government (for both Obama and Clinton) can’t you? But that isn’t noted in the JAMA, March 21, 2012 “Viewpoint,” only that he’s in the Department of Medical Ethics and Health Policy at University of Pennsylvania.  His NIH web site: “Ezekiel J. Emanuel is Head of the Department of Bioethics at The Clinical Center of the National Institutes of Health and a breast oncologist. He is on extended detail as a special advisor for health policy to the director of the White House Office of Management and Budget. “ According to a quote at Wikipedia, he believes you and I have an obligation to participate in biomedical research as a civic obligation.

Santorum on abortion

From George Will's column today:

On Sept. 26, 1996, the Senate was debating whether to ban partial-birth abortion, the procedure whereby the baby to be killed is almost delivered, feet first, until only a few inches of its skull remain in the birth canal, and then the skull is punctured, emptied, and collapsed.

Santorum asked two pro-choice senators opposed to the ban, Russ Feingold, D-Wis., and Frank Lautenberg, D-N.J., this: Suppose the baby slips out of the birth canal before it can be killed. Should killing it even then be a permissible choice? Neither senator would say no.

On Oct. 20, 1999, during another such debate, Santorum had a colloquy with pro-choice Barbara Boxer, D-Calif. Santorum: "You agree that, once the child is born, separated from the mother, that that child is protected by the Constitution and cannot be killed. Do you agree with that?"

Boxer: "I think that when you bring your baby home . . ."

Boxer Santorum exchange here so you can see how she tries to weasel out of a simple question.

I think there are two of Obama's czars (Sunstein and Emanuel) who believe that within one year of birth it would be OK to kill a baby born alive. Obama is the only (then) Senator, as I recall, who actually approved of partial-birth abortion as described here, but you can see from this account, how careless Democrats are with life and which why when carried to its logical end, having life totally under the control of the government is acceptable to them.

Sarah Palin's charge of death panels

In an article at American Thinker on the existence of “death panels,” the author, Joseph Ashby, says it’s not in HR 3200 because it already exists: “H.R. 1 (more commonly known as the Recovery and Reinvestment Act, even more commonly known as the Stimulus Bill and aptly dubbed the Porkulus Bill) contains a whopping $1.1 billion to fund the Federal Coordinating Council for Comparative Effectiveness Research. And on this council is Dr. Death himself, Rahm Emanuel’s brother, Dr. Ezekiel Emanuel.

One of the commenters at this post, Redhawk, analyzes the role of statism in our Congress’s health care plan.

When you get past all the doubletalk, this is what the people who are advocating a government-run healthcare system truly believe. The foundation of the statists' philosophy is that the people in a society are in essence the property of the state. Given limited resources and the state will always claim to be short of resources, the state will decide the extent to which a person will be medically treated for a serious illness, depending upon that person's perceived value to society. To the statist, this makes perfect sense. Of course in actual practice, the final decision can be heavily influenced by how many friends in Washington one can petition, which is a storyline right out of Atlas Shrugged; how one's success in life and in this case life itself will be determined by political pull. Washington apparatchiks and their hangers-on will of course automatically receive the best of care.

I have not read whether this is happening in Britain, but I would be surprised if it were not, since such a system invites corruption. There you can be denied cancer treatment even if you are willing to pay for it out of your own pocket or you may be denied stints if you are above the arbitrary age limit of 59; unless of course you lucky enough to have friends in high places who can make an exception in your case. Otherwise, you have a duty to die. They may or may not decide to pay for the pain medication to relieve your final suffering, since it is all subject to the whim of some bureaucrat. This is the type of system to which we are heading unless we can stop it. We are being asked to quietly accept a socialist plan that promises to improve the healthcare of roughly 20% of the population, many of whom are here illegally, but in doing so will intolerably degrade the healthcare for the rest of us.

HT Murray

Did you see that Sarah's book is already #3 on Amazon and it isn't published yet, and that Glenn Beck's new book is outselling the Kennedy memoirs?

The Wisdom of Sarah Palin

"Ezekiel Emanuel is upset. The president's health care czar sees the growing resistance to his vision, to his brave new world of government-run "communitarian" health care in which politicians and bureaucrats control one-sixth of the economy and 100% of our bodies. He doesn't quite understand how it all came apart on him, but he does know who started the unraveling: Sarah Palin. . .

Sarah Palin had done the unthinkable. She had read the health care bill. Mainstream journalists hadn't read the bill. Congress hadn't read its own bill. But Sarah Palin did. Sarah Palin! He has a medical degree and doctorate in political philosophy from Harvard. The only Harvard she's knows is the chunk of ice off Prince William Sound, Harvard Glacier.

Then she writes something on Facebook -- Facebook, for Obama's sake! -- and suddenly the president, congress, the media, and everyone who is anyone inside the beltway is scurrying for cover. Palin wrote that she wanted nothing to do with Obama's "death panel," the collection of bureaucrats who Zeke was so proudly putting together to assess the "level of productivity" that would determine individual access to medical care. . .

No, Zeke believes that those who know better, who understand morality, should make decisions for those less able to do so. Like Sarah Palin. Like Trig. Like your grandma. And this is because he cares. Just ask him." Read the whole article; this woman makes me proud!

HT Pat in North Carolina, another senior blogger paying attention

Why you need an independent guidance group for end times

Who would that be--the group that Obama said in April you needed to help you make decisions about end of life. Well, maybe his chief medical advisor, Ezekiel Emanuel.

"Someone like Dr. Ezekiel Emanuel, health advisor to Obama, and Zeke's brother Rahm, who loves to hurl thunderbolts from Mount Olympus and bully freshman congressmen. They and their ilk will give us "guidance" about who is worthwhile, who is ready to die, who shall live a week or two longer. Zeke is a Harvard academic who is arrogant enough to believe that he can change human nature and decide the most intimate and complex of human issues -- those of life and death. The man, a bona fide MD, clearly prefers writing bushels of words about what's good or bad for society to caring for people and being responsible for suffering patients. The soft-spoken arrogance and vanity of this administration is sometimes stunning.

Dr. Emanuel thinks health care must be distributed according to the group to which an individual belongs. Valued groups include young and healthy persons, and favored racial and gender groups. Those of less value, of course, are those with medical problems and the elderly.

According to Emanuel's "Complete Life" plan, society's scarce resources should be spent mostly on those under 40 years of age. ["Unlike allocation by sex or race, allocation by age is not invidious discrimination. . . . Treating 65 year olds differently because of stereotypes or falsehoods would be ageist; treating them differently because they have already had more life-years is not." Dr. Emamuel, Lancet, Jan. 31, 2009] Old folks get what's left over as determined by him and his ilk. How they will make their decisions is not at all clear." American Thinker.

Let's be nice to condemned murderers, terrorists, and abortionists. Those old timers need to go. They've lived their time. It's the liberal, caring way.