Dr. Fontana—do your research and rewrite your blog

From the website, KevinMD.com: "Health care workers need to start talking about white people killing black people, and here’s why: every victim of racial violence will be seen by a health care professional at or near the time of the event."

Except, Dr. Elizabeth Fontana, MD, (the author), you've not given the facts. 93% of the injured or killed or assaulted black people you will see who called the squad or the police have had a black assailant, NOT white. Not police. Even so, fatal injuries caused by police officers is miniscule and you as a health professional/provider are more likely to treat a police officer hurt by a black youth or gang member than the other way around.

All criminal violence has been reduced drastically, about 50%, since the early 90s. Millions of black lives have been saved because the crime rates for blacks reduced more than whites after the Omnibus Crime Bill of 1993. By 2010, the rate of firearm homicide for blacks was 14.6 per 100,000, compared to 1.9 for whites, a decline of 51% for blacks and 48% for whites. Nationwide, there were over 1.5 million firearm non-fatalities in 1993 compared to about 478,000 in 2011. Because of the bias in research based on political and religious views, it’s difficult to tease out the details, but one thing is for certain, the media distort reports of violent crime and despite your excellent education, you've fallen for the big lie.

That said, millions of black babies die in the womb from chemical and surgical abortions. That's at genocidal levels. Rates for heart disease, hypertension, diabetes and obesity are much higher for blacks than whites, and yes, that IS something you as a doctor can tackle, but with them, not me. I have my own health problems.

Violent crime is committed close to home; black on black, white on white, Hispanic on Hispanic, gay on gay. Except for women. And you Dr. Fontana, should be concerned about all young male victims (usually), not just those black men assaulted by whites or police. When George Floyd was killed, there were many other black men killed that same day in Minneapolis, Chicago, Cleveland, and LA, but because a black man killed them, you didn't hear about it on the news. 24/7. But it's in the statistics. Their families grieve also. So too, if they died of a stroke or heart attack. Get to work, doctor. You have a job to do.

https://www.kevinmd.com/blog/post-author/elizabeth-fontana

Letter to my statistics professor

You are in Cape Town, and I’m in Columbus, Ohio.  Through the miracle of on-line learning and MOOC, I am in week 6 of your Coursera offering on Understanding Medical Research, in which you often stress the importance of statistics, choosing the right tests, and having access to the original data. I'm definitely a statistical outlier among your students--I'm 78 and retired in 2000, and have had no math since 1955. And although this class doesn't demand a heavy background in math, I even had to review fractions, percent, and square root!

So, in the Nov. 28, 2017 JAMA there is an article, "Adherence to Methodological Standards in Research Using the National Inpatient Sample," that caught my eye, and impressed upon me everything you've been teaching us. I was surprised to read that of 120 articles (the sample) of the 1082 (the population) published in a 2 year period using data from 35 million hospitalizations in the U.S., 85% did not adhere to 1 or more required practices of the AHRQ (Agency for Healthcare Research and Quality), and 62% did not adhere to 2 or more required practices. A total of 79 of the 120 in the sample (68.3%) did not account for sampling error, clustering, and stratification; 62 (54.4%) extrapolated non-specific secondary diagnoses to infer in-hospital events, and so forth.
So I began linking the people involved; not only did the researchers get it wrong, the peer reviewers missed the errors, as did the editors of the medical journals (some with a high impact factor). The articles with incorrect statistical information were used to get promotion and tenure at universities.  Possibly policies and regulations for hospitals may result from some of these published articles with careless statistics, or, a "medical journalist" will attempt to translate the results for a layman, and it will be reported in the media.

In the U.S. we have been subjected to a horribly expensive electronic medical records law which all physicians and hospitals had to incorporate (I think it began around 2010).  There was no evidence this would improve medical care, but it was apparently "needed" so researchers had more data to mine.  I still have to ask for my medical visits from Dr. A to Dr. B, two miles apart, to be faxed because these systems don't talk to each other. Now with all this data ready to be mined, someone will mess up the statistics!

So, Dr. Juan Klopper, you are definitely needed, and will never run out of things to talk about.

The duping of Americans

If you look at the rationale for Electronic Medical Records, it was always about the data (which can be massaged, sold to the highest bidder and used for policy), because its value for health had never been decided. This should come as no surprise. It's the invention of Zeke Emanuel who said, "Vague promises of savings from cutting waste, enhancing prevention and wellness, installing electronic medical records and improving quality of care are merely 'lipstick' cost control, more for show and public relations than for true change." JAMA, Feb. 27, 2008.

And now this. . . and it won’t be the only invasion of your private records.

The federal government is piecing together a sweeping national “biosurveillance” system that will give bureaucrats near real-time access to Americans’ private medical information in the name of national security, according to Twila Brase, a public health nurse and co-founder of the Citizens Council for Health Freedom.

The Department of Health and Human Services’ (HHS) Office of the Assistant Secretary for Preparedness and Response is currently seeking public comment on a 52-page draft of the proposed “National Health Security Strategy 2015-2018” (NHSS).

Read more here.

How to promote a social agenda with medical statistics

If I were to tell you I still have my 1955 waist measurement, I wouldn't exactly be lying, but I would be measuring my thigh and not my waist with a tape measure and my fingers crossed. So it is with "developed countries" medical statistics like this one--"The U.S. spends more money per person on medical care than any other developed country in the world." (JAMA, July 28, 2010 citing OECD 2009 statistics). Notice, that's "per person" and not per citizen as it is in most countries. Someday I'd like to see a breakdown, by developed country, of non-citizens in their health care system, people who arrive with exotic diseases, not knowing the language, and with unfamiliar cultural patterns. Of course, it's a bit difficult to flee to Ireland or Finland from Guatemala or Haiti, isn't it?

And since we have so many ethnicities in the USA, I'd like to see a comparison of health and disease of Scandinavian Americans as compared to their 2nd and 3rd cousins once removed in Norway, Sweden and Finland, or 2nd generation middle class Mexican Americans compared with their peasant cousins still living in the home village in Mexico. Or Haitian American doctors and rock stars compared to working family in Port-Au-Prince. Oh, those aren't developed countries are they? No, but those new Americans had American healthcare resources at their disposal.

Obamacare trumped up measurements did not just come in since he took office in 2009--his plans have been in many government plans and planning for decades. Here's one of three "medical models" (the others being clinical and public health) currently in place, according to JAMA, July 28 (Commentary, p. 465, R. H. Brook)

1. Redistribution of wealth; 2. meaningful guaranteed jobs for all adults to have the income to pursue healthy behavior; 3. helping children feel safe and be healthy and ready to learn; 4. empowering women and communities so that they can work more effectively to increase the health of the population.

I'd truly love to see a medical study of Americans with meaningful jobs, able to afford the best health care and education who are politically empowered, who also are obese, who smoke, and who engage in dangerous and risky behaviors. Now that would be a study for the books, because I know a lot of people with unhealthy lifestyles who have all the perks of life that Dr. Brook describes in his commentary.

The deep desire to control others' behavior and lives (for their own good and the betterment of society and mother earth) is not just ingrained in the government--it's in medicine, academe, education, religion and just about any other field that requires a college education.