Here’s another picture of the birthday baby. This one was taken today. Isn’t she sweet. Look at that smug face. Is that the look of spoiled beyond spoiled or what?

Happy birthday to the most wonderful, perfect, beautiful, precious, and lovable kitty in the world. Thank you for being part of my life, and I hope we celebrate many more birthdays together!

Ideally, Americans should be able to buy prescription drugs in our own country. Health insurance should cover the cost. The price should be reasonable, and by that I mean in line with what people pay for the same drug in comparable “first world” nations.

But as anyone who uses prescription drugs knows, that is not the case. People without insurance, or those without decent prescription coverage, are the hardest hit. Going to Canada to buy drugs seemed a reasonable option, but now Canada is going to make it more difficult for that to occur.

Canada to Ban Prescription Drug Exports; U.S. Seniors Left With No Alternative

Canadian Health Minister Ujjal Dosanjh announced today that he will introduce legislation this fall to ban bulk export of prescription drugs to the U.S. by likely requiring Canadian doctors to examine patients before writing prescriptions. Under current practice, Canadians physicians co-sign Internet orders after reviewing a prescription that had already been written by an American doctor.

In August and October of last year FTCR sponsored two chartered train trips that took groups of seniors to Canada to buy their prescription drugs. Participants on the trips saved an average of 60% off what they pay in the U.S. for the exact same drugs. The reason behind the trips was to display the need for a system similar to Canada’s. Read more about the trips at RxExpressCanada.org

Tabloids are trash, we all know that. Even those who read them for pleasure, that sweet little decadent treat. I suppose it is lower in calories than gorging yourself on Krispy Kremes, and less toxic than some of the packaged baked goods that don’t appear to have any recognizable food source listed in their ingredients.

But you know, it’s one thing for tabloids to giggle and titter about J. Lo’s break-up with Brad, or Ben, or whoever the hell she was dating, or hint about the forthcoming nuptuals of a the star of a braindead sit-com. However, they cross the line when cruelty towards a decent human being becomes their latest pathetic attempt to gain readership.

One of the ten ugliest people in the world. I can name them, no problem. First one has the initial GWB. Second DR. Third DC. And so on. But the trash rag that calls itself the World Weekly News called Jason Schechterle, a police officier who was severely burned and disfigured, one of the “10 ugliest people in the world.”

Schechterle was nearly killed on March 26, 2001, when a taxicab rammed into the back of his patrol car, which burst into flames. Yes, he is not an attractive man, physically speaking. Burns to your face have a habit of doing that. But to call a man who has gone through so much suffering, painful medical treatments, and has managed to bounce back and make an attempt at resuming a normal life “ugly” is beyond shameful.

The small comfort is knowing that the public, for the most part, was also outraged.

The Weekly World News story came out in February, and the outcry from the Mayor’s Office and the general public was so great that many retailers refused to carry the issue and American Media reportedly removed it from newsstands nationwide.

“American Media stands for quality journalism,” Zakim said.

Quality journalism, huh. But what motivates an editor to print something like that in the first place? Did they think it was funny? A million and one laughs, to call a badly burned and disfigured police officier ugly? Did they think that Schechterle is unaware of his appearance, and this was a reality call to him? Gee, maybe they can fix him up with a good plastic surgeon. Give him some Botox.

Besides issuing an apology, the trash rag is donating a chunk of money to the Foundation for Burns and Trauma, which is affiliated with the Arizona Burn Center at the Maricopa Medical Center, the facility where Schechterle was treated.

Somehow, though, I suspect that the editors who decided to run this story aren’t sorry at all. Oh, I’m sure that they are bitching and whining about losing their jobs, but really don’t think they did anything wrong. Maybe we can run their faces through a meat grinder, and then plaster their photos across a tabloid, as part of the “10 humans closest to resembling alien scum.”

The full article is at AZcentral.com

Not good news for people in Washington state (like me), and especially, those who have the misfortune of living near the Hanford nuclear mess. New studies in Richland, Washington have revealed that the local Hanford Nuclear site has contaminated the area far more than previously thought. For the first time, plutonium has been found in clams and fish in the Columbia River. In addition, radiation levels of area mulberries are so high, eating less than a teaspoon full of the berries would cause a person to exceed EPA maximum allowable risk levels for an entire year.

Mmm, I wonder if those mulberries give your skin that extra sheen? That glow that you thought could only be achieved with make-up?

From the Environment News Service

The American Medical Association wants to investigate the impact of drug advertising on consumers, but what about on doctors? How much money is spent on consumers vs. doctors? That is what a consumer would like the AMA to tell us: How much are they paying you?

Consumer Group Challenges the American Medical Association to Disclose Advertising Dollars From Drug Companies; AMA’s Advertising Revenue is Twice as Much As Subscription Revenue

Santa Monica, CA — A consumer group called on the American Medical Association (AMA) today to disclose the amount of advertising money that the AMA collects from drug companies in the wake of the AMA’s announcement that it will “investigate” the impact of drug company advertising on consumers. In the June 15 issue of the Journal of the American Medical Association, 9 of the 16 full page advertisements were for pharmaceuticals, including the first six pages and the inside and back covers.

The AMA’s announcement failed to acknowledge the fact that drug companies spent five times more on marketing to physicians, including advertising in journals, than they do on advertising to consumers.

A large body of research has found that pharmaceutical advertising and marketing to doctors has led to increased prescribing, use and possibly over-use of prescription drugs.

“The AMA’s feigned concern for the fate of patients targeted by drug advertising makes about as much sense as a pusher enrolling his customers in drug-addicts anonymous,” said Jerry Flanagan of the Foundation for Taxpayer and Consumer Rights. “Patients and doctors have a right to know how much advertising money the AMA’s journal receives from drug companies. Drug companies spend five times as much on marketing to doctors than they do advertising to consumers because they know their profits depend upon whether a doctor is motivated to prescribe the newest blockbuster.”

According to the AMA’s 2003 tax return, the AMA receives two times more money in advertising dollars than it does from subscriptions. In 2003, the latest data available, the AMA received $41,123,622 from advertising revenue, compared to $17,677,540 from subscription fees. The AMA’s advertising revenue accounts for 45% of the group’s total program revenue.

In 2000 (the latest data available) drug companies spent $4.8 billion on “physician detailing,” the practice of sending marketers to doctors’ offices to encourage doctors to prescribe a company’s drugs. In the same year, drug companies spent $2.4 billion on consumer advertising. Total physician promotional spending by drug companies in 2000 was $13.2 billion, including $484 million for journal advertising.

In 2004, Pfizer settled a lawsuit for $430 million with the U.S. Attorney General’s office that alleged that the company had promoted its anti-convulsant medication, Neurontin, to doctors for “off-label” treatments — those not approved by the FDA.

The Foundation for Taxpayer and Consumer Rights (FTCR) is a leading nonpartisan and nonprofit consumer advocacy organization. For more information, visit us on the web at: http://www.ConsumerWatchdog.org

Imagine being a teenage boy, having a stomach ache, and then all of a sudden finding out that you’re the father of a dead fetus!

No, this is not from Jerry Springer or Oprah’s freak of the week. And yes, unbelievable as it may seem, there is a scientific reason for it. And no, the boy was not pregnant.

Doctors in Bangladesh say they have removed a long-dead foetus from the abdomen of a teenage boy who was complaining of stomach pains.

They said it was a case of an extremely rare condition where two foetuses are conceived as conjoined twins but one absorbs the other.

Talk about truth being stranger than fiction. The fetus weighed about 4.5 pounds. Yikes, that must’ve caused one helluva stomach ache.

Read the article in the BBC.

This is another woe-is-me tale, blaming staffing shortages on that ever available patsy, the great nursing shortage of the New Millennium. What a relief it must for hospitals, to blame everything and anything on the “nursing shortage” as though it is no way connected to their own policies and procedures. And what a convenient excuse to milk the system for all its worth, and cut expenses at the expense of the patient.

A nursing committee at the University of Virginia Medical Center has come up with a way to help alleviate the nursing shortage - without hiring new nurses.

What is astounding about this article is that nurses cooked this up. I don’t know what type of nurses they are speaking of–perhaps the management dorks who spend the day pushing pencils and finding ways to cut their budget to rock bottom. That type of nurse?

Rather than hire new nurses, the committee came up with a brainstorm to train certified nurse aides to become advanced certified nurse aides, or patient care technicians.

Patient care technicians are able to draw blood, insert catheters and perform more complicated positioning moves, duties that would otherwise have to be performed by a nurse.

Um, excuse me guys, but haven’t we been there done that? That was the great scheme of the early to mid-90s, when hospitals decided that nurses were superfluous, and that their job could be performed by lesser trained staff. Thousands of nurses were laid off and replaced with “caregiver associates,” and “patient techs,” and what have you. That’s an experiment that reached its heyday 10 years ago, and was one of the causes for a mass exodus from nursing. Remember those good old days, guys?

Marian Lawson, the nurse manager in the Coronary Care Unit, was on the committee that helped create the program.

“This program is near and dear to me,” Lawson said. “PCTs are the backbone of patient care.”

Judging from this comment, now we see what kind of nurses staffed the committee to create this program. PCTs are the backbone of patient care? Give me a break, lady. PCTs are part of a team. Their job is to assist with patient care. The NURSE is the backbone of patient care.

This type of program is open to widespread abuse. Where do you draw the line between the PCT’s job and the nurse’s? That was a major problem back in the 1990’s, when unlicensed personnel were doing the job of nurses, and let’s just say the outcome wasn’t peaches and cream.

If they want to give the nurses some help, fine. But don’t do it at the expense of hiring more nurses.

Now, here is more interesting news about this facility, lest you really believe their pathetic poor-us-we-have-to-do-this-because-we-can’t-find-nurses dribble. Last October, the University of Virginia hired 12 foreign nurses at $18,500 a head, and said that they have plans to hire more. At the same time, the hospital received 200 applications from American nurses, but claimed that many of them didn’t have the experience needed. And to add salt to the wound, they also cut the hourly rate of per diem nurses, causing several to quit.

Doesn’t a story like this make you want to vomit up Thursday’s dinner? What the hospital is saying that they would rather spend $18,500 on hiring a foreign nurse, than spend far less than that and train an American one. And I can tell you why. I’m sure that most of those 200 applicants were well qualified. The hospital just prefers to go with the foreign nurses because they are like indentured servants. They sign a 3 year contract with the hospital, and have to stay or pay back a huge chunk of money. The hospital can pay experienced foreign nurses rock bottom wages–basically those of a new grad–and get away with it. And they don’t have to worry about these nurses quitting, no matter how badly they’re treated.

And then they cut the pay of per diem nurses. It’s like they’re saying, please quit. We don’t want you. We want our nurses to quit and we’ll find any excuse not to hire new ones.

Just think how much cheaper it is to use a combination of foreign nurses on contract and patient care technicians. Think of the savings.

University of Virginia Medical Center, let me commend you on your sleazy contribution to the world of healthcare. You should get a medal, pinned right up your ass.

Oh, I forgot, it’s because of the nursing shortage that you have to do this.

The article about the PCTs can be read at the Daily Progress

And now, the cure for waiting at the pharmacy. Banks have done it, so why not put the technology to extended use. If you love the convenience of the ATM machine, then “drugs via instant kiosk” may be right up your alley. And I’m not talking about that tedious spam which arrives in you email box every 12 seconds, offering you the best and outstanding prices for Viagra and Paxil.

Several pharmacies in California and Virginia are testing ATM-like kiosks that will allow patients to pick up refills at any time, even when the pharmacy counter is closed. Considering that many drug stores are open 24/7, that may not be a big boon to many, but those stores are not universal. The machines can make it easier for those with busy schedules, in the same manner that ATMs have solved the problem of having to be at the bank during regular business hours.

However, the machines still require patients to order their refills in advance, either online or by phone, after which a pharmacist places the medications in the machine for later pickup. So not quite the same as a bank ATM, where you don’t have to call the bank in advance to make sure that they’ll have your money waiting for you.

And like all new technology, the kiosks are causing a bit of controversy. From the Wall Street Journal:

The ATM-like machines are raising questions among pharmacists and state regulators who oversee prescription-drug dispensing. One worry is that patients might end up with the wrong drug. Some pharmacists also don’t like the machines because they cut out traditional face-to-face consultations with patients. The concern is that patients might be discouraged from asking pharmacists about such things as whether alcohol should be avoided with a medicine, or possible drug interactions.

“There’s lots of leeriness on the part of regulators and the fear that something like this could replace the pharmacist,” says Mary Ann Wagner, vice president of pharmacy regulatory affairs for the National Association of Chain Drug Stores, a trade group in Alexandria, Va.

That can be a difficult argument to make given how many drugs are now dispensed by mail order. Indeed, driving this effort is a need by drugstore chains to boost competition against mail-order pharmacies by making pickups faster and easier. Mail order accounted for 14% of prescription drug sales last year, up from 10% in 1999, according to IMS Health Inc., a drug information and consulting firm in Fairfield, Conn. The machines will be particularly attractive to 24-hour supermarkets that want to cut back their pharmacists’ working hours to reduce costs, says Christopher Thomsen, a pharmacy consultant in Kansas City, Mo.The machines, of course, are not without controversy. Some pharmacists worry about problems if the machine dispenses the wrong drugs, while others have expressed concern about lack of face-to-face contact with patients. T

Well, a lot people end up with the wrong drugs from their pharmacist. So the human touch doesn’t always mean the error-free touch. And with mail-order soaring, and people heading to the North and South to buy cheaper drugs across the border, we are already moving beyond the friendly Dr. Marcus Welby-like neighborhood pharmacist, who also works behind the counter and dishes out banana splits and cherry Cokes.

Also, I don’t think that we need to worry about pharmacists becoming an extinct species just yet. There is a tremendous shortage of pharmacists, and theses kiosks merely represent a convenience. ATMs haven’t replaced bankers, and it’s silly to think that having another means of dispensing drugs (pharmacists still have to fill the scripts) is going to destroy the profession.

The drugstore machines are different from another growing drug-dispensing technology called InstyMeds that is used in about 20 urgent-care centers and hospital emergency rooms. The InstyMeds machines, often located in the waiting room, are prestocked with commonly used drugs. Physicians working in those centers can send an electronic order for a prescription to the machines, which print up a label and dispense the drug to the patient.

“We don’t have any present plans to move into drugstores,” says Ken Rosenblum, founder and chief executive of Minneapolis-based Mendota Healthcare Inc., developer of the InstyMeds machines.

Read the article in the WSJ (this is unusual because WSJ articles are usually available only to subscribers but this one appears free to the public.)

The good news is–my website hasn’t been destroyed by the evil forces of FatCow. The bad news is that the stats are in limbo land. Yes, I remembered to push the update button, and it updates to about the time when the Fatcow server went back online this morning. That’s it. The date of June 26 has not yet appeared on the traffic listing.

Woe is me, I think we are having a reenactment of the problem I had last time. Just as things were beginning to finally become somewhat normal, FatCow strikes again. However, I will not deal with the support crew again. This time, a phone call will be placed to the commander of the troops. I refuse to deal once again, with those asinine emails from the so-called support team, who don’t appear to have ever even laid eyes on a computer.

Anyway, I have to bitch and complain, so here it is. And believe me, I am dumping my FatCow server as soon as I get hooked up with a new one.

My blog survived the Fat Cow Maintenance Marathon. Seemingly intact. Whether or not the stats are screwed up remains to be seen. So far, June 26 does not even appear in the stats. Not a good sign, and this is after I updated the stats page.

Well, I won’t get my knickers in a twist just yet. Let’s give it a few hours and hope for the best. I simply can’t bear the thought of having to deal with the band of dimwits at customer support.

I lost track of the dates–I really thought that today was the 24th. Not good for a writer who has deadlines. I really need to look at my calendar more often, which is hanging right behind me on the wall.

Anyway, another tidbit in health history. The doom of the cigarette. A dark day for the tobacco industry, when the Federal Trade Commission announced on June 24, 1964, that cigarette cartons would carry a warning. It seems like another world. When I was growing up in beautiful Brooklyn, NY, our co-ops all had cigarette machines in the basement. And you’d always see kids down there buying cigarettes for either their parents or themselves. It really was no big deal. I don’t know if cigarette sales were restricted in stores, but it sure was easy enough to buy them from the local machines which were all over the place.

And every one on television smoked. And not only that, but they looked so cool when they did. I have been watching the old series “The Saint” with Roger Moore, which is out on DVD, and he is so handsome and so cool with his cigarette. I mean, I couldn’t imagine it if he didn’t smoke. The glass of booze, the cigarette, his calm demeanor–who cares what his lungs and liver look like.

Just to give a little background (no, not about Roger Moore)…the warning on cigarette cartons was the result of one of the U.S. government’s first forays into medical research following World War II. One of the most significant studies, undertaken in the early ’60s, was the Surgeon General’s report on the effects of smoking. Not a popular report, I may add, as it would have untold effect on tobacco growing states, cigarette companies, and on the public who adored their cigarettes and cigars. Not even Humphrey Bogart dying of throat (or mouth) cancer was a deterent.

But the study confirmed that smoking cigarettes increased a person’s risk of cancer. I mean, it doesn’t take a rocket scientist to figure that one out. If you’re inhaling hot smoke into your lungs, and hot smoke filled with a cornucopia of noxious chemicals, what do you expect? Everlasting health? Sparkling fresh breath and pearly white teeth? Gee, they don’t call it smoker’s cough for nothing. Although, lifelong cigar smoker George Burns did live until 100…

When the ruling on warning labels took effect in 1965, more than 42% of Americans were puffing away. That number has since dropped dramatically. I have to say, I was rather stunned by smokers when I first moved to Seattle. After living in California for so long, I had almost forgotten that cigarettes even existed. Seeing people smoking in restaurants and bars was like being transported into the Twilight Zone.

I was sure that I would be under full attack for daring to come out and speak the truth about a treasured American icon, and one that the nursing profession has appropriated exclusively as their own. In case you haven’t a clue what I am talking about, I am referring to my post on the myth of Clara Barton.

Clara Barton, the nurse who really wasn’t a nurse; just a big-minded and forward looking woman who sought to break through red tape and change the way things are done. And this was reflected in all of the numerous careers that she held (notice I said numerous), of which pseudo-nursing was just one.

It is strange how some nurses can’t just accept the fact that many in the profession move on, choose a different career, or redirect their energies. In the case of Barton, I don’t hear school teachers demand that she be relisted in history books as “Clara Barton, American schoolteacher,” even though she spent more years teaching than nursing. And even though that was her first career.

Same thing happened with an article I wrote about Florence Nightingale. I tactfully mentioned that Nightingale actually spent less than 3 years physically doing patient care, and that after her establishment of the St. Thomas nursing school, her interests moved elsewhere. She spent the remainder of her life doing statistics, designing hospitals, and devising a health system for India. A nurse wrote a huffy comment that Nightingale was in fact, doing “nursing” and that “nursing is more than just changing bedpans.”

La-de-dah. Yes, nursing is much more than that, but one does not need to be a nurse to do statistics, and architects do not first attend nursing school in order to be permitted to design hospitals. Nightingale had branched into other worlds–certainly they are jobs that a nurse can do, but they are not jobs unique to nursing.

Same with Barton. I’m surprised no one has commented on how Barton was really just a nurse-to-be while she worked as teacher and patent clerk, and how locating missing soldiers and establishing the Red Cross after the Civil War are really part of nursing. I doubt that Barton ever referred to herself as a nurse, and it is sad that all of her momentous accomplishments have been distilled into that one tiny capsule of time.

I suppose that I am just doing another form of nursing by being a medical writer. And a nurse that I know who now operates a gift shop in the Cayman Islands is really also just doing another form of nursing. Or some nurse who won an election in California–is politics another form of nursing? And speaking of which, what about that famous singing nurse, Naomi Judd?

Anyway, while I did get far more positive responses to my article on Nightingale (I’ve done a few actually), and the article I did for the Washington Post was reprinted (with my permission) in three nursing journls, there’s always been the feedback from the nursing police, who want to smack my hands for being so cheeky. So I am surprised that they haven’t yet caught up with my article about Barton.

My website will be unavailable from about midnight EST until tomorrow morning. That is because my ISP, FatCow, is upgrading. Again. For 10 hours.

I used to be very happy with FatCow, but to be quite honest, their service is really beginning to suck. There have been sporadic outtages when their server goes down, and I cannot not access my page. This is occurring with greater frequency.

And then there was their great maintenance on May 28, which totoally screwed up my stats. Worse yet, I discovered that their customer support team is basically a handful of high school drop-outs with a collective IQ of about 10. Their ability to do basic math is nil, as is their ability to read a simple request.

The readership on my blog has been rapidly increasing (thanks, guys!) and the day after the great servicing of May 28, I had 9 visits to my site. The next day was something like 13. I contacted FatCow customer report, was assured by a prompt reply that it would be looked into. And then the answer returned that the “situation has been resolved.”

Well no, it had not been resolved. An increase from 13 to 17 is not resolving the issue. And so began my email exchange with the greatest and most exasperating group of customer service dorks on the planet. And it sealed my fate with FatCow.

The next note arrived, saying something to the effect, “oh, it does look like your stats today have been affected. But I looked at the other two days and everything appears normal.”

Obviously, this person did not bother to look at what my stats were pre-maintenance. And no, it is not normal for stats to suddenly drop 99% in a day’s time. And strange how it coincided with their maintenance. Well, our conversations went back and forth like this. The emails I received from customer support was these childlike, patronizing, formulaic notes that merely repeated, “Everything has been resolved,” “It all appears normal.” “Please let us know if there is anything else we can do to assist you.” The clincher was when one of the more moronic of the bunch told me to “not to forget to click the button to update the stats.” As though it was all the poor button’s fault, and I was just too stupid to figure it out. Unlike the customer support team, I do know how to read.

The stats have become more normal, but are still below what they were for the month before. Maybe that’s just because FatCow has been down so many times, and therefore, people just can’t access my site. Who knows. They never did tell me what happened to my site when they did their maintenance, and never, did I received one single intelligent sentence from them.

Can you tell that I am thoroughly frustrated with them? And now they are going to do yet another major overhaul, and I shudder to imagine what my site will look like on Sunday morning. When they sent me a reminder about the coming outtage, I replied with a scathing note about my last experience with them. And then having to deal with moron-central, in trying to get it fixed.

FatCow used to be a good service. Then something happened. They don’t seem to have the capacity to maintain service on a steady and regular basis. This coming maintenance is supposed to fix it all, but I have my sincere doubts. Perhaps their idea of “fixing” their service is to limit traffic on websites.

I have nothing against hiring the mentally deficient, but I don’t think that they belong in customer support. My problem was a relatively minor one. I couldn’t imagine dealing with these people if I had a major problem. What they seem to conveniently forget is that I’m paying for this service, I expect it to work correctly, and if it breaks, I expect it to be fixed. Their idea of fixing things was to give me the run around and hope that I would eventually just disappear.

So if you are looking for an ISP, skip FatCow. Unless you truly enjoy dealing with the mentally challenged, and enjoy wasting your time reading email notes by people who seem dumber than George Bush.

Since yesterday morning, I have deleted close to 100 spam messages that were trying to weasel their way onto my blog, thinking that I would just love to have them on my comment boards. It used to primarily be online poker and Texas hold ‘em, but now I’m getting spam for breast enlargers, hot dates, and viagra. Cool.

Go to hell and die. When judgment day arrives, spammers will burn at temperatures hotter than even Satan can withstand. They will be filleted and dismembered, and then put back together so that the cycle of pain and torture can continue all over again. And over again.

Oh, and in between torture sessions, they will be chained to their computers and forced to type 10 million times (until their hands crack and crumble) “Thou shalt not send spam.”

Amen.

It was unheard of in 1948, to actually write a book about sex. I mean, these were the years leading up to the stifling 1950s, when Father knew best, and June and Ward Cleaver would swear on a stack of bibles that the stork delivered Wally and the Beaver.

Of course, everyone was having sex, but the puritanical U.S., Hollywood censors made sure that no one even assumed that unmarried couples did, uh, that. Or that even married couples did. Mom and Dad slept in twin beds, and sex was by osmosis. And it was almost a scandel when Lucille Ball was pregnant on “I Love Lucy.” Ricky and Lucy were a happily married couple, but yet, showing that she and Ricky actually had sex and produced a baby was quite another thing altogether.

So the study of sex, save for the musings of Sigmund Freud, was a wide open field of research and investigation–if one dared to dabble. Brave man that he was, Alfred Charles Kinsey’s “Sexual Behavior in the Human Male,” or the “Kinsey Report” as it came to be known, was published in 1948. Kinsey was born on this date in 1894, and was a sociologist and student of human sexual behavior. His book certainly ruffled a lot of feathers and put many myths to rest (alas, twin beds were still de riguer on TV for another decade at least). He conducted extensive interviews with 18,500 subjects, and his work revealed that many so-called perversions were actually common practices. Like, like, like….

Needeless to say, his book probably set the Bible belt preachers into a tizzy of fiery sermons on hell and brimstone, just as it caused sighs of relief among millions of Americans across the land. He was both vilified and praised for his work. The book remains a classic to this day.

This isn’t hot news, but somehow I missed it in April, so here it is again. Fresh off the newswire, my blogwire anyway.

New York will become the first city in the nation to make “morning after” contraceptive pills readily available to all women who want them. Mayor Michael Bloomberg announced yesterday a $3 million initiative that will include offering advance prescriptions for the drug to women at city hospitals, outreach to low-income women and a program to guide mothers in the South Bronx through pregnancy and the first two years of their children’s lives. The mayor said that of the estimated 215,000 pregnancies in the city last year, 130,000 were unintended - and 90,000 of those were terminated.

I don’t have an exceptionally high opinion of Mayor Bloomberg, who seems to think that banning smoking will solve all of New York City’s pollution and health problems, so it is finally nice to see him doing something worthwhile.

This is a really frightening story, and adds considerable strength to what most of us in healthcare have known all along–the current system of licensing sucks. And it sucks big time, because it allows the incompetent, the negligent and the downright malicious to keep on working.

In Queensland, Australia, a Dr. Jayant Patel has been nicknamed “Dr. Death” and he was such a horrific doctor that nurses actually hid patients from him. He worked at Queensland’s Bundaberg Hospital from 2003 until recently, and the “realisation of just how many botched operations were carried out by Dr Patel is only now coming to light.”

An inquiry into Dr Patel’s alleged malpractice has linked him to as many as 87 patient deaths. The investigation was launched in March after a nurse, Toni Hoffman, finally complained about him (hooray for the nurses.) But alas, Dr. Patel has vanished. Good for the patients of Australia, but not so for anywhere in the world where he may decide to hang up his shingle.

An interim report, however, has recommended that he should be charged with both murder and negligence, should he ever be found.

So what did Dr. Patel do? Well, here are some examples, from the BBC article:

The head of the inquiry team, Tony Morris, said the surgeon should be charged with the murder of James Edward Phillips, who died shortly after Dr Patel surgically removed part of his esophagus.Other medical staff at the hospital said they had refused to carry out the surgery, because it was too risky.

Another charge relates to the care of Aboriginal woman Marilyn Daisy, who developed gangrene in her leg after she was allegedly left without treatment for weeks following an amputation.

“There was no follow-up, the stitches in the stump were left there for six weeks…there were areas of infection, areas of gangrene, areas of necrosis and, in fact…there was quite a concern whether… this lady might lose a bit more of her leg,” the inquiry heard.

In another case, a woman’s life support machine was reportedly turned off because Dr Patel allegedly wanted her bed to operate on another patient.

Nurse Toni Hoffmann told the inquiry that Dr Patel had tried to drain blood from a man’s heart with a “stabbing motion”. The man died later that night.

Pretty scary doc, don’t you think? And now here’s the really frightening part–Dr. Death could have prevented from practicing in Australia. He could have been prevented from slicing up patients a very long time.

So what happened? What gives? Why was this horrific facsimile of a surgeon on the loose for so long?

I’ll give you two answers; greed and incompetence.

You see, Dr. Patel has also been accused of fraud for allegedly falsifying his application to practise medicine in Australia, by removing any mention of his previous blemished record in the US. That’s right, folks. Dr. Death used to slice and dice right here in the U.S. He first practiced in the state of New York, and when complaints started piling up, he moved to Oregon.

He moved to Oregon in 1989, to work for Kaiser Permanente in Portland as a general surgeon. Due to concerns over his work, Kaiser restricted him from carrying out certain types of operations - such as liver and pancreatic surgeries - in 1998.

In September 2000, the Oregon Board of Medical Examiners made these restrictions state-wide, and the year after that Dr Patel was forced to surrender his US medical licence in New York.

Now, one has to wonder why Kaiser didn’t just boot him out the door. Would you want to be a patient of a doctor who has been banned from performing certain surgeries? Why not just forbid the man from ever holding a scalpel again?

But that’s another issue that I don’t want to get into right now. My main focus is the greedy system that we have here of licensing by state. There is no reason for it. If we had a national license, it would be impossible for a doctor or nurse to lose their license in one state and still be able to practice elsewhere. But all of the state boards want to retain their little kingdoms, and everytime a doctor or nurse changes states, they have to dish out the cash. Pay for the state where you are requesting the license, pay the state where you took your boards, pay the state where you currently hold a license, pay your school for transcripts….this can all be easily computerized and available at the touch of a button. But greed keeps this silly archaic system going.

And it fosters the presence and safety of incompetent dorks like Dr. Patel.

Now, since computers are so advanced, one would think that a database would have been set up, that even other countries could check. If you have a guy like Dr. Patel coming from the U.S., but lying about his work history, a quick search by the licensing authority in Australia could turn up his name and work history. For starters, we could at least have one among English speaking countries. It would be relatively easy to do, and it would keep rifraff from circling the globe.

So where is Dr. Patel now? Who knows. Perhaps back in his native India. And this they have no knowledge of his medical history, and no real way of finding out, he can begin killing patients there.

The first official day of summer and it is pouring, and also quite cool. I was hoping to walk over to the Wednesday organic market at the Pike Market this am, but maybe I’ll go by boat.

I don’t really mind the rain, as it forces me to sit by my desk and get work done, but it would be nice (even if just symbolic) to have the sun shine on the first day of summer.

C’est la vie. I may go the market anyway, as its cherry season, and my refrigerator needs an influx of a fresh batch of organic cherries….

Well, considering the prices, they may well be made of platnium. Or diamonds. And you know what I’m talking about if you take prescription drugs, and happen to have the misfortune of not having health insurance or a piddly drug plan–and have double the misfortune of not living in a border state. You know, like scooting down to Tijuana to fill up on your Retin-A and Lipitor, or heading up north to Toronto to make a similar score.

Here’s the sad truth: Americans pay more for brand-name prescription drugs than anyone else in the world. Isn’t that a dubious honor. It assumes that either we are all very wealthy and don’t notice the missing cash in our wallets, or else we enjoy being ripped off.

From CBSnews.com:

Why? Well, the drug companies and the government say we have to, so the companies can keep developing new drugs.

Rost has taken the risky and possibly career-shattering step of opposing his own employer, and the rest of the drug industry, by saying America can have cheaper drugs if it set up a system like the one in Europe.

Now see if these prices don’t set you in a tizzy. Yo, you lipitor users–read this and weep. The commonly prescribed cholesterol-lowering drug Lipitor, made by Pfizer, the company he works for. In the United States, the full retail price is about $76 dollars for a month’s supply. The exact same drug costs $55 dollars in Canada and just $43 dollars in Italy.

The price in Italy in almost half of what it sells for here, and I bet it’s even lower in Mexico.

Rost argues patients shouldn’t have to travel to other countries to obtain cheaper drugs, but rather the discounted drugs should come to them. That’s what happens in Europe …

In Europe, pharmaceutical companies sell the exact same drug to different countries at different prices. An entire industry has been created that buys up drugs in countries where they are cheaper and then repackages and sells them in countries where they’re more expensive, at a discount — this is known as parallel trading.

However, American drug makers want no part of that system, and Pfizer, in a statement by its vice president of global security, said the practice can be potentially dangerous. However, when asked if anyone had been harmed by this method of selling drugs in Europe, the Pfizer VP couldn’t recall a single incident.

Rost argues that America’s views on parallel trading are clearly a matter of profits, not a matter of safety.

A bill has been introduced in the Senate that, if passed, would allow the United States to import cheaper drugs from other countries like Europe does. While the pharmaceutical industry opposes it, large drug companies have announced they are expanding their programs to offer low-cost drugs to the poor.

I guess things are going to keep cooking. It’s quite interesting that Rost works for Pfizer (or does he still have a job?) and has been so vocal and active in trying to change the system, which will inevitably cause pharm companies to lose some revenue.