Bad Medical Decisions

Thought I would share a patient story to illustrate a point. I had seen a five year old child last year with recurrent ear infections and after failing numerous courses of antibiotic therapy the recommendation was to insert tubes in the child's ears. The child was covered by medicaid, the health insurance for the poor. The patient was scheduled for surgery but for whatever reason failed to show for the appointment. I am not sure why the child didn't show up but it was never re-scheduled. About one year later the child shows up with the parent and it appears that permanent damage ensued since the problem was never dealt with and the parent didn't pursue the appropriate treatment. What was an easy problem to fix last year has become a much more difficult problem and perhaps not fixable with a permanent deficit.

My initial reaction was that the nanny state can give the poor all the benefits they want but ultimately an individual or parent still needs to take some individual responsibility for their health care. I blamed the parent for stupid decision making which results in their child having a more serious problem. But after watching 60 minutes last week regarding Steve Jobs it seems that stupid decisions regarding ones health are not limited to a certain segment of the population or income level. It seems there was a chance had he taken care of his tumor when it was initially found he could have beaten the disease. Probably out of fear, he decided to wait and try alternative treatment and that may have cost him his life.

Why do people fail to pursue the recommendations of their doctors? Is it just fear or is there something else that influences their decisions? I put part of the blame on the media. There is so much negative media attention paid to the medical profession that people question the recommendations of their doctors. You hear so many times on the TV the vast number of deaths that are caused by medical errors. You hear how American health care is rated low compared to other nations (totally ridiculous, just look at cancer survival in the US vs. anywhere else). Even BO promotes this skepticism towards doctors when he questions doctors/surgeons motivations when they perform operations. Specifically he questioned the motivations of doctors who perform tonsillectomy in children as well as the greed of doctors who perform amputations only to line their pockets (as if this community organizer has a clue about the indications for such surgery). This environment of suspicion regarding the motivations of doctors has an adverse effect by allowing patients with serious problems to justify putting off needed interventions. On a similar note, there are so many false claims by alternative treatments (which are legally permitted) that the public buys into it. People don't realize that medical treatments go through rigorous trials to ensure efficacy and safety whereas alternative treatments do not.

In no way am I advocating for people to blindly follow any doctor's recommendations as I have encountered many a patient who I believe were advised incorrectly. Similarly, I am sure I have had patients who have seen me and then went elsewhere for another opinion that was different and may have been correct when I was wrong. Doctors are human and can make mistakes or overlook something which is why I always encourage second opinions in my own patients. I never look at it as a threat to my abilities but rather what is in the general welfare of the patient which is the ultimate goal. I believe most physicians feel similarly.

Whatever one may think of a doctor it is imperative that if an individual does not believe or trust the recommendations of a specific doctor that he/she seek another medical opinion.

Herman Cain's Appeal

The reason Herman Cain has such appeal to the republican party (btw, I thought the GOP was a racist institution) is that he does not define himself by his blackness. He is a post racial politician that looks past the color of his own skin and rather defines himself as an American who worked hard his entire life, achieved to the best of his abilities and succeeded and just so happens to be black. He bought into the greatness of this country which is to work hard using your innate and learned abilities to compete on a level playing field and succeed and/or fail in the marketplace. He didn't rely on his blackness as a source for entitlement or as a reason to provide an advantage over non-blacks. He didn't claim to be a victim and use that as an excuse for failure or to not even try. He personifies an America where you can go as far as your abilities take you and what makes this country great. This message needs to be taken to the entire black population and to all segments in this country that race to be the most victimized and in need of a handout.

This message stands in stark contrast to BO whose message is that your failure or inability is not due to you but to the rich guy on the other side of town who doesn't pay his fair share of taxes. He encourages scapegoating another group for one's own shortcomings. The OWS ( occupy wall street) rally is a perfect example of this by blaming wall street bankers (?code name for Jews?) for the lack of jobs and unavailability of opportunities. BO's only chance is to continue his lies that the reason for this country's economic malaise is due to group x and not due to his own political and ideological failures. He is the scapegoater in chief and nobody does it better. The problem is the masses will believe his lies since it is easier and more comfortable to blame someone else for your misfortune then to look inside of yourself and admit to your own failures and lack of success.

These two figures, Cain and BO, have as their only similarity the color of their skin. On everything else they stand in stark opposition. Two black men, two disparate ideologies, two visions for what America is and what it should be. The only way this country can survive and thrive is for the Cain mentality to succeed over BO's.

It seems as though my prayers from my last post were answered (Gilad Shalit) but I never would have imagined they would be answered so quickly . So I am now going to turn my prayers to the downfall of the Iranian regime and support for the suppressed population in that country. As the main source of exported terror to the entire world and instability around the globe as well as the oppression of the Iranian people I hope this prayer gets answered as timely as my last.

5772

One of the nice things about being Jewish in America is the reaction of non-Jews to the celebration of our holy days which we are presently enjoying. There are those who say that spending the holidays in Israel is the only place to be because the entire country revolves around those holy days. But I think that there is something truly special in observing the holidays in America and portraying as a living example to the general population our ancient customs and our dedication to the service of the Almighty. It also demonstrates the religious tolerance of this nation and the respect we all have for each other's religious practice.

The number of people who convey to me new year's wishes this time of year amazes me and they are from all different walks of life. Their wishes seem to be with true sincerity and I think it comes with a deep respect for our religion. The cleaning lady in my house, the loan officer at the bank where I am applying for a mortgage, the stranger on the street who sees me walking to synagogue all wish me well. Additionally, it is nice to hear from so many of my patients who wish me a happy new year. I sincerely appreciate their New Year's wishes.

The New Year reminds me though of Gilad Shalit who is spending yet another year as a prisoner in a Hamas dungeon. No contact with the outside. No red cross visits. No knowledge of his health. My prayers go out to him and his family who have had to endure this torture of being used as a pawn by the Pals. It wouldn't surprise me if the Israelis had intelligence on his location and may even have a plan in place to extract him. It is a risky undertaking but a point may be reached where there is no alternative. The parents may get desperate as they realize the longer he stays there the higher his mortality. The family and the government may soon reach a conclusion that an attempted rescue is the only option. I pray that next year the Shalit family will be celebrating Rosh Hashanna together with Gilad.