3 Things To Understand About America’s Opioid Crisis And Pain-Pill Addiction


Each time the American people think the nation’s opioid crisis can’t get any worse – it gets worse.

In 2016, 42,249 people died from opioid overdoses, which comes to 116 deaths every day, according to the United States Department of Health and Human Services. In addition, 11.5 million people misused opioids.

But, in a nation that takes so many prescription medications, perhaps no one should be surprised. And one underlying cause of the opioid crisis could be the way we take care of – or fail to take care of – our bodies.

“There’s a reason why Americans feel that the answer to every health problem is a pill,” says Dr. Raj Gupta (, founder of Soul Focus Wellness Center and author of Wellness Center Solution: How Physicians Can Transform Their Practices, Their Income and Their Lives.

“It’s because we don’t really have ‘health care’ in America. We employ a ‘sick-care’ model. We only go to the doctor when we are sick. And then we demand that doctors prescribe something for whatever ails us, and if they don’t we feel like we wasted our time.”

Antibiotics became so over-prescribed – often used when they weren’t even necessary – that they started to lose their potency. Now, Gupta says, people are doing the same with pills used to combat chronic musculoskeletal pain that results from stress, bad posture, aging bodies, sports injuries, car accidents and other causes.

He says Americans need to step back and understand a few reasons why relying on these powerful pain pills may be the wrong solution for what’s troubling them:

  • Pills don’t correct the problem. A pain pill may temporarily take pain away, but it doesn’t fix whatever the underlying cause is. “When the pill wears off, the pain comes back,” Gupta says. Pain is your body’s way of telling you that something is wrong. “I may not know why you are in pain, but I can assure you that it’s not because your body is depleted of Percocet or Oxycodone,” Gupta says. “If you have a pebble in your shoe that irritates you and worsens with each step, the answer is not a pill called ‘Pebble Ease.’  A pill doesn’t remove the irritant.  It covers it up.  Your pain is a physical problem that requires a physical answer.  You must remove the pebble that is irritating you and address the actual problem that is causing the pain.”
  • Opioids are addictive, but not always effective. A new study shows that over time opioids don’t provide any more relief for people suffering from chronic pain than other pain relievers that don’t come with so much risk of addiction. In some cases, people using non-opioid drugs such as Tylenol, ibuprofen and lidocaine experienced more pain relief than those who used morphine, Vicodin and oxycodone. “People risk becoming addicted to these pills and yet they may not even be getting the pain relief they’re seeking,” Gupta says.
  • You are responsible for your health. True health care consists of doing things that prevent you from getting sick, Gupta says. It involves a balance of proper diet, rest, exercise and a positive mental attitude. “Adopting this lifestyle of preventative healthcare will allow you to lead a prosperous, fulfilling life without the need for drugs and surgery,” he says.

“Our culture has been brainwashed to believe that there is a pill for every problem,” Gupta says. “But the real solution is that we need to move past our ‘sick-care’ model of health care and concentrate on taking better care of ourselves so we don’t feel the need for that pill to begin with.”

About Dr. Raj Gupta

 Dr. Raj Gupta (, who has more than 20 years experience as a chiropractor, is the founder of Soul Focus Wellness Center. He also is author ofWellness Center Solution: How Physicians Can Transform Their Practices, Their Income and Their Lives. He has been featured in US News and World Report Health, Woman’s World Magazine and New York Daily News. He has a doctorate in chiropractic from Life University.


Medical Care in 2018: Ring Out the Broken Promises and Bring In Solutions

Medical Care in 2018: Ring Out the Broken Promises and Bring In Solutions

By Marilyn M. Singleton, M.D., J.D.

The U.S. “health care system” continues to be a costly behemoth. Health care costs were the number one financial concern for 17 percent of families in 2017—the same level as it was in 2007 pre-Affordable Care Act era. And only 18 percent of those polled said the Affordable Care Act helped their family.

 The ACA did not work as promised.

 “If you like your health care plan, you can keep it.” Unfortunately, health insurance companies canceled plans for 4.7 million people. Many insureds chose to have inexpensive, limited plans to cover major expenses. These plans however were not ACA-compliant as they did not contain the mandated 10 “essential health benefits” with no copays or deductibles. While many of these required “benefits” are medically useful, many (e.g., pediatric vision and oral care, maternity care, breast cancer genetic screening, mammograms, and female contraception) are superfluous for childless unmarried men.

 “I’ll also bring Democrats and Republicans together to provide every single American with affordable, available health care that reduces health care costs by $2,500 per family.” Kumbaya? The ACA was passed in the dark of night with only Democrat votes. Affordable? Overall costs to the consumer have risen dramatically.

 In 2008, the cost of the average employer-sponsored family plan was $12,680, with an employee share of $3,354. The 2016 cost topped out at $18,142 with a $5,277 employee cost. In the individual market, the biggest losers are those who earn a little too much to qualify for federal premium subsidies, particularly the self-employed in their 50s and 60s. For a bronze-level plan with a health savings account, a three-person family can pay $15,000 a year in premiums and paid out-of-pocket for the first $6,550 of medical expenses for each family member.

 Moreover, many insurers have requested—and will likely receive—double-digit premium increases for 2018. Nationally, the increases between 2017 and 2018 for unsubsidized premiums for the lowest-cost bronze plan averaged 17 percent, the lowest-cost silver plan averaged 32 percent, and the lowest-cost gold plan averaged 18 percent.

We’ll start by increasing competition in the insurance industry.” That was a colossal failure. Overall, the number of insurers in the individual market has decreased since 2014. In 2017 UnitedHealth Group eliminated ACA Exchange plans in 31 of 34 states and Aetna remains in only four states. Humana and Aetna plan to exit all ACA Exchanges in 2018.

 Agreed, some Americans gained health coverage. Medicaid and the Children’s Health Insurance Program (CHIP) accounted for 14.5 million of the 20 million of newly covered. The 2014 cost per non-disabled adult and child enrollee was $3,955 and $2,602, respectively. Some 27.5 million people remain uninsured with cost cited as the main problem.

 Further, being “covered” was meant to keep emergency departments (EDs) from being used as an alternative to primary care. But according to the federal Agency for Healthcare Research and Quality(AHRQ), the number of emergency department visits covered by Medicaid increased by 66.4 percent between 2006 and 2014, outpacing population growth by a factor of two, making Medicaid the leading payer for ED visits.

 These data tell us we must have a serious conversation, not intellectually lazy political slogans, like “Repeal and Replace!” Instead of ruminating about how to modify the government’s involvement in medical care, Congress and policymakers should ask how can we take better care of more patients and be open to all suggestions.

 One successful model is direct primary care (DPC) mainly seen in solo and small medical practices. Here, patients pay a monthly fee (generally ranging $75 to $150) directly to the physician’s office for 24/7 access, and in many cases, basic labs and medications, and steep discounts on radiology and pathology services. Also growing are direct pay specialty and surgical practices where the fees for the operating room, surgeon, and anesthesiologist are included in one low price. And yes, many of these practices (even in California) offer sliding scales and charity care without running afoul of rigid federal regulations.

 With DPC, patients spend more quality time with their doctors and physicians can shed the administrative burdens of government programs and insurance companies and treat patients according to their best judgment. A testament to the success of this model is the University of Michigan offering such a program this spring. Hopefully, the big boys won’t ruin a good thing.

 ObamaCare’s individual mandate is dead. It’s time to use our healthcare dollars wisely and pay for the medical care, not the middlemen.


 Bio: Dr. Singleton is a board-certified anesthesiologist and Association of American Physicians and Surgeons (AAPS) Board member. She graduated from Stanford and earned her MD at UCSF Medical School.  Dr. Singleton completed 2 years of Surgery residency at UCSF, then her Anesthesia residency at Harvard’s Beth Israel Hospital. While still working in the operating room, she attended UC Berkeley Law School, focusing on constitutional law and administrative law.  She interned at the National Health Law Project and practiced insurance and health law.  She teaches classes in the recognition of elder abuse and constitutional law for non-lawyers.

6 Things Anyone with an Autoimmune Disease Wants You to Know

March is National Multiple Sclerosis Awareness Month and with my having it and it being an Autoimmune Disease I will be posting blog posts this month centering around MS and Autoimmune Diseases.

6 Things Anyone with an Autoimmune Disease Wants You to Know

By Dr. Chad Larson, NMD, DC, CCN, CSCS, Advisor and Consultant on Clinical Consulting Team for Cyrex Laboratories


With over 100 autoimmune diseases identified and about 50 million Americans currently suffering from at least one of them according to the American Autoimmune Related Disease Association, it’s likely that we all know at least one person leading a life complicated by an autoimmune condition. While autoimmune disease and all its variations can be complex to understand, there are many commonalities among them—and your friends and family who are currently living a life complicated by autoimmune issues would love for you to understand what they are dealing with. They want you to know so you have a sense of what they’re facing, how they handle it, why they feel the way they do and how they approach their health. Not only will this allow you to be an invaluable part of their support system, but you just might be able to help keep them healthy.

Here are six important facts about autoimmune disease that every sufferer wants their friends and family to understand:

  1. Autoimmune disease is not just a women’s health issue – Although women account for almost 80 percent of the population diagnosed with autoimmune disease, men can fall victim, too. Even if just 20 percent of those suffering from autoimmune disease are men, that would still mean 10 million plus American men suffer from autoimmune disease – hardly a figure to simply brush off.


  1. Sometimes they just need to rest – Fatigue is a common symptom of autoimmune disease. Sometimes they just don’t feel well and need some time to reboot. It can be frustrating for loved ones to have their plans broken or altered due to the fatigue an autoimmune disease sufferer feels. Unfortunately, recurring bouts of fatigue are par for the course for millions of those dealing with an autoimmune disease. The extreme lack of energy can impact everything from the ability to carry out household chores, to weekend dates, to vacation plans. People battling autoimmunity feel it’s important for supporters to understand that fatigue is a very real symptom, one that can strike at any time.


  1. Management is key – Sadly, there is no cure for autoimmune disease. However, symptoms can be minimized through proactive management, once the disorder is properly identified. Functional medicine, which offers invaluable methods for diagnosing and treating autoimmune disease, focuses on causes in addition to symptoms. This system is based on an understanding of the dynamic way our genes interact with environment, and goes beyond simply treating diseases based on their label. Prioritizing sleep, getting regular exercise, and managing nutrition and stress are all a part of proactive functional medicine.


  1. One autoimmune disease often translates to more – About 25 percent of patients with one autoimmune disease are likely to develop additional autoimmune diseases. This is because an immune system that begins attacking its own cells in the first place is a confused system, likely to continue the pattern in different areas of the body when falsely recognizing healthy cells as harmful. This makes management all the more important, as it becomes a preventative measure in addition to a proactive treatment. The lifestyle vigilance that people with autoimmunity need to maintain to manage their disease can sometimes be seen as overkill or be difficult for others to comprehend, but it is important to understand what is at risk for any individual with an autoimmune disease.


  1. Diet and nutrition matter – Food, additives and even preparation are proven to affect autoimmune response. There are a few key aggravators known to cause inflammation and symptomatic flare-ups for those with autoimmune disease. Gluten, sugar, dairy, mold, mercury and antibiotics are among the many immune irritants to trigger autoimmune response. However, they do not stand alone. Individuals are unique in their genetic makeup; those suffering from an autoimmune condition have varied sensitivities and reactions to different foods, chemicals and environmental elements, which can also impact autoimmune response. Cyrex Laboratories, a clinical laboratory specializing in functional immunology and autoimmunity, offers advanced, innovative tests designed to detect and monitor autoimmune reactivities and their possible triggers. People suffering from autoimmunity often get evaluated with comprehensive tests like the Array 10 – Multiple Food Immune Reactivity Screen™ which evaluates immune reactions to foods, raw, cooked and modified, food enzymes, lectins and artificial food additives.


  1. They must protect their children – As you now understand, autoimmune disease can be genetic or developed. Children of sufferers are genetically at risk for developing autoimmune disease in any form, regardless of the specific disease that their parent may have. Likewise, they are at risk for developing an autoimmune disease from environmental, lifestyle and food-related factors regardless of their parents’ history. Parents with autoimmune disease can sometimes seem over-protective with their children as they strive to head off the autoimmunity that they suffer from.

A significant element of leading a healthy life for those who suffer from autoimmune disorders is found in the support they receive from friends and family. As with any disease or illness, compassion goes a long way. Knowledge is everyone’s best tool.


Dr. Chad Larson, NMD, DC, CCN, CSCS, Advisor and Consultant on the Clinical Consulting Team for Cyrex Laboratories. Dr. Larson holds a Doctor of Naturopathic Medicine degree from Southwest College of Naturopathic Medicine and a Doctor of Chiropractic degree from Southern California University of Health Sciences. He is a Certified Clinical Nutritionist and a Certified Strength and Conditioning Specialist. He particularly pursues advanced developments in the fields of endocrinology, orthopedics, sports medicine and environmentally-induced chronic disease.


FDA/Kratom Scare

WASHINGTON, D.C. – March 7, 2018 – Four of the world’s leading kratom researchers today called on the U.S. Food and Drug Administration (FDA) to cease the agency’s scientifically unsupported attacks on the coffee-like herb kratom. The scientists strongly believe that the current body of credible research on the actual effects of kratom demonstrates that it is not dangerously addictive, nor is it similar to “narcotics like opioids” with respect to “addiction” and “death” as stated by the FDA in its public advisories and subsequent warnings. It is the scientists’ position that a ban on kratom could result in a “serious public health threat” as consumers are pushed to dangerous alternatives in the black market, while at the same time halting much needed scientific research on the risks and benefits of kratom and its alkaloids.

The four kratom experts who organized today’s news conference and were not paid to participate in it. The scientists are: Marc T. Swogger, Ph.D., associate professor of psychiatry, University of Rochester Medical Center; Oliver Grundmann, Ph.D., clinical associate professor, College of Pharmacy, University of Florida; Paula N. Brown, Ph.D., director of applied research, BC Institute of Technology, Canada Research chair, Phytoanalytics and adjunct professor of biology, University of British Columbia; and Dr. Jack Henningfield, vice president of research, Health Policy and Abuse Liability, at PinneyAssociates, and adjunct professor of Behavioral Biology, Johns Hopkins University School of Medicine.

Instead of a de facto ban on kratom, the scientists urged the promotion of good manufacturing practices (GMP) complying to FDA standards, as is the case with other widely available supplements in the United States.

The following are the statements of the four experts:

Science suggests removing kratom from market would be a risk, not benefit, to public health —Marc T. Swogger, Ph.D., associate professor of psychiatry, University of Rochester Medical Center

– Risks associated with scheduling and loss of access

– Contrary to the President’s Commission on Combating Drug Addiction and the Opioid Crisis

“We have science-based objections to the scheduling of kratom under the Controlled Substances Act. The existing science indicates that many of the millions of people in the U.S. who use kratom rely on it as a lifeline away from potentially deadly opioids. People use kratom to ease opioid withdrawal and to manage acute and chronic pain. Scheduling kratom would remove a valuable pain treatment option for millions, leading to greater opioid use with the likely consequences of increasing dangerous opioid dependence and overdose deaths.”

“Our objection to the scheduling of kratom is supported by data from four national scientific surveys conducted in the past two years, as well as decades of information from Southeast Asia, where this plant has been widely used as a safer alternative to opioids for more than a century. We cannot say that kratom is harmless for everyone, nor can we say that we know everything there is to know about the plant; rigorous, well-controlled studies are necessary. At this juncture, however, there is no high-quality evidence to indicate that kratom is a serious public health threat, and much evidence to suggest that banning it would be.”

“If the government fails to seriously consider the unintended consequences of banning kratom, they will be abdicating their duty to protect the safety of consumers – the expressed purpose of the enactment of the CSA by the U.S. Congress. Neglecting the available science and scheduling kratom are exactly what one would do if their aim was to worsen the opioid crisis.”

The FDA has pointed to 44 deaths over the last decade in the U.S. as their basis for concern, while the actual role of kratom in these deaths is speculative — Oliver Grundmann, Ph.D., clinical associate professor, College of Pharmacy, University of Florida

– Speculative; lack of causality for deaths involving kratom

– Differentiation of mode of action for kratom alkaloids from opioids; do not cause respiratory depression upon binding the same opioid receptors

“It is our strongly held belief that the claims that kratom has caused the deaths of all or even most of the 44 individuals cited by the FDA cannot be supported by any reasonable scientific or medical standard. Unlike overdose deaths that are rightly attributed to classical opioids, which reliably cause respiratory depression and death at high doses, the fatalities that the FDA lists as having been associated with kratom include deaths with a wide variety of apparent causes in people suffering from various diseases and/or taking other substances, thus allowing for no conclusive determination of the causative agent(s) responsible for deaths.”

“The FDA used a computer simulation, the PHASE model, to justify classifying Kratom and its major alkaloids, mitragynine and 7-OH mitragynine as opioids. Using a computational model alone is not sound science and fails to consider the additional scientific literature that has reported a distinct difference in how the alkaloids in kratom interact with the same opioid receptors in the brain. In isolated receptors and animals alike, the alkaloids presented with different effects from that of classical opioids like morphine or heroin, primarily not presenting with potentially fatal respiratory depression at higher doses.”

Publicly available research documents illustrate kratom has a long history of acceptably safe consumer use — Paula N. Brown, Ph.D., director of applied research, BC Institute of Technology, Canada Research chair, Phytoanalytics and adjunct professor of biology, University of British Columbia

– Import advisory of February 2014 by FDA identifies kratom as dietary ingredient

– History of safety for traditional use and modern use for pain relief

– Regulation as a dietary ingredient means compliance with Good Manufacturing Practices

“The FDA issued an import alert in February 2016 that stated, ‘Kratom is a botanical that qualifies as a dietary ingredient under section 201(ff)(1) of the Federal Food, Drug, and Cosmetic Act (the Act) [21 U.S.C. 321(ff)(1)].’ When marketed as a dietary ingredient, FDA also considers kratom to be a new dietary ingredient under section 413(d) of the Act [21 U.S.C. 350b(d)] because, to the best of the agency’s knowledge, there is no information demonstrating that this substance was marketed as a dietary ingredient in the United States before October 15, 1994.”

“So while we can argue whether FDA’s consideration of kratom as a New Dietary Ingredient is substantiated or not, the focus should be on compliance with Good Manufacturing Practices (GMP) to ensure the public has access to products that are not adulterated with opioids (e.g., fentanyl, carfentanil, and other morphine-derived products), spiked with concentrated amounts of mitragynine and 7-OH mitragynine that are not consistent with levels in historical products and are tested for microbials to meet purity specifications. We agree that these concerns should be eliminated with a single kratom-based product regulatory standard that would protect both kratom manufacturers and consumers.”

“Documented literature demonstrates widespread use of kratom leaves for centuries; traditionally used as an energizer, relaxant, and to relieve stress and/or minor aches and pain (Suwanlert 1975; Watanebe et al., 1997; Vicknasingam et al., 2010, Adkins, 2011; Stolt et al., 2014; Brown et al. 2017). Kratom has also been increasingly used as a natural remedy to improve mood and quality of life and as substitutes for prescription and illicit opioids for managing pain, as shown in the recent four published surveys. The current scientific research suggests that kratom provides some pain relief without the dangerous and potentially deadly respiratory suppression induced by classical opioid medications. Risk assessments must rely on laboratory, clinical, and epidemiological evidence including the four national surveys of kratom use and other federal survey data and not the non-validated computer model referenced by the FDA in its February 6th Advisory.”

“Rather than foster an illicit and dangerous kratom market, the FDA could protect the American public by appropriate regulation of kratom, as the FDA’s Office of Dietary Supplements has been working toward. This could provide consumers and health professionals with the information to help guide safe use, and ensure that lawfully marketed products meet the same standards as other natural and dietary products relied upon by American consumers.”

The federal government should be encouraging additional research into the potential therapeutic benefits of kratom, while ensuring that the products available are not adulterated — Dr. Jack Henningfield, vice president of research, Health Policy and Abuse Liability, at PinneyAssociates, and adjunct professor of Behavioral Biology, Johns Hopkins University School of Medicine

– Scheduling would stymie research

– Possibility of breakthrough in pain and addiction treatment

– Need alternate regulatory pathways – drug model too costly for non-patentable plant

“In the report issued on November 1, 2017 by the President’s Commission on Combating Drug Addiction and the Opioid Crisis, where the Commission strongly supported research and development of alternatives to opioids for pain management, the powerful conclusion offered was that ‘[F]irst, individuals with acute or chronic pain must have access to non-opioid pain management options.’ The available science is clear that kratom, although having effects on opioid receptors in the brain, is distinct from classical opioids (e.g. morphine, heroin, oxycodone, etc.) in its chemistry, biological effects, and origin (kratom is a tree in the coffee family, not the opium poppy family).”

“The possibility that extracts of kratom and/or new medicines that are similar to kratom’s active ingredients might serve as breakthroughs in pain relieving medicines that are so desperately needed, should not be ignored. However, this latter path will not be a rapid one, since the average time and cost of new drug development is more than 10 years and 2.5 billion dollars. Placing kratom into Schedule I of the CSA will also have a profound and pervasive chilling effect on this needed additional research.”

“The assertion that scheduling recommendations can be based on claims of deaths ‘associated with kratom’ rather than deaths ‘caused by Kratom’ is not, in our judgement, either scientifically valid nor the standard that was contemplated by the U.S. Congress for scheduling of any substances, and would appear to be a significant overreach of the regulatory powers of the FDA and DEA beyond the currently established, rigorous, and clearly limited eight factors set forth by CSA for scheduling a substance.”

“We encourage you to support efforts to ensure continued lawful access to kratom, guide balanced regulation by the FDA, and facilitate research, thereby protecting and not harming public health.”

MEDIA CONTACT:  Max Karlin, (703) 276-3255 or

EDITOR’S NOTE:  For more information, go to, where a streaming audio recording of today’s news event will be available online as of 4 p.m. ET/1 p.m. PT on March 7, 2018. Limited and unrestricted support for this news event is being provided by the nonprofit People Plants Health.



I would like to apologize for the long time between posts. Things have been hectic in my life.

I am still having problems with my ankle that I broke.

Between Thanksgiving and Christmas I came down with bronchitis then a couple of weeks ago I came down with the flu after my daughter had it and was actually diagnosed with it.

I am now in the hospital due to chest pressure and chest tightness. I also still have a cough that I just can’t get rid of.

I hope all of you are staying warm from the extreme cold, being healthy and not getting the nasty flu going around, and are staying safe.


Making Lemons from Lemonade:Squeezing the Joy Out of Medicine

December 12th, 2017

Making Lemons from Lemonade: Squeezing the Joy Out of Medicine

By Marilyn M. Singleton, M.D., J.D.

Scandal upon scandal has dominated the airwaves and the web. Other than those involved, we have no way of knowing the truth or misremembering of the allegations. But we do know it is beyond sad that our congressional representatives who have the privilege and honor to serve their country have used the public purse to whitewash their misdeeds. These critters certainly know how to drag a noble calling into the gutter.

In the case of medicine, it is not the few well-publicized bad apples, but government and corporations injecting themselves into clinical practice that is driving the down trajectory of patient care. The days of physician as independent member of the community are fast waning—thanks to those paragons who run our country.

According to an American Medical Association survey, by 2016 only 47.1 percent of practicing physicians owned their own practice. Another report noted that hospitals acquired 31,000 physician practices, a 50 percent increase, from 2012 to 2015.

Now UnitedHealth Group plans to purchase the physician group from DaVita, a chain of dialysis centers, adding to their urgent care and surgery centers. Insurers owning (enslaving?) physicians is hoped to contain costs. While innovation in improving delivery of medical care is laudable, it is not without risks. Patients likely will have fewer choices of physicians or be told whom to see. As far as insurance pricing, economists agree that more competition benefits consumers.

We must be wary: as these behemoths consume and control medical care, sins are mounting. A few transgressions include Northern California’s Sutter Health that intentionally destroyed 192 boxes of documents that employers and labor unions were seeking in a lawsuit that accuses Sutter of abusing its market power and charging inflated prices. Anthem, the second largest health insurer in the U.S., was fined $5 million by California’s Department of Managed Health Care for “flouting the law” in dealing with consumer complaints. In 2016, insurance company denials were overturned in nearly 70 percent of medical review cases. California had already fined Anthem more than $6 million collectively for grievance-system violations since 2002.

And the federal government has stacked the deck in its new Quality Payment Program that “adjusts” physicians’ government payments if they don’t comply with the complex metrics. First, electronic medical records are a must. On the clinical front, anesthesiologists are scored on the percentage of current smokers who abstain from cigarettes prior to anesthesia on the day of elective surgery or procedure. Is the anesthesiologist supposed to send a proctor home with the patient? How is patient compliance grafted on to a physician whom the patient just met—no matter how convincing the anti-smoking pitch?

And then for internists there are “Additional improvements in access as a result of QIN/QIO TA” [Quality Improvement Network/Quality Improvement Organization technical assistance]. Or participation in a QCDR that promotes use of patient engagement tools. And what is aQCDR? A qualified clinical data registry. “A QCDR is a CMS-approved entity (such as a registry, certification board, collaborative, etc.) that collects medical and/or clinical data…”

The new medicine is forcing the remaining independent physicians to devolve from trusted confidants to automatons in order to survive in medicine’s brave new world. And it is not so pleasant for the patients: the algorithms, electronic computer screens, and hospitalists taking over care often with no consultation with the primary care physician.

Call me old-fashioned, but I come from a line of private practitioners who provided “population health” by being an integral part of the community. The Bradfield Community Association of Lima, Ohio, was formed in 1938 and named after my grandfather,Joseph C. Bradfield, M.D., a World War I veteran and beloved physician. The San Diego Board of Supervisors adjourned in memory of the death of my father, E.B. Singleton, M.D., a Tuskegee flight surgeon and primary care physician who charged people what they could afford and accepted tamales as payment. He didn’t need to take classes on dealing with denied insurance claims or filling our government forms.

Dr. Benjamin Rush, a signatory of the Declaration of Independence said, “Without virtue there can be no liberty and liberty is the object and life of all republican governments.” Liberty is also the cornerstone of good medical care.

Ask yourself do government bureaucrats and nameless faceless insurers have the moral authority to tell us what is just in delivering medical care to our populace? If the current happenings do not convince you that you and your private physician are your best advocates, then nothing will.

I wish you love, peace, and joy in this blessed season.

Bio: Dr. Singleton is a board-certified anesthesiologist and Association of American Physicians and Surgeons (AAPS) Board member. She graduated from Stanford and earned her MD at UCSF Medical School.  Dr. Singleton completed 2 years of Surgery residency at UCSF, then her Anesthesia residency at Harvard’s Beth Israel Hospital. While still working in the operating room, she attended UC Berkeley Law School, focusing on constitutional law and administrative law.  She interned at the National Health Law Project and practiced insurance and health law.  She teaches classes in the recognition of elder abuse and constitutional law for non-lawyers.