ONE NATION OVERDOSED:

ONE NATION OVERDOSED:

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 (www.drrajgupta.com), 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 (www.drrajgupta.com), 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.

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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.

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 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.

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.

Leaky Gut Test

Cyrex Laboratories (a provider of autoimmune reactivity screenings) has announced the availability of their intestinal antigenic permeability test—the Array 2. Known as the “Leaky Gut” test, Array 2 is unique among clinical testing in its ability to identify the route of damage occurring in the intestinal barrier.

PHOENIX (July 13, 2016) – Cyrex Laboratories, a clinical laboratory specializing in functional immunology and autoimmunity, offers Array 2, an intestinal antigenic permeability screen. The Array 2 is the most advanced test on the market to accurately measure intestinal permeability or “leaky gut” as well as assess systemic Lipopolysaccharides (LPS)—a byproduct of bacteria. The Array 2 is unique among clinical testing in its ability to identify the route of damage occurring in the intestinal barrier.

Knowing the pathway of degeneration helps the practitioner narrow his/her focus in identifying the triggers causing damage and choose the most effective gut healing protocol for the patient. Dr. David Perlmutter, a renowned neurologist and leader in preventative medicine who recently released the New York Times Best Seller Brain Maker, said, “I consider the Cyrex Array 2 to be the most effective laboratory study available for evaluating gut permeability.”

Array 2 is recommended for patients who have food sensitivities, abnormal immune cell count and function, or who present multiple symptoms suggestive of autoimmune disorders, such as chronic fatigue, joint pain, skin issues and/or cognitive impairment.  Because of the significant correlation between the gut and brain barriers, Array 2 can also be used in combination with Cyrex’s Array 20, a potent tool for assessing permeability of the blood brain barrier.

“With gastrointestinal barrier integrity being a causal mechanism for so many autoimmune and metabolic diseases, there has never been a more important time for those practicing to quantify what is being observed clinically,” says Dr. Randall Gates, D.C, D.A.C.N.B. and Board Certified Chiropractic Neurologist and Dr. Martin Rutherford, D.C., C.F.M.P and Certified Functional Medicine Practitioner. “Simply, the Cyrex Array 2 allows us as practitioners to ascertain and demonstrate to patients the problem at hand.”

Physicians and other licensed healthcare professionals, as well as patients, interested in learning more about Array 2, 20 or any of the Cyrex Arrays that are part of the Cyrex System, are encouraged to visit www.joincyrex.com for additional information.

About Cyrex Laboratories
Cyrex is a clinical immunology laboratory specializing in functional immunology and autoimmunity. Cyrex offers multi-tissue antibody testing for the early detection and monitoring of today’s complex autoimmune conditions. Cyrex develops innovative testing arrays through continuous collaboration with leading experts in medical research and clinical practice. Cyrex technology is built on four pillars of excellence, including the antigen purification system, optimized antigen concentration, antigen-specific validation and parallel testing technology. Cyrex is a CLIA licensed laboratory based in Phoenix, Arizona and holds a Medical Device Establishment License in Canada.