Sunday, September 25, 2016

Statement on Nurse Practitioners with Independent Prescribing

 

 

If any member of the legislature were having crushing chest pain, and had shortness of breath, with a family history of premature  deaths by heart attacks,  would they want to be seen by a cardiologist or by a nurse practitioner filling out a form on the electronic record? Why are the lives of black people on Medicaid worth any less than that of the legislator?

The movement to allow nurse practitioners to prescribe unsupervised, will result in a two tiered health system, one for whites, one for blacks. It stems from racial animus. The aim is to raise the mortality of black people even higher than it is already.

Their role is falsely justified by lack of access to medical care. There is no doctor shortage. There is a shortage of doctor time. Half of that time is consumed by regulatory quackery. Regulatory quackery is a rule that has not been shown to improve patient outcomes. Its intention is take up doctor time with worthless procedure so that fewer payments are made for real patient care by government and by insurance companies. Because regulatory quackery has consumed $trillions and prevented the real care of millions of patients, it is the greatest financial fraud crime  in the history of mankind. Examples of regulatory quackery include, the electronic medical record, pre-authorizations with all out, implacable resistance to paying for any care, including cheap generic medications, almost all accreditation standards, privacy destroying patient registries, such as those for pain medications, pseudo-scientific and false practice guidelines.

Nurse practitioner programs are so competitive that only people with nearly perfect grades get in. Most qualify to get into medical school. They have chosen to bypass that harder road to clinical competence, to begin making money earlier, and with less student debt. That corner cutting should not be rewarded with independent prescribing privileges.

As a result, they know one quarter that specialists know, and half as much as primary care physicians. They are fit only to prescribe for patients doing well, needing routine refills without any change. They are fit to diagnose routine, common and mild disorders. They are fit to administer first aid and nursing care.

New patients with serious or life threatening conditions should not be evaluated by them. They can read off checklists, but have none of the skills that come from the experience of doctors.

Even after 5 years of experience, because they have not been challenged by difficult experiences of physicians, they will require supervision.

A patient commented on the internet. A nurse practitioner insistently called the growing lesion on his arm  an "age spot" for a year. The patient demanded to see the dermatologist. The doctor arrived at the door, and from that distance, stated, “That is a squamous cell carcinoma. It has to come out.” Squamous cell carcinoma is a common skin lesion in the elderly.

Email sent to Jeff@Amazon.com: You need to address this allegation of fraud

Here.

Friday, September 23, 2016

Name Mispronunciation as a Micro-Aggression and a  Evidence of Bias

I suggest an alternative scheme.

Eventually, this idea will be enforced in judge made law and precedent setting. Schools may face ruinous litigation for the mispronunciation of a name. Today, employers face the same for an off color joke at work. Both employers and school systems are mere pipelines from the tax payer and consumer to the pockets of lawyers, mostly, with some crumbs going to injured plaintiffs.

I propose that the naming of a child with an unusual or difficult to pronounce name be deemed evidence of child neglect. The same should go for misspelled names. Hospitals delivering children should assist parents to spell names correctly. The name is Antoine, not Antwan. The French province is called Brittany, not Britney.  It is established that people with such names are less likely to be hired or to be admitted into schools. They are a signal for bad attitudes, low performance ability, and dangerousness, wrongly or correctly. This problem is a problem of the American South, not of blacks alone. The Spears family is white, but from the South. It says, raised by parents who do not know how to spell.

Based of the great economic performance of African immigrants in the 2010 Census, a really impossible to pronounce name, with tongue clicks and other impossible sounds is associated with a great employment prospect, and a curve busting student. So that is likely to result in a form of reverse bias, and superior performance.

Sunday, September 18, 2016

Reply to Government Propaganda Article.

The_Economic_Burden_of_Prescription_Opioid Overdose, Abuse, and Dependence in the United States, 2013The

You forgot some things to deduct from your cost analysis. 

1) The productivity and tax payments of people able to get to work because of opiate pain relief;

2) The value of the 200 crimes a year not committed by the deceased drug addicts;

3) the value of the deaths of criminals to families that will not be exploited, injured, and abused by the deceased.

Thursday, September 15, 2016

Productive and Non-Infringing Restrictions of Second Amendment Right to Have a Gun

Half the murderers, half the murder victims, half the suicides are legally drunk. The most prevention of gun violence would come from restricting access to guns to people with evidence of alcoholism. Such evidence would include convictions for drunk driving, public intoxication, and alcohol induced liver disease.

Paranoid people kill 10% of murder victims around the world, or around 2000 people a year in the US. That number includes almost all rampage killings. It is in the nature of paranoia to not believe there is anything wrong with oneself. So even people doing well in treatment will try to stop treatment, and will relapse.

In the absence of drug induced paranoia, marijuana is associated with lower rates of violent crime. So, its use should not exclude people from their gun rights.

None of these policies are in place. They have the potential to cut the overall murder and suicide rates by two thirds, without infringing on the Second Amendment. They would withstand the strictest of scrutiny. There are no racial differences in the risks of mental illness.

Tuesday, September 13, 2016

Venezuela, Here We Come

As government grows, so does poverty and shortage.

http://www.zerohedge.com/news/2016-09-12/tent-cities-full-homeless-people-are-booming-cities-all-over-america-poverty-spikes

Past a Low Amount of Money, Increasing Wealth Yields Asymptotic Value, Mostly in Esthetics

The Versailles Palace remains a very beautiful place. At the time of its construction, it would be deemed unfit for human habitation today. Only technology adds the value of utility beyond esthetics. The poorest person in our nation has electricity, and goes to the bathroom indoors in the winter.

As wealthy people, we should therefore invest even more in technological development, to exponentially increase our wealth.

One easy place to get money is from the $trillion wasted on a legal system in failure, in every law subject. The nation should have the research and development budget of a technology company, around 20% of revenues. We have to, or we will be overtaken by Chinese and Indian wealth.

The most opulent hotel in the world, today.

Saturday, September 10, 2016

Obama Succeeds in Denying Access to Care. Doctors Now Spending Twice as Long on the Electronic Record as on Patient Interaction


The Obama Administration achieved what they wanted. To cut clinical care. They imposed electronic record mandates. Now doctors spend twice as long on the record than on patient interaction. Organized medicine is collaborating. The article is in plain English.

This a review of the problems of the electronic record and their one solution. It would save $70 billion a year, and potentially end co-pays. Here.

http://annals.org/article.aspx?articleid=2546704

Thursday, September 1, 2016

Personal Patient Experiences with Alpha Stim

Totals:

Responders:

On Label:

Off Label:
1) An older woman had the compulsion to climb the stairs precisely 60 times a day. She had severe back pain. She had a heart attack, with heart damage. She could potentially suffer heart failure. She got Alpha Stim 20 minutes day, set at 1 for one week, then at 2 for one week. Her compulsion was gone. I stopped the treatment for 2 weeks, and there was no return of her obsessive-compulsive disorder. There was no substitute compulsion, as sometimes occurs. The compulsion has not returned for 4 months. She requested to continue regular treatments for anxiety and for insomnia. I restarted treatment at her request.

2) An adolescent had a form of autism, once called Asperger Syndrome. He had a very high level of rage, despite high doses of a major tranquilizer, with high blood levels. If he did not get what he wanted, he jumped from a high balcony. I asked him what was the date today. He replied, that is a stupid question, and walked out. He had two treatments at a level of 1. He said, he would go to the pool, for the first time of the summer. The bus was 45 minutes late, but he just paced and waited. He went to the pool. He had two more treatments, and a home visit. Instead of being destructive and assaultive, his mother reported he started talking to her about his interests, such as computers and games. After a year, but only a month on Alpha Stim AID, he went home. He was asking for the treatment, and for an extension of the time to 30 minutes. It is unclear if he liked the treatment or access to the internet offered to him while on it.

3) A woman is received Alpha Stim M treatment for neck pain. After several treatments, she reported no improvement in her neck pain. However, her tinnitus (ringing in the ear) of many years was completely gone.


Non-Responders:


Bibliographies:

On label reports here.


Off label reports here