Thursday, September 20, 2007


If you are a patient in 21st century American Medicine I have some shocking news for you.

A significant portion of your health has NOTHING to do with the enterprise/business of American Medicine. Social factors like poverty and jobs are much more important for example. This has been known for years but paternalistic organized medicine has duped us and infantilized us. (not unlike what most organized religion has done to us!)

Much of what doctors do to/for people has never ben proven to be effective-putting aside that MUCH of what they do is unsafe especially in hospitals! Surgeons are especially culpable.

Please read this provided by Maggie Mahar “When it comes to wasteful healthcare spending, the work done at Dartmouth by Dr. Jack Wennberg and Dr. Elliot Fisher does the best job of exposing how much money we spend on unnecessary, unproven, and sometimes unwanted treatments and hospitalizations."

I would add Dr. Nortin Hadler from University of North Carolina who has also brilliantly explicated how much US health care has been unproven to be effective or even worse safe. Hadler’s book The Last Well Person is a true landmark.

And of course Shannon Brownlee’s new book Overtreated is excellent validation of its own title.

Today Dr. Steven Schroeder published an article- maybe the most important article in on health care reform in a decade in the prestigious New England Journal of Medicine drove home these points and more.


Wake up America-Grow up America- Retake your health care.

Be Well and-

"See you on the new highground!"

Dr. Rick Lippin


Blogger jeywolf said...

Excellent blog. People really need to take a step back and ask themselves, do I really need this treatment? Especially the pharmaceuticals, which are completely out of control.

3:49 PM  
Blogger Blake said...

thanks jeywolf

I agree overuse of pharmaceuticals is leading the pack in dangerous and costly overutilization of medical care.

Up there also are MRIs of orthopedic joints and backs where most people over 40 have some positive findings.Almost useless information.


Dr. Rick Lippin

4:47 PM  
Anonymous Anonymous said...

I had an interesting anemia this year. No one could find what it WAS. I decided that the only thing new was my intake of an anti-osteoporosis drug. Since that works - I thought, I know nothing - on metabolism of the bone, and blood is also made, not only in the bone marrow, but all over, in those bones, I experimented stopping taking it. That, together with over the counter Fe, did the trick.

3:18 PM  
Anonymous Anonymous said...

Well, Blake, MRI's of orthopedic joints may be useless. However, X-rays are still needed. I had to wait to get those, although privately insured, until I was on Medicare, and finally received needed hip replacements - after 25 yrs of hobbling around, barely. Now I can walk and EVEN sleep. Which is difficult to do if you are all crooked and curled up by deformity and exhausted from pain, except, of course, sitting on a straight chair and leaning against a cabinet all night.

3:22 PM  
Anonymous Anonymous said...

Social factors like poverty and jobs are, indeed, much more important. The problem in the U.S. is that if you have a disability, or even a possible disability, you can not get a job, and you will, therefore, by default, be poor. Even if you do have private insurance, and you have an illness or need a procedure, you may lose your job, and become poor, before you get the needed procedure. You will be fired and lose your insurance, at the same time. Illnesses are coded, and to get reimbursement, these codes are applied. If there is no illness, no code applies, and the doctor may not get paid without just putting in some code. I saw this happen regularly in patient accounting. Taking anamneses (histories) is an art, for which there is not enough time, and patience, with HMO's and profit motives regulating what happens when one sees a doctor.

3:31 PM  
Anonymous rini said...

I agree that prevention is key.

However, don't blame the patients for the ridiculous costs of health care in this country. Don't even blame us physicians. I will not hesitate to order any necessary test on any patient, no matter how expensive until the CEO's of the HMOs and other insurers earn a normal/human salary and the insuring corporations themselves are non profit. This is where the money is going, people. Wake up. People who have nothing to do with helping patients or giving health care are raking it in. Let's cut this out before we worry about limiting care for patients.

8:27 AM  
Anonymous Anonymous said...

I'm pleased to find your blog Blake. It's important to think this stuff through and there's nothing like writing it out and getting feedback to force us to look as deeply as we need to go.

I hope we can all agree that the crisis in American health care can't simply be attributed to one group of people. If it were really as simple as "physician greed", "patient over-utilization", "dictatorial business practices", or the "liability-hungry legal profession" - the remaining groups would have turned on them en masse and whacked them into shape.

Unfortunately there are multiple causes for everything that ails the system, and you have to conduct a full root-cause analysis on the entire matrix of inter-related causes before we can rationally construct a solution.

For anyone who would like a quick review of the issues driving health care reform today, I wrote a (reasonably) plain english brief in my blog, Healing Health Care.

4:26 PM  

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