Health

Nurse Practitioners Can Make Health Care Cheaper (and Doctors Want to Stop Them)

(REASON TV)   “The major motivation in this opposition is kind of a turf war,” says Dale Ann Dorsey, a nurse practitioner who runs her own women’s health clinic in Scottsdale, Arizona.

Arizona is one of 18 states that allows nurse practitioners to run independent primary care practices, with full prescribing privileges, and without the oversight of a licensed physician. Earlier this year, nurse practitioners in California pushed to liberalize scope-of-practice rules in the Golden State, only to be stopped dead in their tracks by the powerful California Medical Association (CMA), which poured more than $1 million into lobbying efforts in the first half of 2013, when the legislation was under consideration.

“[Nurse practitioners’] training is very limited compared to physicians,” says Paul Phinney, a California pediatrician and former CMA president. “They lack a certain kind of experience that I believe is very important to the safety of patients and the quality of medical care that they’re providing.”

He has a point. Physicians are required to obtain far more education and clinical experience than are nurse practitioners. But there’s little to no evidence showing that, when it comes to primary care, all of that extra education makes any difference in patient health outcomes. A 2012 Health Affairs survey of the medical literature found no difference in patient health between the two groups and even found a slightly higher satisfaction rate among patients of nurse practitioners.

So if outcomes are similar, and patients are satisfied, why are states like California hesitant to let more nurses open their own practices, especially when groups like the Association of American Medical Colleges are expecting a doctor shortage time-bomb to detonate in the near future due to the aging population? Reason policy analyst Adam Summers says that concern for the public good is a secondary consideration at best in this case.

“Licensing laws are almost always sold as being in the public interest,” says Summers. “But in reality all they do is drive up prices and reduce competition, which reduces the incentive to provide good services to the consumer.”

‘Superbugs could erase a century of medical advances,’ experts warn

 

(THE INDEPENDENT)   Drug-resistant “superbugs” represent one of the gravest threats in the history of medicine, leading experts have warned.

Routine operations could become deadly “in the very near future” as bacteria evolve to resist the drugs we use to combat them. This process could erase a century of medical advances, say government doctors in a special editorial in The Lancet health journal.

Although the looming threat of antibiotic, or anti-microbial, resistance has been known about for years, the new warning reflects growing concern that the NHS and other national health systems, already under pressure from ageing populations, will struggle to cope with the rising cost of caring for people in the “post-antibiotic era”.

In a stark reflection of the seriousness of the threat, England’s deputy chief medical officer, Professor John Watson, said: “I am concerned that in 20 years, if I go into hospital for a hip replacement, I could get an infection leading to major complications and possible death, simply because antibiotics no longer work as they do now.”

About 35 million antibiotics are prescribed by GPs in England every year. The more the drugs circulate, the more bacteria are able to evolve to resist them. In the past, drug development kept pace with evolving microbes, with a constant production line of new classes of antibiotics. But the drugs have ceased to be profitable and a new class has not been created since 1987.

Writing in The Lancet, experts, including England’s chief medical officer, Dame Sally Davies, warn that death rates from bacterial infections “might return to those of the early 20th century”. They write: “Rarely has modern medicine faced such a grave threat. Without antibiotics, treatments from minor surgery to major transplants could become impossible, and health-care costs are likely to spiral as we resort to newer, more expensive antibiotics and sustain longer hospital admissions.”

Strategies to combat the rise in resistance include cutting the amount of antibiotics prescribed, improving hospital hygiene and incentivising the pharmaceutical industry to work on novel antibiotics and antibiotic alternatives.

However, a leading GP told The Independent on Sunday that the time had come for the general public to take responsibility. “The change needs to come in patient expectation. We need public education: that not every ill needs a pill,” said Dr Peter Swinyard, chairman of the Family Doctor Association.

“We try hard not to prescribe, but it’s difficult in practice. The patient will be dissatisfied with your consultation, and is likely to vote with their feet, register somewhere else or go to the walk-in centre and get antibiotics from the nurse.

“But if we go into a post-antibiotic phase, we may find that people with pneumonia will not be treatable with an antibiotic, and will die, whereas at the moment they would live.

“People need to realise the link. If you treat little Johnny’s ear infection with antibiotics, his mummy may end up dying of pneumonia. It’s stark and it’s, of course, not direct, but on a population-wide level, that’s the kind of link we’re talking about.”

There are no reliable estimates of what resistance could cost health systems in the future, but the European Centre for Disease Prevention and Control believes that €1.5bn (£1.2bn) a year is already being spent on health problems associated with antibiotic resistance in Europe.

Joanna Coast, professor of health economics at the University of Birmingham, said that the problem of resistance had the potential to “affect how entire health systems work”.

Professor Coast added: “We don’t know how big this is going to be. It’s like the problems with planning for global warming. We know what the costs are now but we don’t know what the costs will be into the future.

“Much of what we do in modern health system relies on us having antibiotics. We need them for prophylaxis for surgery, for people having chemotherapy for cancer. The worry is that it might make big changes to how we run our health system.”

Antibiotics are also used in vast quantities in agriculture, fisheries and by vets, the resulting environmental exposure adding to bacterial resistance, with further consequences for human health.

Experts say that to meet demand without increasing resistance, drug companies will need to find new ways of financing antibiotic development that are not linked to expectations of large volume sales. Global health authorities such as the World Health Organisation have also warned that global drives to reduce antibiotic use must not harm access to life-saving drugs in poorer countries.

Writing in The Lancet, Professor Otto Cars of Uppsala University in Sweden, and one of the world’s leading experts on antibiotic resistance, said: “Antibiotic resistance is a complex ecological problem which doesn’t just affect people, but is also intimately connected with agriculture and the environment.

“We need to move on from ‘blaming and shaming’ among the many stakeholders who have all contributed to the problem, towards concrete political action and commitment to address this threat.”

SOURCE

Patient in So-Called “Vegetative State” Knew Doctors Were Dehydrating Him to Death

 

(Wesley J. Smith)   We dehydrate to death helpless people in this country because they have a catastrophic cognitive impairment. Advocates for dehydration say it is just medical ethics, the withdrawal of the medical treatment of tube feeding. (Now, there is even a lawsuit to compel starvation by withholding spoon feeding–not a medical treatment!)

Dehydrating helpless people to death was once unthinkable. Then, in the 80s, bioethicists began advocating withdrawing tube-supplied food and fluids. And so it came to pass.

READ THE FULL ARTICLE HERE

Common feminine health products riddled with dangerous chemicals

(RT)   Common feminine care products contain hazardous chemicals including carcinogens, endocrine disruptors and reproductive toxins that can cause cancer among other dangers, a new report shows.

Women’s Voices for the Earth (WVE) released Wednesday the report Chem Fatale revealing feminine care products, a $3 billion industry, are marred by toxins and void of crucial regulations, putting the health of millions of women at risk.

The report finds that the products used on or in absorbent parts of the female body are sold with little or no data provided about the ingredients they contain.

“The chemicals used in these products are a real concern given the inevitable exposure to sensitive and absorptive vulvar and vaginal tissue,” said Dr. Ami Zota, a professor of occupational and environmental health at George Washington University, in a press release.

For instance, tampons and menstrual pads are regulated by the US Food & Drug Administration (FDA) as medical devices, thus are not required by law to disclose ingredients, making “it nearly impossible for consumers to avoid chemicals of concern found in these products.”

Feminine washes, wipes and sprays are defined as “cosmetics” and are required to be free of harmful substances that would harm users under normal conditions. Yet the FDA says it does not assess or pre-approve products before they are marketed.

“Companies and individuals who manufacture or market cosmetics have a legal responsibility to ensure the safety of their products. Neither the law nor FDA regulations require specific tests to demonstrate the safety of individual products or ingredients. The law also does not require cosmetic companies to share their safety information with FDA.”

The FDA admits it also has no power to recall products. That is done by an industry-funded group the Cosmetics Ingredient Review (CIR). Though WVE says the panel rarely considers concerns with the products connected to exposure to “sensitive vulvar and vaginal tissue or their mucous membranes.”

Anti-itch creams and douches are over-the-counter drugs, but only the main ingredient of these products is regulated. For the rest of their ingredients, safety and compliance with regulations rests with the manufacturer.

Tampons and menstrual pads are used by 70 to 85 percent of women, the report states. Various brands of these products contain ingredients that expose women to pesticide residue, dioxins and furans, obscure fragrance chemicals and allergens. Subjection to these can lead to reproductive harm, endocrine disruption and cancer.

Products like feminine sprays or wipes, douches and anti-itch cream are used by 20 to 40 percent of women. A higher percentage of Black and Latina women use these products, which contain toxins like formaldehyde-releasing preservatives and parabens.

“We know that many of the most dangerous products that are found to cause chronic diseases also target women of color. The reality is knowledge isn’t enough—Latinas who already have health disparities, also face financial, economic, and geographic barriers to accessing safe alternatives,” said Cristina Aguilar, Interim Executive Director of Colorado Organization for Latina Opportunity and Reproductive Rights.

The report comes with list of products and their ingredients of concern. Top brands of these various products include CVS, Equate, Kirkland, Massengill, Summer’s Eve, Vagisil, VH Essentials and Walgreens.

SOURCE

Radioactive Bluefin Tuna Caught off California Coast

(ANN WERNER)   Every bluefin tuna tested in the waters off California has shown to be contaminated with radiation that originated in Fukushima. Every single one.

Over a year ago, in May of 2012, the Wall Street Journal reported on a Stanford University study. Daniel Madigan, a marine ecologist who led the study, was quoted as saying, “The tuna packaged it up (the radiation) and brought it across the world’s largest ocean. We were definitely surprised to see it at all and even more surprised to see it in every one we measured.”

Another member of the study group, Marine biologist Nicholas Fisher at Stony Brook University in New York State reported, “We found that absolutely every one of them had comparable concentrations of cesium 134 and cesium 137.”

That was over a year ago. The fish that were tested had relatively little exposure to the radioactive waste being dumped into the ocean following the nuclear melt-through that occurred at the Fukushima Daiichi plant in March of 2011. Since that time, the flow of radioactive contaminants dumping into the ocean has continued unabated. Fish arriving at this juncture have been swimming in contaminants for all of their lives.

Radioactive cesium doesn’t sink to the sea floor, so fish swim through it and ingest it through their gills or by eating organisms that have already ingested it. It is a compound that does occur naturally in nature, however, the levels of cesium found in the tuna in 2012 had levels 3 percent higher than is usual.

READ THE FULL ARTICLE HERE

Veterinary Cannabis?

(AVMA)   Miles was dying. The 12-year-old black Labrador Retriever–type dog had developed a splenic tumor that eventually metastasized to the liver and lungs. Miles was given two months to live and tramadol for the pain. But, Miles’ owner didn’t like the way tramadol affected her pet. “Every time we gave it to him, he would just sleep; he wouldn’t even move. He’d just lay there like he was dead,” said Denise, who asked that her real name not be used. Sitting outside a West Hollywood, Calif., café with Miles at her feet, Denise recalls how a friend suggested she try a glycerin tincture of marijuana that is sold as a pet medicine in dozens of licensed medical marijuana dispensaries throughout Los Angeles. Within an hour after she gave Miles the tincture, the dog’s appetite returned, and he was no longer vomiting. “It couldn’t have been a coincidence,” Denise said.

Veterinarian Administers Medical Marijuana to Dogs, Says it Works Wonders

(THE JOINT BLOG)   Veterinarian Doug Kramer considers his work to be “enlightened”, even naming his clinic the Enlightened Veterinary Therapeutics. When hearing about his out-of-the-box methodology, it’s hard to argue.

Dr. Kramer administers medical marijuana to dogs, especially those with late-staged cancer. He does so in his clinic, and is undeniably vocal about it. He’s not hiding what he’s doing, and instead is making sure to spread the word as far and wide as he can.

 

In an article published recently on Dogster.com, one of the largest dog sites in the world, Kramer states, regarding the decision to go against the law:

“The decision was an easy one for me to make…I refuse to condemn my patients to a miserable existence for self preservation or concerns about what may or may not happen to me as a consequence of my actions. My freedom of speech is clearly protected by the First Amendment to the Constitution. This is an issue of animal welfare, plain and simple. Remaining silent would represent a clear violation of the veterinarian’s oath I took when I was admitted into this profession.”

Certainly noble.

On his website, Dr. Kramer notes that; “Overwhelming documented and empirical evidence suggests that there is a role for medicinal marijuana in veterinary medicine…In many, many scientific studies, THC and its synthetic derivatives have been shown to be effective in most animal models of pain.”

Dr. Kramer, who’s the first veterinarian in the country to (at least openly) administer medical cannabis to dogs, is not a medical cannabis patient himself. His venture started when his dog, Nikkita, was diagnosed with cancer. This led to Dr. Kramer studying recent cannabis research, which pushed him to create a homemade cannabis tincture, which he administered to her.

Dr. Kramer, who spoke with us briefly, states; “It restored her appetite, made her lively again. It was a complete turnaround and she got to live her final days in a much better way.”

After Nikita’s death, Dr. Kramer felt bound to continue harnessing cannabis as a medicine so that he could help other dogs with terminal diseases that may benefit from it. This led to him opening Enlightened Veterinary Therapeutics, which specializes in palliative and hospice care, and is the first and only clinic in the country to offer cannabis consultations as a pet treatment plan.

Going forward, Dr. Kramer hopes that his message spreads, and that we change our laws to enable doctors and others to truly study and recognize the vast benefits that medical cannabis can bring, whether you’re a human, or a dog.

SOURCE

Vet Recommends Medical Marijuana for Pets in Pain

(KTLA) — A growing number of veterinarians across the U.S. support the idea of using medical marijuana to treat pets in pain.

Local veterinarian Doug Kramer, who runs the Vet Guru animal center in Chatsworth, said the active ingredient in pot, THC, could be the key to helping Fido feel better.

Kramer, 36, said a friend told him she used marijuana to treat her dog when other traditional medications failed.

So when his own dog, a Siberian husky, was diagnosed with terminal cancer Kramer felt he had nothing to lose.

Marijuana didn’t cure Nikita, but she seemed to feel less pain during her final days, Kramer said.

But uncontrolled use of the drug has some veterinarians concerned about the possibility of toxicity.

“Those veterinarians are seeing the worst of the worst overdoses, all they’re seeing is the toxicity, all they’re seeing is the negative impact of giving too much,” Kramer said.

Kramer said he hopes an open discussion about the benefits of marijuana in veterinary medicine will lead to more research on the issue.

ORIGINAL SOURCE

There Is Antifreeze In Your Ice Cream

bowl of ice cream

(THE HEALTHY HOME ECONOMIST)   One thing I try to do on this blog is alert folks to the sneaky, underhanded and frequently toxic chemicals that Big Food processors add to their products.

One of these dirty little secrets is the fact that propylene glycol, a cosmetic form of antifreeze, is added to commercial ice cream.

You see, when you make ice cream at home, you immediately notice that it is as hard as a rock very unlike store ice creams (even the organic ones) that seem to scoop out of the container so conveniently.

Homemade ice cream has to be taken out of the freezer and softened on the counter for a few minutes before you have any hope of scooping some out into a bowl.    I even store mine in a shallow, Pyrex baking dish as this makes it much easier and faster to scoop out when I want some.

Antifreeze, then, is simply ice cream manufacturers’ answer to hard as a rock ice cream and the ice crystals that inevitably form as it is shipped long distances and moved between many different freezers before it finally makes it to your supermarket.

If you’ve ever left homemade ice cream on the counter too long and then put it back in the freezer, you notice how icy it can get.   Antifreeze added to store ice cream helps prevent this from happening!

Sometimes when I tell folks this for the first time, they have trouble believing it.  Why?   Because propylene glycol isn’t listed anywhere on the ice cream label or ingredients list.

While it may come as a shock to some of you, there is such a thing as an “Industry Standard“, which means that if everyone does it, you don’t have to label it!   For those who need specifics, USDA reg 21 CFR 101.100 deals with labeling exemptions dealing with incidental food additives.

Nice, huh?   Where I grew up, this was called deceit.

Can you believe it?  Just because commercial ice cream manufacturers make a practice of adding a little bit of antifreeze to their ice cream, then it doesn’t have to be labeled!   I don’t even trust organic ice cream as it is way too easy to scoop out of the container right out of the freezer for my comfort level.   My efforts to confirm this one way or the other were not successful, so at this time, it is only a very strong hunch.

Just to get you a little more hot under the collar, the FDA actually had the gall to grant GRAS status to antifreeze!    What is GRAS?   It is an acronym for “Generally Recognized As Safe”.

Well, isn’t that interesting?   Antifreeze safe to eat!   You learn something new every day!

Wait a minute!   Antifreeze safe to eat, yet a dog would probably die if a car radiator leaks in his owner’s driveway and he laps some of it up?

Ok, ok, I know that antifreeze used in radiators is ethylene glycol, but the fact is that propylene glycol is a related chemical that is known to cause heart, kidney, liver, and central nervous system damage if sufficient quantity is absorbed by the body.

Given that Americans eat approximately 5 times the ice cream they did only 50 years ago, it is anyone’s guess what the long term effects of the small amounts of propylene glycol in store ice cream might be (source: WAPF).

So, ethylene glycol will kill you quickly and propylene glycol will kill you slowly and perhaps painfully.  That seems to be the gist of it to me.

I used to wonder why whenever I ate store ice cream or got an ice cream cone at the Mall, the next day I seemed to have a very close relationship to the bathroom.   Turns out that a side effect of consuming antifreeze is loose bowels, even diarrhea.    Propylene glycol is even used to clean out the bowel before surgery and is a primary ingredient in some over the counter constipation meds!

By the way, there are MANY other chemicals added to commercial ice cream that are toxic and unlabeled.   Piperonal, for example, is used in place of vanilla and is a chemical used to kill head lice, so you’re not even safe getting a basic flavor like plain vanilla ice cream!

What if the ingredients label lists vanilla?    Does this mean there is no piperonal in there?   Not necessarily.  A mixture of piperonal and vanilla could be used with the vanilla listed (to make the customer happy) and the piperonal not listed (to fool the customer and increase profits).   Not surprisingly, piperonal is cheaper to use than vanilla.

Food manufacturers are really good at the cat and mouse games and are complete virtuosos at playing the USDA regulations.

So, if you aren’t into eating antifreeze with your ice cream, check out my videoblog on how to make your own, safe, delicious, healthy ice cream!

SOURCE

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