Controversies in Clinical Medicine (Fall 2001)



Author: Harold E. Buttram, MD
Article Type: Feature Article
Issue: Fall 2001
Volume Number: 6
Issue Number: 3


Shaken baby syndrome (SBS) commonly describes a combination of subdural hematoma, retinal hemorrhage, and diffuse axonal injury (DAI) as the triad of diagnostic criteria. In some, the presence of rib or other fractures is also taken as a sign of abuse.(1-3) The basic issue to be reviewed here is whether or not in some instances in which a father, family member, or caretaker has been accused of causing the death of an infant or child from the SBS, the true cause of death was a catastrophic vaccine reaction. This article concerns an unpublished series of 25 cases involving accusations or convictions for the SBS, largely collected by attorney and jury counselor Toni Blake of San Diego, California (personal communication, 2000), as well as some from personal knowledge, which have the...




Author: Kyle McCammon, DO
Article Type: Feature Article
Issue: Fall 2001
Volume Number: 6
Issue Number: 3


Part I of this article discussed Medicaid eligibility requirements and regulations and chronicled the extensive growth in Medicaid caseloads and spending. Part I also reviewed how Medicaid is funded and how states have utilized funding schemes to increase the amount that is funded by the federal government. Part I chronicled the federal legislation that has been enacted in response to state Medicaid funding schemes and the subsequent states' responses to this legislation, including the use of provider taxes. Part II will discuss the detrimental effects that Welfare and Medicaid have on society and the health care system. Part II will also discuss specific proposals for Welfare reform and health care reform.   Medicaid and the Incremental Assault on Health Care   It appears that...




Author: F. Edward Yazbak, MD, FAAP and Kathy L. Lang-Radosh, MS
Article Type: Feature Article
Issue: Fall 2001
Volume Number: 6
Issue Number: 3


ABSTRACT We identified 60 rubella-susceptible mothers who were revaccinated in the postpartum period with either the measles-mumps-rubella (MMR) or the monovalent rubella vaccine and whose children later received MMR vaccine. Forty-five of these women have children diagnosed with autistic spectrum disorder (ASD); another ten women have children with autistic symptoms, ADD/ADHD or other developmental delays; and four women have children with other health problems, mostly immunologic. These outcomes raise concerns about the practice of postpartum vaccination and suggest that an immune mechanism may increase children's susceptibility to ASD. Background Although parents continue to report that their previously typical children begin to display symptoms of autism and lose previously acquired...




Author: Conrad F. Meier
Article Type: Editorial
Issue: Fall 2001
Volume Number: 6
Issue Number: 3


In response to one of my columns on health care, a reader wrote and called me an "old geezer" ranting in opposition to universal health care. I confess to having a healthy discontent for the way things are, but I have to draw the line at being called an "old geezer." Having just turned the corner on 66 got me to thinking about ageism --- an ignorant practice of judging people on the basis of age rather than the ability to perform.   Putting This in Perspective   Those of us with birth dates before 1940 were born before long-term care, guaranteed-issue, gatekeepers, managed care, PPOs, IPAs, MCOs, ERISA, COBRA, CHIPs, MSAs and HIPAA. Medicare was an unheard of public policy initiative we are living long enough to see bankrupt the nation's health care system. Social Security...




Author: Richard G. Parker, MD
Article Type: Editorial
Issue: Fall 2001
Volume Number: 6
Issue Number: 3


It is often assumed that Democrats seek more government while Republicans desire less. The recent history of "health care reform" demonstrates why this assumption is incorrect. The Republican's politics of compromise in health care, of sacrificing the principle of individual liberty to any mob that claims to have a "need," necessarily leads to the same destructive end as the leftist politics of the Democrats. The politics of compromise, or "bipartisanship" as it is presently called, in reality represents the sacrifice of the principle of individual rights to statism. Statism is the idea that man's life and his productive efforts ultimately belong to the State.(1) This fact is no more visible than in health care. The history of health maintenance organizations (HMOs) is one illustration of...




Author: Doug Fiedor
Article Type: Commentary
Issue: Fall 2001
Volume Number: 6
Issue Number: 3


Ask any public servant if our Constitution is the "law of the land" and they will reply in the affirmative. However, if one mentions to anyone in government that any action, law, rule, or regulation performed or proposed that is contrary to the Constitution must then be a violation of the law of the land, one would get a blank stare --- and an angry bureaucrat. The sorry fact is that all public servants must swear an oath to God to support the Constitution, but few even know or understand it. There-fore, they violate the law of the land regularly. And often intentionally. One maxim in the law many lawmakers like to use to admonish citizens with is that ignorance of the law is no excuse. The problem is, none of us can know the law anymore because there is too darn much of it. So, as...




Author: Miguel A. Faria, Jr., MD
Article Type: Commentary
Issue: Fall 2001
Volume Number: 6
Issue Number: 3


You may have heard about the story of the psychiatrist who was prosecuted for murder because he prescribed pain medication for several patients who ultimately died. Nevertheless, you may not have thought about the implications of this news story or about how it may affect you and your loved ones. Yes, last year, Dr. Robert Weitzel, a physician, who also happened to be a psychiatrist, was prosecuted for allegedly killing five elderly patients with the effective and legal narcotic analgesic (painkiller) morphine. His intention was to treat their pain, not to kill them; nevertheless, serious complications can arise, including death, in the best of treatment rendered by the most devoted and caring of physicians. Be that as it may, his trial and prosecution is having a cumulative, chilling...




Author: Robert M. Webster, MD
Article Type: Correspondence
Issue: Fall 2001
Volume Number: 6
Issue Number: 3


Dear Editor, The title of the Report from the States (Medical Sentinel 2001;6(1):33) should be "...Assure our Future," not "Insure." ...The American Medical Association (AMA) is dominated by delegates from specialty organizations instead of delegates appointed by the county and state medical societies, as was its original purpose and policy. In organized medicine solo and general practitioners are being decimated. Our two-county medical society is of no interest to our physicians. There is very poor attendance at the sporadic meetings at a restaurant. No input, no output and no money! Physicians at one very good suburban hospital 25 years ago limited staff membership to those physicians in the local community by home and office. Now "itinerant" physicians with many offices all over the...


AMA


Author: T. Jackson Tidwell, MD
Article Type: Correspondence
Issue: Fall 2001
Volume Number: 6
Issue Number: 3


Dear Editor, I have followed up on the notion that the AMA is another "arm of the government." The more I learn the more I am convinced all 32 percent AMA membership has going for it is "scream power." AMA leaders can scream about the benefits of "AMA Publishing, Inc." but that doesn't mean they have legitimate excuses. The AMA can scream and scream but when all is said and done and all the screaming is over, the federal government has the final say. All the government has to do is withdraw the AMA's exclusive publishing contract on the CPT code books. If the government were to put it out on bid, as it should like in a free market economy, the AMA would lose all that money and then the organization would have to go out and get members and work the old fashioned way. Right now, the AMA is...


AMA


Author: Frank Rogers, MD
Article Type: Correspondence
Issue: Fall 2001
Volume Number: 6
Issue Number: 3


Dear Editor, Gun control was a subject at everyone of the fifty-three AMA sessions at which I represented California. It was always loudly supported, but I and a few others were able to defeat each resolution and/ or amendments. I remember one time having to move for "informal session" and then bringing on the defeat after resuming regular session. I'm not sure why that doesn't work now. I have several articles on "gun control" --- in fact, a three ring binder [having bearing on these proceedings]. It is a brief and compelling list. The leadership for pediatrics, psychiatry and internal medicine are among the most adamant. Frank Rogers, MD Reno, NV Correspondence originally published in the Medical Sentinel 2001;6(3);73-74. Copyright©2001 Association of American Physicians and Surgeons (...




Author: Charles Curley
Article Type: Correspondence
Issue: Fall 2001
Volume Number: 6
Issue Number: 3


Dear Editor, Dr. Faria's revealing articles, "Public Health and Gun Control --- A Review (Parts I-II)," which have also been posted at NewsMax.com, are excellent and much of it news to non-medical professionals like me. Some thoughts: 1) Is the AMA headed in the direction of becoming a self-funded organization, answerable to no-one, not even its membership --- rather like AARP? 2) Is the AMA headed in the same direction as the American Bar Association: headed toward a political black hole of leftist political activism, which turns off non-leftist professionals to the point where they resign or never join? This gives the leftist activists a positive feedback loop of ever more control over the organization, until it falls inside some Schwartzchild radius of professional irrelevance. 3) How...




Author: Compiled by Medical Sentinel Editors
Article Type: News Capsules
Issue: Fall 2001
Volume Number: 6
Issue Number: 3


Lawsuit Filed Against HHS and Medical Privacy Rule "Opposition to the new medical privacy rule and support for privacy rights took a giant leap forward on July 16, says one health care policy organization. A group of physicians and medical societies from South Carolina and Louisiana have filed a lawsuit against Secretary Tommy Thompson, and the U.S. Department of Health and Human Services (HHS), charging that the medical privacy rule, and a portion of the 1996 Health Insurance Portability and Accountability Act that required writing the rule, violate the U.S. Constitution and are impermissibly vague on federal preemption of state law. Civil Docket No. 3:01-CB-2965 was filed in the United States District Court for the District of South Carolina Columbia Division. " 'This lawsuit is the...




Author: Robert J. Cihak, MD
Article Type: President's Page
Issue: Fall 2001
Volume Number: 6
Issue Number: 3


In the last issue, I wrote about the possibility and hope of top down Medicare reform. But there's even greater hope of reform from the bottom up. More and more physicians are seeing through the smoke and mirrors of the current managed care and government systems. Physicians in all parts of the country are firing their managed care plans and managers. Many doctors and patients around the country are re-creating truly private medical practice. By cutting out the insurance company middlemen, doctors and patients do an end run around insurance company bureaucracies. The SimpleCare.com non-profit organization that originated in the Seattle area and many other independent doctor organizations around the country are developing parallel tactics. Doctors and patients deal directly with each other...




Author: Jane M. Orient, MD
Article Type: Editorial
Issue: Fall 2001
Volume Number: 6
Issue Number: 3


It has been said that every epidemic begins with a single case report. A single case report, however, could just be an anecdote, and most "clusters" turn out to be statistical artifacts. One can make two types of errors: Type A --- overreacting to a false alarm like Chicken Little; and Type B --- ignoring a sentinel event and behaving like an ostrich. To limit the mortality and morbidity if there really is an epidemic, we must investigate case reports dispassionately, following the evidence wherever it leads --- even if we must dare to question some sacred cows. Two syndromes devastating to children are discussed in this issue: Shaken Baby Syndrome (SBS), which is being treated as an epidemic, and autism, in which a four-fold increase is treated as a mere change in diagnostic criteria. (...




Author: Curtis W. Caine, MD
Article Type: The Constitution - Plain and Simple
Issue: Fall 2001
Volume Number: 6
Issue Number: 3


Religion in America...must be regarded as the foremost of the political institutions of that country;for if it does not impart a taste of freedom, it facilitates the use of it.Indeed, it is in this same point of view that the inhabitants ofthe United States themselves look upon religious beliefs.Alexis de Tocqueville   The Founders/writers/signers of the Constitution of this Republic knew this, believed it, wrote/spoke of it. George Washington, the Father of America, in his farewell address (delivered September 17, 1796) said "Of all the dispositions and habits which lead to political prosperity, religion and morality are indispensable supports." John Adams said "Our Constitution was made only for a moral and righteous people. It is wholly inadequate for the governance of any other...



It is now legend the AAPS legally lanced the secret task force and pulled its secrets...into the sunshine. It destoyed the Health Security Act.


The Oath of Hippocrates
and the Transformation of Medical Ethics Through Time


Patients within a managed care system have the illusion there exists a doctor-patient relationship...But in reality, it is the managers who decide how medical care will be given.


Judicial activism...the capricious rule of man rather than the just rule of law.


The largest single problem facing American medicine today is the actions of government...


The lessons of history sagaciously reveal wherever governments have sought to control medical care and medical practice...the results have been as perverse as they have been disastrous.


Children are the centerpiece of the family, the treasure (and renewal) of countless civilizations, but they should not be used flagrantly to advance political agendas...


Prejudice against gun ownership by ordinary citizens is pervasive in the public health community, even when they profess objectivity and integrity in their scientific research.


The infusion of tax free money into the MSA of the working poor give this population tax equity with wealthier persons...


It was when Congress started dabbling in constitutionally forbidden activities that deficit spending produced a national debt!


Does the AMA have a secret pact with HCFA?


The lure of socialism is that it tells the people there is nothing they cannot have and that all social evils will be redressed by the state.


Canada's fatal error — Health Care as a Right!


The Cancer Risk from Low Level Radiation: A Review of Recent Evidence...


...Moreover, the gun control researchers failed to consider and underestimated the protective benefits of firearms.


Vandals at the Gates of Medicine — Have They Been Repulsed or Are They Over the Top?