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oh and by the way for the person who used the term WHEN TREATMENT IS COMPLETE CHRONISC INTRACTABLE PAIN by definition MEANS THERE IS NO COMPLETION OF TREATMENT IT MEANS YOUR GONNA DIE WITH THIS PAIN AND ALL METHODS OF TREATMENT HAVE BEEN EXHAUSTED AND THE MEDICAL PROFESSION HAS NOTHING ELSE FOR YOU THATS WHAT IT MEANS

chronic itractible pain by douglas huberdouglas huber, 10 May 2015 02:30

i have chronic intractable pain i have failed back surgery with metal rods and screws and plates in me and i take 2 different kinds of oxycodone xanax to keep me calm so i dont strangle some asshole who thinks they know what i am going through and to keep me from punching out a pharmacist who thinks he is saving the world from oxycodone,.. i hjave been on this stuff for about 8 years i can eat 80 mg extended release like they are candies and 30mg roxies also like they are candies there is no relief ever all it does is keep me out of a hospital ,.. you people say you want to legalize heroine for CANCER PATIENTS WHAT ABOUT ME i got something thats JUST AS PAINFULL AS SOMEONE WITH CANCER I ASSURE YOU come and meet me see how I GET ALONG everyday i am not morphine intolerant though and dialaudid IV works for me but has to be like 8mg every 3 hours ,.. thats hwere i am at then you got these liberal scumbag assholes at EXPRESS SCRIPTS that think they are saving the world COUNTING MY PILLS TO THE day after i need a refill I GOT NEWS FOR YOU its ALWAYS A STRETCH ALWAYS i wanna move to the UK where they GIVE HEROINE FOR PAIN MANAGEMENT why is it alway cancer patioents that everyone thinks about when they say intractable pain I GOT NEWS FOR YOU THERES A WHOLE LOTTA OTHER PEOPLE IN JUST AS MUCH PAIn only thing is i don't have THE LUXURY of knowing i am GONNA DIE ONE DAY i am probably going to LIVE WITH THIS UNTILL I GET THE BALLS TO END IT MYSELF

I think increasing the role of nurses for primary care is a step forward in alleviating the primary care shortage. However, I don't think this is the only way to go about it. By increasing nurse's scope of practice, you may cause confusion among patients as to who really are doctors. I've read stories about how some nurse practitioners asked patients to refer to them as "Dr. So and So" even if they didn't have any MD or PhD next to their name.

I'm curious as to how this may affect reimbursement rates for doctors. If insurance companies see that nurses are willing to provide a service for a reduced price (considering they don't pay malpractice fees), they may force doctors to accept less.

Anyways, I do feel nurses should be given more freedom in a primary care setting, but I don't think they should be paid the same, nor should they be allowed to treat patients the same. The person quoted that if you do the same job, you should get paid the same. That's a good point, but there is always the issue of quality of care, one that a doctor ideally should be more apt to provide.

by Andres GonzalezAndres Gonzalez, 14 Nov 2010 22:19

To provide another perspective on this, how would reformed health care certainly fix this problem? Might not putting all Americans on an even plane shift the survival rate of all toward the group of people that are currently uninsured? While it is certainly troubling to have such evidence, how can we be sure that universal health care will solve the problem and not cause more time delay and lower survivability rate. At the same time, no other health care options seem to be available besides what is on the table at the moment, so at this point there really isn't much choice. I'm just nervous that the results could possibly be the exact opposite of what we predict.

by Mark CorreaMark Correa, 12 Apr 2010 02:25

I think that, while Dr. Cassell is not breaking any laws, he is probably doing more harm than good socially. I feel that there would be a much more appropriate and effective way to protest Obama's Health Care instead of suggesting that he would rather not help people who support the new health care bill. If he feels so strongly about this, wouldn't it be better to take in those patients who supported Obama and talk to them one on one in the hopes that he can make them see his side of the argument. Simply shutting others out will not be as proactive as a more humanitarian view could be.

by Mark CorreaMark Correa, 12 Apr 2010 02:21

First, I think Dr. Cassell should be commended for taking such a risky venture. I think it's important to say that he's speaking/offering his point of view and probably the point of views of many other physicians about the bills. We hear about politicians and regular citizens' point of views everyday-but I think it's important to hear from the side of doctors and medical personnel.
Despite this, his approach of doing such an act is inappropriate. It's not necessary to display such a sign in front of his office to the public, and especially, to his patients. At the end of the day, he is a physician, and patients should be his number one priority. He should put his professional obligation first in this case-his expression will probably alter his relationships with his patients-and this is unacceptable and unnecessary. The fact that only three patients have complained or the fact that the majority has been supportive of his action does not deem it appropriate in the end. Even though his actions are not illegal, his medical office is not an appropriate place for such actions, and that there should be a separations between politics and health care in his office.

by Lang LeLang Le, 11 Apr 2010 20:31

Despite the article mentioning that most of Dr. Cassell's patients have been "overwhelmingly supportive" of his political stance, his profound outspokenness has the potential to offend and distance the same people he is obligated to be caring for. I think the article makes a good point that the patient-physician relationship could very well be compromised by Dr. Cassell's actions, and any patients with an opposing viewpoint would at the very least be made uncomfortable. This feeling would not be ideal in a place of healing, and is unnecessary in this case. I agree that his actions are probably not illegal, but personally I don't think he should be bringing politics into the professional office to the point of preferring to serve certain patients over others due to their ideology. Every doctor, as a contributing citizen, of course has the right to attempt to sway voters, I just don't see the doctor's office as the appropriate place for it. Part of being a doctor is acting as the neutral, objective scientist in search of the "right" answer. If a physician chose to begin educating his patients on the health care bill, I think it would be important to offer both the pros and cons rather than just sharing personal propaganda. My advice would be the same to a doctor completely in support of Obama and/or the health care bill.

That being said, I think it's also worth noting that historically doctors have been opposed to most types of health care reform (see addition of Medicare in the '60s, for example) because, I would argue, it is legitimate threat to their salary to expand coverage to consumers who would otherwise be unable to afford it. Perhaps it is a balancing act to keep the care-givers adequately content and providing equal access to care for all. The fact that many doctors are dissatisfied with the bill probably is an important point, but in my opinion, expected. Dr. Cassell has gone too far in discriminating which patients he would and would not like to give care to.

by Danielle ChangDanielle Chang, 07 Apr 2010 17:47

This is a tough and unfortunate issue. Dr. Cassell's posting is in my opinion legal and does not break the Hippocratic Oath. He said he would not refuse to treat any supporters of the President or his health care plan which is a key point; he therefore shouldn't have his license removed. However, as a person who also strongly disagrees with the new health care law, I do not think the sign is appropriate and his statement that he "would prefer not to treat people who support the president" is troubling. My advice, if he or someone else were to openly post their political views (which may be dangerous from a business standpoint in most areas) would be to educate those about the laws and try to persuade them to see why the new law will do more harm than good. As doctors we should put the politics aside when focusing on treatment, but not be shy to tackle political issues that affect our profession. That is how the President was able to portray physician support for the bill even though most in practice opposed it but just were not as organized and vocal as the AMA (which represents < 14% of doctors).

There are way too many health risks associated with using heroin, primarily the inevitable addiction to heroin after treatment is complete. There are other options to be explored before resorting to medical heroin.

by jkennedy748jkennedy748, 14 Dec 2009 03:49

Although I can see William Beaver's and other people' points in trying to find out whether heroin can prove to be helpful to patients; I feel that overall, the cons outweigh the pros in this situation. I think that the money generated on the heroin bill could have been used to develop other drugs even more potent. The article also mentioned that heroin is less potent than Dilaudid. Also, concerns about heroin getting onto the street and side effects of the drugs need to be looked upon.

by Lang LeLang Le, 14 Dec 2009 00:28

Injustices such as the one suffered by this family reflect the need to change certain aspects about the United States's health care laws. Even though the family tried to receive compensation for the fact that their health insurance did not cover their daugher's liver transplant,thus leading to her death, the courts and lawyers did not want to deal with the case because the cost of trial would exceed the original cost of treatment. We need to develop ways to grant compensation to such injustices.

by imbigger99imbigger99, 13 Dec 2009 23:26

I agree with my peer above that this article shows that our health care system needs to be reform. Although it is obvious that those who are unassured don't receive the same quality of health services as the assured, I feel the discrepancy is too great. I also agree with Matt in that there are too many variables that are unaccounted for. It seems like the article only focus on the fact that people who don't have health insurance are worst off; but they fail to mentioned how being uninsured also results in other factors that may contribute to them being worst off. For example, they are more willing to not go to the hospital unless it becomes too necessary; and there are also other sociocultural factors.

by Lang LeLang Le, 13 Dec 2009 23:22

While my peer does provide a valid point, this article only furthers the idea that our health care system needs to be reformed. Numerous presidents have attempted to alleviate this serious health care issue, with President Obama being the latest one to step up to the plate. As long as the leadership of our country fails to correct our broken system by finding a way to provide affordable health insurance, situations like the ones described above will persist.

by imbigger99imbigger99, 13 Dec 2009 23:03

This article seems a little misleading to me. There are too many variables involved in the study- for example, people who don't have health insurance are more likely to be in worse health before experiencing a traumatic injury then those who are covered. Therefore, they would have a lower survival rate.


Matt Bloom

Response by Matt D BMatt D B, 13 Dec 2009 20:13

I've heard of doctors exhibiting this behavior multiple times, and it's truly upsetting. With all the training and compassion for patients doctors are required to have, it's surprising that they treat coworkers so poorly. Nurses also undergo alot of training, and most doctors do acknowledge this. Still, I feel like some sort of education implemented by each hospital into coworker respect could help smooth these relationships greatly. Maybe if doctors were reminded when they start working that the hospital revolves around more htan just the MD's but also the janitors, nurses, businessmen, etc, this issue would diminish.

by Mark CorreaMark Correa, 12 Dec 2009 00:45

I don't know, in my opinion, heroin is a class A drug in most countries for a reason. I feel like the number of problems heroin causes (addiction, death, etc.) far outweigh the painkilling benefits, especially since marijuana is used in these cases. I think we shouldn't make an exception to the use of the worst types of drugs.

by Mark CorreaMark Correa, 12 Dec 2009 00:39

This was very shocking. Although I knew that nurses many times do not receive the respect they deserve, I never realized it was this bad. I am taking a Health Professions class where healthcare professionals from all different areas come and talk about what they do. One of the topics most emphasized is the interdisciplinary approach to healthcare. This article does not reflect that ideal smooth-running relationship among the professionals. Especially after reading that '“often there is somebody in that operating room who knew the event was going to occur who did not feel empowered enough to speak up about it,"' I understand why so much of our healthcare costs are being wasted on malpractice. Doctors need to remember the hippocratic oath they took and apply it to not only patients, but their coworkers as well. This proves that bad work relationships can be more dangerous in this field than most others.

Re: A Real Eye-opener by sstaubsstaub, 07 Dec 2009 16:51

I agree and you bring up many good points. Some doctors may feel superior to nurses and assistants simply because of that MD, which is sad because they shouldn't be belittling anyone for the very reasons you mentioned. I used to work at a call center back in high school and used to experience the same attitude sometimes with angry doctors. Calling them was a hassle and one time when I transferred a line to the patient, I heard the doctor being rude and impatient. It sucks sometimes.

Re: A Real Eye-opener by Andres GonzalezAndres Gonzalez, 29 Nov 2009 21:07

Harry Reid’s Health Care Bill has gotten unnecessarily complex. It has turned into insurance and tax reform instead of health care reform, so I can understand why you’re frustrated about some things. The purpose of that article actually wasn't to show how proposed reforms would fix all those inefficiencies, but I actually just wanted to highlight how our system is broken and the billions of dollars that are being hemorrhaged. Sorry that I failed to mention that. That was a critical point and it’s good you saw that because it is pretty misleading. Harry Reid’s Senate Leadership Bill claims to reduce deficits by $777 million in the next 20 years.

This bill definitely needs to be improved. It does offer some form of subsidies, as it would require most Americans to carry insurance and also provide hundreds of billions of dollars in subsidies to those who cannot afford it. Medium and larger companies wouldn’t be required to offer coverage, but they would be forced to pay fees if the government ends up subsidizing their employees’ insurance. The bill would also set up exchanges, which are insurance marketplaces for those who have a hard time getting/keeping coverage. Consumers would have the choice of buying government-sold insurance there. This is an attempt to hold down prices charged by private insurances. I agree in that we definitely need medical malpractice reform and must work harder on promoting a healthier lifestyle and preventative care. I always wondered why this was pretty much absent from the Health Care Debate. However, it is very difficult to muster the political will to change something as drastic as health care. Efforts by both the Clinton Administration and the Bush Administration failed. The proper changes need to be made but if nothing happens, I just hope some positive reform is made.

http://en.wikipedia.org/wiki/Clinton_health_care_plan_of_1993

http://www.efluxmedia.com/news_George_Bushs_Health_Care_Legacy_32464.html

http://www.dailycomet.com/article/20091118/ARTICLES/911189841/1212?Title=Democratic-leadership-unveils-Senate-health-bill&tc=autorefresh

Response by Andres GonzalezAndres Gonzalez, 29 Nov 2009 21:01

I am shocked to hear some of the stories presented in this article. I guess I never really stopped to think about severe anger and disruptive behavior affecting the medical profession. It is true that only a small percent of doctors seem to act this way but some of the scenarios were just horrific. Belittling nurses and assistants who are generally very bright and facilitate the doctors with crucial assistance is terrible and hard to imagine. I could never see myself acting in this manner, but the article was useful in that it shows that other physicians can act up and as soon to be students, we cannot be afraid to speak up even if there is retribution. We will have the lives of others in our trust after all. I hope more oversight can be put in place to curb the despondent behavior.

A Real Eye-opener by Naveen MudaliarNaveen Mudaliar, 29 Nov 2009 19:32
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