- Del Meyer, MD - http://delmeyer.net -

A case of H1N1, a war on many fronts, communicating with new generations

Emily Dalton, MD, wrote her final President’s Message in the December issue of The Bulletin of the Humboldt-DelNorte County Medical Society.

It was on “Health Care Reform” and she was in bed with the flu.

…It is hard to believe that when I started the State of California was seriously considering a plan for a statewide program of health insurance for all Californians (a la Massachusetts), and as I finish Schwarzenegger slashed fund-ing for the Healthy Families program, Medi-Cal and Medicare, while the federal government is working on health care reform…

As I have been writing this I have been bedridden for 6 days with what is most likely H1N1. Fever, cough, head-ache, muscle aches and tremendous malaise — enough to make one sorry for the pigs! According to the health de-partment virtually all “ILI” (influenza-like-illness) has tested positive for H1N1, and in pediatrics one cannot avoid a heavy exposure to whatever is circulating. A pediatric intensivist from UCSF came up for a conference and described how unnerving it is to be in the ICU at UCSF right now: it is full of pregnant women on ventilators with H1N1. What an eerie and unsettling image! I can see how this virus would do that — even vaccinated, the first day I got it I could feel the deepest portions of my lungs get irritated and full of what felt like necrotic phlegm. I am finally able to take brief walks without feeling utterly exhausted. But enough whining — on to better things…

To read her original column, go to the website at http://www.sonic.net/~medsoc/images/bulletins/2009-12%20DECEMBER%20BULLETIN_for%20web.pdf.

An editorial, “On Finding Ourselves at War,” by Guest Editor Kenneth Y. Pauker, MD, appears in The Bulletin, Fall 2009, of the California Society of Anesthesiologists.

We are at war, and we had better understand that, and act like it. Although we are reluctant soldiers in what has become an expanding and intensified struggle for the safety of our patients and the viability of our profession, fight we must. We cannot simply be conscientious objectors for the reason that we are ethically obliged to secure ground that was made sacred by — and inherited from — our forebears.

Arrayed against us are forces that seek to redefine who we are and what we do. There are those who, to ad-vance their own economic and political agendas, fully intend to divide our House of Medicine and enslave and muzzle us, to break our spirits, to further alienate us from the patients whose welfare has always been at the heart of our medical journey. There are others, so-called “do-gooders” and health care planners, who mean well enough, but who, with their imperfect understanding of the nitty-gritty of the actual practice of medicine, would restrict us, redirect us away from the essentials of our professionalism, create hurdles and diversions that distract us and consume our time and energies, and to boot, visit upon us a plague of unintended consequences. And then there are the usurpers — circling, lurking, and pouncing on opportunities as they present themselves, trying to carve out a little something more for themselves.

So who are we? We are the descendents of Hippocrates, practitioners of an ancient method of discourse and learning, perpetual learners — an inquisitive, reasoning, obsessive, and compulsive lot…. We are protectors of our pa-tients…

So who, then, is the enemy with whom our relations have devolved to the point of war? First and foremost, pow-erful and essentially unchecked as we have seen merger after merger and the amassing of monopsony power, are the health insurers. They have over time ceased being insurers in the common vernacular, but now see themselves as guarantors, regulators, protocol makers, evaluators, and profit makers for executives and investors…

Next on my hit parade of “enemies of the state” of grace are plaintiff attorneys and our (more appropriately, “their”) system of adjudicating claims of medical malpractice. We have been told over and over that what we have in California, MICRA, is the best system in our nation. To me that is not nearly good enough.

We still have essentially a lottery, lawyers sharking around continually in search of a really big hit. Pretty much none of this is about the “Truth of the Matter,” but rather it is all about money, pure and simple, and sometimes a whole lot of money…

And last, but certainly not least, we are at war with ourselves, our alter egos in other specialties who all too often want what they need for themselves, no matter the cost to others in the House of Medicine. Our state and national medical professional societies are fractionated and often nonfunctional. We contribute to organizations within medi-cine that lobby against the positions of one another. As Pogo wisely observed, “We have met the enemy, and it is us.” We must discuss and find a better way to advance our positions, form new alliances across specialty lines…

This editorial represents the views and opinions of its author and not CSA policy.

The entire article is on the CSA website at www.csahq.org/pdf/bulletin/ednotes_58_4.pdf.

“Social Media — Fad or Fundamental Shift?” is the subject tackled by Sue U. Malone, executive director of the San Mateo County Medical Association, in the September issue of the society’s Bulletin.

Every day we are hearing more and more about the wave of social media that surrounds us. Is it a fad or a new way of life? Perhaps it is not a fad but a revolution.

Some Interesting Stats:

Compare the time it took various forms of communication to reach 50 million users:

80 percent of Twitter usage is on mobile Does this mean email is passé?

To assist you, we are planning to redevelop our Web site to better serve members and the public. The new site will provide a self-service online membership locator, directory, and profile, which will permit physicians to create their profile and update their directory listing, join or pay membership dues online. The system will be designed to run with limited administrative oversight aside from regular posting of new content. The site will provide both the general community and physicians with local health-related resource locations, allow members to create and manage classi-fied listings, and furnish the tools for physicians to create a full Web presence…. Physicians will also have the oppor-tunity to share content from our site to Facebook via SMS text message as well as Twitter

*Footnote: These are approximations, as opinion varies: Baby Boomers – born 1946–1964; Generation X – 1965–1981, Generation Y – in the 1980s and thereafter.

Her article can be found at the SMCMA website: www.smcma.org/bulletin/issues/BULLETIN-09SeptemberF.pdf.