A patient mentioned that he had escaped Canadian Medicine. While living in Canada, he would take his wife to a 10AM doctor’s appointment by dropping her off at 9 AM. It was frequently 5 PM when he was called to pick her up. He states there were usually 50 people waiting and patients went through at a rapid clip. One time he accompanied his wife and timed how long she had with her doctor. It came to 45 seconds… He feels so fortunate that in this country he sometimes has to wait less than one hour for a 15 minute appointment here.

The world wide organ market has been highlighted in the current issue of Scientific American. Some three decades ago, science-fiction writer Larry envisioned a world in which organ transplants were common. To ensure a continuing supply of organs for the public at large, he suggested draconian laws mandating capital punishment for a host of offenses, and shadowy “organ-leggers” plucking victims off the street to extend the lives of the rich and remorseless… Human rights organizations estimate that China executes somewhere between 3,000 and 20,000 prisoners every year and harvests organs from at least 2,000. They also allege that prison officials allegedly “botch” executions so that prisoners die slowly, giving transplant teams more time to get their organs. Although government officials claim the prisoners agree to the harvesting, critics argue that meaningful consent is impossible under conditions preceding an execution. (The US forbids such transplants.) India, known as the spare-parts repository for richer nations, where $30,000 could buy a new kidney from doctors who paid a living donor less than $1,000, last year banned organ sales. Scientific American showed photographs of Indian villagers with large diagonal flank scars consistent with the harvesting of kidneys without consent.

The University of Arizona has developed a systems approach to medical education in North America for International Health. This program for senior medical students and residents was made possible through the International Health Medical Education Consortium. The focus is on relationships between health care careers internationally and among our own domestic underserved population.

Once while returning from an overseas meeting, a man on a stretcher was in line to board the plane ahead of us. He had a patch on one eye and stated that he had a detached retina. He was flying directly home to see his ophthalmologist. He stated that any loss in vision by delaying treatment could not be worse than his brief encounter with international medicine.

A lady from England commented on her sister who had a colon polyp removed. The sister was told to call back in two years for a follow-up colonoscopy. When she did, she was given an appointment 18 months later. That was the best they could do. She developed a recurrence waiting for that 18 month appointment.

Rhone-Poulenc Rorer, Inc introduced a new drug (Rilutek for ALS) over the Internet. It was the first time that cyber “chat-rooms” were used by the drug industry to publicize a new product. Although RPR had planned a Manhattan introduction, bad weather cancelled the meeting and a cyber-press conference was organized by America’s House Call Network (AHCN). It was promoted via the Business Wire and PR Newswire as well as e-mail to key reporters. There were 14,000 inquiries (multinational) at the Website in the first two hours. The market for on-demand health care information is expected to grow from $20 million to $500 million by the end of this year when 18 million people will spend $10 per month to access online services to find health related information. Medical experts say that about 80% of most healthcare problems can be handled at home, without the assistance of a physician (see “Selfcare,”Sacramento Medicine, April 1993, p 18).

Received an E-mail from a science editor I met at the medical writers conference in Monterey. Of 171 scientific papers reviewed, only 19 had adequate statistically valid techniques and 11 had minimal deviation. The other 141 were not thought to have a valid basis for the conclusions rendered. There were similar discrepancies in Australian and European research with as high as 88% of scientific papers having no scientific value.