First Step in Our Journey to Better Healthcare System in NH.

Elections bring out strong emotions in all of us.  There are winners and losers and we often feel very strongly about the candidates we supported.  Following the election, we are exhausted from the campaign.  We are left wondering what, if anything, are we to do next and how can we move our agenda forward.  The answer is rarely clear, however, regardless of how we feel about the results of the election, doing nothing is not an option.

The work of the NHMS is critically important to advancing our profession and the public's health. While we may not know how our agenda will be received by our elected officials, we must reach out in good faith to them because they are the ones with whom we will work with over the next few years. 

First (Worst) In the Nation?

Last week, the New Hampshire Department of Insurance presented information about worker’s compensation medical costs in the Granite State.  This information came from the National Council on Compensation Insurance, or NCCI, which gathers data, analyzes industry trends and prepares objective insurance rate and loss cost recommendations from 35 states.

Supporting Mental Health Crisis.

On Monday of this week, I joined representatives from a variety of health profession, law enforcement, and patient advocacy organizations to speak about the mental health crisis in New Hampshire.  The National Alliance on Mental Illness New Hampshire (NAMINH) organized the press conference to share new data on the excessive wait times for people in mental health crisis.  

At the time of Monday's press conference, 31 adults and five children sat languishing in hospital emergency rooms across the state waiting for a bed to open at the New Hampshire State Psychiatric Hospital.  Since July, there have been a minimum of 30 patients per week waiting for admission, with a maximum of 120.  You can read full  details here.

Taking a Stand on Addiction – Changing Behaviors, Theirs, Ours and Yours

As the epidemic of over prescribing pain meds, drug addiction and associated overdoses rages on, there is evidence that efforts to universally direct and limit the prescribing of controlled substances has had a positive effect on one of the largest underpinnings of this public health crisis.  The Department of Health and Human Services has directed initiatives to help limit the prescribing practices for opioids. There has been: updated training and education guidelines, increased use of naloxone and an increase in medication-assisted treatment combining medication with counseling and behavioral therapies to treat substance abuse disorders. Refer to New weapons combat opioid addiction, ID tools, e-prescribing are key, by Mari Edlin; Managed Healthcare Executive, Vol. 25 No.

The Fetus is the Parent of the Child

As summer winds down and the seasons begin to change again, a new child will enter this world in the next few weeks.  My office manager will give birth soon, and while we may consider the notion that knowledge and ideas begin the day we are born, research has proposed that even in the womb, a developing fetus is learning things that will affect his/her own future and parents as well.  Most healthcare clinicians, and even the general public, understand how prenatal exposure to chemicals such as alcohol, nicotine and drugs will negatively affect the developing fetus.  See the article in Pediatrics.

The Gift of SGR

As we head into the holiday season, one gift that most, if not all, physicians would enjoy is a permanent fix to the Sustainable Growth Rate formula, or SGR.  The current SGR formula, introduced in 1997, has threatened to cut physician Medicare payments by up to double digits.  The last proposed cut for 2013 was 26.5 percent, but was postponed due to a last-minute congressional “patch” known as the American Taxpayer Relief Act, which was passed on this past New Year’s Day.

The House of God, Part II

For anyone interested in medicine beginning in the late 1970s, the book The House of God, by Dr. Stephen Bergman (aka Samuel Shem, MD,) was often recommended (or reviled) by those who were in the field as a sort of rite of passage to provide some idea of what a career in medicine might be like (before the Libby Zion case) with the caveat that it was fiction.  Four decades later, the book still provokes questions and discussions for many.

The Importance of Fellowship...

In 1791, Josiah Bartlett and 23 others doctors came together to enjoy each other’s company and to be the vanguard for our sacred profession... and the NHMS was born!   They spent much of the first century of our existence setting standards for professional conduct, emphasizing scientific rigor, and building membership.  Perhaps most important to them was fellowship with other doctors – as evidenced by always meeting in taverns.

The JUA Journey

I am not a NH JUA policy holder but I believe it is important for all NHMS members to understand that lead plaintiffs in the NH Supreme Court case, Dr. Georgia Tuttle, Lakes Region General Hospital and Derry Medical Center, with support of NHMS, successfully sued the state and JUA to stop the state from taking $110 million excess surplus belonging to policyholders.   

The Normal Heart

A recent film on Home Box Office deals with the story of the beginning of the AIDS epidemic in New York City in the early 1980s.  Having grown up in the Big Apple and having spent many years during the 1980s in medical school and residency taking care of patients with HIV/AIDS, the movie  took me back to an earlier decade when the lack of medical knowledge, fear of the unknown and significant prejudice in our nation against homosexuals were common.  It made me wonder about the current status of HIV/AIDS in our own state.

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