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.

The Pain Puzzle

On April 22, 2014, the Food and Drug Administration’s Center for Drug Evaluation and Research held a scheduled meeting of the Anesthetic and Analgesic Drug Products Advisory Committee (AADPAC).  One of the main issues discussed and voted on concerned the proposed drug Moxduo, which is developed by QRxPharma and is a combination pain medication made up of morphine sulfate and oxycodone hydrochloride.  The proposed indication was for “the management of moderate to severe acute pain where the use of an opioid analgesic is appropriate.”  The “Combination Rule,” which is part of the FDA regulations under 21 CFR 300.50, states that:

The Right to Bear Arms, Part 2

On June 2, 2011, Republican Florida Gov. Rick Scott signed into law House Bill 155, The Privacy of Firearms Owners Act, which in the state of Florida would, according to the National Rifle Association, “stop pediatricians from invading privacy rights of gun owners and bringing anti-gun politics into medical examining rooms.”  The American Academy of Pediatrics and the Florida Pediatric Society urged Gov. Scott to veto HB 155 to no avail. The penalty for asking a patient about gun ownership? A $500 fine and loss of medical licensure.

The Refugee Healthcare Experience

Three days before I was born in 1964, Nelson Mandela was found guilty of sabotage against the South African National Party in the Rivonia trials. Two days after my 12th birthday, the Soweto Uprising occurred, which eventually led to the African National Congress taking a lead role in the anti-apartheid struggle.  As I have watched the memorials last week after the passing of Nelson Mandela, it is an appropriate time to look at the healthcare experience of African (and other) refugees in our state.  

The N.H. Department of Health and Human Services has an Office of Minority Health and Refugee Affairs, which was initially established in 1999 as the Office of Minority Health.  It has three main focus areas:

The right to bear arms.....

"A 7-year-old boy was killed Thursday at a Fourth of July celebration in Virginia after someone evidently fired a gun in the air." July 4, 2013

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