We Have the Technology

On March 7, 1973, when I was 9 years old, the medical future came into my living room in Brooklyn, N.Y., via a 25-inch Zenith color television.  On that night, Steve Austin, a civilian astronaut, crashed in a test flight accident and lost his right arm, left eye and both legs.  Luckily for Colonel Austin, a Vietnam veteran who had walked on the moon, he was able to be “rebuilt” with artificial legs that allowed him to run at 60 mph, a prosthetic arm that could lift 150 pounds (and had a Geiger counter for radiation detection) and a bionic eye, complete with a 20:1 zoom lens and infrared capabilities, thanks to the generosity of the American Broadcasting Company.  Total cost?  6 million dollars.

Bullying in Health Care

Over the past few weeks, a sports story has grabbed national attention because of its implication for workplace bullying issues.  This case involves the Miami Dolphins of the National Football League, and the main players involved are Richie Incognito (the alleged bully) and Jonathan Martin (the alleged victim).

Boston Strong

This past weekend I happened to be walking up Boylston Street in Boston at night when I passed the site of the first bombing location from last year’s Boston Marathon bombing.  The building that was damaged from that explosion was being repaired, and as I looked across the street at the Boston Central Library, I thought of the horrible events from last April 15 and wondered how the victims were doing at this time, almost one year later.  It was surreal to touch a green mailbox at that site and see many parts of the metal showing damage and indentations, perhaps from the pressure-cooker bomb that damaged and forever changed so many lives.

We Need to Do Better

Last week New Hampshire lost two young university women to suspected Ecstasy or MDMA overdoses.  We offer our deepest sympathies to the families and friends of these women.  Such tragedies highlight the problems we face of drug use and addiction in New Hampshire and serve as a call to action to do all we can to prevent the physical and emotional harm that result from substance use and abuse.

Be Mindful of Habits

We are what we repeatedly do. Excellence, then, is not an act, but a habit.   - Aristotle 

What Can You Buy for $40 Billion a Year

It isn't news that we are in a budget crisis or that our leaders in Washington are looking at ways to reduce spending, but how they are planning to do this is worthy of our attention.  AMNews reported last week that President Obama's 2014 budget blueprint aims to cut $400 billion from healthcare over the next 10 years.  AMNews link: Click here

Addressing the State's Mental Health Crisis.

The state budget cuts over the past two years have impacted the health of our patients and the public health infrastructure in many ways, but perhaps the most damaging cuts have fallen on those with mental illness.  In 2009, the legislature's budget resulted in the closure of 60 beds at New Hampshire Hospital (NHH) the state’s inpatient psychiatric care hospital.  The community mental health safety net took a significant hit as well.  While this made the budget look better on the surface, the problems associated with mental illness did not disappear and neither did their costs.  

Yesterday we received good news from the state. Health and Human Services Commissioner, Nick Toumpas, announced short term and long term plans to address the state's mental health crisis.  

Ace of Spades

This past Sunday, as our nation readied itself to partake in the annual Super Bowl ritual of food, spirits, commercials and, of course, football, a man lay dead in his apartment across the river from MetLife Stadium. Too many chicken wings, Bud Lights and blue-green Skittles? Not at all. This man died from a presumed heroin overdose, possibly from a batch of heroin laced with fentanyl, which has caused numerous deaths in the past few months.  See the CBS News report here.

What's in a zip code?

As there are many more states and providers across the country focusing on the epidemic of opioid abuse and addiction concerns, there can be some utility in recognizing patterns that exist within your own zip code. “Each community chooses its opioid.  Within a 60-mile radius of where I have worked, patients have told me that ‘only idiots’ abuse any opioid other than ‘fill in the blank.’  Heroin, oxycodone, meperidine, hydromorphone, fentanyl, dextromethorphan- they all have been abused, but usually only one is abused in any given community. This is primarily due to control of the drug scene by one gang or another.  If opioids do have to be prescribed, limit dosing to three to four days maximum because follow-up for persistent pain is essential.”  ACEP Now, Feb 2015, Vol.34, Number 2, p.

A Worthwhile Trip to D.C.

Last week I had the pleasure of joining Scott Colby, the NHMS Executive Vice President and Dr. Gary Woods, the NHMS Delegate to the AMA, for the annual AMA National Advocacy Conference and Lobby Day in Washington, DC.  Each year the AMA sponsors this conference to update us on current national policy issues and to provide us an opportunity to meet with our congressional delegation to discuss those issues.  We learned about: the challenges of paying for Graduate Medical Education and workforce adequacy; proposals coming out of the CMS Innovations Center; and that everyone wants to fix the SGR but no one believes a permanent fix is possible... for now.  The conference was informational and prepared us to meet with our delegation.