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

The Stand

By the time you read this blog, there will already have been a webinar put on by the New Hampshire Department of Health and Human Services on Ebola virus disease titled “Moving Clinicians from Panic to Prepared.”  As some of you may know, I wrote about EVD a few months ago for the bimonthly NHMS newsletter and asked the question about how the spread of disease could be stopped, when healthcare workers were one of the most at-risk populations.  How could a clinician not panic, seeing how egalitarian this virus has been, having complete disregard for social or professional status as it has claimed victim after victim, spreading across continents at will.

The Times They Are A'Changin

On February 5, 2014, the Centers For Medicare and Medicaid Services sent out a transmittal (505) lifting the restriction on Medicare contractors, including Medicare Administrative Contractors (MACs), Recovery Audit Contractors (RACs) and Zone Program Integrity Contractors (ZPICs), from taking action on claims that are "related" to but not included in claims currently under review, with an effective date of March 6, 2014.

The Unthinkable

An American nurse is infected with a deadly disease while working in her own hospital.  Accusations of breached protocols and changing guidelines.  Too much of a hazmat suit is not a good thing.  Taking off the personal protective equipment the wrong way may kill you.  The virus is the enemy, people, don’t forget that.  What a crazy three days it has been.  Now a second healthcare worker has tested positive for Ebola.  When the executive director of a national nurses union says that she and her members are deeply alarmed about the lack of protocols at Texas Health Presbyterian Hospital, a new day has truly dawned.

There is a Seasonality to our Work

For me as a family physician, my seasonal work  includes, school and sports physicals in the summer, flu shots in the fall and winter and attention to problems associated with allergy in the spring. Similarly NHMS has seasonal priorities and now is our time to be active legislatively. We don't do this often but over the past few weeks we have asked you to speak out on an issue of importance to all of us. Thank you for taking time from your busy schedules to contact your legislators asking them to support the tobacco tax increase. Your calls will make a difference as the Senate and House negotiate the final budget.

Tommy, Can You Hear Me?

Spring is finally here, and Little League baseball players throughout the Granite State are oiling up their baseball gloves, taking swings in the batting cages and finally running around the infield.  Pitchers are staring intently at the catcher’s mitt, ready to strike out another Casey at the plate.  But a cautionary tale came our way from Major League Baseball last week from Miami via Tampa via Santa Clara, Cuba, about the limits of even the greatest young prospects.

Tragedy and Horror: Must Renew our Efforts to Prevent Violence.

Horrific events like last week's shootings shake us at our core, bring fear into our lives, and focus our thoughts on how precious and fleeting life truly is.  We ask ourselves why and seek answers so that we can prevent this from ever happening again. Unfortunately, these shootings are only the most recent in a string of violence and mass killings over the past 2 decades. The typical responses include that there are too many guns, or that there are too few guns, or that the mentally ill are dangerous, or that the mental health system is broken and severely underfunded.  Initially, there are calls for tighter gun control, looser gun control, and enhancing the mental health system. However, as we get further from each of these events, the energy and passion for prevention wanes, and we are then left with two highly polarized groups fighting over gun control sucking up all the airtime and energy for change.

Faster May Be Better

Last week a friend of the family suffered an ischemic stroke while talking to her children.  She developed difficulty speaking, had a right facial droop and right arm weakness.  She was taken to the local acute care hospital, had imaging studies to check for bleeding in the brain and, after a few days, was discharged home.  As I was told about her situation, a media story was released concerning recommendations about acute stroke management.  It related a series of articles from the Journal of the American Medical Association, discussing early management of stroke and the impact on decreasing disability.

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