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.

When Traumatic Events Unfold...

“When I was a boy and I would see scary things in the news, my mother would say to me, "Look for the helpers. You will always find people who are helping.” Fred Rogers  Since the tragic events of Monday's bombing at the Boston Marathon there has been a tremendous outpouring of emotions and I was particularly moved by the above quote that is making the rounds on Facebook and twitter.  Perhaps this resonated with me because I grew up watching Mr.

A Painful and Protected Disease Kept Isolated From the Cure



Anytime there is a really sick child or adolescent, regardless of whether or not you are specialty trained in pediatrics, there is a visceral pain and wanting to immediately remedy the condition.  For many of those faced with such circumstances, there is rarely an opportunity to completely eradicate the underlying disease or offending circumstances.  We look to bring more eyes and minds together to stop the disease process, to reduce the suffering and to help the patient, their parents and caregivers. Often entire communities come together to raise support for a child or a family dealing with cancer.  Dozens or more people put their personal needs aside and focus intently on those of a family hoping to stop the cancer that is ravaging their child’s physicality, devouring their emotional existence and impacting their lives forever.   This occurs despite a complete lack of knowledge about the disease.

Where there's smoke...

Smoking is on the minds of our legislators. Both tobacco and marijuana have been the subjects of spirited discussion and hearings the past few weeks and NHMS has been present bringing the voice of science, reason, and our patients. In regards to tobacco, NHMS has prepared a policy analysis (see report) that looks at the impact of a tobacco tax increase, taking into consideration the following:

• Smoking costs an average of $2,784 in direct medical expenses per smoker per year;
• Tobacco price increases of 10% consistently yield a 4% decrease in adult smoking and a 7% decrease in youth smoking;
• People of low socio-economic status have much higher smoking rates and poorer health outcomes; and
• The smoking rate among Medicaid beneficiaries is 57% compared to the overall NH of 19%.

A New Term

This past weekend, the New Hampshire Medical Society voted in a new slate of officers, and I am honored to be approved as your 182nd president.  The Annual Scientific Conference, held at the Mountain View Grand Resort, was the largest attended conference ever, with great lectures, energy and camaraderie.  It even snowed!  This year I hope to continue the excellent work of Dr. Harker and the previous 180 presidents who have represented physicians in New Hampshire.  I plan to focus on disability issues (both physical and mental/emotional) as well as the numerous healthcare transformation topics that lay ahead.  This will be a year of challenge, but also opportunity, for medical leaders who answer the call.  I look forward to representing you and working with you.

A Dream Dies To Save a Life

On June 26, 2014, the National Basketball Association Draft will take place in Brooklyn, N.Y.  One of the top picks expected in the first round, Noah Vonleh, was a star player at New Hampton School (N.H.) from 2011 to 2013 and was my oldest son’s teammate before playing for the University of Indiana last year.

Who's Afraid of the Boogeyman?

Toothpaste grenades.  Bombs in iPads?  Exploding clothing!  How scared I am.  Not the typical Dr. Seuss rhyme we grew up reading.  U.S. officials announced on Tuesday, Sept. 23, that one of the reasons for the recent bombing on Islamic State (ISIS) and Khorasan Group member locations in Syria and Iraq was because of intelligence that indicated these groups had obtained materials for improvised explosive devices (IEDs) that could be concealed in handheld devices such as smart phones and tablets as well as clothing dipped in explosive material.  These could then be used in coordinated, multiple “lone wolf” attacks.  See the story on CNN.

50 Years Ago Today

“Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” -- Dr. Martin Luther King Jr., in a speech to the Medical Committee for Human Rights, 1966

Fifty years ago today, nearly 250,000 people joined together in the March on Washington for Jobs and Freedom, calling for human, civil and economic rights for African Americans.  This march has been heralded as one of the greatest political rallies in our nation’s history and is widely credited for helping pass the Civil Rights Act of 1964 and the Voting Rights Act of 1965 (which has now recently come under attack).

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