Health
Medical Reforms Needed:
Cut down on the 80 hour weeks for interns
#polypharmacy
licensing to ensure protocol compliance
eliminate Payola
QUESTION:
https://twitter.com/AjKavanaugh/status/1650985315346128905/
Hospital prices aren’t real.
Insurance rates aren’t discounts.
PBMs don’t lower Rx costs.
EMRs were built to bill.
There is no physician shortage.
There is nothing affordable about ACA.
Private equity hurts patient care.
Healthcare is filled with groupthink.
What would you add?
5:09 PM · Apr 25, 2023
MY REPLY: Doctors are in a tough spot:
They have $xxx,xxx in student debt, and are forced to demand high payments to pay off the debt.
Despite their highly vaunted training, they become followers of the protocols prescribed by their administrators. Too scared to give up their sinecure that pays for the high debts they incurred, they are vulnerable to pharmaceutical sales pitches, and become legal pill pushers, when their medical training suggests otherwise.
AI will soon be able to make a diagnosis comparable in quality to that performed by a human. Doctors will become overpaid, administratively-bullied, protocol-restricted, pill pushers and Spineless debt-slaves. Too scared to speak the truth regarding current public health issues.
Who repeated drug company talking points, and were too afraid to speak out, and unable to defend the scientific method which relies on free inquiry “Ask a better question get a better answer!”
Hours worked by Residents is hazing. Even if supervised, It is a dangerous practice for their patient’s health, and also the resident’s health and mental well-being. It also leads to burn out, and leaving the profession early after all of the debt is incurred.
Hospital pricing is a joke, hidden behind opaque walls where patients are unable to make an informed decision. This and other factors caused medical costs to skyrocket.
+++++
Polypharmacy: multiple drug combinations, cause exponential number of side effects and interactions
If you take ONE drug, you have one side effect, no interactions. ONE condition to check for.
side effects: a
interactions: zero
If you take TWO drugs, you have two side effects, one interaction. A total of THREE conditions to check for.
side effects: a, b
interactions: a-b
If you take THREE drugs, you have three side effects, three interactions. A total of SIX conditions to check for.
side effects: a, b, c
interactions: a-b, b-c, c-a
If you take FOUR drugs, you have four side effects, six interactions. A total of TEN conditions to check for.
side effects: a, b, c, d
interactions: a-b, a-c, a-d, b-c, b-d, c-d
If you take FIVE drugs, you have five side effects, ten interactions. A total of FIFTEEN conditions to check for.
side effects: a, b, c, d, e
interactions: a-b, a-c, a-d, a-e, b-c, b-d, b-e, c-d, c-e, d-e
It goes up from there. Do the math.
I have heard of cases of people in nursing homes taking THIRTY drugs. That adds up to 465 conditions to check for.
It might be legal, and each individual drug may be medically called for, but, in combination, is it malpractice?
+++++
How Many Pills Are Too Many?
https://www.nytimes.com/2017/04/10/upshot/how-many-pills-are-too-many.html
What really happens when you mix medications?
http://www.ted.com/talks/russ_altman_what_really_happens_when_you_mix_medications
If you take two different medications for two different reasons, here’s a sobering thought: your doctor may not fully understand what happens when they’re combined, because drug interactions are incredibly hard to study. In this fascinating and accessible talk, Russ Altman shows how doctors are studying unexpected drug interactions using a surprising resource: search engine queries.
paroxetine, or Paxil, an antidepressant; and pravastatin, or Pravachol, a cholesterol medication; when combined, cause a 20 point increase in blood glucose.
+++++
Medicine interactions adds up exponentially
# of medications, each with side effects (left)
# of interactions(right)
1_0
2_1
3_3
4_6
5_10
6_15
7_21
8_28
9_36
10_45
Now add in side effects of those 10 meds.
Some patients are on 20+ meds
#polypharmacy
I take Metformin for the diabetes
caused by the Hydrochlorothiazide I take for high blood pressure
which I got from the Ambien I take for insomnia
caused by the Xanax I take for the anxiety
that I got from the Wellbutrin I take for chronic fatigue
which I got from the Lipitor I take because I have high cholesterol
because a healthy diet and exercise with regular chiropractic care and superior nutritional supplements are just too much trouble!
