M x 5
The New England Journal of Medicine presented online a case of a 68-year-old woman with metastatic breast cancer and asked physicians to vote whether she should be prescribed marijuana to alleviate her symptoms. 76% of 1446 physicians from 76 countries voted “yea”. About 2/3 of all votes came from North America (that includes Canada and Mexico you know) and 76% of North American physicians voted “yea”, BUT the range of response was huge. Only 1% of 76 Utah physician voters said “yea”, but 96% of 107 Pennsylvania physicians said “yea”. Hardly any physicians chimed in from Asia or Africa causing the NEJM to comment, as only it can, “perhaps this topic does not resonate as much as other issue there”.
One of the physicians conducting this poll was James Colbert. We have been unable to ascertain if he is a relative of Steven Colbert. (When IS the technology of PRISM going to be available to us bloggers, anyway?)
Common threads in the 118 comments posted were:
1. Does marijuana even belong in the purview of physicians, or just legalize it and let patients decide whether to use it or not?
2. Most physicians who supported its use would do so “in certain circumstances”; implying strongly, to me, that physician control over use was assumed by supporters.
3. All camps called for more research to move toward a stronger basis of evidence
Remember December 2, 2012?
That was the day two Australian DJ’s called a London hospital and got all sorts of confidential medical information from a nurse caring for the Duchess of Cambridge. It was a prank, easy to do, but had disastrous consequences – and NOT for the patient, as you may recall. HIPPA established federal laws to protect privacy of medical information in 1996. The HITECH Act set up legal mechanisms to “ensure” privacy and security of electronic medical identity and health information. The Office of the National Coordinator for Health Information Technology recommended no less than eleven things individuals should do to protect their information on mobile devices.
And … CMS (Centers for Medicare and Medicaid) currently track at least 300,000 compromised Medicare-beneficiary numbers. A “Medicare-beneficiary number” is the number your health care provider uses to bill Medicare. It is like someone using your, or your physician’s, ATM card! The Office of Civil Rights has investigated 27,000 of 77,000 complaints regarding breaches of health information privacy. About 18,000 of those resulted in a required “corrective action”. That ain’t hay.
The human in the protective chain of health information confidentiality may be the most common weak link, but a lap top in the car of an Office of Inspector General auditor in the hospital parking lot in 2011 could pick up private health information from unsecured hospital wireless networks.
I must admit it is hard for me to get too excited about NSA knowing “who calls who and when”, since I accept that it could enhance our national security, but I am waiting for the other shoe to drop, as I think it eventually will, on medical information about the Boston Marathon bombers.