Vol.120 February 15, 2015 Disillusioned …Again and Again

February 14, 2015

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 “Scratch any cynic and you will find a disappointed idealist.”
― George Carlin

Maybe it is just that time of year, the record snowfall, the frigid temperatures, the lack of sun, but I feel like the world as I have known it is crashing down around my ears. Brian Williams has fallen off his pedestal, Bill Cosby is canceling shows all over the place, Tiger Woods is not coming back, Jon Stewart is leaving The Daily Show, Steven Colbert has already left, the towns are running out of sand and salt, and the trial of Dominique Strauss-Kahn, former head of the International Monetary Fund, has come up with the unique defense of his “aggravated pimping” “at a sex parties with “you can’t tell the difference between a prostitute and a naked socialite”.

So many of the truths we have held dear in medicine, science, politics, and society are being revealed as mere illusions. To wit:

  • Cholesterol need no longer be a nutrient of concern”. So sayeth the “nation’s top nutrition advisory panel” after 40 years of telling us just the opposite! High cholesterol levels in your blood do increase your risk for heart disease, BUT dietary cholesterol contributes only about 10% of that level. Of course, the panel couldn’t just leave it at that. According to them the REAL danger lies in foods heavy with trans fats and saturated fats. However, if you follow recent arguments in the literature closely enough you will see that there is some debate about which are the “good fats’ and which are the “bad fats.” Maybe we’ll have  to wait another 40 years for consensus.
  • Mississippi and West Virginia, among the poorest states in our country, have the best rates of measles immunization, and it is because they are the ONLY states that refuse to accept a waiver from immunizations on the basis of parental beliefs when children enter school. Mississippi’s measles vaccination rate is 99.7% for entering kindergarten students. West Virginia is at 96%. Epidemiologists have established a 94% immunized rate for measles as necessary to sustain “herd immunity”. In California and Arizona ( where thousands of Super Bowl visitors came and went back to their own states) the rates are 90.7% and 91.4% respectively.
  • Spewing sulphur gas into our high atmosphere could help block sun radiation and help cool off a warming earth. Isn’t sulphur one of those toxic pollutants given off by burning coal and other fossil fuels? Well, yes, says the National Academy of Science, but the computer models of blocking the sunlight with released sulphur have such a positive logic about them that “we should test it in some small pilot studies”.
  • Four out of five bottles of supplements taken off the shelves of GNC, Walmart, Walgreens, and Target in New York did NOT contain ANY of the herbs listed on their label. Ginseng pills “for physical endurance and vitality” contained only powdered garlic and rice. Ginkgo biloba for “memory enhancement” contained powdered radish, houseplants, and wheat. That label even claimed that it was wheat- and gluten-free! The FDA can only target products that have dangerous ingredients. It took the NY State Attorney General’s office to reveal this harmless ingredient sham, aka “profit by placebo” (NY Times, Feb. 3, 2015, pg.1)
  • Half of the health information and recommendations given on The Doctor Oz Show and The Doctors is false. Not only did 80 recommendations from each TV show picked at random from the 900 recommendations identified have NO evidence to support them, but many were even contradicted by evidence. In typical academic, “English speak” the authors suggest that “consumers and clinicians should be skeptical about these TV show recommendations”. (BMJ 2014 Dec. 17, 2014, 34)

Is there any hope for us optimists?   Well …

  • Crime rates in Boston have plummeted during this cold snowy weather. Homicide is down by 70%, rape by 50%, and vehicle theft by 46%. I guess everyone is staying inside, wearing lots of clothes,  and skipping the shoveling needed to steal a car. Rates for violent crimes in New York City, which had less snow and higher temperatures, all increased during the same period.

Vol. 84 February 15, 2013 Let’s Treat Gun Owners Like Doctors

February 15, 2013

hubThe number of physicians in the U.S.:  700,000.
Accidental deaths caused by Physicians per year:  120,000.
Accidental deaths per physician:   0.171%
.                                  U.S. Dept. Of Health and Human Services

Number of gun owners in the U.S.:   80,000,000  (Yes, that’s 80 million)
Number of accidental* gun deaths per year: 1,500.
Number of accidental* deaths per gun owner:   0.0000188 %
.                                   Statistics from  FBI
So, statistically, doctors are approximately 9,000 times more dangerous than gun owners .- a popular internet 2011 chestnut

* “Accidental” excludes homicides and suicides. If you count those the number of gun deaths is about 30,000 per year. Between 2003 and 2007 15,000 of those gun deaths were children 19 or younger. (That is about twice the number of children deaths in motor vehicle accidents.) In 2010 there were 6750 U.S. gun deaths among 1-24 year olds. (Twice as many deaths as cancer, 5 times as many as heart disease, and 15 times as many as infectious disease for this age group)

The gun owners I know are very responsible about gun safety. Why make them “pay” for the transgressions of a few with stricter enforcement of regulations and/or creation of new ones?  Why not! We do it to physicians!

In response to a million dollar Medicare scam in Florida that billed sham patients for sham home care services Congress passed a law requiring that EVERY physician had to attest that he or she had met the patient “Face to Face” (F2F) within 30 days of ordering home care services.  Fraudulent actions by less than 0.001% of physicians have burdened all of them with a duplicative, clinically irrelevant, non-reimbursed reporting requirement that is of no use to patient, physician, or home care agency. No big deal you might think, but in reality the absence of the F2F report has delayed millions of dollars of Medicare reimbursement to all certified home care agencies throughout the nation. Hm-m, maybe that was the real reason the law was passed?

In response to “just a few deaths” from automatic weapons in the hands of less than 0.01% of gun owners why shouldn’t we pass some laws to improve gun safety.  Well, we apparently have; about 20,000 of them; laws that is, not gun owners. One problem is that they are not enforced.  The chief enforcement agency, the Bureau of Alcohol, Tobacco, and Firearms (ATF) of the Department of Justice is hobbled… restricted… dare we say “castrated” … as Jon Stewart has.

The ATF, THE federal agency overseeing firearms:

is prohibited from establishing a registry of gun owners (imagine no one keeping a registry of car ownersis prohibited from requiring gun dealers to maintain inventories of their wares

is prohibited from inspecting any gun dealer’s records more than once a year

is prohibited from revealing firearms trace data to anyone other than law enforcement personnel (firearm tracing is done for  firearms used in crimes. One study showed that 57% of guns used in crimes in one state were traced to only 1% of gun dealers.)

is prohibited from requiring gun dealers to respond to police inquiries.

Who made these rules?  Rep. (former) Todd Tiahrt (R-Kansas) put them deep into a 2006 spending bill. The Tiahrt Amendment, as it has become to be known, also permits gun dealers to destroy gun registration applications within 24 hours of completion so as “to avoid any inadvertent errors from being promulgated.”

Why doesn’t the ATF Director complain? Another Congressman, who was the winner of the NRA Defender of Freedom Award for that year, inserted into the 2006 Patriot Act the requirement that the ATF Director ( a mere Bureau chief)  be subject to Senate confirmation; the only Bureau Chief with that requirement. Senate has never done it.  The current part-time ATF Director is a Prosecutor from Minnesota.

Why are Federal laws needed? Massachusetts has some of the most comprehensive gun laws and in 2009 had one of the lowest per capita gun deaths in the country, BUT…in 2011 366 of the 699 guns used in crimes in Massachusetts were traced to sales in other states. One-third of them (133) were bought in New Hampshire and used in Massachusetts.

So we may not need any more laws or regulations for gun safety. We could just repeal the one “Tiahrt Amendment”, and let the ATF begin to do its job
… but maybe physicians should hire the NRA lobbyists to push for repeal of the F2F regulations.


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