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Teen Drug Abuse - Preventive Role of Healthcare Providers Print E-mail
Written by By Ramsey Bradley, M.S.   
Wednesday, 20 April 2011 15:33

Drug abuse and addiction are a major burden to society, with economic costs alone estimated to exceed $600 billion annually in the United States (ONDCP 2004; Rehm et al. 2009; CDC 2007). This includes health and crime-related costs, and losses in productivity. As staggering as these numbers are, they provide a limited perspective of the devastating consequences of this disease for individuals, families, communities, and society as a whole.

While there are no statistics available to show the extent teens play in the overall economic costs, recent statistics show that illicit drug use is declining among US teenagers.  This sounds good until you look at the fact that prescription drug abuse has risen sharply.  Between 1999 and 2006, the US Department of Health and Human Services reports, the number of surveyed 12 to 17-year-olds who reported nonmedical use of a psychotherapeutic medication with the previous year increased by more than 60%.  In 2005, an estimated 1.4 million US emergency department (ED) visits were related to substance abuse.  Abuse of prescription drugs accounted for 37% of these cases.  Of these overmedication numbers, teens 12 to 17 years old accounted for more than 13,000 ED visits per year.

The statistics listed above emphasize the importance for clinicians, especially emergency medicine providers to appreciate the magnitude of prescription drug abuse among adolescents so that overdoses or chronic abuse can be identified and treated.  Although data involving emergency PAs and NPs are not readily available, fewer than 40% of physicians receive formal medical school training in recognizing prescription drug abuse.  According to the Center on Addiction and Substance Abuse (CASA), 43% of physicians neglect to ask about prescription drug abuse during the patient history.  Clinicians who provide emergency care, and primary care providers, are in a position to help identify and assist in treatment with the growing abuse of prescription medications by teenage patients.  Everyone in the medical profession needs to be more informed of recent trends in drug abuse and treatment resources.

Many agencies and personnel in this country are working diligently to stop the growth of substance abuse of any kind.  If we all work to keep informed and regularly reach out to resources that can provide timely information. We can save many teens that will die young or enter adulthood with debilitating medical problems and/or addiction.

Mr. Ramsey Bradley,Founder/Facilitator of the Adolescent Drug Awareness Program (www.adolescentdrugawareness.com), has a Masters Degree in Psychology/Counseling and has more than 20 years of experience working with teens and their families.  His experience includes Private Practice, Public Mental Health and Substance Abuse areas of interest.  Throughout his many years of experience, he has observed a huge gap in programs that address the specific needs of today's teens and their families.  The Adolescent Drug Awareness Program is the result of his findings, many years of ongoing research and dedication into finding successful strategies for both teens and their families.

 
Florida Docs Monitor Pending Legislation Print E-mail
Written by Jeffrey Herschler   
Wednesday, 20 April 2011 11:31

At the state and federal level, legislation is pending that, if passed, could have a significant impact on Florida providers.  

In Tallahassee Sen. Ellyn Bogdanoff, R- Fort Lauderdale has introduced a bill to fight staged automobile accidents and excessive PIP claims.  Consumer advocates and the insurance industry support the bill.  See Strange Bedfellows: Insurance Industry Unites with Consumer.  The FMA and the Florida Chiropractors Association have voiced their opposition to the pending legislation. The concern is that the proposed new law would make it easy for insurers to delay payments and deny PIP claims to legitimate providers.  In other words, "this new law would cast too large a net thus ensnaring honest docs already squeezed by declining healthcare reimbursements," stated a leading physician advocate. Adds Glen Ged, Ellis, Ged & Bodden "All legitimate parties want to see fraud out of the system -- the stated aim of these bills. However, many provisions would only open the door to greater insurance company profits at the expense of providers."  An editorial in the Ft. Lauderdale Sun Sentinel, insists that the proposed new law is not good news for consumers either.  See PIP Legislation Bad News for Docs and Citizens.  However according to a recent article in the Daily Business Review, the Insurance Information Institute estimates Floridians have paid an extra $1 Billion in auto insurance premiums due to bogus claims.  

Meanwhile, in D.C. the Help Efficient Accessible Low-cost Timely Healthcare Act of 2011 would cap contingent attorney's fees in medical malpractice cases.  Sponsored by US Rep. Phil Gingrey, R-Georgia, the bill also includes a cap of $250,000 for non-economic damages.  The goal of this legislation is "To improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system" according to GovTrack.us.  The CBO estimates savings of $35 per American over five years.  Opponents of the legislation assert that the caps, while appearing consumer-friendly, are actually bad for consumers.  In an article published recently in the Daily Business Review, Brian Wolfman, a law professor at Georgetown University stated that the bill "...fixes non-economic damages at $250,000 forever, regardless of the impact of inflation" and that this illustrates that the cap "...is not a genuine attempt to gauge the impact on real people's lives..." Predictably Democrats are against this legislation.  Ironically they cite the sanctity of free markets and states' rights (two subjects typically championed by Republicans) as reasons to oppose the bill. 

Stay tuned.

Last Updated on Tuesday, 24 May 2011 08:58
 
House Budget Chairman Paul Ryan Unveils GOP Resolution Print E-mail
Written by Jeffrey Herschler   
Wednesday, 13 April 2011 15:37

According to Money.CNN.com:

"Starting in 2022, the House GOP resolution would convert Medicare -- the health care program for seniors -- into a voucher program, or what Ryan calls a premium-support model.  Under such a system, seniors would choose from a Medicare-approved list of private insurance plans and the cost of their chosen plan would be subsidized in part by the federal government."

And with regard to Medicaid reform, CNN.com reported that

"The resolution would also convert the federal government's payments for Medicaid -- the health program for the poor and disabled -- into a block grant to be allocated among states. Currently, federal payments to states are determined by a formula."

 Read the complete Money.CNN.com story HERE.

The GOP Path to Prosperity by Paul Ryan was posted to the Wall Street Journal website on Monday (April 4) evening.  In that op-ed piece, Representative Ryan said:

"The open-ended, blank-check nature of the Medicare subsidy threatens the solvency of this critical program and creates inexcusable levels of waste,"  

He also stated:

"The new health-care law is a fiscal train wreck."

Click the link to see the Paul Ryan video: 

Free Healthcare is Costly

"If you think healthcare is expensive now, wait until it's free," states House Representative, Paul Ryan (R), Wisconsin.

Last Updated on Thursday, 14 April 2011 09:38
 
HCR: The Discussion Continues Print E-mail
Written by Jeffrey Herschler   
Wednesday, 13 April 2011 15:16

On March 24th the Coalition Panel on Health presented a debate on healthcare with the provocative title:

FINDING THE BALANCE BETWEEN REFORM AND REPEAL.  Produced by EarQ, the event was held at Ana G Mendez University System in Miramar.  The purpose of the event was to address issues such as:

·         Defining the healthcare debate

·         What HCR means for America

·         Can we afford reform?

·         Can we afford repeal?

Moderated by Rochelle Latkanich, Regional Vice President, Take Care Health Systems, the participants possessed diverse backgrounds and viewpoints.  The panel consisted of Dr. Olveen Carrasquillo, UM School of Medicine, Chief of General Internal Medicine, Tom Gomez, Transformation at the Edge, Executive Director, Dr. Manuel Laureano, Ana G. Mendez University System, Professor of Healthcare Administration, Linda Quick, South Florida Health & Hospital Association, President, Allan Boshell, AvMed Health Plans,  Vice President and Brian Payne, Catholic Hospice, Executive Director. 

The starting point was a discussion of anticipated benefits of HCR.  Dr. Carrasquillo noted that young people will now have more career and education options now that they can ride their parents' plan until age 26.  Dr. Laureano stated "I think HCR will be good for everyone eventually."  He went on to point out that the current situation is clearly unsustainable, "I have an employee who is 60 years old. Her health premium is over $1000 a month and she only makes $2000 per month."   

The current system's shortcomings were expounded upon by Mr. Boshell who emphasized the need to transition to a new method of compensation.  "The old paradigm of do more (procedures), make more (money) is unsustainable," he stated.  And "Payment reform is essential to solving the primary care physician shortage," Dr. Carrasquillo added.  Bringing the conversation closer to home, Mr. Gomez stated "Miami leads the nation in avoidable hospital admissions for Medicare patients. The probing question for this community is:  How do we reduce the waste?"  

Next the conversation turned to one of HCR's core goals:  Moving toward Universal Care.  "I don't think we can go from 75% insured to 97% insured like they did in Massachusetts; maybe we can fulfill half of that," Dr. Carrasquillo said.  Ms. Quick pointed out that of 4.5 million uninsured in Florida, 1 million are undocumented aliens who are specifically excluded from HCR.

Mr. Payne bemoaned the area's unique challenges stating "The problem in South Florida is a lot of illegal citizens die here and that is the first time they are documented. This affects our CON" (adversely). 

Ms. Quick was passionate about the government's role in health policy and administration stating flatly "I don't object to paying more in taxes."  She emphasized the government's role in educating citizens to make healthy lifestyle choices, addressing the primary care shortage and providing safety net health services, among other things.  "Many of us believe this individually but apparently not collectively" she said.  

All panelists agreed that the Great Recession combined with an aging demographic creates fiscal challenges for governments as well as at the organizational level.  "There has to be a change in culture," Dr. Laureno noted.  "How can we provide care within our economic limitations?" he asked rhetorically.

Mr. Boshell challenged Ms. Quick's faith in the government's role in fixing our flawed health system stating "I don't think the government can solve healthcare.  We saw what happened in Massachusetts.  I believe the American entrepreneur will deliver the solution."  Mr. Gomez then added "And that entrepreneur will be a doctor!"

Mr. Herschler is the Editor & Publisher of FHIweekly & FloridaHealthIndustry.com.   

Last Updated on Tuesday, 24 May 2011 08:43
 
Expert Witness Certificates Print E-mail
Written by Michael J. Sacopulos, JD   
Wednesday, 06 April 2011 14:29

At the present time, expert witnesses do not need a certificate to testify in any medical malpractice action pending in the State of Florida. However, there is a bill pending before the Florida Senate that would require expert witnesses to receive a certificate prior to offering testimony in Florida medical malpractice cases. Senate Bill 1590, sponsored by Senator Hays (and co-sponsored by others) would require physicians, that are not licensed in the state of Florida, to receive a certificate from either the Florida Board of Medicine or the Florida Board of Osteopathic Medicine in order to testify regarding the prevailing professional standard of care in a medical malpractice case. First, we should note that this requirement has not been enacted into law yet.  Next, it is important to note that it would apply only to individuals not holding a valid license to practice medicine in the State of Florida.

Traditionally, judges have had wide discretion in determining who may provide expert testimony. However, many boards of medicine across the country have declared that the offering of expert testimony in their state constitutes the practice of medicine. This would seem to mean that the state boards of medicine should have some involvement with out-of-state expert witnesses offering testimony in their state. Florida SB 1590 seems to be the first action by any state to address this matter head on. If enacted, this law could allow the state boards of medicine to prohibit certain individuals from testifying in state court medical malpractice actions.

As currently described by SB 1590, an out-of-state health care provider would need to have an active license to practice medicine in another state or a province of Canada and submit "to the board a complete registration application in the format prescribed by the board." In addition, the individual would need to pay an application fee not exceeding Fifty Dollars ($50.00). The Florida State Board of Medicine or the Florida Board of Osteopathic Medicine would then have five business days to approve or deny the application for an expert witness certificate. The certificate would be valid for two years.

It will be interesting to see if this bill is enacted into law in Florida. If so, the law would be the first of its kind and certain to receive national attention. 

Michael J. Sacopulos is a Partner with Sacopulos, Johnson & Sacopulos, in Terre Haute, Indiana. His core expertise is in medical malpractice defense and third party payment disputes. Sacopulos is also the general counsel for Medical Justice. He may be reached at mike_sacopulos@sacopulos.com

Last Updated on Sunday, 01 May 2011 12:55
 
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