“30,000 Britons die annually from staph infections contracted in a hospital. The per capita equivalent in the US would translate into 150,000 Americans dying of staph infections annually. The actual number of Americans dying of staph infection is much lower than that, therefore, our for-profit healthcare system in the US is much better than the taxpayer funded health care system in the UK.”

My Analysis

Using round numbers, UK has a population of around 60 million, so a death rate of from staph infection is 1 in 2,000. In the United States, 80,000 Americans die of staph infections each year. With the U.S. population of around 305 million, the death rate from infection is about 1 in 3,800. Though the host’s math is not accurate, it is true that per capita more Britons die of staph infections than in Americans. But does the death rate from one infection spread a good measure of an entire health care system?

My first thought was that the use of hospitals per capita under a government provided health insurance system would be greater than the use of hospitals in a for-profit system. The logic being than a Briton can go to the hospital without having to worry about personally paying for the visit (Yes, they pay for it via a tax, but money isn’t a factor when deciding to go to the hospital). Therefore, Britons probably go to the hospital more often and by the nature of being in the hospital more often, catch staph infections, and die more often from staph infections. Americans number of death by staph infections would be suppressed by Americans not being the hospital as often as Britons. After searching the internet for statistics to support my theory, I came up empty handed. Although, I think my logic is sound, I would concede the effect of this difference is most likely nominal.

I recently read a book, “Junk Science: by D.P. Agin. It is at the Clarksville Montgomery Library on the second floor (500 Agi). Some information I learned in that book lead me to ask another question: Why is the host using the example of staph infections? Why not infant mortality rates, life expectancy data, or any other measure? It seemed to be a very specific, somewhat obscure measure to use. The World Health Organization uses dozens of specific data measures to determine the healthiness of a country. I wont rehash these here as I assume that these are well known, but I will include a link to their website. In general, we are not at the top of their list in regards to health measures.

7,000 Americans die from medication errors in hospitals annually. 106,000 Americans die from adverse side effects of prescriptions. And don’t forget the staph infection death rate of 80,000 annually. The medical profession classifies these events as “iatrogenic” deaths. Iatrogenesis is defined as “induced by physicians words or therapy.” It should also be noted that I believe these occurrences are self reported by physicians. More people die by “Iatrogenesis” in the United States than by:

• Stroke (4th leading cause of death at 137,000 annually)
• Diabetes (5th at 72,000)
• Alzheimer’s Disease (6th at 72,000)
• Flu and Pneumonia (7th at 56,000)

Iatrogenesis is the third leading cause of death in the United States. I’ll let that sink in, Death by a physicians words or therapy is the THIRD LEADING CAUSE OF DEATH IN AMERICA. Our heath care system is killing us off faster than diabetes, strokes, mental diseases, and Influenza.

Beyond at least casting doubt on the host’s reasoning, selection of a limited measure, and sheer ignorance of other more pertinent issues, this research has lead me to ask myself a question.

Everyone is aware of medical issues like strokes, diabetes, Alzheimer’s disease, and all the various forms of flu. The media is bombarding us with commercials for diabetes supplies, signs of strokes, entire televisions shows devoted to how to cope with the Alzheimer’s patients, the next scare tactic for the upcoming (but never arriving) flu pandemic… but where is the coverage on the bigger killer, the healthcare system itself. Before you read this, did you ever hear the word Iatrogenesis? If not why do you think that is?

Sources

• http://www.statistics.gov.uk/cci/nugget.asp?ID=6
• http://www.census.gov/main/www/popclock.html
• http://www.cancure.org/medical_errors.htm
• http://cmc-websvr.clarksville.org/aquabrowser/?q=junk+science&x=0&y=0
• http://www.who.int/research/en/

NASHVILLE – Tennessee Health Commissioner Susan R. Cooper, MSN, RN, will visit Camp Widjiwagan, a YMCA of Middle Tennessee day and overnight camp, on Wednesday, Aug. 5 between 8:00 a.m. and 11:00 a.m., to educate campers about the importance of healthy living.

Tennessee Health Commissioner Susan R. Cooper

Cooper, along with the Get Fit Tennessee team, will spend the morning with more than 300 campers from the Middle Tennessee area in an effort to encourage the children to begin making healthy choices at a young age. Cooper will have breakfast with the children, discuss steps the kids and their families can take to make Tennessee a healthier state and lead campers in an obstacle course designed to showcase fun fitness activities.

Get Fit Tennessee is a statewide awareness program developed by Gov. Phil Bredesen with a focus on educating and empowering Tennesseans to move more and eat healthier to combat health risks facing the state, such as obesity, Type 2 diabetes, heart disease and stroke.

Who: Susan R. Cooper, MSN, RN, Commissioner, Tennessee Department of Health
What: Cooper will spend the morning with campers at YMCA’s Camp Widjiwagan
When: Wednesday, Aug. 5, 8 a.m. – 11 a.m. CDT

Where:

Free Kidney Disease Screening Available Saturday!

Consider these simple questions:

1. Do you have diabetes?
2. Do you have hypertension (high blood pressure)?
3. Do you have a family history of high blood pressure or diabetes?

If you answered ‘yes’ to any of these questions, you are at risk for kidney disease. This Saturday, July 11th, you, your family, loved ones and friends can get free medical assistance. Faith Outreach Church is hosting a free kidney screening from 8:30 AM to 3:30 PM. The church is located at 731 Windermere Drive. While the screenings are free, pre-registration is requested. Call 615-383-3887 to pre-register.

Free Centerstone Mental Health Fair

Also happening on Saturday is an later day health care outreach event at Burt Cobb Community Center.The Burt Cobb Community Center, 1011 Franklin Street, will play host to a free Mental Health Awareness Fair, from 2 to 4 PM. There will be information booths, mental health screenings, activities for kids and door prizes and free food. This is a Centerstone event. For more info, call 931-920-7247 or 249-5330.

Both events are free and open to the public. The general public is encouraged to support these free health care events and participate in the services being offered.

In my practice, patients have a mix of private and public coverage.  While I work with some extremely impoverished patients who qualify for public insurance through Medicaid, it is the people with employee sponsored private insurance who are most at risk for roadblocks to care.  As a primary care physician, it is hard enough to fit all of the recommended screening, health education, and chronic disease management that complex patients need into a fifteen minute visit.  When the burden of battling with insurance companies is added to the equation, there is no way that I can succeed.  My patients, especially the ones with private insurance, are forced to deal with the high copays, denials of claims, and delays in care.

Reflecting on the past week, a bunch of cases come to mind.  While these stories may lack drama, it is nonetheless troubling to me how frequently my treatment recommendations are impeded by difficulties with health insurance.  And I am sure my patients are not alone in suffering the consequences:

Ms. P, came in Wednesday.  She has high blood pressure and very high cholesterol.  I had not seen her in over six months, but she works a demanding job, so I figured that she had just been busy.  In the office, we did not talk about her blood pressure.  We did not talk about diet and exercise.  She had not followed up for so long because at the prior visit I had sent her for an echocardiogram of the heart and she was billed $800 for the test.  Her insurance would only cover $200.  We spent the entire visit talking about how she could not afford to pay this bill.  I just don’t get it.  She has private health insurance.  She was having symptoms that had been worsening over several visits and needed further evaluation – exercise intolerance and palpitations.  Now, she is receiving daily letters from a collections agency, and she is frightened to come to the doctor because of the bills that may show up in the mail.

Mr. J, a security guard with diabetes, hurt his knee while fishing and had severe pain and swelling.  When I initially saw him a few weeks ago, there did not seem to be any major structural damage to the ligaments, so I recommended a conservative approach with rest, ice, and anti-inflammatory medications.  Now, several weeks later, the pain and swelling had not subsided, so I ordered an MRI to evaluate for more subtle damage to the knee.  After several attempts at prior authorization, the private insurance company refused to pay for the test.  Baseball players get MRIs the same day for any bump or bruise, but even going through the appropriate prior authorization process, I could not order an MRI for my patient with private health insurance.  I am not looking forward to all the phone calls that it will require to protest this denial of necessary diagnostic test.

On Thursday, Mr. A came in to have his blood checked.  He requires blood thinners to prevent recurrence of blood clots which could be fatal.  He has twice previously had clots in the blood vessels of his calves, and he once had a blood clot travel to his lungs.  He has a clotting disorder that makes any break in treatment with the blood thinners extremely dangerous.  Warfarin is an effective and inexpensive blood thinner, but it requires frequent monitoring because its activity is affected by numerous interactions with other medications and foods.  His blood test showed that the warfarin was not doing its job, so I recommended an increased dose.  It takes about three days for the dosage change to have a full effect, so I also recommended injectable blood thinners, which act more rapidly, until we could demonstrate that his warfarin had reached a therapeutic level.  However, he could not afford the copay for the injectable blood thinner, so he must hope that he does not develop another blood clot as we wait for the higher dosage of warfarin to take effect.

Yesterday, I saw Ms. R for a follow up appointment.  She is only in her 30s but has already had major back surgery for a disk problem.  She stands for six hours a day at work and has recently had worsening of her back pain.  Her spine specialist had recommended physical therapy, instead of a repeat operation, but she cannot go because her private insurance company requires a copay for every session.  She has been unable to work because of the worsening pain, so she cannot afford these copays and has not been able to follow the treatment plan.  I do not want her to become dependent on pain killers, but since the treatment recommended by her orthopedist is not a realistic possibility, we are running out of options.

I could fill many pages with stories like these of my patients whom are hard working, have private health insurance through an employer, but just cannot get the care that they need, because of unreliable coverage.  It frustrates me that executives of health insurance companies spend millions on advertising to disparage public health insurance, and Republican politicians are stone walling meaningful health care reform because they are afraid that a public health insurance option would put private health insurance companies out of business.  I do not care who provides health insurance for my patients.  Whether they have public or private insurance, I just want them to get the best care possible.  If private health insurance companies provide a high quality product, they will not be “forced” out of business by a public plan.  It makes sense that competition between a public plan and private plans would lower costs, improve quality, and guarantee an option to those who do not have employer sponsored coverage.  As a physician, I need to advocate for my patients.  Private health insurance companies have thousand of lobbyists and millions of dollars to spend.  So why do these companies need so many politicians, including Democrats, advocating for them as well?  This is not about ideology.  It’s about patients who cannot afford their medications or who face bankruptcy due to medical bills.  We need change, and this will only come with a guaranteed public health insurance option.

- Aaron Fox,  MD
National Physicians Alliance

About Aaron Fox

Dr. Fox is a primary care physician in a community health center in New York City. He is also a member of the National Physicians Alliance New York City Local Action Network.

The conference will be held Saturday, May30, 2009 at the Riverview Inn Hotel, 50 College Street, Clarksville, TN  37040, from 10:00 a.m. to 4p.m.  (www.theriverviewinn.com).

The aim of our event is to enhance partnerships between women and Montgomery County health professionals in order to improve the health of women in our community and promote health awareness, in general.

The conference will include presentations and discussions of

• Women Health and wellness issue
• HIV/AIDS prevention
• Obesity and pre-diabetes
• Cancer awareness
• Violence against women
• Regional women’s health programs

This free event will be open to health care professionals, service providers, consumers, community leaders, policy makers, and the general public.

As a community health care professional, your knowledge and expertise in promoting the health of underserved populations is invaluable to our community, and we sincerely hope we can count on you to join us in this important outreach effort.

To register please log on to www.latinohope.com or call 931-24905330

CAMTAN is the local organization assisting individuals affected by the HIV pandemic within our own demographic. an IRS certified local 501 (C) 3 non-profit in need of community support.

As 2008 comes to a close, consider making a tax-deductible donation to this Clarksville-based non-profit. Started by a small collective of local ministerial leaders and lay people, the Clarksville Area Ministers Technical Assistance Network (CAMTAN) seeks to provide assistance, support and education to persons affected by the HIV/AIDS pandemic and the greater community.

While Metro-Nashville has Nashville Cares, MICTAN, the Ryan White Foundation, Operation Stand Down Nashville-Street Front, a transportation funding grant from the Nashville United Way and a array of philanthropic foundations: Clarksville, Montgomery County, Dover, Stewart County, Erin, Houston County, Charlotte, Dickson, Dickson County, Springfield, Robertson County, Cumberland City, and other outlying areas must relay on the limited resources provided by a small collective of churches and a few private individuals, with which CAMTAN seeks to address the physical and psychological stresses that can accompany an HIV/AIDS infection.

Rev. James W. Hill Jr., pastor of Greenwood C.M. Baptist Church, serves as the Senior Executive Director of this all volunteer effort. Rev. Hill has attended numerous training seminars with the Nashville United Way -Ryan White Foundation, Operation Stand Down Nashville, the MICTAN initiative and Tennessee Dept. of Health to become certified as a HIV/AIDS counselor-facilitator.

MICTAN is the much larger and better funded Metro-Nashville equivalent of CAMTAN- a faith-based fellowship ministry to those impacted by the HIV/AIDS virus. These efforts are non-judgmental and focus on assisting the client in stabilizing their lives in the areas of housing, medication, counseling, personal relationships, fellowship and employment sustainability and include a general community health education outreach. Of the five county service area, Clarksville leads with the highest number of STDs and HIV transmission cases. The need for education and awareness is real and growing. CAMTAN is seeking to raise funding so that they can hire a case manager, a secretary and a driver and stabilize their client medical appointment transportation support system.

Rev. Timothy Grant- CAMTAN booth, 2008 African Street Festival

CAMTAN has participated in and sponsored several health fairs over the past years in an effort to increase community awareness of the various and diverse health issues confronting our collective communities. Information is available on cancer- be it either female or male breast cancer, colo-rectal or prostate cancer, cervical cancer or testicular cancer. Additionally diabetes, hypertension, obesity and weight control, sexually transmitted diseases (STDs), depression and other mental health issues are all matters that CAMTAN seeks to aide the community in understanding and confronting. All of these health concerns are also of concern to individuals confronting an HIV/AIDS infection, along with issues of homelessness, abandonment and physical or domestic abuse. CAMTAN seeks to educate the community to raise the level of awareness and understanding of these issues and improve the public’s preventive posture addressing these concerns. It also seeks to provide assistance to those confronting an HIV/AIDS infection and/or the consequences of such an infection upon the client or family members.

Donations, both monetary and in-kind services, may be sent to: CAMTAN, 1325 Dodd Street, Clarksville, TN 37040. Receipts will be sent acknowledging all donations for tax reporting purposes. Please include a self-addressed, stamped envelope for the return receipt. Rev. Hill is also available to speak with interested groups and coordinate CAMTAN participation in health fairs and other community events. Contact CAMTAN at 931-249-4262/552-3611. Send e-mail to: .

An April report from the Centers for Disease Control and Prevention in Atlanta found that African American mothers, who are less likely than white or Latina women to breastfeed, have reversed that trend and are now doing so in impressive numbers. Sixty-five percent of black women have nursed their infants at some point. This compares to a 36 percent rate 14 years ago. Still, only 20 percent of black mothers reach the government’s target goal of exclusively breastfeeding when their infants are six months old. Breastfeeding can help address health problems that plague both African American mothers and infants alike. Breastfeeding is the most natural and beneficial way to strengthen your baby’s immune system and provide the best possible nutrition for yourself, as a mother, and your baby.

“Breastfeeding has many benefits ranging from creating an important mother/baby bond to ensuring baby gets natural nutrients,” said Pam Noreiko, a lactation specialist at Baptist Hospital.

Baptist Hospital suggests six reasons why women should consider breastfeeding:

1. Breast milk is the most complete form of nutrition for infants. A mother`s milk has just the right amount of fat, sugar, water and protein that is needed for a baby`s healthy growth and development. Breastfed infants are seven times more likely to maintain a healthy weight gain and formula-fed infants. Breastfeeding also reduces infants’ risk of asthma, diabetes, infections and sudden infant death syndrome, all more common among African American infants.
2. Breastfeeding helps form a significant bond for mother and baby. Physical contact is important to newborns and can help the newborn feel more secure, warm and comforted.
3. Nursing uses up extra calories- 500 calories a day, making it easier to lose the pregnancy weight. It can also help ward off obesity and diabetes for which African American women are at higher risk. Breastfeeding also helps the uterus to get back to its original size and lessens any bleeding a woman may have after giving birth.
4. Breastfeeding lowers the risks of breast and ovarian cancer, and possibly the risk of hip fractures and osteoporosis after menopause. The health benefits continue through the next generation: Studies show breastfed daughters have lower rates of breast cancer when they grow up.
5. Breastfeeding makes your life easier. It saves time and money. There is no need to purchase, measure and mix formula continuously.
6. Breastfed babies score higher on IQ tests later in life, especially babies who were born prematurely.

All across the nation, advocates are offering wider education, tools and models for breastfeeding to make nursing the norm among black women. CDC officials are promoting “Healthy People 2010″ objectives that include having seventy-five percent of all mothers initiate breastfeeding and having fifty percent of all infants exclusively breastfeeding at 6 months.

The federal Office of Women’s Health has made “An Easy Guide to Breastfeeding for African American Women” available online. Thus far, 65 hospitals and birthing centers nationwide have worked to earn “Baby-Friendly” status from the World Health Organization and the United Nations Children’s Fund. This designation is awarded to facilities which offer “optimal” lactation support to patients. Such efforts include:

• breastfeeding videos playing in prenatal clinics’ waiting rooms,
• staff members who interact with patients receiving 18 hours of training in breastfeeding basics and lactation consultants meet with every new mother,
• moving infants out of the nursery into the mothers room, and providing free breast pumps to patients who can’t afford them.

Baptist Hospital’s Lactation Department has the medical knowledge and expertise to answer any questions that would help mothers breastfeed successfully. The department can be reached at (615) 284-3381. The Lactation Boutique at Baptist Hospital also offers a complete line of breastfeeding supplies, pumps and nursing bras to make the breastfeeding experience successful. Hours are Monday through Friday, 10 a.m. to 3 p.m. Please call 615-284-MILK (6455) for more information.

Details for this story was drawn from Baptist Hospital’s website media press releases and The Tennessean’s Healthtalk coverage and The Chicago Sun-Times.