care
hospitals dont save lives, people save lives.
2008-05-02, 07:48:57
Role of routine chest radiography after percutaneous dilatat
2008-04-11, 00:00:00
Predicting death and readmission after intensive care discha
2008-04-11, 00:00:00
Implementation of outpatient preoperative evaluation clinics
2008-04-11, 00:00:00
Bispectral Index asymmetry and COMFORT score in paediatric i
2008-04-11, 00:00:00
Pharmacology for Anaesthesia and Intensive Care
2008-04-11, 00:00:00
Girrawheen Dentist has Become a Participating Dentist
2008-04-16, 21:44:32
Death of G. David Low
2008-04-02, 08:13:37
Ewan McGregor skin cancer?
2008-04-23, 19:44:45
Diagnosis: Non-healing erosions etiology unclear. One always considers factitial disease in health care professionals with atypical skin lesions and this man also has free access to needles as a diabetic. In a year, the scalp lesion has shown no tendency to improve.
Further Treatment: He was treated with topical corticosteroids in case this was erosive pustular dermatitis of the scalp (no response) and imiquimod in case erosion might have been hypergranulation tissue. (no response) We ordered Duoderm dressings, but they were too expensive for the patient.
Questions: Where would you go from here? Diagnostic and therapeutic suggestions.">Stumped...
2008-04-16, 12:14:00
remembrance. (for mr wimps)
2008-04-19, 14:41:46
who will Triage the health system?
2008-04-24, 08:43:21
i heart tattoos.
2008-04-25, 10:56:22
Comparison of the novel hydroxyethylstarch 130/0.4 and hydro
2008-03-16, 00:00:00
Effects of short-term simultaneous infusion of dobutamine an
2008-03-16, 00:00:00
Performance of a minimally invasive uncalibrated cardiac out
2008-03-16, 00:00:00
On leave still
2008-03-11, 15:09:00
JPA scholar
2008-03-23, 16:56:00
In a statement issued to Bernama in Kuala Lumpur today, the Malaysian Embassy in Paris said Dr Tan's father, Datuk Tan Gin Soon, believed that her daughter would have wanted him to donate her organs, given her "deep and abiding interest" to serve fellow human beings.
Died from complications
Her family has donated her organs, including her corneas, heart, kidneys and liver, to patients in France and other countries of Europe.
The statement said Dr Tan had undergone treatment at the Fondation Rothschild, under the care of Professor Jacques Moret, a world-renowned interventional neuro-radiologist.
It said the complicated procedure of the embolization of the AVM on March 11 went well but Dr Tan's condition took a turn for the worse and she died on Wednesday due to complications from the follow-up surgeries.
Dr Tan's remains will be flown from Paris to Penang today.
I am so sad to hear this piece of news.
I have also read all the accounts posted in Chev's Facebook leading to the unfortunate event.
My condolences.
Update links:
Star
MAF
Flickr
">Malaysian doc donates organs to European patients
2008-03-29, 09:05:00
So, what happen if someone owns a gun but doesn't have bullets?
Here are some questions and answers related to my posting:
What is the hottest topic among health care providers these few days until even LKS and Malaysia Today blog about it?
The dispensing rights between the doctors and pharmacists.
What is dispensing (medicine)?
To give out or to distribute (medicine).
Who has the rights to dispense in Malaysia currently?
1) Doctors. 2) Pharmacists.
What has the pharmacists been demanding for the past 20 years and now?
The exclusive rights to dispense medicine, no one else.
Why is the rights so important?
Pharmaceutical industry is an extremely profitable business. There is a huge market out there. One can become rich (like doctors?) with such rights. This can be equate to automobile companies with APs (exclusive rights to import certain cars).
Who are practicing separate dispensing currently?
1) All the government hospitals and clinics in Malaysia (Actually not entirely true as many of the dispensing role are done by "dispensers" because there are shortage of pharmacists in the country).
2) All the private hospitals in Malaysia.
Who are not practicing separate dispensing?
All private General Practitioner clinics and most of the individual Specialist Clinics.
Why are they not practicing it?
1) There are not enough pharmacists.
2) Smaller clinics could not afford to hire pharmacists to dispense.
Why are pharmacists unhappy about it?
They are losing income or business for not been able to get enough prescriptions for them to dispense. That is why they are resorting to selling all sort of stuffs (like supermarket), such as health supplements, milk powder, self-grooming stuffs and even food stuffs like mineral water.
Why are doctors refuse to give away their rights?
Primary care or General Practice in the private sector is very profitable (one can not denied) and very competitive as well. Many GPs resort to lower their consultation fees in order to get the patient volumes and gain from dispensing medicines. Take for example, many GPs lower the cost to charge per patient (in a package of consultation plus medications) in order to get accepted as "panel" for many companies. This lowers the cost of health care.
What happen if doctors loose the rights?
Many will close shops due to competition as they will never get enough from consultation alone in view of so many private GP clinics out there.
While it is really not of my concern about who gets to dispense, because I work in the government hospital, what curious me is, why is the MOH so eager to bring up the issue and to go ahead of such implementation (of separate dispensing)?
Indirectly, this may have to do with stopping more outflux of doctors to the private sector as it may not be profitable anymore to earn a living as GPs in future.
In few years to come, with so many medical graduates coming from every corner of the country and overseas, there will be a time where the market is saturated and doctors would need to start begging to get employed in MOH.
While John Chang and Dr. Khoo Kah Lin can go and debate who and why pharmacists should be or not given the exclusive rights, I am more concern if implementation would be successful if ever the pharmacists won the rights.
This patient has been buying the above three medications from the pharmacy for the past two years without a doctor's consultation and prescription for frequent joint pains.
My few concerns:
1) Will patients ever understand the danger of not consulting the doctors for their problems and to buy medicine from the pharmacies because they are cheaper?
2) Will enough enforcement be there to make sure pharmacists only dispense medicine with only prescription from doctors?
3) Will patients willing to spend more on separate prescription and dispensing (higher cost of health care)?
Meanwhile, few possibilities I could imagine if doctors and pharmacists want to cooperate to share the pie:
1) Doctors to hire pharmacists and pay them accordingly to dispense in the clinics.
2) Doctors and pharmacists to open joint venture and share the profit accordingly.
Related links:
MMR
">Gun without bullets
2008-03-31, 14:29:00
News cross.
2008-03-22, 06:15:27
the well interdigitated penis.
2008-03-25, 08:31:07
Leap Day
2008-02-29, 17:07:00
Your Way to a Healthy Smile
1970-01-01, 02:00:00
Facial Pigmentation in a 31 yr old woman with Protein S defi
2008-02-21, 03:51:00
Recent Advances in Anaesthesia and Intensive Care
2008-02-14, 00:00:00
Evaluation of a decision support system to predict preoperat
2008-02-14, 00:00:00
Closed tracheal suction systems for prevention of ventilator
2008-02-14, 00:00:00
Statins and sepsis
2008-02-14, 00:00:00
The career luck experiences fluctuations, business dealings are with many setbacks. Working persons should continue to be adaptable to environment, and performance is also continued to be good lights of superior. The young tiger persons lack the drive to study, coupled with confused moods. There may be mouth and stomach illness, so take note of daily meal consumption. Beware of muggers when outdoors. Take greater care of the elderly at home. Take precaution against fire hazards.
Wealth luck is low, proper income is stable, with no sign of windfalls, so control your spending to prevent cash flow problem. There may be loss of monetary funds, so manage your finance prudently. This is not a good year for relationship matters, where there are communication issues with family, and lovers; be more tolerant and caring."
For those born in 1974 [Wood (Den Tiger)]: Lucky number is 4296.
Noble persons: Symbols of Ox and Goat.
Noble Person direction: North East or South West.
">Very Fat t Fat t
2008-02-11, 17:19:00
Asistencia Sanitaria para Inmigrantes y Bulk Billing
2008-02-15, 11:26:00
Periodontal Disease
1970-01-01, 02:00:00
organ donation stopped by the Coroner.
2008-02-05, 11:25:22
Management of a parturient with an acute exacerbation of idi
2008-01-22, 00:00:00
Long-term functional outcome and performance status after in
2008-01-22, 00:00:00
Controlled comparison between betamethasone gel and lidocain
2008-01-22, 00:00:00
Tooth decay rampant among children: survey
1970-01-01, 02:00:00
Resolve to be better in 2008
1970-01-01, 02:00:00
Labor Digs its Teeth into HIV Dental Help
1970-01-01, 02:00:00
Pets Need Dental Care Just Like People
1970-01-01, 02:00:00
Your Health: Time to See the Dentist!
1970-01-01, 02:00:00
When Life Hands You Dented Apples, Make Apple Sauce
2008-01-10, 16:35:00
Good Skin Care for Eczema
2007-12-13, 10:07:02
Unusual Keratoderma
2008-01-08, 12:09:00
Hot, hot now
2008-01-09, 18:05:00
Dental Politics
1970-01-01, 03:00:00
Head To Head: Should NICE Evaluate Complementary And Alterna
2007-03-11, 16:24:00
Should NICE evaluate complementary and alternative medicine?
2007-03-19, 23:04:00
That bill also changes the makeup and scope of several other state regulatory boards.
SB413 would mandate that insurance companies accept "ABC Codes," a new type of coding system that has more detail about alternative therapies. Using that system would make it easier for practitioners such as chiropractors, massage therapists and homeopathic doctors, said its supporters.
Using ABC codes could make it easier for massage therapists to get respect -- and money -- from insurance companies, said Billie Shea, head of Nevada's Board of Massage Therapy. But she worried that other aspects of Schneider's proposals could over-regulate some massage therapists.
Non-medical massage therapists don't make more than $40,000 or $50,000 annually, and already have to pay for multiple business and professional licenses, she said.
Larry Matheis, director of the Nevada State Medical Association, opposed all the bills. Schneider's approach wouldn't do anything to integrate alternative medicine into the existing health care system, which already is occurring, said Matheis. Rather, it would create a new state bureaucracy that could endanger patient safety, he said.
The existing medical boards offer sufficient regulation while Schneider's plan would allow unlicensed practitioners to get into the medical field, Matheis said.
"That is a dangerous step," said Matheis. "Your responsibility is patient safety, is public safety. If you're going to err, you have to err on that side."
Deborah Klein, representing the Nevada Dietetic Association, said proposed regulations for "medical nutritionists" in SB432 were vague and should be stricken. They would deceive the public into believing that nutritionists are qualified to do what dietitians do, said Klein.
"Basically, anyone can call themselves a nutritionist," said Klein. "However, they do not have the qualifications of a registered dietitian."
Some of the opposition to his bills came from traditional practitioners who "don't want to give anything up," said Schneider.
"The goal is to get more health care to more people are a more reasonable price," he said.
">Alternative Medicine Debated by Nevada Legislators
2007-03-30, 12:24:00
"There isn't one in 100 that actually knows what alternative medicine means. So, yes, I have to do a lot more education of my patients," Kule said, sitting on the edge of one of his examination tables.
In a middle room, patients receiving intravenous treatments relax in leather recliners. In the lobby, "green-friendly" cleaning supplies and homeopathic remedies are displayed on tables surrounded by horse art prints on the walls and patient information printed simply on laserprinter paper.
"More and more, primary care is coming along my way because you see all the things about nutrition and concerns about prescription medications," Kule said. "Wouldn't it be wonderful if all the Vioxxes worked with no side effects? But they don't. That's not life. To have good health is work. It's a commitment."
Kule's education has taken him from his native Pennsylvania (where he studied biology at Pennsylvania State University) to Canada (where he explored the physical education and sports culture of Soviet Russia) to Bogota, Colombia (where he earned his medical doctorate from Pontificia Universidad Javeriana). He taught middle school science in Georgia and worked as a medical interpreter in Los Angeles before completing his residency at the Medical University of South Carolina in Charleston. He was a partner in family medical clinics in Swansea for six years until he opened East Aiken Health Center in 2000.
His patients say Kule and his staff are willing to spend hours delving into their health histories and trying to find the root causes of their maladies. "He is known to spend two hours with a patient," wrote one client, named Linda, in a letter praising her physician. "His practice is an incredible alternative to conventional health, concentrating on the body, the mind and the soul working together to create a healthy, happy individual."
Kule says that he is bucking an unfortunate trend in modern medicine â?? health care driven largely by insurance and Medicare reimbursements.
"I think that most doctors in primary care would like to do something like what I'm doing except that the reimbursements from the insurance companies are terrible," Kule said. "I don't think it's satisfying to see 50 patients a day and have three offices on this side and three offices on this side and the nurses come in and do most of the history-taking and you just zip in and focus on one column, write a script and go on to the next patient and drink coffee and push, push,