Monday, May 19, 2008

Tear Down Their Cottages. Burn Their Corn.



Why does this song resonate so much with me right now? Hmmm ...

I figured today out how to put my own spin on the Billy Bragg classic. I tried to get it perfect for far too long today before settling for this. You can see where I'm reading the lyrics I haven't learned yet, and my voice is hoarse in a less than pleasing sort of way, but I'm getting somewhere with it. Give me another week and I'll have it nailed.

Meanwhile, an update on the last post. I couldn't stop thinking about how absurd it was for my dentist to advise Advil for a cracked and infected molar. I googled around and discovered that the war on drugs has become a war on doctors. This from the San Diego Union-Tribune.
Part of the problem is that doctors don't want to deal with the paperwork involved.

They must file records to state and federal regulators every time they prescribe a Schedule II or III drug. The state forms, submitted monthly, include the patient's name, address and birth date, the physician's medical license number and controlled substance registration number, and the amount of drugs the doctor dispenses every day.

Doctors who prescribe restricted drugs talk about frightening encounters with law enforcement agents, Hertzka said.

"Investigators ask for records (while) in some cases, these doctors have waiting rooms filled with patients," he said. "The whole thing is worrisome, whether it's the Medical Board or the DEA or federal law enforcement." ...

"There is physicians' fear (of the DEA) similar to the public's fear of the IRS," Patchin said. "They say it is just an investigation, but it is frightening just to receive a letter from any regulatory body.

3 comments:

Mike said...

Before he left the country, my Doctor, Tom Heller said that it's impossible to do medicine here anymore. I've heard lots of other stories of successful, well established physicians warning young people against medical careers, and saying they never would have become a doctor if they knew how constrained their ability to practice would get. Unfortunately, government regulation of drugs, as bad as it is, isn't even the worst part of it. Increasingly, insurance people make more medical decisions than doctors, and the pharmaceutical industry further marginalizes doctors by marketing directly to patients (which are now consumers).

I believe this is all the logical outcome of a system that rewards people who can generate profits from people suffering. In such a system, more people suffering inevitably leads to more profits. The original institutional incentive, to reduce suffering, is reversed at the highest levels.

After checking out Naomi Klein's latest, "Disaster Capitalism," I fear that these people have turned from playing God, by playing doctor, to just playing God. Now it appears that even bigger profits are to be made by taking people's homes and property and, if necessary, killing them. Again, the logic is irresistible--growing populations worth nothing to the rich, occupying increasing acres of valuable real estate, and with global warming and the inevitable shortages guaranteeing increases in natural and man-made disasters.... Looks like it's time to invest--a growth industry if there ever was one.

Dr. Wes Browning said...

The fact that the government makes it so hard for doctors to prescribe Schedule II & III drugs is more immediate confirmation than I expected to hear for what I was saying in the column on pain killer prescription of the week before last. That was based mostly on personal experience and conversations and eavesdrops with other random poor painees. It always surprises me just how well listening to people works.

We should check out how WA State handles doctors in this regard.

Sally said...

On a website covering state pain relief codes: (http://www.painandthelaw.org/statutes/state_pain_acts.php

The summary of WASH. REV. CODE § 69.50.308 says:
A medical practitioner may dispense or deliver controlled substances for the medical treatment of intractable pain.

However, the actual WAC says:

(g) A practitioner may dispense or deliver a controlled substance to or for an individual or animal only for medical treatment or authorized research in the ordinary course of that practitioner's profession. Medical treatment includes dispensing or administering a narcotic drug for pain, INCLUDING intractable pain. [emphasis added]

Which seems to indicate that narcotic drugs can be legally prescribed in Washington State for other types of pain besides "intractable". So it’s likely that fear of prosecution may keep doctors from prescribing narcotics, as Wes says.