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If you need a malpractice lawyer in New Jersey, the man to call is Raymond Gill 655 Florida Grove Road, Woodbridge, NJ Phone:732-324-7600 He is WICKED ASS GOOD!Filed under: General Problems | 1 Comment »
https://www.newswise.com/articles/view/686700/
Newswise — It impacts 100 million Americans, it is the number one reason that people go to see the doctor, and it is now a national crisis. The problem: chronic pain and prescription opioids. The dilemma: how to provide the most effective pain treatment for 80 percent of pain patients who are at least risk for addiction while causing the least harm to the remaining 20 percent who are at most risk. The solution: it’s very complicated, but it may be possible to address both problems without adversely affecting either.
Opioids (morphine, Oxycontin, Viocodin), which can lead to increased risk of addiction, have been the mainstay of treatment for moderate to severe pain for decades. The challenge is that their effects on patients vary tremendously. Prescription opioid-use disorder affects about 2 million Americans each year and is the number one cause of accidental death. Right now, attempts to prevent opioid use disorder focus mainly on reining in prescription practices, which is problematic.
A researcher from Florida Atlantic University’s Charles E. Schmidt College of Medicine has received a five-year, $4 million grant from the National Institutes of Health to help solve the “one-size-fits-all” approach to prescribing opioids for chronic pain. Because of the high heritability, finding the genetic predictors of prescription opioid use disorder is more critical than ever. Currently, little data exists on clinical characteristics and genetic variants that confer risk for opioid use disorder.
In a novel study, Janet Robishaw, Ph.D., professor and chair within the Department of Biomedical Science in FAU’s College of Medicine, and colleagues from Geisinger Health System and the University of Pennsylvania, are assessing clinical and genetic characteristics of a large patient cohort suffering from chronic musculoskeletal pain and receiving prescription opioids. As part of the DiscovEHR project, they have leveraged data from Geisinger’s central biorepository and electronic health record (EHR) database to conduct large-scale genomics research and phenotype development.
With this information, this multidisciplinary team will derive a clinical and genetic profile of prescription opioid-use disorder and use this knowledge to develop an “addiction risk score.” Findings from this study will be key for identifying those who are at low-risk for opioid use disorder from those who are at high-risk and who need additional counseling and access to other treatment options.
“The overall goal of this project is figuring out if there is a unique genetic signature of patients who are most susceptible to addiction,” said Robishaw. “In the first part of our study, we are looking at the clinical characteristics of these patients to understand the cause of their pain and how prescription opioids are affecting their outcomes.”
As part of this initial process, the investigative team composed of Robishaw, Wade H. Berrettini, M.D., Ph.D., Karl E. Rickels professor of psychiatry at the University of Pennsylvania, and Vanessa Troiani, Ph.D., assistant professor at Geisinger, are administering questionnaires that will give them additional information on the patients’ pain phenotype as well as whether or not they’re showing symptomology of prescription opioid-use disorder. It will take them about two years to analyze the data to divide the patient population into cases and controls in order to complete a genome-wide association study, which is the second part of the research project.
The genome-wide association study will help the researchers determine if there is a particular subset of genes and genetic variants that are influencing susceptibility to becoming addicted to prescription opioids. Once they are able to generate the hypothesis that a genetic variant is responsible for increasing risk, the next steps for research will involve functional studies on those top associations to prove causation.
“There is an urgent need to develop clinical, genetic and neural characteristics of patients who are at moderate- to high-risk of becoming addicted to prescription opioids,” said Phillip Boiselle, M.D., dean of FAU’s College of Medicine. “The National Institutes of Health grant awarded to Dr. Robishaw and her collaborators will help them to identify the genetic factors that increase the risk of addiction in patients, which then become targets for new drug development.”
The investigative team stresses the importance of using a multipronged approach to addressing this national crisis, which should involve research, education and engaging patients so that they understand their susceptibility to risks and empower them in their health care decisions.
“Prescription opioid-use disorder is a lifelong problem that requires a thoughtful approach that is not going to be solved just by curtailing prescriptions of these narcotics,” said Robishaw. “We have to employ more rigorous prescribing practices and provide alternative treatments for moderate to severe pain that don’t involve opioids. And, we need to improve access to medication-assisted therapy for those patients already dependent on prescription opioids. Currently, only 7 percent of patients with prescription opioid-use disorder have access to such treatments and this is because of a variety of reasons like costs and availability of these services.”
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http://www.sandiegouniontribune.com/news/public-safety/sd-me-meth-stats-20171212-story.html
More than a decade after a full-scale assault on methamphetamine production in San Diego County, the drug is continuing to ravage the region, killing a record number of users last year and hooking more than half of adults who end up in jail, according to a report released this week by the county’s Methamphetamine Strike Force.
The drug was linked to 377 deaths last year in the county — 66 more than the previous year.
“The trend line is very alarming and continues to head in the wrong direction,” county Supervisor Dianne Jacob said in a statement.
Rather than the sudden overdoses often seen with the opioid epidemic, meth is typically a slow killer.
Many of the people dying are middle-aged, long-term addicts who’ve developed other health complications, said Nick Macchione, director of the county Health and Human Services Agency.
Even though meth isn’t cooked in home labs here anymore — largely a result of laws that restrict access to precursor chemicals — the data show addicts are having little trouble accessing it.
The drug is now produced in mass quantities in cartel “superlabs” in Mexico and smuggled across the Southwest border — particularly in San Diego County, where a significant portion hits local streets before the rest moves on to other parts of the country.
Last year, 47 percent of all meth seizures along the border were in the county, according to the U.S. Drug Enforcement Administration and U.S. Customs and Border Protection.
Plus, San Diego meth is cheap — $250 to $450 an ounce last year compared to as much as $600 an ounce in 2015 — and incredibly pure. Nationwide, average purity levels last year tested above 90 percent per gram, according to the DEA.
The high purity and low cost indicate an oversupply in Mexico.
The drug cartels have also been able to adapt to stricter restrictions on precursor chemicals traditionally needed to make meth — first in the U.S. and now in China — by coming up with new techniques and formulations, according to the DEA.
The report also draws a strong link between methamphetamine and crime, showing 56 percent of adult arrestees booked into county jails tested positive for the drug last year. That’s compared to 49 percent in 2015.
The trend continued on a much smaller scale for juvenile arrestees — with 14 percent testing positive compared to 8 percent the previous year.
Both felony and misdemeanor arrests and citations for selling or possessing meth are also up, from 6,849 to 8,428 last year.
Another trend has emerged: Meth is involved in 20 percent of adult abuse cases reported to Adult Protective Services — mostly meth-using adult children victimizing their parents, according to the report.
Meth’s troubling trajectory in the region comes as attention has drifted to battling the nationwide opioid and prescription drug crisis. The Strike Force report stresses that more is needed to bring the meth story back into focus.
That wasn’t hard to do back in the mid-90s, when the Strike Force was established at a time San Diego was unofficially dubbed the “Meth Capital of the World.” But the county might now be fatigued on the issue, after hearing about it for so many years, Angela Goldberg, who works as the group’s facilitator, said in an interview earlier this year.
Besides greater public awareness, the Strike Force urges greater drug screening in older adults, wrap around treatment services to get addicts and their families into recovery, and continued use of intervention courts to treat underlying problems.
“Sending addicts to jail or prison without addressing their addiction problems does not solve the drug problem in our community,” District Attorney Summer Stephan said in a statement.
Have you noticed that the DEA is really not too interested in going after meth distribution… you see there is a legal prescription meth (DESOXYN) and it is indicated for ADD/ADHD.. and very few prescribers use it.. SO… there are very few prescribers that the DEA has to build a fake case against to seize their assets using Civil Asset Forfeiture Law.. since all the people ODing on meth is being imported from Mexico and ILLEGAL.. Just like most everything else… just have to follow the MONEY TRAIL
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https://www.gofundme.com/dr-tennant-legal-defence-fund
Forest Tennant, MD, DrPH, is an internist who specializes in the research and treatment of intractable chronic pain. Dr. Tennant has operated a pain clinic in West Covina, California for over 40 years, and has authored over 300 scientific articles and books on pain management.
Dr. Tennant is revered in the pain community because of his willingness to treat patients from around the country who have been abandoned by other doctors or have complex conditions such as arachnoiditis that are difficult to treat.
In November 2017, DEA agents raided the home and offices of Dr. Tennant, using a search warrant that alleged he was part of a drug trafficking organization and running a pill mill. The allegations would be laughable if they weren’t so serious and reflect a fundamental lack of knowledge about Dr. Tennant’s practice. Many of his patients require high doses of opioids and other medications, and would die without them.
Dr. Tennant has not been charged with a crime, but he deserves to have the best legal representation possible to defend himself and his reputation. There is legal help in case needed and one can find this info here helpful.
Please consider a donation to Dr. Tennant’s defense fund. Lives depend on keeping this good man in practice.
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https://www.acsh.org/news/2017/12/12/all-i-want-christmas-people-not-hurt-12271
I could never have imagined that I would ever see the cruelty that is now being inflicted upon pain patients – people who have to live their lives under conditions that are so horrible that the rest of us can’t possibly fathom the level of suffering they must endure.
It was bad enough a decade ago when chronic pain patients had two choices, both bad: 1) powerful opiate drugs, which can be very unpleasant to take in larger doses and have addiction potential (1) or 2) suffer from intractable pain that can be so bad that they become housebound. Suicide is not uncommon. And all of this was going on before our government fabricated a war against an unfortunate and powerless group of people under the faulty premise that it would diminish the devastating outbreak of overdose deaths from fentanyl and heroin that now claims tens of thousands of lives every year. (2)
If this meant withholding or forcibly cutting back doses of opiates from people suffering from rheumatoid arthritis, spondylosis or chronic neuropathic pain (to name a few) so what? They’ll get by on Advil, yoga or acupuncture (3). I firmly believe that the CDC, DEA, politicians, and NGOs which all stood to gain from this phony war, knew damn well that their “war” was based on false information, something I have written about countless times. This is even worse than ignorance. They knew and just didn’t care.
So now we live in a pharmaceutical police state where doctors are prosecuted for caring for pain patients, and state laws set arbitrary (and scientifically bogus) daily limits on opiate doses, regardless of whether the pain patient has been doing “well” on these doses, sometimes for decades.
What I want for Christmas is to give back whatever relief pain patients had access to before our own version of Kristallnacht hit them. Leave them and their doctors alone. They didn’t cause the problem.
And just for good measure, let’s leave a lump of coal in the stockings of the CDC, DEA, and Physicians for Responsible Opioid Prescribing (PROP). Or maybe a turd for PROP.
NOTES:
(1) As I have written many times, one review after another has concluded that addiction of pain patients to opiates is rare, estimates ranging from 0.26% to 10%, mostly on the lower end. Pain management physicians who I have interviewed unanimously agree that addiction of pain patients is rare. There is a very big difference between dependence and addiction. And good luck finding a pain management physicians. They are fleeing in droves.
(2) It did no such thing. Opiate prescriptions are down. Total deaths are up. By a lot.
(3) Here’s how bad this has gotten. The FDA has suggested that physicians learn about acupuncture as an alternative to drugs in pain management, despite the fact that it has been thoroughly debunked. (“Do You Believe in Magic?: The Sense and Nonsense of Alternative Medicine.” Paul Offit, M.D., Harper Collins, 2013)
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When my mate picked up this month’s prescriptions for me the pharmacy tech told him they will not dispense any of my pain pills next month unless I talk to the pharmacist about NarCan injectors!
I just got off the phone from talking to the pharmacist – this asinine requirement comes from the lunatic Kansas Legislature over-reacting to the mis-perceived ‘opioid crisis’ – which is a black market issue rather than a prescibed medicine problem.
If I CHOOSE to refuse to purchase the over-priced and totally unneeded injectors it will be entered into my permanent government-mandated official opioid record.
I did manage to get the pharmacy to agree to enter it as “Refused as an unnecessary and excessive cost.”
I am guessing I may have just put my Medicaid-covered pain pills in jeopardy.
I had to pick mine up also. I’m in Virginia but I was told by my doctors nurse he wouldn’t prescribe to me. I want her back in her own lane. When I asked her to refill another med and my husband picked it up she had called the Narcan in so it was ready also. My pain is so under treated now. I’m terrified of not having enough med through the holidays so I use it so sparingly. Wouldn’t I have revealed myself as an addict by now. I mean forget all my swollen red joints even with treatment they remain that way. Blood work with values that indicate both Lupus and RA…. when does this environment stop ???
I’m in Chicago and have been prescribed narcan for the past 2 years. Its 100% unnecessary. My insurance covers it at no cost to me so I just take it home and stick it in a drawer.
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DETROIT — Mark Harris had stopped at a CVS store in Detroit last month to pick up some medicine when he spotted an unusual sight. A young man was fading in and out of consciousness in an aisle, before collapsing to the floor.
Familiar with the neighborhood — Eight Mile and Gratiot — Harris says he didn’t need much convincing to know what had just happened. The man had overdosed.
“I see it a lot right there in the area, you see a lot of drug addicts. You can’t describe them, but when you see them you know it, they fit a profile,” he said.
With the young man on the floor, and CVS employees and customers beginning to buzz around him trying to figure out what to do, Harris pulled out his phone to document the traumatic ordeal.
The nearly 12-minute video, filmed Oct. 11 — and uploaded to YouTube the next day — shows an almost surreal scene. It starts with the young man unconscious on the floor and ends with him standing erect, fully functioning after EMS responders give him naloxone, a drug that blocks the effects of opioids.
The video showcases Michigan’s struggles with the national opioid crisis, the life-saving power of drugs like naloxone, and, most notably, a lack of education when it comes to handling an overdose scenario. As people wait for EMS to arrive bystanders and CVS employees do everything from gawk to pour water on the man’s head to suggest CPR, even though he already breathing.
Most notably, despite the incident taking place in a pharmacy — specifically, a pharmacy that is allowed to sell naloxone over the counter — nobody made any moves to find and administer the drug, waiting instead for the paramedics to arrive.
“People didn’t know how to respond so they didn’t know how to take action, unfortunately,” said Gina Dahlem a clinical assistant professor at University of Michigan’s School of Nursing, whose research focuses on opioid overdose prevention and education using naloxone.
“That shows the need for us to educate these public places and those who are involved — pharmacists, librarians, staff where overdoses are highly likely to occur,” Dahlem continued.
In May, Gov. Rick Snyder announced that pharmacies could dispense naloxone sans prescriptions if they registered with the state Department of Health and Human Services. Previously, only law enforcement, first responders, and doctors could administer the life-saving drug.
As of Nov. 2, 2,840 pharmacies — or 34% of the state total — obtained controlled substance licenses in Michigan in order to dispense naloxone to individuals over the counter. The CVS in question was one of those pharmacies. This led some — like Harris, who filmed the video and kept suggesting someone use Narcan, the brand name version of naloxone — to question why the pharmacist did not administer the naloxone himself.
“That’s heroin, they got some stuff Narcan that they shoot it up their nose to bring them back,” Harris is heard telling the group huddled around the man before paramedics arrived.
Watch (the video might be disturbing for some viewers): Video shows man coming back to life after overdosing at a CVS
In the video, the pharmacist at one point indicates that they may not have had the drug in stock at the moment — though the conversation was hurried and it’s unclear if the pharmacist was specifically answering the question about the drug’s availability.
CVS for its part said the pharmacist should not have administered the drug, but rather waited, as he did until EMS had arrived, stating that the drug is not meant to be “dispensed for immediate usage.”
“We make every effort to stock our pharmacy inventory based on patient demand, however, naloxone is not a medication that is dispensed for immediate usage,” CVS Director of Corporate Communication Erin Shields Britt said in a statement.
“In most cases, opioid users or their family members order naloxone to keep on-hand in an emergency to reverse an accidental overdose. In an emergency situation where naloxone is needed, 911 should be called, as was the case here.”
Dahlem of the University of Michigan, however, contends that the purpose of making naloxone available over the counter is for situations exactly like this and minimizing any lag time is ideal.
“The sooner you are able to revive a person the better the outcome,” she said. “This emphasizes the need for education in the community and of laypeople.”
The video, which documents the young man right after he lost consciousness to the moment he’s wheeled out by medics, shows not only the scary reality of a drug overdose but the confusion of many bystanders over what to do.
A CVS pharmacist is seen pushing on the man’s chest, while the man’s friend is seen pacing around the store dumping water on his head.
Dahlem notes that while the shouting and shaking of the man are actually helpful in an overdose situation, the pouring of water was in fact very dangerous. An overdose is a respiratory problem before it’s a cardiac problem, according to Dahlem, and dousing someone in water — a move people often do in overdose situations because they think it will help wake a person up — can, in fact, make the problem worse.
Michigan’s relationship with the opioid epidemic has worsened over the years. In 2015, the most recent year of data available, the state saw its third consecutive year of record drug overdose deaths. That year, 1,981 people died from drug overdoses, up 13.5% from 2014. Over the last 17 years, deaths from drug overdoses quadrupled, up from 455 in 1999.
For Harris, who decided to document the incident because he had never seen anything like it before, the incident highlighted a clear health and education issue, but also a disconnect between the response to the opioid crisis and what he witnessed 30 years back during the crack epidemic in Detroit.
“In the ’80s during the crack epidemic, most of the victims of the crack epidemic were jailed and criticized and now it’s an opioid epidemic and it’s more like they need help,” said Harris, who says he is a recovering alcoholic and that he’s sensitive to the realities of addiction.
“It’s a person’s own choice to use drugs or alcohol, but once you get addicted you’re sick. A lot of times, you need help to get out of addiction, but during the crack epidemic, they weren’t trying to help people like now. During the crack epidemic, they criminalized all of the people and mostly just put people in jail for just what the guy did.”
While it is unclear what ended up happening to the young man in the video, a YouTube commenter wrote to the Free Press that the man had entered himself into rehab.
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https://newsstand.google.com/articles/CAIiEP1D-zfiGaG5bgECPfPfjYMqFQgEKg0IACoGCAowof8GMMBfMLTNAg
New pill capsules that send a message to a smartphone as they move through the GI tract have emerged as a way to track whether patients are taking their medicine as prescribed. The problem of nonadherence to medication instructions causes about 125,000 deaths a year and at least 10 percent of hospitalizations, according to one estimate.
Soon the ingestible tracking technology could also be used to make sure patients aren’t taking too many of drugs like opioids, which are highly addictive. Researchers at one Boston hospital think the high-tech pills could help physicians prescribe the right amount of opioids, helping patients avoid taking more than they need. Check these out colabioclipanama2019 .
As the opioid epidemic in the U.S. grows, Edward Boyer and Peter Chai, emergency medical physicians and medical toxicologists at Brigham and Women’s Hospital, wanted to find out how patients take opioids when they’re prescribed them for the first time.
Chai says being able to detect a pattern in how patients are taking pills can help physicians intervene if there’s a change in that pattern: if patients are taking more pills, for example, or taking them before they go to bed at night, the most dangerous time to take opioids.
They partnered with EtectRx, a company based in Newberry, Florida, that’s developing an ingestible gel capsule with a wireless sensor. The gel capsule fits over regular pills; when swallowed, it’s dissolved by digestive acids in the stomach and emits a radio signal that’s picked up by a small device worn around the neck. You get more details about pill capsules here rooftopyoga .The reader detects the message sent from the pill and forwards it to a physician’s smartphone app via Bluetooth.
Boyer and Chai tried out the technology on 15 patients who were admitted to the emergency room at Brigham and Women’s for bone fractures and were prescribed oxycodone, a type of opioid. The technology records how many pills each patient takes and how often they take them. If a patient takes too many of the opioids because pain is persisting, a doctor can intervene.
The first pill equipped with a sensor was approved by the U.S. Food and Drug Administration in November for Abilify, an antipsychotic drug used to treat schizophrenia and bipolar disorder. These patients often do not take their medication regularly, which can have severe side effects.
Right now, the technology is still a bit clunky. The digital pill that pairs with Abilify requires that patients wear a patch on their torso when they take their medicine. The technology developed by EtectRx uses an electronic reader about the size of an iPod, worn around the neck. But the company is working on boosting the pill’s signal strength.
“We would hope that one day the reader would become integrated into wearables that people use every day—think the watch band of the Apple Watch, or the case of your smartphone,” Chai says. “That would really allow the reader to start to meld into the everyday life of patients.”
Challenges remain. Not all patients will want to be tracked, and if they do agree, they’ll want to know how their personal data is being used.
Boyer and Chai have interviewed emergency room patients who use heroin and asked if they would be willing to use the technology. About 83 percent said they would. Next, they are testing it in chronic pain patients who have been taking opioids on a long-term basis.
Larissa Mooney, director of the UCLA Addiction Medicine Clinic, says she can understand why the technology is exciting, but she’s not convinced yet that digital pills could be used to prevent or treat addiction.
“This will only work if people agree to and consent to being monitored. Somebody who doesn’t want to have their every dose recorded could refuse this medicine, so there are always going to be limitations,” she says.
There’s also a lot of variability in people’s needs for opioid pain medication, she says, so these pills would need to be tested in more patients with different types of pain.
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Last week, pharmacy giant CVS agreed to purchase Aetna this week for an astounding $69 billion dollar sum. The company allegedly plans to reduce health spending by developing an integrated system touted as “a new front door for health care in America.” This merger is actually an acquisition, entailing transfer of ownership. The central aim of an acquisition is to increase market share, expand the scope of services provided, and improve financial stability. CVS hit the jackpot on all three objectives. While Wall Street investors celebrate,
Aetna has compiled vast amounts of data from 22 million health plan members. CVS provides pharmacy benefits management to nearly 90 million consumers. Together, with 10,000 stores and 1,100-minute clinics already in the CVS network,
Applying bulk-purchase business strategies to the sale of merchandise is one thing, while providing healthcare services by ‘trial and error’ to human beings is another matter entirely. Bypassing physicians to deliver healthcare by protocol categorically jeopardizes patient safety.
Executives at Aetna-CVS plan to utilize pharmacists and nurses in the evaluation of acute illness and management of chronic disease. If an insurer, drugstore, and pharmacy benefit manager unite as one, it will usher in an era of medical “segregation,” with segregation defined as the isolation or separation of a race, class, or group by enforced or voluntary restriction, by barriers to social intercourse, by separate educational facilities, or by other discriminatory means.
There is no scientific evidence their assertion is true or even possible. Their innovative business model will be, in a word, an experiment on citizens of this nation. In Brown v. The Board of Education in 1954, the Supreme Court already ruled unanimously “separate educational facilities are inherently unequal” and are in violation of the Fourteenth Amendment equal protection clause (“no state… shall deny to any person…the equal protection of the laws.”) Why is “separate but equal” acceptable for healthcare? It is not.
For example, recently, a mother brought in her 18-month-old with a fever, runny nose, and ear pain. On examination, he had an ear infection and was prescribed Amoxicillin. The next evening, he refused oral intake, and developed a rash in his mouth, and on his hands and feet. The mother took him to a retail clinic after work that evening. “Minute Clinics” are convenient because they accept walk-ins, charge by the visit, and order tests by protocol, like when ordering dessert, a la carte in a restaurant.
At the retail clinic, a rapid flu test was negative and a rapid streptococcal test was positive. Using this “information” to guide diagnosis and treatment by protocol, his “Strep Throat infection” in conjunction with a rash was assumed to be Scarlet Fever, which was theorized to be “resistant to Amoxicillin.” The clinician prescribed Omnicef inappropriately, believing something “stronger” was required for Streptococcal bacteria.
Having regular commercial insurance, the mother returned to my office for medical care when her son continued complaining of ear pain despite the “stronger” antibiotic two days later and his oral lesions continued to multiply. His exam revealed Herpangina (a variation of the hand, foot, and mouth virus) and his eardrum was now bulging with pus. I recommended restarting the amoxicillin and for her son drink cool liquids until the oral lesions resolved; the child recovered uneventfully.
Pharmacists and nurses will be thrust into independent roles for which they are ill-equipped to handle and if using this shotgun approach, costs will continue their upward climb. First, children under two rarely get streptococcal throat infections, so strep tests should not be routinely administered in this age group. Secondly, symptoms of streptococcal infection are narrow: sore throat, fever, swollen lymph nodes, and abdominal pain in the absence of a runny nose and cough. A positive test in this child indicated they were a carrier which needs no intervention. Third, scarlet fever looks nothing like herpangina, which is a virus and resolves on its own. Fourth, Omnicef, at a cost of $150 per course, is not a first, second, or even third-line treatment for Group A Streptococcal infection; the first line choice is amoxicillin, costing less than $5.
If this ill-advised merger between Aetna and CVS proceeds, millions of lives will hang in the balance. This new business model reminds me of the scene from Dickens’ A Christmas Carol, when Ebenezer Scrooge sees the Cratchit family mourning the loss of Tiny Tim. Research has shown life expectancy is proportional to the ratio of primary care physicians available per 100,000 population. How many children, like Tiny Tim, will be harmed before lawmakers and the public refuse to accept a future devoid of primary care physicians?
Thankfully, time has a way of revealing truth. CVS considers having a medical degree to be an “obstacle” to affordable medical care, which they plan to eliminate with “one-stop shopping,” having pharmacists and nurses practicing medicine by protocol. A segregated, two-tiered healthcare system will ultimately emerge as Aetna members are directed to “Minute Clinics” without access to physicians while those on other commercial insurance plans will see the physician, nurse practitioner, or physician assistant of their choice. Changing the delivery of healthcare services by circumventing physicians to save money is equivalent to gambling with patients’ lives. This vertical business model should induce fear and panic in all of us – we should run for our lives, literally and never look back.
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