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CRUCIFYING BLUE CROSS BLUE SHEILD OF MICHIGAN ON ITS OWN CROSS AS FORD MOTOR CAR COMPANY, ALONG WITH DR. LESLY POMPY, FILED MAJOR LAWSUIT ACTIONS
FRAUD ON ONE FRAUAD ON THE OTHER: ELIZABETH HOLMES GOES TO JAIL??? “THE AMAZING DOUBLE STANDARD OF JUSTICE,” WHY HAS BAMBOO(ZLE) HEALTH “NARXCARE” SYSTEMS NOT HELD ACCOUNTABLE FOR FRAUD IN THE SAME MANNER AS THERANOS!!???
THE US DRUG ENFORCEMENT AGENCY (DEA) IS A COLOSSAL INSTITUTIONAL FAILURE: GETTING CONGRESS TO GET ‘WOKE”???
LETTER THE SENATOR DICK DURBIN OF ILLINOIS: WE SENATE OVERSIGHT HEARINGS ON THE HUGH AMOUNT OF MONEY WASTED ON DEA’S WAR ON DRUGS
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MEMO TO PRESIDENT JOE BIDEN: END NIXON, FORD, CARTER, et. al., WAR ON DRUGS, AGAINST OLDER HEATH CARE PROVIDERS BY END MASSIVE CRIMINAL ACTIVITY OF DEA
Real Pain, Real Talk with APDF – A conversation with Dr. Jay K Joshi S1Ep1
Episode Description
The so-called opioid crisis is a tragedy unique to modern American culture. Our co-hosts ask Dr. Joshi poignant questions about how law enforcement agencies have essentially criminalized the practice of medicine by allowing due process violations, subjective interpretations of the Controlled Substance Act, and through “familiarity bias” by agents not trained in the clinical practice of health care.
The discussion continues about how patients with chronic, intractable pain are treated presently and what patients can expect in the future in light of recent Supreme Court rulings and subtle policy changes. Burden of Pain, A Physician’s Journey through the Opioid Epidemic is available at Amazon.com and Barnes & Noble.com.
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Significant Reduction In Inpatient Opioid Use Achieved With Careeffectstm Stewardship Service
Looking at the website for Troy Medical Center, it is a 97-bed hospital servicing a six-county area in Southern Alabama. According to this https://www.rasmussen.edu/degrees/health-sciences/blog/types-of-hospitals/ a hospital with < 100 beds is classified as a “small hospital” This appears that this system encourages nursing staff to “just say no” when pts request an opioid dose, which there are prescriber’s orders for a particular pt. Does this term “improves nurse practices” means that they lowered the number of “nursing hours per pt” ? I did a word search on this article and the word PAIN did not appear ONCE in the entire text but in the text… Reducing excess.. prolonging lengths of stay and increasing the risk of readmission Is this another reference to the bottom line of the hospital ?
https://www.troymedicalcenter.com/about/
Significant Reduction In Inpatient Opioid Use Achieved With Careeffectstm Stewardship Service
(MENAFN– PR Newswire) Indicator Sciences Highlights 20% Inpatient Opioid Reduction at Troy Regional Medical Center
BIRMINGHAM, Ala.
, June 13, 2023 /PRNewswire/ –Indicator Sciences, the provider of the CareEffects Stewardship consultative analytics service, today proudly unveils the results of a successful initiative at Troy Regional Medical Center. Implementation of the service has led to a 20% reduction in inpatient opioid use within just six months, underscoring its value and effectiveness.
CareEffects reduces inpatient opioid use by 20%, improves nurse practices & elevates patient care at Troy Medical Center
Opioids pose a challenge for hospitals in that inpatient administration can cause complications and influence outpatient utilization.
Reducing excess
opioid utilization is critical to prevent opioid-related adverse drug events, complications which occur in nearly 10% of inpatient admissions in U.S. hospitals, prolonging lengths of stay and increasing the risk of readmission.
Leveraging comprehensive context-of-care risk-adjustment analytics, CareEffects Stewardship identifies individual nurses whose practice patterns lead to increased opioid utilization compared with their peers. As nurses manage roughly 80% of inpatient opioids on a PRN (as needed) basis, there is an urgent need for closer monitoring of individual nursing practices. This pioneering approach paves the way for focused stewardship education, fostering improved patient outcomes.
Rick Smith, CEO of Troy Regional Medical Center, praises the program: “As leaders of a small hospital, we have a zero-tolerance policy towards preventable complications. CareEffects Stewardship has become an integral part of our pursuit of delivering the highest quality of patient care.”
Led by Chief Clinical Officer Amy Minor, RN, a targeted nursing intervention was conducted, focusing on approximately 5% of the inpatient nursing staff. These nurses each exhibited a significant increase in opioid use per shift compared with their peers, after risk-adjusting for context-of-care.
Minor points to a success story: “One of our nurses, initially identified as an outlier, has since evolved into a practice leader. Our non-punitive approach has not just enhanced patient safety, but also nurtured a supportive and learning-centric environment for our nursing staff.”
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An example of our judicial/legal system AT IT’S BEST ?
An example of our judicial/legal system AT IT’S BEST?
https://threadreaderapp.com/thread/1523720324855914498.html
More from @jesusrodriguezb
Jan 31
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US military is so worried about drug safety it wants to test widely used medicines
After reading this, I did a “word search” for “strength” & “potency” and came up with ZERO MATCHES. The word “quality” shows up 18 times and here is a recent post on my blog How Reliable Are Your Generic Drugs From India?
Are they using the word “quality” to encompass strength or potency or give the illusion that the potency and/or strength from the testing are within FDA standards ? Am I the only one that is concerned that the FDA such quality control violations that the FDA shut down a pharma production plant …But it made an exception for 25 medications, including the cancer drugs, because of shortages. If you are dealing with cancer, and your only choice of a med provided by a pharma whose plant has been shut down because of quality control issues in the plant. Would you be concerned that if the cancer does “do you in” .. the medication might ?
How Reliable Are Your Generic Drugs From India?
US military is so worried about drug safety it wants to test widely used medicines
U.S. military officials are so concerned about the quality of generic drugs that the Department of Defense is devising a program to test the safety of widely used medicines.
Defense officials are in talks with Valisure, an independent lab, to test the quality and safety of generic drugs it purchases for millions of military members and their families, according to several people familiar with the matter who asked not to be named as the details aren’t public.
The move raises questions about the Food and Drug Administration’s ability to adequately police generic medicines. With mounting drug shortages, most of which are caused by quality problems, military officials have gone so far as to call vulnerabilities in the drug supply chain a national security threat.
Aware of growing quality problems, the White House has convened a task force that’s exploring whether testing could be expanded more broadly in the US. If the Pentagon pilot is successful, it could serve as a model for Medicare or the Department of Veterans Affairs, people familiar with the matter said. But there are tensions in Washington: In conversations with the White House, the FDA has pushed back against additional quality checks, questioning the accuracy of third-party labs like Valisure.
The agency said it stands behind medicines sold in the US and Americans can be confident about their quality.
Generics 101
Drugmakers are required to test their drugs for impurities. The industry doesn’t share results with the FDA, rather companies keep files that agency inspectors comb through when they visit drug production plants once every year or two. Over the last decade, FDA inspectors have found many manipulated test results. The agency can ask a plant to shut down if it finds major problems. This can lead to or exacerbate drug shortages, which is an acute problem in the US right now.
The FDA said in 2019 that 62% of drug shortages were caused by quality issues. Sometimes even the threat of a shortage can force the US to accept drugs from low-quality suppliers that, under other conditions, would have been cut off. Drug shortages are currently at a five-year high in the US and climbing.
The idea for the Pentagon’s drug testing program was motivated by weaknesses in the pharmaceutical supply chain exposed by the Covid crisis. A recent Congressional mandate also required military officials to further investigate the threat of America’s increasing reliance on overseas manufacturers.
“They’re taking that risk very seriously,” said Valisure Chief Executive Officer David Light, who declined to comment specifically on the department’s plans to partner with his company.
The Defense Department didn’t comment on a detailed list of questions sent by Bloomberg News.
The Kaiser Model
The Pentagon’s proposed program follows a similar one quietly launched by Kaiser Permanente, details of which have never been reported. Kaiser, which serves 12.7 million Americans, started working with Valisure on additional drug quality checks more than two years ago, said Sean Buhler, Kaiser’s vice president of pharmacy strategic sourcing and procurement.
If Valisure detects quality issues, Kaiser turns to other manufacturers. That data also provides an early warning system for shortages: If a drug’s quality is so bad that it could trigger a recall, the health system starts preparing.
Kaiser has pursued the testing program with Valisure as “an additional assurance for our members’ safety and care beyond the current testing that the FDA is mandating,” Buhler said.
Through its testing for Kaiser, Valisure flagged that the ingredients from one supplier contained higher levels of lead when compared with another option — though both suppliers’ lead levels fell within the FDA’s standards. This finding allowed Kaiser to avoid the drug with more lead.
University of Kentucky started a program in 2019 to test drugs purchased through the college’s network of hospitals and clinics. More than 10% of drugs have been flagged with potential problems, said Robert Lodder, a pharmaceutical sciences professor who co-leads the testing effort.
These programs aim to unearth issues that are invisible to the average person. Patients may not know if they’re repeatedly taking small amounts of a chemical that can cause cancer, as has been the case with some heart and diabetes drugs.
Filling the Gap
Valisure is known for finding dangerous chemicals in drugs and personal-care products. It hopes to become the go-to source for ingredient verification for many products on store shelves.
The FDA has repeatedly pushed back against testing programs including Valisure’s, saying third-party labs don’t use the same protocols as drug manufacturers. The agency has also warned unnecessary testing and inaccurate results could exacerbate drug shortages. The FDA does a limited amount of drug testing itself.
“Protecting patients is the highest priority of the FDA,” Jeremy Kahn, an agency spokesman, said in an email. “The FDA continues to work to build a safe, secure and agile drug supply chain so that American patients have the medications they need – medications that have been carefully reviewed by the FDA for safety, effectiveness and quality.”
In response to the FDA’s suggestion that third-party labs don’t follow the same protocols as drug companies, Valisure’s Light said the company’s tests are faster and less expensive and still accurately spot problems.
A Shredding in Ahmedabad
FDA inspection documents, mainly from visits to factories in India over the past year and a half, have outlined a rash of violations. Some of the more alarming findings concern Accord Healthcare, a subsidiary of India-based Intas Pharmaceuticals Ltd.
Intas makes more than 100 generic drugs approved in the US, including copycats of the cholesterol-lowering pill Lipitor and erectile-dysfunction drug Cialis, according to an FDA database.
Last November, agency inspectors visited an Intas facility in Ahmedabad, India. Workers appeared to have recently destroyed sensitive quality-control documents, according to an account of the visit written by FDA inspectors. After shredding documents before inspectors arrived, Intas workers stuffed remnants into trash bags and tossed them into a truck, throwing acid on a bag that hadn’t made it onto the truck.
Following the inspection, Intas shut down operations at the plant. The FDA required extra testing on some cancer drugs — a slow but necessary process that resulted in shortages of critical chemotherapies like cisplatin, methotrexate and carboplatin. Last week, the FDA banned the Intas factory from sending drugs to the US. But it made an exception for 25 medications, including the cancer drugs, because of shortages. Intas didn’t respond to a request for comment.
The FDA is similarly allowing Sun Pharmaceutical Industries Ltd. to send another widely used cancer drug to the US despite it being made in a factory in India that was so rife with safety violations it was banned in December from selling an undisclosed number of other treatments in the US.
Both Sun and Intas are required to get extra quality tests on the drugs they’re sending to the US from banned factories.
A Sun spokesperson said the company is “taking all necessary steps to resolve the outstanding issues as fast as possible.”
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States Must Stop Criminalizing Medicine, AMA Delegates Say
States Must Stop Criminalizing Medicine, AMA Delegates Say
“This is unacceptable…and it’s time for us to push back”
https://www.medpagetoday.com/meetingcoverage/ama/104948
CHICAGO — The criminalization of medicine is taking its toll on physicians — and not just those who perform abortions, members of the American Medical Association (AMA) House of Delegates said here Saturday during the AMA annual meeting.
“A doctor who can’t get in trouble for malpractice because no patient has been harmed can end up in federal prison for 20-plus years because they prescribed off-guidelines,” said Stuart Gitlow, MD, MPH, MBA, of New York City, a delegate for the American Society of Addiction Medicine (ASAM). “This is unacceptable. It’s been unacceptable for more than 2 decades now. And it’s time for us to push back.”
Gitlow was speaking at an AMA reference committee meeting in favor of a resolution introduced by ASAM that called for the AMA to “study the rapidly changing environment in which the practice of medicine has been criminalized” and how that is affecting medical practice. The resolution also sought a report back to the delegates by the AMA June 2024 annual meeting. ASAM’s resolution was discussed in conjunction with a similar resolution from the New York delegation.
Gitlow noted that the Controlled Substances Act “requires that physicians who prescribe controlled substances do so by issuing the prescription for a legitimate medical purpose,” but the Justice Department sees it differently from physicians. The department “has said on multiple indictments, that if somebody departs from guidelines, such as by prescribing a medication off-label, for instance, that they are then not acting in the usual course of professional practice, and therefore, they are subject to indictment,” he said. “As a result, we have past presidents of three different state addiction societies, and multiple pain medicine societies, who are either under indictment, have been raided, or are in prison.”
Monalisa Tailor, MD, of Louisville, Kentucky, speaking for the Kentucky delegation in support of the resolution, said that when gender-affirming care came up for discussion in the Kentucky legislature this year, “there were many terrible things said about the practice of medicine and physicians in my state. This is also applied to our abortion providers and our ob/gyns … We’re going to continue to see state legislatures propose these types of laws that suggest that the practice of medicine should be criminalized — for us just taking care of our patients.”
Criminalization also increases the likelihood of violence towards physicians “because it gives people the idea that we are doing something wrong,” said Sean Figy, MD, of Omaha, Nebraska, who spoke on behalf of the Young Physicians Section and the Plastic Surgery Caucus. “And therefore, for some reason, it makes people think they can threaten us and threaten death for our families … So I do think it’s really important to help us figure out how we can make it better.”
Delegates also discussed a report by the AMA Council on Ethical and Judicial Affairs (CEJA) on ethical principles for physicians involved in practices owned by private equity firms. The report recommended that physicians who contract with these companies make sure that the contract “minimizes conflict of interest” in the way doctors are paid and doesn’t encourage undue restrictions on patient care, and that it also “does not compromise physicians’ own financial well-being or ability to provide high-quality care.”
In addition, the contract should “allow the physician to appropriately exercise professional judgment” and “enable physicians to participate in, if not outright control, decisions about practice staffing,” the report said.
Several people spoke up in favor of the report. “As we know, there is a national trend to more and more practices being taken over by private equity, with the consequent pressure on the physicians to do things not in the best interest of the patients,” said Tim Fagan, MD, alternative delegate from Arizona speaking on behalf of the PacWest delegation. “So the PacWest speaks strongly in support of this report.”
But others complained the report didn’t go far enough. “[The report] did discuss the requirement for physicians to maintain fiduciary responsibility, but does not discuss whether or not it is ethical for a corporation to take large profits out of healthcare,” said former AMA president Barbara McAneny, MD, of Albuquerque, New Mexico, a delegate from the American Society of Clinical Oncology (ASCO) who was speaking for herself.
“Private equity companies are composed of wealthy people seeking to increase their wealth; they expect to exit their investment with returns of five to 10 times the investment. And that level of profit is not going to be generated by efficiencies of delivering care or by avoiding unnecessary care,” said McAneny. “That money will come from somewhere — and the only options are that that money comes from patients, physicians, and the taxpayers who support governmental programs.” She urged the committee to “send this report back to CEJA and ask them to give us guidance on one of the more pressing issues of our time, which is whether or not private equity should be playing any role in profiteering in healthcare.”
“This is a pretty toothless report,” said Brett Coldiron, MD, an Ohio delegate from Cincinnati who spoke for the Great Lakes delegation in favor of sending the report back to CEJA. “Private equity has devastated dermatology and anesthesiology, and it’s coming your way.” When private equity-owned practices go broke, “they seize their accounts receivable and [the doctors] still have a non-compete,” he added. “So it’s a terrible situation and we need a better recommendation to work with.”
The committee will consider the delegates’ comments and then issue a report with its own recommendations, which the entire House of Delegates will vote on during its general session starting on Monday.
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