Monthly Archives: December 2007

Oral contraceptives increase breast cancer risk, study shows

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According to a meta-analysis published in the Mayo Clinic Proceedings¸ but virtually ignored in the mainstream press, use of oral contraceptives increases risk of premenopausal breast cancer, writes Dennis Byrne (Chicago Tribune 12/3/07).

The greatest increase in risk, 52%, was in parous women who used oral contraceptives for four or more years before their first full-term pregnancy (Kahlenborn C, et al.Mayo Clinic Proc 2006;81:1290-1302, 2006).

Byrne notes that stories about other breast cancer risks were plentiful, including one about sleeping with a night light on. The National Institute of Cancer doesn’t mention the study on its web site, nor does the American Cancer Society. The latter concedes only that “it is still not clear what part” the pill plays in breast cancer.

Curiously, those who protest about government and big business failing to “do enough” to protect consumers are silent about this particular risk, Byrne writes.

“Here, I also should clarify some things to all the folks who are itching to hit the ‘post comment’ button. Kahlenborn is pro-life, but what has that to do with his research? As for me, I am not opposed to contraception, oral or otherwise. I am not plotting to get the pill banned. I am not writing this column for hidden religious reasons. I’m not saying the Kahlenborn study is the last word…. I’m writing about it because people have the right to know about the existence of health information, even if it is contradictory to the given wisdom.”

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Ron Paul’s “tea party” breaks fund-raising record

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The second Ron Paul “money bomb” exceeded even the first, raising $6.04 million in 24 hours, beating John Kerry’s previous one-day internet fund-raising record. The event on December 17 honored the 234th anniversary of the Boston Tea Party.

There were 58,407 individual contributors, of whom 24,915 were first-time donors. The average donation was $102. Dr. Paul, a life member of AAPS, describes the effort as an “entirely voluntary, self-organized, decentralized, independent effort.”

As others keep asking Dr. Paul who runs the fundraising and campaigning, he notes that “to these top-down central planners, a spontaneous order like our movement is science-fiction.” (See Message from Ron at www.ronpaul2008.com).

To those who call his supporters “angry,” Dr. Paul writes: “Well, we are the happiest, most optimistic ‘angry’ movement ever, and the most diverse. What unites us is a love of liberty, and a determination to fix what is wrong with our country, from the Fed to the IRS, from warfare to welfare. But otherwise we are a big tent.

“Said the local newspaper: ‘The elderly sat with teens barely old enough to vote. The faces were black, Hispanic, Asian and white. There was no fear in their voices as they spoke boldly with each other about the way the country should be. Held close like a deeply held secret, Paul has brought them out of the disconnect they feel between what they know to be true and where the country has been led.’”

Three of the more than 178 comments (all but about eight of which were positive) posted on the Boston Globe website in response to an article about the tea party.

“I feel stupid. I’m one of the people who thought Ron Paul was fringe (because the media told me so)…. I’ve spent the last 2 hours reading his speeches and articles and I can’t stop….”

“I am heading to a frozen lake to stomp RON PAUL into the lake as a billboard.”

“I re-registered Republican to vote for Dr. Paul.”

“I couldn’t make it to the Tea Party this weekend due to bad weather. So, I made a sign that said ‘Ron Paul is making history today’ and went to the closest intersection. This was a little scary at first, but I thought people in my area needed to know the truth. At first I was met with blank stares. But, after that first person gave me a thumbs up I was on a new high. They just kept coming, people yelling out the windows, ‘RON PAUL….’ The next thing I knew I’d been standing there over 3 hours.”

About 500 people braved the blizzard in Boston to go to Faneuil Hall for the tea part event, where Dr. Paul’s son, Rand Paul, spoke.

Paul could end up raising more money than any of the other Republican contenders and providing the only serious competition for Democrat money leaders Hillary Clinton and Barack Obama, wrote John Nichols (Nation 12/18/07).

The dramatic fundraising feat has attracted some major media attention. See clips on YouTube.

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DOCTORS SUE TEXAS MEDICAL BOARD FOR MISCONDUCT – Cites institutional culture of retaliation & intimidation

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The entire Texas Medical Board (TMB) and its officials have been named in a lawsuit filed by the Association of American Physicians and Surgeons (AAPS). The complaint, filed this week in District Court in Texarkana, accuses the board of misconduct while performing its official duties, specifically:

  1. Manipulation of anonymous complaints;
  2. Conflicts of interest;
  3. Violation of due process;
  4. Breach of privacy; and
  5. Retaliation against those who speak out.

“The situation has reached the crisis point for patients and doctors,” said Jane M. Orient, M.D, Executive Director of AAPS. “Our members are too afraid of retaliation to sue the Board as individuals.”

The lawsuit specifically points out misconduct by Roberta Kalafut, the Board president. The law suit claims that Kalafut “arranged for her husband to file anonymous complaints again other physicians, including her competitors in Abilene…”

She then “…worked inside the TMB, with other defendants, to discipline doctors based on anonymous complaints filed by her physician husband.”

The lawsuit also charges that Kalafut and Donald Patrick, Executive Director, knew about the conflict of interest of Keith Miller while he was Chair of the Disciplinary Process Review Committee. Miller served as plaintiffs’ witness in at least 50 cases brought before the Board without disclosing that to the disciplined doctors or the public.

During a marathon 11-and-a-half hour legislative hearing about the Texas Medical Board on October 23, 2007, Kalafut and Patrick admitted under oath that they were aware of the conflicts of interest.

“It seems clear from the sworn testimony before the legislative committee that they knew about the problems and had done what they could to hide them,” said Dr. Orient.
 

The lawsuit demands that the Court put an immediate stop to abuses by the Board, and that previous disciplinary actions tainted by the Board’s violations be re-opened.

“Doctors in Texas should not be forced to practice in this atmosphere of fear and intimidation,” said Dr. Orient. “Complaints from our members have identified the TMB as probably the worst in the country. It’s bad for patients when their doctors are afraid that doing the right thing could result in licensure action.”

COMPLAINT AVAILABLE: A copy of the complaint is available at www.aapsonline.org.

NOTE: AAPS is a non-profit, professional association of physicians in all specialties, dedicated since 1943 to protection of the patient-physician relationship. It accepts no corporate or government funding, and its board members and officers serve without compensation.

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Medicare fee cut threatened again; AMA to fight for balance billing

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In what has become an annual ritual, Medicare announces a cut in physicians’ fees, and physicians threaten that patients will lose access to care. And this time they really mean it.

An average 10.1% fee cut was slated to take effect on Jan 1, 2008. Two-thirds of the doctors in Sarasota County said they would stop accepting new Medicare patients if federal payments don’t improve.

For the first time in either group’s memory, the AMA and the American Association of Retired Persons (AARP) are working together to lobby Congress on this issue.

Legislation crafted by the Senate Finance Committee, which postponed the scheduled cuts by 6 months and extended SCHIP funding until March 2009, was approved on a voice vote. (Kevin Freking, AP 12/18/07)

“They keep kicking the can down the highway without fixing the real problem,” said AMA board chairman Edward Langston, M.D. (David Gulliver, Sarasota Herald Tribune 12/4/07).

As House and Senate considered a measure to delay Medicare cuts until June, Rep. Pete Stark (D-CA) said, “To push the problems ahead six months is insane.” Senator Jon Kyl (R-AZ) “This kicks the can down the road. That’s going to be tougher next year. There’s a geometric progression which makes it worse each year.”

Congress would “pay for” the measure by trimming $1.5 billion from a fund established for certain insurers that entered underserved regions and by freezing payments for inpatient rehabilitation and prescription drugs provided by physicians under Medicare Part B. The AARP was unhappy that Congress did not cut payments to Medicare managed-care plans.

In response to pressure from delegates at the interim meeting of the AMA, the AMA has said it will “renew [the] fight for Medicare balance billing” —an action that AARP does not support.

The policy adopted by the House of Delegates directs the AMA to “devote its political and financial resources to initiate a measure at the appropriate time that would allow Medicare balance billing” (amednews.com 12/3/07). The resolution did not pass without dissent. Some delegates say the new policy “may draw critics who say physicians are too concerned about money.” Also, “a major push for balance billing would alienate seniors and distract Congress from working on the sustainable growth rate.”

As usual, a reprieve from a pay cut is expected to come at a price. The Pharmaceutical Care Management Assn. is pushing to include an e-prescribing mandate in legislation postponing the fee cut. PCMA is running ads that say “While you wait, thousands die each year” [from lack of e-prescribing] (David Glendinning, amednews.com 11/26/07).

It is claimed that electronic health records would help curb rising costs and hence help offset the cost of a physician pay increase. And who would pay for the EHR?

Health and Human Services Secretary Michael Leavitt said, “In my view, any new bill should require physicians to implement health [IT] that meets department standards in order to be eligible for higher payments from Medicare.” For the moment, this proposal was not enacted.

Only 10% of physicians in solo or small group practices use EHR systems, which can cost $20,000 to $40,000 to implement (iHealthBeat 12/4/07).

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