Majikthise

Nurse whistleblowers face jail time for reporting quack to medical board

Dr. Dave Gorski reports on a stunning miscarriage of justice: Two nurses face possible  jail time because they filed an anonymous complaint against a doctor who was peddling natural remedies out of the ER of their small rural hospital in Kermit, TX.

The quack turned out to be a vindictive quack. When the Texas Medical Board informed Dr. Rolando Arafiles, Jr. that he was under investigation, he lodged a complaint of criminal harassment with the Winkler County Sheriff, who worked tirelessly to unmask the anonymous tipsters:

To find out who made the anonymous complaint, the sheriff left no stone unturned. He interviewed all of the patients whose medical record case numbers were listed in the report and asked the hospital to identify who would have had access to the patient records in question.

At some point, the sheriff obtained a copy of the anonymous complaint and used the description of a "female over 50" to narrow the potential complainants to the two nurses. He then got a search warrant to seize their work computers and found a copy of the letter to the medical board on one of them. [New Statesman]

This is a a caliber of detective work scarcely seen outside of TV cop shows, especially for non-violent, non-crimes like complaining to a medical board. How did Dr. Arafiles get such vigorous policing from the Winkler County Sheriff's Department? Dave wonders if Dr. Arafiles and Sheriff Robert Roberts, Jr. are buddies. I think I found the answer. According to a lawsuit filed by the nurses, Arafiles and Roberts were--wait for it--associates in the herbal supplement business!

In theory, the Texas Medical Board allows anonymous tips, but privacy protections are so weak that the sheriff was able to figure out who blew the whistle.

The nurses, Anne Mitchell and Vickilyn Galle, were charged with improper use of official information, i.e., the state alleges that they improperly divulged confidential patient information in their complaint to the medical board. In fact, complaints to the medical board are HIPAA-exempt, which means that the nurses didn't have to get patient permission to share medical information with the board.

Dr. Arafiles was familiar with the workings of the Texas Medical Board, having already been disciplined in 2007. That time, the board fined him $1000 for failing to properly supervise a nurse practitioner and ordered him to educate himself on ethics, medical records and the treatment of obesity.

The Texas Nurses' Association has set up a legal defense fund for the Kermit Two, which you can support by clicking here. Dave is encouraging his readers to write polite letters to the Wikler County District Attorney's Office protesting the charges. 

Drug policy FAIL: LSD for cluster headaches

Newsweek has an interesting feature on LSD as an experimental therapy for cluster headaches. Cluster headaches are excruciatingly painful and often resistant to existing treatments. Anecdotal reports suggest that LSD can help sufferers.

Unfortunately, US drug laws preclude clinical trials. LSD is a so-called Schedule 1 drug, which means that the Drug Enforcement Agency has decreed a priori that it has no medical application.

The DEA is a law enforcement agency dedicated to drug prohibition. It has neither the expertise nor the inclination to evaluate the medical potential of controlled substances dispassionately. What if the DEA is wrong about the medical value of LSD? We'll never find out because it's illegal to do research on Schedule 1 drugs.

Update: In theory it's possible to apply for waivers to study Schedule 1 drugs, but according to Newsweek, "[t]hese drugs are so restricted by the DEA that researchers at the country's top universities find it almost impossible to get the permission and funding necessary to study the substances in humans." Legal clearance for a large scale clinical trial is inconceivable in the current climate. 

Cervical cancer vaccine didn't kill U.K. teen

It turns out that the Cervarix cervical cancer vaccine was not responsible for the tragic death of 14-year-old Natalie Morton of Coventry who died earlier this week within two hours of receiving the shot.

An autopsy showed that the young woman died from a previously undiagnosed chest tumor. Doctors said it was an advanced malignant growth that was so far gone that it could have killed her at any moment.

Statistically, if you give a vaccine to enough people, a certain percentage will end up dying within hours, even if the vaccine doesn't kill anyone. Such deaths must be investigated, especially if they happen to young healthy people with no apparent risk of sudden death.

This case is a reminder of the risks of conflating correlation and causation in advance of the facts.

Canadian health care as good as American, 47% cheaper

Foes of health care reform are making up all kinds of scurrilous nonsense about Canada's universal health care system.

Canadians have slightly longer life expectancy than their American counterparts and are just as likely to survive heart attacks, breast and cervical cancer, and childhood leukemia:

Sept. 18 (Bloomberg) -- Opponents of overhauling U.S. health care argue that Canada shows what happens when government gets involved in medicine, saying the country is plagued by inferior treatment, rationing and months-long queues.

The allegations are wrong by almost every measure, according to research by the Organization for Economic Cooperation and Development and other independent studies published during the past five years. While delays do occur for non-emergency procedures, data indicate that Canada’s system of universal health coverage provides care as good as in the U.S., at a cost 47 percent less for each person. [Bloomberg]

The U.S. had the highest rate of deaths preventable by health care in the entire OECD, 110 deaths per hundred thousand people. Canada had the sixth-lowest rate, 77 deaths per 100,000. 

Canada covers everyone with results as good as, or better than, the U.S. health care system, all for 47% less per person.

I grew up in Canada and I can attest that the system offers excellent care--equaling or surpassing any medical care I've received in the states, and with none of the bureaucratic nightmares of the private insurance system. 

Wombs for Rent: Surrogacy scams

Tomorrow NOW will broadcast an expose of scams in the surrogate motherhood industry, supported by my friends at the Nation Institute. Old school investigative reporting meets cutting edge medical technology:

Many European countries, from Spain to Germany to the Netherlands, have banned surrogate motherhood. But in the United States it's the Wild West -- an almost completely unregulated industry that has left some surrogate mothers with thousands of dollars in unpaid medical bills and would-be parents with pilfered bank accounts. "If you compare surrogacy to buying a used car," says one expert in the field, "there are many more rules when you buy a used car."

Investigative Fund reporters Habiba Nosheen and Hilke Schellmann traveled the country speaking with surrogate mothers, agency operators, and intended parents to expose the human costs of this lack of regulation and produced a segment for NOW on PBS, "Wombs for Rent," which takes a close look at one of the industry's many bad actors, SurroGenesis.

"Wombs for Rent," which was supported by the Investigative Fund at The Nation Institute, airs Friday, September 18, at 8:30 p.m. in New York City. Go to http://www.pbs.org/now/sched.html for broadcast times nationwide.

Alties vs. healthcare reform

Dr. Amy Tuteur, the Skeptical OB, notices that multi-millionaire crackpot Andrew Weil is making the case against healthcare reform at the Huffington Post. (Update: In a follow-up post, Dr. Amy takes a closer look at Dr. Weil's natural products empire.)

Why? Because he thinks the reforms are inexplicably focused on saving money while curing diseases with medicines. Weil thinks we should scrap that model and focus on making people "healthy," i.e., plying them with his industry's products.

Dr. Weil is so warm and cuddly and charmingly befuddled that it's easy to forget his an advocate for an industry that's every bit as mercenary as Big Pharma. All these special interest groups are vying for government giveaways under the guise of reform, and Big Placebo is no exception.

Jon Stewart vs. Betsy "Death Panels" Betsy McCaughey

The Daily Show With Jon Stewart	Mon - Thurs 11p / 10c
Exclusive - Betsy McCaughey Extended Interview Pt. 1
www.thedailyshow.com
Daily Show Full Episodes Political Humor Healthcare Protests

Tom Daschle is working for the insurance industry, again

Ever wonder why single payer is never, ever on the table? Maybe because so many ostensibly liberal health policy leaders are as beholden to the insurance industry as their conservative counterparts.

For example, Business Week reports that former Democratic senator Tom Daschle is once again working closely with UnitedHealth, the nation's largest health insurance company.

Sommer has retained such influential outsiders as Tom Daschle, the former Democratic Senate Leader who now works for the large law and lobbying firm Alston & Bird. Daschle, a liberal from South Dakota, dropped out of the running to be Obama's Secretary of Health & Human Services after disclosures that he failed to pay taxes on perks given to him by a private client. He advised UnitedHealth in 2007 and 2008 and resumed that role this year. Daschle personally advocates a government-run competitor to private insurers. But he sells his expertise to UnitedHealth, which opposes any such public insurance plan. Among the services Daschle offers are tips on the personalities and policy proclivities of members of Congress he has known for decades.

Conceding that he doesn't always agree with his client, Daschle says: "They just want a description of the lay of the land, an assessment of circumstances as they appear to be as health reform unfolds." He says he leaves direct contacts with members of Congress to others at his firm. [BW]

Even reform standard-bearer Howard Dean joined the lobby firm of McKenna, Long & Aldridge in March as a strategic adviser and policy consultant. McKenna lobbies on behalf of several health care, life science, and insurance companies. When Dean joined the firm, it was announced that he would be advising the firm's lobbyists on healthcare issues.

The White House shouldn't allow Daschle and Dean to continue such apparent conflicts of interest. I'm guessing that their job descriptions have been carefully vetted to avoid violating any ethics guidelines, but let's get real here. Lobbyists are paying top dollar for inside information from current movers and shakers in healthcare policy. That stinks.

Even if everything is on the up-and-up, these arrangements make me question Daschle and Dean's leadership. Can't they wait just a few more months to cash in their public sector credentials?

Sometimes the oligarchy in the United States seems every bit as intractable as the power structure in Honduras.

Standup comic Dara O'Briain on homeopathy

Brilliant stand up routine Dara O’Briain mocking pseudoscience, New Age thinking, and sloppy "balance" in science journalism:

Could dieting spike a drug test?

Extreme dieting might cause false positive drug tests, the New Scientist speculates.

Here's the theory: THC, the primary psychoactive component in marijuana, is fat soluble and traces of the drug accumulate in adipose tissue. So, maybe burning a large amount of body fat in a short time releases enough of those stored chemicals to deliver a positive drug test in someone who hasn't used the drug lately. There are anecdotal reports of rapid weight loss causing people to fail drug tests long after they stop smoking marijuana.

The New Scientist's conjecture was prompted by a new rodent study reportedly accepted by the British Journal of Pharmacology. Researchers found that a 24-hour fast doubled THC metabolite levels in rats compared to animals that were allowed to eat normally after the same dose.

Even if the study results prove robust, there are a lot of unconnected dots separating starved rats and dieters undergoing drug tests. Still, the fact that rapid fat breakdown seems to increase THC metabolites lends credence anecdotes about false positives linked rapid weight loss. Clearly, more research is needed.

I wish I could say these findings would strike a blow against the urinalysis-industrial complex, if they were ultimately confirmed in humans--but compulsory drug testing is about social control, not scientific precision. The drug testers are probably already scheming to impose mandatory fasting protocols to reach even further back into subjects' chemical history.

On the other hand, this line of research might help victims of false positives dispute the results in court. One study cited by Consumer Reports found that forty-one percent of Americans were dieting.