HMOs Dangerous to Elderly?
A recent study1 compared the health of chronically ill patients treated in health maintenance organizations (HMOs) and fee for service systems (FFS). Although they observed adults ranging from 18 to 97 years of age, after four years of observations in three geographic areas, the investigators discovered a disturbing difference:
"For elderly patients (those aged 65 years and older) treated under Medicare, declines in physical health were more common in HMOs than in FFS plans (54% vs 28%; P<.001)"Reference
1. Ware JE, Bayliss MS, Rogers WH, Kosinski M, Tarlow AR. Differences in 4-year health outcomes for the elderly and poor, chronically ill patients treated in HMO and fee-for-service systems. JAMA 1996;276: 1039-1047.
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
Spearheaded by burgeoning scientific and clinical research literature, psychedelics have reached a level of media coverage and popular interest that has not been seen for over half a century. By “psychedelics,” we are referring to the unique class of substances that includes psilocybin (the active compound found in so-called “magic mushrooms”), LSD, dimethyltryptamine (DMT), ayahuasca, 5-MeO-DMT, and mescaline – each of which occurs in the natural world (except for LSD, which is a semi-synthetic compound).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
