Archive for the ‘medical care’ Category

Flood of wounded GIs swamps care units

November 3, 2008

In a rush to correct reports of substandard care for wounded soldiers, the Army flung open the doors of new specialized treatment centers so wide that up to half the soldiers currently enrolled do not have injuries serious enough to justify being there…

Army leaders are putting in place stricter screening procedures to stem the flood of patients overwhelming the units — a move that eventually will target some for closure.

By LOLITA C. BALDOR, Associated Press Writer

According to interviews and data provided to the AP, the number of patients admitted to the 36 Warrior Transition Units and nine other community-based units jumped from about 5,000 in June 2007, when they began, to a peak of nearly 12,500 in June 2008.

The units provide coordinated medical and mental health care, track soldiers’ recovery and provide broader legal, financial and other family counseling. They serve Army active duty and reserve soldiers.

Just 12 percent of the soldiers in the units had battlefield injuries while thousands of others had minor problems that did not require the complex new network of case managers, nurses and doctors, according to Brig. Gen. Gary H. Cheek, the director of the Army’s warrior care office.

In this undated photograph provided by the Department of Defense, ... 
In this undated photograph provided by the Department of Defense, Brig. Gen. Gary Cheek is seen. In a rush to correct reports of sub-standard care for wounded soldiers, the Army flung open the doors of new specialized treatment centers so wide that up to half of the soldiers currently enrolled don’t have injuries serious enough to be there, the Associated Press has learned. The overcrowding was a ‘self-inflicted wound,’ said Cheek, who also is an assistant surgeon general. ‘We’re dedicating this kind of oversight and management where, truthfully, only half of those soldiers really needed this.’ (AP Photo/Department ofDefense)

The overcrowding was a “self-inflicted wound,” said Cheek, who also is an assistant surgeon general. “We’re dedicating this kind of oversight and management where, truthfully, only half of those soldiers really needed this.”

Cheek said it is difficult to tell how many patients eventually will be in the units. But he said soldiers currently admitted will not be tossed out if they do not meet the new standards. Instead, the tighter screening will weed out the population over time.

“We’re trying change it back,” to serve patients who have more serious or multiple injuries that require about six months or more of coordinated treatment, he said.

By restricting use of the coordinated care units to soldiers with more complex, long-term ailments, the Army hopes in the long run to close or consolidate as many as 10 of the transition units, Cheek said during an interview in his Virginia office near the Pentagon.

In the past, a soldier with a torn knee ligament would have surgery and then go on light duty, such as answering phones, while getting physical therapy. But last October, the Army began allowing soldiers with less serious injuries such as that bad knee to go to the warrior units.

The expansion came in the wake of reports about poor conditions at Walter Reed Army Medical Center in Washington, D.C., including shoddy housing and bureaucratic delays for outpatients there.

Brigade commanders began shipping to the transition centers anyone in their unit who could not deploy because of an injury or illness. That burdened the system with soldiers who really did not need case managers to set up their appointments, nurses to check their medications and other specialists to provide counseling for issues such as stress disorders.

Read the rest:
http://news.yahoo.com/s/ap/20081103/ap_
on_go_ca_st_pe/wounded_warriors;_ylt=
AoQlAisEZ88qx8GhXb.Gzsus0NUE

Nearly 1 in 5 troops has mental problems after war service

April 17, 2008

By PAULINE JELINEK, Associated Press Writer

WASHINGTON – Roughly one in every five U.S. troops who have survived the bombs and other dangers of Iraq and Afghanistan now suffers from major depression or post-traumatic stress, an independent study said Thursday. It estimated the toll at 300,000 or more.
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As many or more report possible brain injuries from explosions or other head wounds, said the study, the first major survey from outside the government.

U.S. troops search for Taliban forces during a patrol in Afghanistan's ... 
U.S. troops search for Taliban forces during a patrol in Afghanistan’s Shamal district of Khost province April 16, 2008. About 300,000 U.S. troops returning from Iraq and Afghanistan suffer symptoms of post-traumatic stress disorder or depression, but about half receive no care, an independent study said on Thursday.REUTERS/Rafal Gersza

Only about half of those with mental health problems have sought treatment. Even fewer of those with head injuries have seen doctors.

Army Surgeon General Eric Schoomaker said the report, from the Rand Corp., was welcome.

“They’re helping us to raise the visibility and the attention that’s needed by the American public at large,” said Schoomaker, a lieutenant general. “They are making this a national debate.”

The researchers said 18.5 percent of current and former service members contacted in a recent survey reported symptoms of depression or post-traumatic stress. Based on Pentagon data that more than 1.6 million have deployed to the two wars, the researchers calculated that about 300,000 are suffering mental health problems.

Nineteen percent — or an estimated 320,000 — may have suffered head injuries, the study calculated. Those range from mild concussions to severe, penetrating head wounds.

Read the rest:
http://news.yahoo.com/s/ap/20080417/ap_on_go_ca_
st_pe/troops_mental_health;_
ylt=AkKRKrcCTNidVr3yzaBFe.es0NUE

Related:
Crisis: Soldiers, Marines Returning from War with Mental Health Issues

China’s Population of Severely Poor Equal To Entire U.S. Population

January 13, 2008
January 13, 2008
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YANGMIAO, China — When she gets sick, Li Enlan, 78, picks herbs from the woods that grow nearby instead of buying modern medicines. This is not the result of some philosophical choice, though. She has never seen a doctor and, like many residents of this area, lives in a meager barter economy, seldom coming into contact with cash.
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 “We eat somehow, but it’s never enough,” Ms. Li said. “At least we’re not starving.”In this region of southern Henan Province, in village after village, people are too poor to heat their homes in the winter and many lack basic comforts like running water. Mobile phones, a near ubiquitous symbol of upward mobility throughout much of this country, are seen as an impossible luxury.
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People here often begin conversations with a phrase that is still not uncommon in today’s China: “We are poor.”

Read the rest:
http://www.nytimes.com/2008/01/13/
world/asia/13china.html

France is healthcare leader, US comes dead last

January 9, 2008

WASHINGTON (AFP) – France is tops, and the United States dead last, in providing timely and effective healthcare to its citizens, according to a survey Tuesday of preventable deaths in 19 industrialized countries.

The study by the Commonwealth Fund and published in the January/February issue of the journal Health Affairs measured developed countries’ effectiveness at providing timely and effective healthcare.

The study, entitled “Measuring the Health of Nations: Updating an Earlier Analysis,” was written by researchers from the London School of Hygiene and Tropical Medicine. It looked at death rates….

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http://news.yahoo.com/s/afp/20080108/ts_alt_afp/ushealthfrancemortality;_
ylt=AgrM_z7dz7ZFsNZ0BL0WOI2s0NUE

Docs Told To Give Fewer Antibiotics

January 9, 2008

The Telegraph (UK)
January 9, 2008

Alan Johnson, Britain’s Health Secretary, says it is time to end the unnecessary use of penicillin and other commonly-prescribed pills, which cost the NHS £1.7 billion a year.

Using antibiotics too liberally has led to bugs such as MRSA becoming resistant to treatment with the drugs. Most colds, coughs and flu are caused by viruses, which cannot be treated with antibiotics anyway, Mr Johnson points out.

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http://www.telegraph.co.uk/news/main.jhtml;jsessionid=IVLWZ0LAPX2IPQFIQM
GCFFOAVCBQUIV0?xml=/news/2008/01/09/nbiotic109.xml

Over prescribing and overmedicating is common in the U.S., U.K. and elsewhere.  Related:
Addicts Neglected, Over-Medicated Despite Vast System of “Care”

Addicts Neglected, Over-Medicated Despite Vast System of “Care”

January 8, 2008

By John E. Carey
Peace and Freedom
January 8, 2008

We are facing a crisis of drug and alcohol addiction in America. Most experts agree that about ten percent of our population of 300 million people are addicted or routine users. Many more family members, friends, co-workers and employers suffer harmful consequences – and our medical establishment is strained by people suffering from addictions.

On January 1, 2008, in almost every hospital emergency room across America, at least one or two individuals could be found suffering from Delirium Tremens (DTs), milder tremors, seizures and other alcohol and drug-related overdose symptoms.

My friend, physician and recovering alcoholic Len, took me for a post-party tour of a big city hospital emergency room on January 1.

“Look at the carnage following the biggest annual drinking binge Americans wink at every year. It will look like this the Monday after the Super Bowl, too,” Len told me.

In fact, experts say “Super Bowl Sunday” is the biggest day for drinking in America because it is an all day party. Most police agencies issue more tickets for impaired driving on “Super Sunday” than on any other day. And the Center for Science in the Public Interest claims that beer and alcohol advertizing for the Super Bowl targets underage drinkers.

Len invited me into his work environment after reading a Washington Times commentary I wrote for the December 27, 2007 editions. That article discussed the time of year when many recovering alcoholics and drug abusers relapse and end up in the hospital: the “holiday” season between Thanksgiving and January 1.

“For all sorts of reasons, many of the addicted who are in recovery and making progress crash and burn during the holidays. I think the pressure and chaos of buying too many presents and acting like a boy scout drives some in recovery back into really bad and sometimes fatal habits,” Len said.

Len is a recovering alcoholic who attends daily Alcoholics Anonymous (A.A.) meetings. Len is not his real name. We agreed to protect his anonymity in keeping with A.A. traditions and guarantees. As an emergency room physician, Len has gained invaluable insight into the disease of the mind called addiction. He is also an expert in how many of his colleagues treat alcoholics and the drug addicted.

“Most physicians I know are first rate. They care deeply for their patients, spend the time necessary to provide excellent care, and operate fair and honest practices,” Len told me.

But once Len finished with what sounded like an American Medical Association (AMA) commercial, I told him I had personally seen some sloppy, even potentially criminally negligent “care” of the addicted doled out by his MD colleagues.

Two patients seeking emergency care for bouts with alcohol were not admitted to emergency rooms while I researched this topic. They were told to make an appointment for ten days to two weeks into the future. For some: this poses a life-threatening dilemma. We also experienced physicians mis-prescribing and over prescribing drugs and medications to patients they knew to be addicted.

One doctor had his sleepless patient on Ambien for two years. The maximum recommended duration of Ambien therapy is one week. Ambien is addictive. Withdrawal symptoms include behavior changes, stomach pain, muscle cramps, nausea, vomiting, sweating, anxiety, panic, tremors, and seizure (convulsions).

The Food and drug Administration (FDA) warns doctors and pharmacists not to prescribe Ambien to alcoholics or other addicts.

We also saw doctors giving Xanax to drinking alcoholics to relieve anxiety. Xanax relieves anxiety in people who do not drink: but it is never recommended for heavy drinkers. This medication may cause dependence. Addicts frequently react violently to the drug and vomit sometimes for hours after taking it and experience other distressing and even life-threatening side effects.

We met a man who went to his doctor two years ago with severe anxiety symptoms. Today he rarely ventures out from his one-bedroom apartment. There are three deadbolts on the door. He has five physician prescribed drugs delivered to his apartment when he needs refills. He is no longer able to work. He is lost as a productive member of his family and our American society.

“There are doctors in America who are killing alcoholics and drug abusers because they haven’t properly availed themselves to the literature and education needed for treating the addicted and they pay too little attention to the warnings associated with all medications,” said Bill Alexander, who manages a private drug and alcohol rehabilitation facility in Oklahoma.

We also observed a clear disregard for many addicted patients: an attitude and actions akin to racial prejudice. Alcoholics and others are frequently looked down upon and can be viewed as “winos” or other disreputable types not worthy of full and complete diagnosis and care. If the addicted man or woman seeking treatment causes the doctor to become unsettled, the doctor might quickly end the evaluation phase of treatment and hastily write prescriptions for pain killers, sleep aids and other drugs.

“Some doctors, but clearly not all, cut corners. They reach for the prescription pad too readily. They under evaluate and over-prescribe. They are in too much of a hurry. Even when the vast majority of care givers to the addicted advise doctors to first consider a cold-turkey detoxification – without the benefit of additional medications,” said Dr. Len.

“We doctors write prescriptions sometimes even when they are not mandated. Insurance companies pay most of the cost and the doctor feels that he has taken action on behalf of his patient. Some have even told me, ‘I gave the patient exactly what he wanted.’”

The patients, because they are addicted, often act irrationally and not in their own best interests. They self medicate, over medicate, and “shop” for agreeable doctors willing and ready to help them get their “fix.” Addicts are risk takers – and even knowing that buying drugs below cost and on the street probably means the drugs are impure, dangerous or otherwise filled with a foreign country’s idea of a money-making substitute – they often use and abuse until death.

Despite the herculean efforts of an army of diligent care-givers and treatment facilities nation-wide, many alcoholics or drug addicted people are misdiagnosed, living on the streets, ignored, abused or shunned. Treatment facilities and in-patient care is at maximum capacity with no room for new comers. And the care of medical professionals is stretched thin.One doctor told us, only after asking for anonymity, “You’ll be lucky if this man can see a physician’s assistant or a nurse. There are no doctors available.”

And more doctors may not necessarily make things better.

“Calling for more doctors, like prescribing more drugs, for an already overmedicated patient, may only make things worse,” said Dr. David Goodman, a professor of pediatrics and family medicine at Dartmouth Medical School, which researches heath care quality and costs.

He says as the American population grows and the “baby boomers” enter their retirement years, more doctors writing more prescriptions and seeing more patients only escalates the costs of an already exorbitantly expensive medical system. He favors more study and analysis before anyone jumps to conclusions on how to solve the multi-faceted dilemma of our medical system’s future.

Between the end of the holiday season and “Super Bowl Sunday” might be a good time to start to re-assess America’s response to a growing number of alcoholics and drug addicted people in need of treatment.

We can ill afford to ignore or “write off” the ten percent of our potential productivity, scientific development, and artistic and creative wonder that this segment of our population represents.

John E. Carey is a frequent contributor to The Washington Times, a former senior U.S. military officer and president of International Defense Consultants, Inc.

Overprescribing and overmedicating are common problems.
Related:
Docs Told To Give Fewer Antibiotics