YOU CAN'T (AND SHOULDN'T) ALWAYS GET WHAT YOU WANT

I think too many people are on chronic narcotics. There is a reason that prescription drug abuse and overdose deaths are at a record high. The biggest reason is the over-prescribing of these medications.

Narcotics are a godsend to people in pain from terminal diseases. Nobody would argue that doctors shouldn't prescribe whatever is necessary to ease the suffering of those at the end of life.

These drugs are also clearly beneficial in patients recovering from surgery and significant injuries. Studies demonstrate that uncontrolled pain causes a release of hormones that slows the healing process.

Narcotics are too often prescribed to young patients for long-term use by naïve, inexperienced, lazy or unethical doctors (or inadequately trained nurse practitioners). These patients often have vague or unsubstantiated diagnoses.

A doctor is not doing a patient who has chronic pain any favors by additionally burning them with a chronic dependence on narcotics. There are multiple nonnarcotic medication that can be used to ameliorate different types of chronic pain.

Once a patient who has chronic pain is provided a routine, ongoing prescription for narcotics, they are being committed to a lifetime of use by the prescriber. It is very difficult to convince the patient to switch to safer medications for long-term use. Long-term narcotic use is associated with depression and increased risks of falls and injuries.

It has been my experience that many patients who have a chronic, large supply of narcotics are more than willing to play the "good Samaritan" and offer their drugs to friends and relatives who are in pain. This is problematic for reasons both medical and legal.

Patients who have chronic pain need to be treated with medications that are safe and appropriate for long-term use. Narcotics are rarely the right choice.

INSURANCE SHMINSURANCE

I think that health insurance is not needed (and in my opinion should not be used) to have affordable basic primary health care. Healthcare reform is only needed in areas involving insurance for the expenses associated with hospitalizations and procedures.

The average American spends $65 per month on a cell phone bill, $40 per month on Internet access and $70 per month on a cable/satellite TV bill. That is over $2000 per year on (what I would argue is) discretionary spending.

In my practice, the average person who has 2 or more chronic conditions will spend per year about $120 for 2 office visits, $100 on labs and $160 on prescribed medications. This averages out to a little over one dollar per day for their basic healthcare.

There are very few people who cannot afford that amount. It is about priorities. If your health is important enough you will use your discretionary spending money on that first even if that means cutting down on smoking, eating out, cell phone use, Internet access or cable TV.

If you're spending more than that on your primary healthcare, you need to ask yourself why. Is your doctor charging you too much? Can your medications be changed to cheaper ones? Are you provided with samples of medications you cannot afford? Are the prices being charged for lab tests too high? Are all the labs necessary?

I encourage you to compare prices. Call various doctor's offices and ask how much a visit is, ask if medicine samples are available and ask how much a lab test such as a cholesterol screen will cost you.

Don't assume that you can't afford to care for yourself just because you don't have health insurance or have a high deductible. Receiving healthcare now can save your money and health for the future.

SPMC IS THE PLACE FOR ME (AND YOU)

I think the reason that the Spiceland Pike Medical Center (SPMC) has been successful for over 15 years is because of several factors. It involves continuity of care, good employees, patient focused concepts and comprehensive care.

A doctor/patient relationship is more valuable the longer it develops. Patient's don't like to see a new face when they are sick, especially when that new face belongs to the doctor or a lesser trained healthcare provider. At SPMC there has always been just one full-time doctor.

Employees are hard to find when expectations are uncompromising. I am criticized for being hard to work for her, but I make no apology for having high customer service and technical standards. Quite frankly, few people are excellent enough to be hired and stay hired at SPMC.

From day one, SPMC has focused on what I would want as a patient. I would want to be able to see my doctor when I want and at a price I could afford even if I didn't have health insurance. Having that doctor board-certified in the top 2% is a nice bonus.

Only at SPMC can patients see the same board-certified doctor at each visit and not someone else's doctor or a nurse practitioner. Only at SPMC can patients be seen without an appointment, after 5 PM and on the weekend. And only at SPMC can patients without insurance not be expected to pay more than patients with commercial insurance.

SPMC provides for patients to be cared for by the same doctor in the office, hospital and nursing home. This comprehensive care used to be the standard but is now a rarity as other practices have abandoned a patient centered focus in favor of having a better lifestyle.

I thank the people of New Castle, Hagerstown, Knightstown and other surrounding towns for entrusting their healthcare to SPMC. We will continue to provide you the healthcare you deserve.

2012 DINKTHINK ROUND 2

I think that it is again time for me to inform people about changes in healthcare that are occurring both locally and nationally. These are changes that are largely harmful to patients and their pocketbooks.

As you may remember, I ran a series of these educational advertisements several years ago. There were many people who appreciated hearing an honest viewpoint from an independent, self-employed physician who was not under anyone's thumb.

There was even one patient who offered me a check to fund additional newspaper ad space for me. I declined of course, but was taken aback by how he and others were longing to hear the truth about various healthcare issues.

Many things that need saying about the changes in healthcare are not being said. Since my last series of ads there are even fewer people with inside knowledge of the local and national healthcare situation that are are willing/able to speak their mind.

Just as my office has always provided flu shots at cost (charging about 50% of what Medicare allows), this is a service to the community that otherwise wouldn't get this candid information. Hopefully, this will spark dialogue and action to correct problems both locally and nationally.

Healthcare reform so far has been a pseudo-science at best. Changes such as mandatory electronic health records are being enacted at great expense in the name of progress, modernization and efficiency despite it never having been shown to improve the health of patients.

Over the next 11 weeks I will be enlightening many, shocking some and annoying a few (OK , maybe more than a few) by illuminating the problems with the present state of our local and national health care system. So buckle up, it could be a bumpy ride for some.