Should Police Officers Be First Responders For 911 Medical Calls

Mental Illness vs Terrorism

These days medical problems are  morphing into “national security” risks.

Muslims with mental illness, who commit violent acts, are diagnosed as ‘terrorists’ and their mental illness ignored. Black people with mental illness, who are a threat to themselves, maybe suicide, are now being killed by first responder cops who feel threatened by their color and illness.

So as more medical problems are misdiagnosed as national security risks, negative health outcomes increase.

What do we physicians do to honor the oath of doing no harm? By permitting first responders to harm mentally ill patients, we abandon our oath and add to poor outcomes and the mounting expense of healthcare.

Aren’t we the gatekeepers of healthcare? Shouldn’t we intervene when harm is done by those who are supposed to transport and help keep our patients healthy?

{I believe} There are no official statistics on the number of deaths or injuries caused by first responders.

Given the current environment, where cops ‘shoot to kill’ suicidal patients and those with flare ups of their mental illness, isn’t it time we track such?

If the medical community remains silent and blind to these egregious deviations in the standard of care, we will herald in a new era of medicine where harm is normal. A situation where medical error is the number one leading cause of death instead of a close third.

Lack of responsible oversight or statistics on LEO (Law Enforcement Officer) encounters with patients experiencing flare ups, or severe mental illness, has put patients at risk for death and worsening of their mental and physical ailments.

Simple interventions can go a long way. Straightforward respectful communication, on the part of first responders, can go a long way to averting bad outcomes.

Unfortunately, in most cases with bad outcomes, communication is poor. Attempts to get family members or friends involved, to de-escalate the situation, are now rarely sought.

Why? Is it better to just kill these patients who are in need of help?

Cops are first responders in the healthcare delivery system and as such should attempt to do no harm at all cost.  They chose to be police officers and are paid well for the service they are hired to perform.

Has the principle of mental illness care changed such that death by first responders is a more cost effective mode? Has imprisonment become a more secure environment for patients with mental illness? Where have all the State mental hospitals gone?

These are all problematic questions. We have a rise in mental and physical illnesses with poorer medical outcomes. And are we planning to exclude these patients from government statistics to make our health outcomes sound better than they actually are?

Misdiagnosing those with severe mental illness as terrorists, or threats to police security, leads to an escalation in problems. More power and money spent on law enforcement and less on effective treatment that could improve health outcomes.

Over 55 cents of each dollar goes to the DoD instead of money spent to better understand and treat people with mental illness humanely. We could target effective approaches to treat and de-escalate flare-ups so common in patients with severe mental illness.

Much debate has gone into First and Second Amendment rights. Let’s now face in earnest the reality around us.  A reality for which we have no metric or indicator to guide us when police officers administer inappropriate first responder care. A reality that unnecessarily mislabels patients and does harm when patients are treated as criminals.

I leave the reader with this last question: Should Police Officers be first responders for 911  medical calls?

Leave me your answer in the comments…

 

 

IT’S NOT ALWAYS DEPRESSION!

IT’S NOT ALWAYS DEPRESSION!

Diminished activity, fatigue, weight gain and little interest in activities that once brought delight.

With normal laboratory findings, most doctors would diagnose depression.

It’s not always depression!

Other physical ailments presenting similarly make the history and physical pertinent, as well as understanding culture and the differences in the clinical narrative due to culture.

To simply say it is depression, without a thorough review of all symptoms, is to jeopardize the health of patients. Plus not appreciate the impact of culture on health outcomes.

Unfortunately, nowadays, that is the case. Most doctors don’t dig deeper and many have forgotten the relevance of a good history and physical. The latter now relegated to cursory scope on the chest and back.

Such is the state of medicine today in the United States! I know because I have been a physician for all my career.

The above symptoms are actually due to visual problems. Mine!

Diminished vision can affect ones ability to function. Presenting similar to depression as well as leading to secondary complications of depression.

[ Link to Visual problems http://www.health.harvard.edu/newsletter_article/the-quirky-brain-how-depression-may-alter-visual-perception ]

By not recognizing the primary problem as visual, misdiagnosis and unnecessary medications follow, as well as deterioration in vision and functional capacity.

Unfortunately, the medical textbooks do not tell doctors this. Many lazily believe those symptoms signal depression until stated otherwise, despite the fact that depression is a diagnosis made after other illnesses are excluded. This is not done, hence the massive over-prescribing of antidepressants.

[ Link with data http://www.drugwatch.com/2015/07/29/drug-abuse-in-america/ ]

Patients typically tell their stories to non-doctors at least 2 to 4 times before they see an actual physician. (And in many poor communities patients will not visit or see their doctor.) Still the narrative and details charted rarely reflect the patient’s complaints, leading to misdiagnosis. Here repetition of the patient’s history does not breed knowledge or accuracy.

Why does this happen?

In a nutshell, over reliance on technology to make the diagnosis compounded by a bureaucratic and arcane workflow. Also treating symptoms while ignoring the root cause.

Medical staff are often under-trained and over-worked. The importance of accurate charting (of the patient’s narrative) lost in time, ignorance and even arrogance.

The end result is this: many patients are over medicated and misdiagnosed.

The recent epidemic of opioid overdoses is an example where doctors treat symptoms without making diagnoses. Opioids were over prescribed, especially in Emergency Departments where toothaches were routinely treated with Penicillin and 15-30 pills of Percoset. Doctors became legalized drug dealers! One study showed in 2012, doctors prescribed enough narcotics for every person in the United States to have a 30 day supply.

Now the pendulum has swung in the opposite direction: pain is treated suspiciously. Everyone is an addict until proven otherwise.

What is the solution?

One solution is Community Medicine. Studies demonstrate that medical outcomes, or health outcomes, are determined in the community.

Over 50% of outcomes are determined in the community. That means lifestyle or culture is very important as well as the environment (which actually has a great impact on lifestyle) to managing diseases. Genetics accounted for 30% of health outcomes and a doctor’s office visit 15%.

Using technology to facilitate accurate diagnosis is good, but technology should not be the gold standard alone for diagnosing. The history and physical still remain pertinent and relevant. The absence of radiographic or laboratory findings does not exclude pathology.

Most importantly, doctors need to know the patient’s community, and be engaged with that circle, to understand and improve the health outcomes of their patients.

What do you think?

Do you have any other solutions?

Boston Children’s Hospital Arrogance Knows NO LIMITS

Justina Pelletier Released from Bader 5 and K Carl Lewis Visit to Boston. MA

Huckabee – Should State Overrule Parent On Child’s Health Care

Justice For Justina – Should State Overrule Parent On Child’s Health Care? – Huckabee Part 1 Of 2

Justice For Justina – Should State Overrule Parent On Child’s Health Care – Huckabee Part 2 Of 2

State of CT visited the Pelletier’s home and determined, no abuse.

Fourteen months later, Justina is going back to Dr Korson, her mitochondrial specialist.
Justina secretly seen by Dr Korson who cannot speak about to parents about their daughter’s care.

What is Boston Children’s Hospital/Harvard HIDING? Let us hear from Justina!

What harm has been done to Justina Pelletier by Boston Children’s Hospital and the State of Massachusetts?

Which Chart is My Real Chart?

Which Chart is My Real Chart?

Do I have my entire medical record, finally? Where are the incident reports? These reports would substantiate Tufts Medical Center’s defamatory remarks about me. #MedicalRecords

There is no documentation in the chart of a wild ghetto-black Jamaican woman with a shattered and dislocated jaw screaming, as stated by Littler in Tufts’ letter to MCAD. Why not? #Discrimination #PatientEngagement

When such incidents occur they are clearly charted for liability purposes!  I am a Board Certified Internist who practiced Emergency Medicine for over 15 years, with 20+ total years of experience in medicine. I know the process.

On the other hand, copious documentation unequivocally demonstrated that Tufts Medical Center employees lied or intentionally deceived. Why does that not matter in this case? What about intentionally altering my medical records? At a minimum, this subterfuge or deception suggests that Tufts Medical Center is hiding something about this incident. What is it?  I say, they are hiding their discriminatory and unprofessional behaviors in the ED on the night I needed healthcare. #PatientSafety

Arguments based on unsubstantiated stories should be grounds for an appeal, with the opportunity to finally question or depose Tufts Medical Center employees, in particular, those listed below.

Why were these ‘fabrications’ overlooked by the MCAD investigator? Clearly, she did an incomplete job.  She never read the chart or checked Tufts Medical Center claims.  Why didn’t she?

Why did the MCAD investigator not include statements by my witnesses in her report?  Why did MCAD make a decision when they did not have enough information?

Why don’t they return calls?  Now, I can’t even get a voice mail!

MCAD procedures—were they followed? Why was I discouraged from getting an attorney?  I inquired several times.  Why did it take MCAD over 9 months to pass on a hand-delivered letter from Tufts Medical Center to MCAD on September 2012, delivered to me in June 2013?  My impression is that the process took less than 6 months.

MCAD’s decisions were based not only on incomplete information but incorrect interpretation of public data, indicating  a lack of understanding of medicine, public health, medical jargon, and buzzwords—words that are often discriminatory.

Will MCAD grant an appeal; the opportunity to prove discrimination directly to the Commission? One cannot make a decision based on summaries of third parties, particularly on complex issues of discrimination. Why should one have to die to get justice or for government to recognize a problem?

There are several important issues around the process and procedure, as well as  questions concerning defamation, subterfuge, and altered and false information by Tufts Medical Center.

Below are the stated providers in the ED at Tufts Medical Center.  They are part of the culture of corruption and cruelty that has taken control of medicine.  Watch out!

 

Below are the stated providers in the  ED at Tufts Medical Center.  They are part of the Culture of Corruption and Cruelty that has taken control of medicine.  WATCH OUT!!!  They almost KILLED ME on April 5, 2012.

  • Stacia Khorey, RN                   sk12

  • Sunil Shroff, MD                       ss27

  • Zeng, Mabel                             mz 1

  • Marian Lemieux RN                   ml

  • Lynda Fitzgerald                       lf4

  • Tania Chacon                           tc8

Law Firm for Tufts Medical Center:   Littler Mendelson, P.C.

BTW, I didn’t realize it but I was representing myself.  Not sure what the investigator at MCAD was doing.  

 

 Of Note:  if your name does not belong on this list please contact me.  Tufts Medical Center’s charting is not very reliable

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Real chart

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Doctors with Crystal Balls

Do they belong together?
Do they belong together? Doctors and Crystal Balls

Doctors with Crystal Balls

by Angela Grant

It is terrible to be a patient and not be heard. Terrible to be in need, and that need ignored. Apathy seems to rhyme with this culture of domineering minds. Men of medicine who lack skills of listening miss the story, miss the diagnosis. Still clueless, they dismiss you. If only those doctors saw the hidden gem: the art and science in the words of the history and physical findings.

Now I am left to float wandering aimlessly about because listening, even purchased, is never in vogue particularly when god almighty gave doctors crystal balls. Use it, use it now, tell me why I feel so ill; can’t move my foot at will. Waited I did, patiently for this important exam… I saw the male resident who knew immediately. Oh yes, and his senile, attending in the role of supervisor came in for a ride.   The resident had the latest technology crystal ball plus an attending  and training from the best of them all. To my chagrin, his faulty ball, customized for clueless idiots with malicious gall, dismissed my symptoms as unreal despite the physical findings: my inability to move a foot,  an important finding. When did medicine rely on crystal balls and unsupervised residents to make ‘the calls’?

Almost as if I have to learn to communicate anew, to make doctors understand the mind and the body can be one. A problem in the mind or body can cause pathology. Why did this problem occur? They did not help instead attempted to create another.  My real problem: Oh… it’s not your field; pass it on for another to add-on.   Incomplete diagnoses, only speculations, data based on the average. Have you not figured out that I, like most, am not the average? Why so many die from common treatable problems?   Millions, ignored, whilst you doctors with crystal balls create mental hysteria.

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