Government program for medical marijuana

Are you a supporter of medical marijuana? Do you support the legalization of marijuana? Well, this story is for you. The governor of the great state of New Mexico is proposing a government program to pay for those who need marijuana for medicinal purposes. (Associated Press)

On Friday, [New Mexico Governor Bill] Richardson directed the [New Mexico Department of Health] to plan for full implementation of the program, such as preparing the regulations that will permanently govern how it operates.

Under the law, the department is to issue the rules by October, including for licensing marijuana producers and developing a system to distribute the drug to qualified patients.

The new state law allows the use of marijuana for pain or other symptoms of debilitating illnesses such as cancer, glaucoma, epilepsy, multiple sclerosis, HIV-AIDS and certain spinal cord injuries.

New Mexico is the 12th state to legalize marijuana for certain medical uses, but it's the only one calling for state-licensed production and distribution of the drug.

Supporters of this policy should be cheering, right? Well, there is a little itty-bitty hangup in federal law stating that the distribution and use of marijuana is illegal -- DUH! So, this may become a state government vs federal government media circus.

New Mexico, and any other state considering taxpayer sponsored medical marijuana, has to be very careful if they actually decide to implement this. (My personal feeling is that this is political posturing, and will never happen since the NM governor is running for US president.)

Canada made this same move. And, instead of people being happy, they eventually became upset because of the perceived low quality marijuana that was being given out. Check out the news report below or click here.

Too much depression?

Not very long ago, mental illness, particularly depression had this negative stigma. Many were embarrassed to even talk about it. It was thought of as "going crazy" or "going insane." I believe there have been many positive strides in both the recognition, diagnosis, and treatment of depression.

Now, there is a leading British psychiatrist who is saying that depression is being overdiagnosed? He just completed a 15 year study looking at 242 teachers and found that more than 75 percent of them fit the current criteria for depression. (BBC News)

Professor Gordon Parker claims the threshold for clinical depression is too low and risks treating normal emotional states as illness.

He writes in the BMJ [British Medical Journal] that almost everyone [in the study] had symptoms such as "feeling sad, blue or down in the dumps" at some point in their lives - but this was not the same as clinical depression which required treatment.

He said: "Over the last 30 years the formal definitions for defining clinical depression have expanded into the territory of normal depression, and the real risk is that the milder, more common experiences risk being pathologised."

Now, this may surprise you, but I do agree with the professor to a certain extent. Currently, the cultural norms are such that the term depression does not carry as much negative connotation as in the past. In fact, one could argue, that the current en vogue mental illness diagnosis is bipolar disorder as this is more prominent in the media these days.

I would even go as far as saying that there is a certain element of Western culture, especially American culture, which loves to avoid personal responsibility and accountability. I wasn't really speeding, I was responding to my bad day at work, and it's their fault that I was going so fast. Alcoholism is an illness, so I cannot control any of my actions, so I'm not responsible for any consequences.

Don't get me wrong, I believe it is appropriate to treat substance abuse and depression as illness. But, I also believe that some people in the culture use this as an excuse of convenience. And, that is very sad...

Need cash? Lose weight!

You're probably going to think that I'm making this up. In the northern Italy town of Varallo, Mayor Gianluca Buonanno is offering cash rewards to its citizens not only to lose weight, but to keep it off as well. (Associated Press)

"We wanted to encourage people to lose weight, and we thought that both the money and the idea of joining a group could be stimulating," Buonanno said in a telephone interview Thursday.

Participants in the week-old Varallo initiative will be given $67 when they reach their ideal weight. If they don't gain any weight back after five months, they will receive $268.

If they maintain their ideal weight for a year, they will get $670 more. So far, 30 of the townsfolk have signed up, Buonanno said.

It's an intriguing idea, but will it work? People say that money is motivating. But, to maintain your ideal weight for one year for approximately $1000? Will the combination of less weight, increased health, and cold hard cash be the secret to success?

The baby formerly known as baby

Remember in the mid 1990's when Prince was mad as his record label and changed his name to that unpronounceable symbol? What happened? It really didn't do to much for his career and everyone called him "The Artist Formerly Known As Prince" or "The Artist." Meethinks that a Chinese couple has been listening to too many Prince albums lately.

BEIJING (Reuters) - A Chinese couple tried to name their baby "@", claiming the character used in e-mail addresses echoed their love for the child, an official trying to whip the national language into line said on Thursday.

The unusual name stands out especially in Chinese, which has no alphabet and instead uses tens of thousands of multi-stroke characters to represent words.

"The whole world uses it to write e-mail, and translated into Chinese it means 'love him'," the father explained, according to the deputy chief of the State Language Commission Li Yuming.

While the "@" simple is familiar to Chinese e-mail users, they often use the English word "at" to sound it out -- which with a drawn out "T" sounds something like "ai ta", or "love him", to Mandarin speakers.

Uh, yeah. I get it. In looking at weird baby names, one doesn't have to look to far. I mean, just look at Hollywood babies. Some of them are definitely scarred for life. I also did a quick Google search of changing names to people like Peyton Manning and Jesus Christ. What is the most unique baby name you've heard of?

Beginner's guide to medblogs

As you all know, I'm addicted to my stats, and I'm always interested in who is linking to this blog. When I was browsing through my Technocrati stats, I saw a post linked to this blog which I wanted to share with you. (image credit)

The post is called "New to medical blogs? Vitum's Beginner's Guide to Reading Medical Blogs." It was a long post (at least for me) to read. But, I thought it was well done.

It starts off with this question, "What is the Medical Blogging Community?" And, it goes on from there. This blog is not mentioned by name, but the blogger did put a link to my post about Flea in the "Medblog Gossip" section. (Thanks so much for the link)

So, if you're new to the medical blogosphere, or, even if you've been around a year (like me) or more, I encourage you to check out the link above. It's an interesting read. Who knows? You may learn something you didn't know before.

Doctors failing obese patients

Here's breaking news: Doctors are responsible for America's obesity epidemic. Did you know that? Well that's what the press in this country want you to believe. Here's the latest example. (image credit)

According to a study involving almost 10000 patients at the Mayo Clinic in Minnesota, only 20% of study subjects had their obesity formally documented. However, if this condition was documented, then patients were more likely to be given a treatment plan which included exercise and diet instructions. (Reuters)

Not surprisingly, [the principal investigator] noted, study patients who were severely obese were more likely to have a diagnosis and a treatment plan -- suggesting that doctors need to take a closer look at patients with less severe weight problems.

I have a few of problems with this. First, I never knew that I was responsible for the obesity epidemic continuing. Those of you conspiracy theory people out there probably even believe that docs are intentionally not treating obesity because it would decrease business for medicine. How ridiculous is that?

Second, this article appears to want doctors to label their patients as obese so that they can get the proper treatment. No one likes to be labeled. In fact, if I even hint at the word obesity with my patients, I know that they would leave my practice. Labeling is a big no-no - whether it's obesity, mental illness, or any other term with a negative perception.

Third, even if I give my patient a very specific treatment plan, am I responsible for them to follow it? Well, according to the concept of pay-for-performance, physician accountability is more important than patient accountability - meaning if the patient does not lose the weight, it is my fault and it will hit my pocketbook. I know you doctor haters out there don't care about this. But, I have an office full of staff and I care how much this would affect them.

So, now that I'm done rambling, this article is just part of my continuing frustration with the press in this country. Not that I care, but articles like this create a false perception. Perception is reality to some people. And, it is this false reality that makes it difficult for me to deliver adequate health care to my patients.

Antioxidants don't help heart

I'm probably going to get in trouble for saying this, but there are many homeopathy and complementary health professionals (image credit) who are scratching their heads following the latest study from the Archives of Internal Medicine. (abcnews.com)

A study released today in the Archives of Internal Medicine is the latest to put a dent in the theory that vitamins such as C, E and antioxidants such as beta carotene can reduce the risk of heart attack, stroke or other cardiovascular events.

Although previous research has come to similar conclusions, the study at hand is perhaps one of the largest to debunk the idea that these vitamins can lead to a healthier heart.

In the past, conventional wisdom (as well as some early research) stated that there was a protective effect that antioxidant vitamins had on the prevention of heart disease and stroke. In my opinion, there has been an entire alternative medicine industry built on this belief.

"Although theoretically these antioxidants would appear to be protective … these antioxidant vitamins have not lived up to their promises," says Dr. Carl Lavie, director of cardiac rehabilitation and prevention at Ochsner Medical Center.

"Studies of nutrients for disease prevention all indicate that the active ingredient in a healthful diet is a healthful diet, and not some isolated nutrient we can put in a pill," says Dr. David Katz, director of the prevention research center at Yale University.

Of course, research is ongoing. And, probably in 3-6 months, there will be another study published claiming to debunk this study. Don't get me wrong, I'm not saying that complementary medicine is bad and the type of medicine I practice is better.

I'll just be curious on the public reaction to this news. For example, when I mention any prescription drug, my patients can list all the side effects that they say on television. 

How about when I tell them, "You know, the $50 you spend every month on antioxidants may not help your heart as much as you think." Will people stop taking their antioxidant vitamins based on these study results?

Revisited: Blogging Personna

About a week ago, I wrote a post about the thoughts I had about how a blog reveals the type of person that you are. I very much appreciated everyone's comments on this. Today, A Mom Who Thinks Too Much wrote a post called, "Is This Blog, Me?" I usually place my comments in the 'comment section.' But, her post brought out an assortment of thoughts that would probably be better expressed in a conversational full post.

Some bloggers, like some "people," are simply more steady in the face they present to different people (these are the people who say "my blog is pretty much me"); others are more chameleon, showing a different face to different people. There's nothing wrong with either way. Personally, my blog is in many ways the core me---but it isn't the full me. Sometimes when I write an edgier post, that departs from my normal "sweet, but cerebral" self, I feel I am taking a risk.

At least for me, blogging is kind of like a window into the soul. What the heck do I mean by that? When we're with certain people, or in certain situations, we can (and do) reveal what we want to reveal about ourselves and our personality. I can be upbeat or more subdued when I'm with certain people or in certain situations. Writing posts are the same thing. But, when it comes to your core self, I believe that blogging, as in real life, there are certain qualities that you cannot hide.

But even our cores have more than one side. My friends would add "wicked" (and "funny"), my mother would add "stubborn---but sweet," my husband would agree with the "stubborn" part but would protest vehemently that I am not as sweet as I appear. (He is my spouse after all.) Casual friends would be surprised to find me as talkative and opinionated (even cutting) here than I am in their company. (Though it depends on the person. Some people "see" us better. Why is that?)

I believe that with certain people whom you "just click" with. There are some whom I immediately feel a connection with (granted this is a very small number). But, I definitely understand that some people just "see" us better. Here's a final comment that I will respond to:

I know some bloggers, when they feel a need to depart from their usual "face," or when they are moving into a different phase of their life, will start a new blog entirely. Often it is still even linked to their profile. (Naturally, we don't see easily those that aren't.) "This blog isn't me anymore. I've now moved to ...." It's interesting. I see that and I know exactly what they mean.

I'm so glad that you brought this up. I contemplated for a long time whether to close up this blog and start over - start over with a new blog name and a new blogger name - as a kind of transition to myself. Obviously, I elected not to to that.

Even if you change your clothes, or hair color, or where you live, or whatever external changes you want to make to yourself - or, even if you change your blog color, blog address, or whatever appearance changes to your blog - the essence of your blog comes from within. Your true blog readers and your true non-blog friends will accept you for who you are.

Thanks AWMTTM for your insightful post and your thoughtful response. I feel I'm more of a chameleon type like you...

USA: The World's Best Medical Care?

I seldom read the New York Times, because I pretty much know what I'm going to get even before picking up the paper. (image credit) But, in this morning's editorial section, there is an essay called, "World's Best Medical Care?" Here's the opening paragraph:

Many Americans are under the delusion that we have “the best health care system in the world,” as President Bush sees it, or provide the “best medical care in the world,” as Rudolph Giuliani declared last week. That may be true at many top medical centers. But the disturbing truth is that this country lags well behind other advanced nations in delivering timely and effective care.

Groups like the World Health Organization and the Commonwealth Fund have ranked the US low in certain areas. The NYT piece goes on to outlines eight areas in which the US could do better which include areas like lack of universal health care, high infant mortality rate, low life expectancy at age 60, poor patient satisfaction, and being slow to adopt electronic medical records.

I'm not going to dispute most of this article. There are some good points and it is a decent analysis of how the American health care system could improve. But, like most things in the New York Times, I took it as a political commercial as opposed to an informative piece of journalism.

After throwing the US health care system under the bus for two pages, the NYT does try to make a comeback with this kind of backhanded compliment - or maybe it's not a compliment.

Top-of-the-line care. Despite our poor showing in many international comparisons, it is doubtful that many Americans, faced with a life-threatening illness, would rather be treated elsewhere. We tend to think that our very best medical centers are the best in the world. But whether this is a realistic assessment or merely a cultural preference for the home team is difficult to say. Only when better measures of clinical excellence are developed will discerning medical shoppers know for sure who is the best of the best.

Is health care the most important issue in the upcoming US presidential election? Some people think yes and this editorial is proof of that. For me, it's just too early. It's a long 15 months until the election. However, I do appreciate that health care issues are probably getting a little more press than they did a year or two ago. Nothing will change without getting the public's attention. As I always say, we'll just have to see how this all plays out....

Paintball practice

In today's addition of Dr. A's small town news, here's a funny quote from the police blotter. It's always interesting to see what our citizens are doing around here.

A state Route 9, Salem, man reported Wednesday someone in a passing car fired paintballs that struck his son-in-law’s vehicle and nearly some children playing outside. Denny reportedly chased the vehicle into Perry Township, where it was stopped by police.

Viewing the video above, I never knew that paintball is such a big deal to some people. Of course, who am I to judge? I mean, for enjoyment and relaxation, I hit a little white ball around - but I love it!