Consulo Indicium - 11/15/22

Information for your Consideration…

North Dakota – Leading The Nation!! – I’m from North Dakota and when I was growing up, it always seemed like the “Top 10” lists ignored us even though we had the bluest of blue skies, the cleanest of clean air, the flattest of flat prairie lands, the nicest of nice people and the like. I have also frequently regaled people with the fact that when I left North Dakota for my residency in New York City, I was at first intimidated and self-conscious of my origin. Why? Because I had not gone to one of those “special” East Coast schools. However, I very quickly came to the realization that my clinical skills were every bit as good – if not better in most instances – than my colleagues from those “named” medical schools. So…imagine to my surprise and excitement when I learned that North Dakota was able to capture the designation for four of the Top 10 Cities in the USA in a special survey. The North Dakota winners came in on positions: #2: Grand Forks (where I practiced for 10 years); #3: Williston; #4: Fargo; and, #8: Bismarck (where I grew up). The only problem with the rating is that it was for the Top 10 “Coldest” Cities in the USA. However, as noted above global climate change is affecting North Dakota as much as other states. In fact, I’ve predicted that if the trends continue North Dakota will be the new Napa Valley due to Global Warming. For the interim, we’ll stick with our “coldest city” status. After all, we’re proud of our ability to wear short sleeved shirts on cold winter days…😊…

American Medical Association Advocacy On Track – While I have been a vocal critic of the American Medical Association on many issues since my days as a medical student when I served as the President of the American Medical Student Association – when an organization does the right thing – it needs to be called out. So, I wanted to call attention to a policy established at the 2022 AMA House of Delegates that I only recently learned about on the issue of “government interference into the practice of medicine”. I’m simply going to restate (i.e. copy) the policy in whole. It states:

Our AMA opposes the interference of government in the practice of medicine, including the use of government-mandated physician recitations. Our AMA endorses the following statement of principles concerning the roles of federal and state governments in health care and the patient-physician relationship:

• Physicians should not be prohibited by law or regulation from discussing with or asking their patients about risk factors, or disclosing information to the patient (including proprietary information on exposure to potentially dangerous chemicals or biological agents), which may affect their health, the health of their families, sexual partners, and others who may be in contact with the patient.
• All parties involved in the provision of health care, including governments, are responsible for acknowledging and supporting the intimacy and importance of the patient-physician relationship and the ethical obligations of the physician to put the patient first.
• The fundamental ethical principles of beneficence, honesty, confidentiality, privacy, and advocacy are central to the delivery of evidence-based, individualized care and must be respected by all parties.
• Laws and regulations should not mandate the provision of care that, in the physician's clinical judgment and based on clinical evidence and the norms of the profession, are either not necessary or are not appropriate for a particular patient at the time of a patient encounter.

I agree. I support. I shout out!!

A Forewarning Of the Feast To Come – There’s a new report by a group of investigators that the timing of our meals affects hunger as well as appetite-regulating hormones, thereby causing weight gain. However, the study only included 16 obese individuals who maintained a strict schedule of a meal in the early morning and late in the evening – once a week in the lab with the remainder of their meals held to the same schedule at home. The study showed that they burned fewer calories, had an increase in fat tissue and also had increases in leptin and ghrelin – which control “hunger”. The student was published in Cell Metabolism. Long story short, don’t have a late evening Thanksgiving Dinner 😊.  Now, about that Maple Syrup Pie recipe I mentioned in my November 1, 2022 issue of The Fickenscher Files. Have you tried it yet? If not, the weight gain is worth it…

• Consumers Weigh In: Virtual Primary Care Is A Positive – A new poll/survey by Elevance Health (formerly known as Anthem, Inc.) on the attitude of consumers toward virtual primary care points in the direction of “very positive” on the convenience and accessibility side of the equation. The key findings included:
• 63% of Americans are living with or managing chronic health conditions with nearly 2/3 indicating that the believe primary care could help them with their care needs.
• 73% of the respondents indicated that virtual primary care was appealing primarily due to convenience (35%), accessibility (31%), and overall ease of use (30%).
• 31% of those who have not used telehealth services indicated that they prefer in-person visits and 21% were not sure if their health care policies covered telehealth services. 
• Of those individuals who have used telehealth services, 94% indicated they were satisfied with their virtual care experience and 79% indicated that virtual care "has allowed them to take charge of their health."