Tag Archives: GP

Online death dealers

Yes, it sounds ominous, but it is no JK Rowling, it is no fabrication of the H Potter variety. This is healthcare. And it woke me up when I saw the advertisement on Google YouTube today. You see, the advertisement sounds dangerous right off the bat. And the weird part is that the warnings at ABC are two years old. They gave us (at https://www.abc.net.au/news/2020-02-05/instant-online-prescription-app-raises-medical-safety-concerns/11925700) ‘‘Instant’ prescription providers prompt warnings from GPs and pharmacists’. There we see “Doctor and pharmacist peak bodies are voicing concerns about online services offering “instant” prescriptions to people who fill out a digital questionnaire, arguing they heighten the risk to patients.” In addition we get “Instant Scripts is one of several online platforms offering immediate prescriptions for medications such as pain management, steroid creams and anti-depressants by having patients fill out a digital questionnaire.” So first we get the entire Oxycontin issue, and now they let an online setting handle pain management? How long until someone gives the people the setting if you need Drug A, you need to answer the following questions (and so on). So how dangerous is this setting?

I personally believe that it is very dangerous. The fact that a patient (optionally an addicted one) can circumvent both doctor and pharmacy is likely the most dangerous one of all and I reckon the makers covered themselves with “You must always be completely honest” or something of that effect. Yes, because a written warning always helps when the person is addicted. So when we get to “But the Royal Australian College of General Practitioners (RACGP) and the Pharmacy Guild of Australia are both concerned a growing number of companies are trying to shake up traditional healthcare in the name of convenience.” I wonder whether it will be convenience or profit that some companies will adhere to. 

As such I have issues and perhaps they are hot valid ones, but the ABC supported my train of thoughts hours ago on the 5th of February 2020. Whatever we call it, an algorithm, a script that leads to a prescription, the only one who can do it safely is the GP of the patient and I have seen several options from my GP so wonder how essential that ‘instant’ part is. And when the issues start, when the complications start, where will the app builders be? Where will the people be who signed of on this? Simple questions that the greed driven will avoid and counter with some claim that is likely to have little foundation in reality. Is an app like this valid? If we take away the ‘instant’ part yes. In rural settings this app could do a lot of good, take away the stress from several parties, least of all the patient, but the ‘instant’ part makes it dangerous. It to some effect reverberates in another statement I saw today. “We cannot get rid of guns, but what if a citizen needs to be over 25 to own one?” I feel that this idea has merit. We cannot control the immediate, so what happens when we set the age, just like voting and alcohol? And it is the same for this app. ‘Instant’ is not acceptable, but the app itself could do a lot of good, if only it goes via a GP for approval, and this GP has to sign off on it. Suddenly ‘instant’ no longer applies, is no longer valid. Consider the doctor signing off on a prescription that has lasting damage? This is one issue the doctor cannot avoid, one the pharmacist cannot avoid. And there is reason for this. How many pharmacists selling Oxycontin have gone to prison? I wrote about it as early as 2019 (before the ABC article) in ‘A larger failure’ (at https://lawlordtobe.com/2019/10/13/a-larger-failure/) A stage that was even dealt with in 1978, a reference to ‘When in doubt’ (at https://lawlordtobe.com/2019/08/31/when-in-doubt/) So well over a year before there is a clear setting that gives pause to anything offered ‘instantly’ and now you want to do away with GP’s and pharmacists (to some degree)?

With them in place there was still a gap to sell 76,000,000,000 opioid pills. How many will the ‘instant’ marker allow for? And the moment the people see the Google advertisement and figure out that certain combinations guarantee certain ‘solutions’ how will this not go from bad to worse?

On the other hand, if we can get rid of 35% of the population this way, go right ahead, it will benefit nature in other ways. So have a good thought of what you want and how you want it.

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Slaves of a different nature

The sci-fi fan sees in his/her mind a woman, all green, preferably close to naked growing lust in their mind. It is the Orion Slave girl fantasy. This comes from a TV-series that is half a century old. In that universe created by Gene Roddenberry these green ladies were introduced in the original pilot of the Star Trek series in the episode ‘the Cage’, there they were depicted in a sexual context. This is not that kind of slave. Neither is it the kind that is forced to create products through prisons or work camps where they make license plates, or set up governmental mailings. Neither are they children under 18, forced into some kind of servitude. No, these are not one of the 5 forms that the National Underground Railroad Freedom Center is illuminating, this is a sixth kind.

It is the kind of servitude that was once a calling, once a choice of life, which governments and insurers alike have been putting under pressure beyond any normal acceptance of labour. That part has been ignored for too long. People all believing in the wealth that a doctors and lawyers income brings. Later in a career that might have some level of truth when you ignore the elements on the other side of the scale. The fact that someone in IT will surpass the income of those graduates from the very beginning is often ignored. When I see some of my friends in health care, I see friends who are exhausted 70% of the time, some working in excess of 14 hours a day. So when I read ‘Nearly 60% of Scottish GPs plan to leave or cut their hours‘ (at http://www.theguardian.com/society/2016/apr/28/nearly-60-of-scottish-gps-plan-to-leave-or-cut-their-hours), I am not overly surprised.

We all claim that we are against slavery and injustice, yet the governments on a global scale are seeing their health systems collapse and as such, hiding behind the false image of all doctors are wealthy, they have been cutting into the incomes of doctors and stretching the hours they have to make. Underfunding practices and making them work ungodly hours. What we see in Scotland is only the beginning. In the Netherlands we saw in 2014 that GP’s would work around 60 hours per FTA (Full Time Equivalent), making that 13 hours per day, whilst IT staff would get more for a mere 40-45 hours a week, 9 hours a day at the most.

So in all this, whilst health care workers availability are at an all-time low, we see the quote: “26% planned to leave general practice in the next five years“, so one out of four is stopping whilst one in 6 patients will at current pressure not receive the minimum level of care which will now get close to another 1.5 out of 6. This gives us 33% to 50% of the patients in a tough spot. One foot in the grave will get a whole new meaning soon enough when that comes to pass. Certain elements of these changes are already visible in France and the Netherlands, the United Kingdom is in a harsher place than the Netherlands, but I cannot confirm how France is set. Outside of the large cities the information tends to be sketchy and cannot completely be relied upon (read: my knowledge of French sucks big time). Sweden is heading towards a new economic crises on more than one side. Healthcare is one (but less visible), the issue that is visible is the economic drain that the refugees are causing, well over 100,000 have no place and no matter how obliging Sweden is. The refugees are confronted with language issues and a skill set problem. The latter one can partially be adjusted, the first one can be overcome by the refugees who truly want this, but it takes time, which is one side Sweden is having less of. Sweden is trying to recruit doctors in many ways and their approach might work, but it will work slowly and it will cost the Swedish government a fortune. The reason for focussing on Sweden is because for the most, Sweden is a social success. Sweden has made social changes that the nation accepted (including paying a lot more tax than there neighbouring nations). The refugees are changing this, a social system can only survive in balance, the refugees arrived in such massive amounts that the system cannot cope. The total refugees that recently arrived have surpassed the size of the Swedish city of Västerås, which by the way is not the smallest of places. With the banking in disarray and Sweden missing sales marks gives additional problems for Sweden and healthcare will feel the brunt as doctors are now moving to other non-Swedish shores. Sweden illuminates the required need for the UK, a need that the UK is unable to adopt at present. In addition, the approach that Jeremy Hunt is taking will not help any.

When we see the British Telecom News page, we see “But in a letter to the BMA’s junior doctor committee chairman, Dr Johann Malawana, Mr Hunt said: “It is not now possible to change or delay the introduction of this contract without creating unacceptable disruption for the NHS.”

As I see it, my response would be ‘Yes, Mr Hunt!‘ you had alternatives but you chose to ignore them. Focussed on a system that had collapsed, focussing on the approach of slavery, you saw in your school years the Slavery Abolition Act 1833, yet as we see the words from the English poet William Cowper (1785) as he wrote:

We have no slaves at home – Then why abroad?
Slaves cannot breathe in England; if their lungs
Receive our air, that moment they are free.
They touch our country, and their shackles fall.
That’s noble, and bespeaks a nation proud.
And jealous of the blessing. Spread it then,
And let it circulate through every vein.

 

Bankers are overprotected whilst being vultures, for not being held accountable for the mess they created (as it was not illegal), whilst at the same speed, junior doctors are reset with contracts that amounts to becoming an involuntary slave labour force. This to the degree that doctors are packing their cases and moving to Australia and other Commonwealth nations that will take them and with the shortage the world at large has, for them moving to Nassau and live by the beach with a small practice would be preferred to a city job with a mortgage they cannot pay off and working 60 hours a week. Jeremy Hunt dropped the ball. He did not do this intentionally. He was given a bad hand from the start, yet in all this instead of going on the same way, the NHS needed another direction entirely, that part was never really investigated.

For me, with whatever I have left?

If I had to go into healthcare, I would try for Radiologist position in Essex or something like that. I still have 15 years in me. For now, I have a nice idea for Google to grow their revenue by 3.5 billion dollars over the next 5 years, and gradually more after that and for £25M post taxation it is all theirs! For now, I am considering to do some teaching in Italy in the future. Teaching English in Catholic Public Schools near the Vatican. You see, this crazy merry go round we have in Europe now will collapse, there is no viable way to stop that at present as I personally see it. We must focus on what comes after. That part is now gaining visibility as we see the US President (read: Mr Lame Duck Obama) is quoted in Forbes “President Obama’s Implicit Message To Taxpayers: ‘I Own You’“. My response?

No, Mr President, you do not. You never did. Like a weakling you stopped taking taxation to a realistic level, you refused to do anything to stop greed. That part was clearly shown at the G-20 in 2013, three years ago. You might actually end up becoming the most useless president in the history of the United States of America

That would be my response!

When we look at Forbes (at http://www.forbes.com/sites/johntamny/2016/04/10/president-obamas-implicit-message-to-taxpayers-i-own-you), we see that the Obama treasury stopped one deal, one deal only. This is about a lot more than just that 212 billion dollar deal. You see, this is not about the Panama Papers, this is what they enabled. When we consider the Guardian (at http://www.theguardian.com/news/2016/may/06/panama-papers-us-launches-crackdown-on-international-tax-evasion), we see that same duckling state “the president will take executive action to close loopholes used by foreigners in the US and call on Congress to pass legislation“, how interesting that it is just about the foreigners, so how much is in Rothschild wealth management directly from foreigners and how much is arranged through American agents?

In addition we have “The Panama Papers underscore the importance of the efforts the United States has taken domestically, and the efforts we have undertaken with our international partners, to address these shared challenges”, which is an empty statement as I see it, because over the next 6 months too little will be done and it will be left to the next person in office. The final quote is “The problem is that a lot of this stuff is legal, not illegal”, which is something we already knew. Yet when we consider the change that could have been brought in 2013, he (read: the Democratic Administration in power) backed off, forcing a watered down version that was close to useless. This is the evidence I see as to the level of uselessness that the USA currently represents. Poverty levels are still at a high and in Europe that number is growing, this is the foundation that allows for the growth of what can be regarded as legal slavery. It is legal because it is governmentally arranged, it is slavery as the medical industry is pushed into a level of servitude of no-choice. In Europe, some are now claiming that the amount of people under the poverty line is now one out of four. That push is a great hammer for Jeremy Hunt to use to push for cheap contracts and ungodly working hours, but in the end, when doctors stop working, there is no NHS to continue to cure people (source: http://www.euractiv.com/section/social-europe-jobs/news/eurostat-one-out-of-four-eu-citizens-at-risk-of-poverty/).

There is no clear solution, but another path needs to be taken. The push from NHS and the deal that people get through what I call ‘deceptive insurances‘ and ‘skewed medicinal solutions‘ is changing the game. It now reflects back towards the change I was willing to make. What if we make hospitals self-sufficient? What if we take the insurance out of the equation and push for a self-sustaining level of hospitals on local foundations? You might think that the given logic forces us to look at Behemoths like the NHS and large medical corporations. I am stating that it is my belief that the medical gravy train is losing too much cargo on route. So it is our need to have a neutral solution. When medical suppliers start pushing on ‘how it will be too expensive that way‘, the people will have to push back. So that means that the UK hospitals start getting supplies from other sources, independent and possibly even non-UK sources. How long until greed driven corporations cave? They only need to fail 2 quarters of forecasting and THEIR nightmare begins! Trust me when I state that a merger making the board of directors over 200 billion means that their margins were really really good and via Ireland they were only getting better.

That is the issue and solving that is a first step in solving the slavery riddle, which is not a riddle, it is a mere puzzle that can and should be solved.

 

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