Deregulation and the Healthcare sector

There has been an inordinate amount of discussion about deregulation and our flourishing economy.  Unfortunately, none of this deregulation has entered the healthcare sector.  Medicine has become an over regulated conglomerate fueled by the forces of large hospital systems, the pharmaceutical and insurance industries and government regulations, all of which are suffocating healthcare providers

There was a time when the provider was actually allowed to practice medicine with latitude and genuine decision-making entered into the equation.  Nowadays, the burden of restrictions dictates case-making decisions with the erroneous belief that this is all for the better.

Patient care is mandated by algorithms, EMR (electronic medical records) documentation, insurance industry restrictions for prescribing medications and diagnostic tests and a mound of preauthorizations.  The physician lacks autonomy and is left with relatively no say in the process of true decision-making without asking ‘Big Brother’.  Practicing medicine is not any easier than navigating a complicated maze riddled with obstacles. Some might say that it’s easier to practice medicine because everyone else, except the physician, has already decided what is good for the patient.  I see it a bit differently.  Physicians are over-regulated, overburdened and part of a broken profession.  It’s no wonder that burnout is at an all-time high

Let’s encourage our goverment to ‘loosen the reins’on the healthcare sector and restore some dignity to a demoralized profession which is on the brink.  I can only imagine how some degree of  deregulation might add a breath of fresh air for a profession which once  took pride in their  endeavors and were committed to the forgotten “Art of Medicine”.

Ronald G. Frank, MD FACS
Urologist
West Orange, New Jersey

A New Trend Among Trendsetters: The Hamptons Vasectomy

A page one article from Today's New York Post confirms what Dr. Ronald Frank sees at his office - an increase in the number of young, successful man who come in for a simple, minimally invasive vasectomy.

According to the report, affluent bachelors who visit The Hamptons on weekends are worried of women who have sex with them in order to get pregnant. These men prefer to minimize potential complications by undergoing the procedure, which removes sperm from a man's semen.

Dr. Frank's no-scalpel vasectomy with local anesthesia is designed to minimize discomfort and provide men with a safe, quick form of vasectomy. Visit the website or call (973) 731-6600 to schedule an appointment. For NYC patients, we arrange for transportation to and from NJ.

Elevated Prostate Specific Antigen

A recent article in the NYTimes, shows a shift in early-stage prostate cancer treatment. Over the past few years, treatment for men with early-stage prostate cancer has dramatically shifted from surgery to surveillance. In the past, most early-stage prostate cancer patients chose to remove or treat the cancer with surgery or radiation. Only 15% of patients left their cancers alone and had regular monitoring or active surveillance to make sure the tumor was not growing. Now, about 40-50% of patients are choosing active surveillance of their prostate cancer. In 2011, the National Institutes of Health concluded that active surveillance is a good choice for patients with small non-threatening tumors. Active surveillance requires regular PSA blood tests to determine the state of the cancer. Though active surveillance is helpful, it is not for everyone. Speak to a medical professional about the best treatment for you. 

PROSTATE CANCER AND EJACULATIONS

Recent data from the American Urologic Association(AUA) meeting reported a decreased incidence of prostate cancer with increased monthly ejaculations.  This data is not altogether surprising since certain cancers are associated with chronic inflammatory conditions .  Frequent ejaculations will decrease gland engorgement and the associated inflammation.  This is clearly good news as a proactive measure to help ensure a healthy prostate.

XIAFLEX and Peyronie's disease

Xiaflex is the first FDA-approved drug for the treatment of Peyronie's disease. The drug, collagenase clostridium histolyticum, had previously been approved as a treatment for Dupuytren's contracture. Xiaflex acts by breaking up the collagen scar tissue and allowing for remodeling of the scar with improvement of the penile curvature. Candidates for Xiaflex injection would be a man with stable disease, Peyronie's disease for at least 12 months and a curvature of 30 degrees or more. Xiaflex is a product of Auxilium pharmaceuticals. Xiaflex is available through urologists participating in the REMS program for Peyronie's Disease.

More on EMR

In the NYT article-"A Busy Doctor's Right Hand"-1/14/14, I am amazed how the burden of EMR is magically solved in some corporate boardroom or home garage. 
The result is the absurd entity known as a "scribe".  A non-professional hired to shadow and assist the physician by insinuating and infiltrating the private domain of Medicine.  While assisting the physician with cumbersome tasks of entering data, the scribe will only further fracture the personal doctor-patient relationship which is already severely damaged.  Shame on those in the corporate world who concocted this pathetic entity and to those who subscribe to this service.  Yes, the problems of EMR were answered with this "Band-Aid" of a solution.  Yet, the root of the problem is once again ignored.

Prostate exams go live on TODAY show

In an effort to publicize awareness for men's health, Matt Lauer and Al Roker are to undergo prostate exams on live TV. How about that? Might this be a little too personal!! There are other more discrete ways to convey the message. I will wait and see the result of this demonstration.