The following is an email I received soliciting me t sign a petition supporting the "Manhattan Declaratipon". The Declaration's goals are described in the email.
I composed the response at the bottom as I have not seen any comparable reply to thee solicitations. Common sense is the least common thing in the world, it would seem.
JSH
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Subject: Manhattan Declaration
Friends, If this is your religious persuasion, I invite you to go to the website below and sign the "Manhattan Declaration".
From the website:
We are Orthodox, Catholic, and evangelical Christians who have united at this hour to reaffirm fundamental truths about justice and the common good, and to call upon our fellow citizens, believers and non-believers alike, to join us in defending them. These truths are:
1 the sanctity of human life
2 the dignity of marriage as the conjugal union of husband and wife
3 the rights of conscience and religious liberty.
Inasmuch as these truths are foundational to human dignity and the well-being of society, they are inviolable and non-negotiable. Because they are increasingly under assault from powerful forces in our culture, we are compelled today to speak out forcefully in their defense, and to commit ourselves to honoring them fully no matter what pressures are brought upon us and our institutions to abandon or compromise them. We make this commitment not as partisans of any political group but as followers of Jesus Christ, the crucified and risen Lord, who is the Way, the Truth, and the Life.
===========================================================================
I am puzzled why anyone would want to interfere with any other person's right to live life as they wish. For example, the proposition that a gay couple's desire to wed somehow "threatens the institution of marriage" seems completely without any logical basis. If I, a male heterosexual, want to marry a woman, how could two gay people getting married threaten me in any way? How could that threaten the "dignity" of my marriage? My marriage's dignity is something I have to maintain. No one else has anything to do with it. Seems like the objection is just a tabloidism - a catch-phrase to use as a rationalization for trying to interfere with other people's rights. If one is a confident, comfortable, married heterosexual, homosexuality is no threat at all. (If I like vanilla ice cream and you like pistachio, how does that threaten the "dignity" of MY ice-cream?}
The same truth applies to all matters of faith and belief. If one's faith is genuine and solid, one doesn't need 10,000 people agreeing with you. In fact, it doesn't matter if no one else shares your belief. Belief and faith are entirely personal. It is not something proven by counting on a crowd.(As I recall it, when Jesus was on the cross he didn't ask for a show of hands or count the crowd of his supporters. He just called out to his Father.)
So, as far as stem cells, abortion, "matters of faith and belief", all these are personal matters. They are not something to be put up to a vote and the majority rules (and the minority should be punished or jailed.) Personal faiths and beliefs, are personal. They don't require consensus. If a consensus is required, one didn't have a true belief in the first place. It was just insecurity - searching for the reassurance of the crowd mentality.
J.S. Hochman MD
Tuesday, November 24, 2009
Wednesday, November 18, 2009
"A Call to Revolutionize Chronic Pain Care in America"
(But hang up after one ring)
The Mayday Foundation has a long credibility in Pain Management. For over 20 years it has been s significant voice and funding source in approaching pain management policy. The November 4, 2009 publication of the recommendations of a Special Committee, convened by the Foundation to address the continuing suffering of millions of adults and children, is an example of its commitments. The Recommendations provide very useful background information and policy suggestions.
Unarguably the situation for acute and chronic pain patients is currently horrific, and the report clearly documents the situation. Further, pain care should be coordinated, beginning with primary care providers, disparities should be eliminated, unnecessary and ineffective invasive procedures and medication treatments should also be eliminated, and effective, comprehensive treatment should be universally available and implemented.
Further, federal and state agencies, state medical boards, health care payors and providers, medical schools, specialty and subspecialty organizations and all other "stakeholders" should be enlisted in achieving the goals of universal pain care available to all. And specifically the HRSA, HHS, NIH, AHRQ, the Surgeon General, health care providers, insurers and government should work to eliminate disparities in access to pain care related to race, ethnicity, gender, age and socioeconomic status; and federal, state and local agencies should adopt a balanced approach to the regulation of controlled prescription drugs, particularly opioids
Specifically, the report calls for:
· government, health care payers and health care providers should develop and use coordinated health information technology systems to track pain disorders, treatments and outcomes to improve care;
· physicians should be trained to assess and treat pain, and licensing examinations should include assessment of clinical knowledge related to pain care;
· the Health Resources and Services Administration should expand funding for training programs that address pain assessment and management;
· HHS should establish an independent commission to reform the reimbursement practices for chronic pain treatment;
· the NIH should increase funding for pain research;
· the Agency for Healthcare Research and Quality should expand funding to establish a set of best practices that could be used to treat specific types of chronic pain;
· the U.S. surgeon general should create a public education campaign about the risks of untreated and undertreated pain
However, amazingly, what the Committee did not mention was the "War on Doctors' - that horrific campaign that has destroyed the careers (and even the lives) of so many decent,
dedicated and caring physicians, and left thousands upon thousands of chronic pain patients in an abyss of abandonment and professional and regulatory indifference.
Also, conspicuous in its absence, was any mention of the single largest obstacle to adequate pain care - "Opiophobia".
Perhaps the members of the Special Committee believed that their studiously polite diplomacy required that these topics not be mentioned, as education and collegiality would cause them to dissipate before a wave of enlightenment. Perhaps they believed that it was best not "to kick the sleeping dog" - that confrontation would be best avoided in favor of education and the confluence of policy.
We have no way of knowing the Committee's motivations in this regard. However, it is safe to assume that opiophobia will disappear no more quickly than did racism. History makes it abundantly clear that a Chamberlain approach to brutality will accomplish little but self-delusion.
Sad to say, but I predict that collegial policy thumping will have no impact on the destructive mythologies and pharmacological shibboleths that characterize opiophobia. The myths of addiction, tolerance, toxicity, criminality, abuse, diversion are deeply engrained in the professional mindset of opiophobic physicians and the medical Boards upon which they sit. We have already seen in the examples of the "Model Intractable Pain Policy" adopted by the Federation of State Medical Boards in 2003, the "Pain as the Fifth Vital Sign" initiative of the Joint Commission on Accreditation of Health care Organizations in 2001, and the Pain Initiative of the Veterans Administration, that noble pronouncements are completely disconnected from the realities of the day to day priorities and actions of these boards. Everyone already knows the information summarized by the Mayday Committee. It has been part of the Zeitgeist since Dr. Pappagallo's news releases in 1996.
What is needed now is not polite policy but hard-nosed mandates. Whether it is to be federal legislation, state regulations, or a federal lawsuit, the opiophobes must be removed. Politeness and diplomacy will go nowhere (again). So thanks, Mayday, and the "Special Committee". Your intentions are noble. But one of the things that made the Committee "Special" is that there wasn't a single person sitting on it who's life and career is on the line every time they write a schedule II prescription. It's easy to be polite and diplomatic when no one is sticking a gun in your mouth.
I have to agree with Siobhan. Talk, talk, talk.
Joel Simon Hochman MD
Executive Director
The National Foundation for the Treatment of Pain
www.paincare.org
(But hang up after one ring)
The Mayday Foundation has a long credibility in Pain Management. For over 20 years it has been s significant voice and funding source in approaching pain management policy. The November 4, 2009 publication of the recommendations of a Special Committee, convened by the Foundation to address the continuing suffering of millions of adults and children, is an example of its commitments. The Recommendations provide very useful background information and policy suggestions.
Unarguably the situation for acute and chronic pain patients is currently horrific, and the report clearly documents the situation. Further, pain care should be coordinated, beginning with primary care providers, disparities should be eliminated, unnecessary and ineffective invasive procedures and medication treatments should also be eliminated, and effective, comprehensive treatment should be universally available and implemented.
Further, federal and state agencies, state medical boards, health care payors and providers, medical schools, specialty and subspecialty organizations and all other "stakeholders" should be enlisted in achieving the goals of universal pain care available to all. And specifically the HRSA, HHS, NIH, AHRQ, the Surgeon General, health care providers, insurers and government should work to eliminate disparities in access to pain care related to race, ethnicity, gender, age and socioeconomic status; and federal, state and local agencies should adopt a balanced approach to the regulation of controlled prescription drugs, particularly opioids
Specifically, the report calls for:
· government, health care payers and health care providers should develop and use coordinated health information technology systems to track pain disorders, treatments and outcomes to improve care;
· physicians should be trained to assess and treat pain, and licensing examinations should include assessment of clinical knowledge related to pain care;
· the Health Resources and Services Administration should expand funding for training programs that address pain assessment and management;
· HHS should establish an independent commission to reform the reimbursement practices for chronic pain treatment;
· the NIH should increase funding for pain research;
· the Agency for Healthcare Research and Quality should expand funding to establish a set of best practices that could be used to treat specific types of chronic pain;
· the U.S. surgeon general should create a public education campaign about the risks of untreated and undertreated pain
However, amazingly, what the Committee did not mention was the "War on Doctors' - that horrific campaign that has destroyed the careers (and even the lives) of so many decent,
dedicated and caring physicians, and left thousands upon thousands of chronic pain patients in an abyss of abandonment and professional and regulatory indifference.
Also, conspicuous in its absence, was any mention of the single largest obstacle to adequate pain care - "Opiophobia".
Perhaps the members of the Special Committee believed that their studiously polite diplomacy required that these topics not be mentioned, as education and collegiality would cause them to dissipate before a wave of enlightenment. Perhaps they believed that it was best not "to kick the sleeping dog" - that confrontation would be best avoided in favor of education and the confluence of policy.
We have no way of knowing the Committee's motivations in this regard. However, it is safe to assume that opiophobia will disappear no more quickly than did racism. History makes it abundantly clear that a Chamberlain approach to brutality will accomplish little but self-delusion.
Sad to say, but I predict that collegial policy thumping will have no impact on the destructive mythologies and pharmacological shibboleths that characterize opiophobia. The myths of addiction, tolerance, toxicity, criminality, abuse, diversion are deeply engrained in the professional mindset of opiophobic physicians and the medical Boards upon which they sit. We have already seen in the examples of the "Model Intractable Pain Policy" adopted by the Federation of State Medical Boards in 2003, the "Pain as the Fifth Vital Sign" initiative of the Joint Commission on Accreditation of Health care Organizations in 2001, and the Pain Initiative of the Veterans Administration, that noble pronouncements are completely disconnected from the realities of the day to day priorities and actions of these boards. Everyone already knows the information summarized by the Mayday Committee. It has been part of the Zeitgeist since Dr. Pappagallo's news releases in 1996.
What is needed now is not polite policy but hard-nosed mandates. Whether it is to be federal legislation, state regulations, or a federal lawsuit, the opiophobes must be removed. Politeness and diplomacy will go nowhere (again). So thanks, Mayday, and the "Special Committee". Your intentions are noble. But one of the things that made the Committee "Special" is that there wasn't a single person sitting on it who's life and career is on the line every time they write a schedule II prescription. It's easy to be polite and diplomatic when no one is sticking a gun in your mouth.
I have to agree with Siobhan. Talk, talk, talk.
Joel Simon Hochman MD
Executive Director
The National Foundation for the Treatment of Pain
www.paincare.org
Wednesday, November 11, 2009
It's time for the revolution
It's time for the revolution
November 11, 2009
I am really offended now. It is now totally obvious that the Congress and the Insurers:
1. Think we are all too stupid to get what is going on;
2. Don't give a damn if we know what is going on;
3. Are so arrogant in their sense of privilege and power they think they can do whatever they want.
The "Health Care" legislation now before the Congress is an abomination. The insurers have simply hi-jacked the legislative process. The bill from the House simply mandates an additional 35 million subscribers into the existing nightmare of for-profit health "insurance" and gives the insures a half TRILLION dollars a year in additional subsidies to continue screwing the electorate into bankruptcy (60% of all bankruptcies now arise from the unpaid costs of health care!)
I say we have had enough. I am ready to invade Washington DC and picket the Congress. We need to tell Congress that if they want a job they had better get off their asses and give us REAL health care reform.
1. Get private insurers either entirely out of health care or regulate them into providing full coverage to everyone; no exclusion of pre-existing conditions; no prior approvals, denials, delays, deferments, weaseling of any variety; prompt payment of benefits; market level pricing of services, medications and devices; a 15% cap on "overhead" with sane salaries and other corporate expenses.
2. Provide a competitive one payor system that is consumer-oriented and totally responsive to the individual patient (not a sinecure for bureaucrats and a playground for profiteers).
3. Support a revolution in health care which makes physicians responsible for not only medical services but also the financial management of the system. Who is more qualified to understand needs, services, standards of care, measurement of outcome, efficiency, patient and provider needs?
It is time for us all to stand up - patients and providers - and tell them "Hell NO! We are sick of being raped and the party is over!" Get straight, Congress, or go find a real job. If you don't listen to us you are OUT of there, come the next election!!"
J.S. Hochman MD
Executive Director
The National Foundation for the Treatment of Pain
www.paincare.org
Monday, November 9, 2009
Advice ot the Parents of would be Overdose Victoms
DR. HOCHMAN’S GUIDANCE FOR THE PARENTS OF POTENTIAL OVERDOSE VICTIMS
1. Do not pretend that your child will never be involved in drugs
2. Assume that drugs are everywhere and will always be available (“supply-side”
strategies have never succeeded and will NEVER succeed)
3. Make sure that your kids are factually educated about every drug
4. If you misinform them, or give them propaganda, your credibility and
authority with them is over
5. Share your personal experience and knowledge with them. Do not be a
know-it-all (because you don’t)
6. Accept the fact that they may be smarter and more knowledgeable about drugs
than you
7. If you are going to keep medications in your home, keep them absolutely
locked up – NO EXCEPTIONS!
8. Do not expect that they will not try to defeat the security
9. Be informed about the symptoms and signs of intoxication and/or overdose
10. Have an overdose plan. Know what to do, who to call and what to say
11. Do not blame the drugs. Your kid took them; they didn’t take your kid
12. Expect that your kids will experiment. You probably did.
13. Make sure that they know what to expect, and what to do, if they get in
trouble with a drug.
14. Tell them you really love them, will miss them the rest of your life if they
kill themselves and that you would really appreciate it if they don’t
15. Don’t do ANYTHING to convince them it’s too risky to tell you the truth
16. Give every child in your home a copy of my advice to them and discuss it
with them.
1. Do not pretend that your child will never be involved in drugs
2. Assume that drugs are everywhere and will always be available (“supply-side”
strategies have never succeeded and will NEVER succeed)
3. Make sure that your kids are factually educated about every drug
4. If you misinform them, or give them propaganda, your credibility and
authority with them is over
5. Share your personal experience and knowledge with them. Do not be a
know-it-all (because you don’t)
6. Accept the fact that they may be smarter and more knowledgeable about drugs
than you
7. If you are going to keep medications in your home, keep them absolutely
locked up – NO EXCEPTIONS!
8. Do not expect that they will not try to defeat the security
9. Be informed about the symptoms and signs of intoxication and/or overdose
10. Have an overdose plan. Know what to do, who to call and what to say
11. Do not blame the drugs. Your kid took them; they didn’t take your kid
12. Expect that your kids will experiment. You probably did.
13. Make sure that they know what to expect, and what to do, if they get in
trouble with a drug.
14. Tell them you really love them, will miss them the rest of your life if they
kill themselves and that you would really appreciate it if they don’t
15. Don’t do ANYTHING to convince them it’s too risky to tell you the truth
16. Give every child in your home a copy of my advice to them and discuss it
with them.
DR. HOCHMAN’S GUIDANCE FOR WOULD BE OVERDOSE VICTIMS
IF YOU ARE CONSIDERING USING A DRUG:
1. To change your mood
2. To get high
3. Because your friends are doing it
4. In combination with other mind-altering substances, particularly alcohol
5. To cope with stress
6. To escape
7. In a party situation
8. Alone, with potential help unavailable
9. For the first time and you are unfamiliar with it
10. At a dose higher than you are used to (or you don’t know how strong it is)
11. When you have health issues that might affect your breathing or your ability to metabolize the drug
12. And for opiates if you don’t know about Naloxone and it’s not available anyway
The possibility that you may kill yourself is VERY high. Proceed at your own risk and do not blame the drug (you took it, it didn’t take you).
Relax – if you kill yourself, your parents will blame the drug, not you. And they will think about you every day for the rest of their lives.
IF YOU ARE CONSIDERING USING A DRUG:
1. To change your mood
2. To get high
3. Because your friends are doing it
4. In combination with other mind-altering substances, particularly alcohol
5. To cope with stress
6. To escape
7. In a party situation
8. Alone, with potential help unavailable
9. For the first time and you are unfamiliar with it
10. At a dose higher than you are used to (or you don’t know how strong it is)
11. When you have health issues that might affect your breathing or your ability to metabolize the drug
12. And for opiates if you don’t know about Naloxone and it’s not available anyway
The possibility that you may kill yourself is VERY high. Proceed at your own risk and do not blame the drug (you took it, it didn’t take you).
Relax – if you kill yourself, your parents will blame the drug, not you. And they will think about you every day for the rest of their lives.
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