EPtalk by Dr. Jayne 6/23/22

I wrote recently about hospital shootings and the other unsafe situations that healthcare workers are encountering with greater frequency. We can add another hazard to the list. Earlier in the week, batteries exploded in a Milwaukee hospital parking garage, injuring two people. The incident, which occurred at Aurora St. Luke’s Medical Center, is attributed to an acid spill in a container that was holding recycled batteries. Unanticipated combustion is a thing, and it just goes to show that regardless of how well you think you’ve planned or prepared, there’s always something that has the potential to surprise you.

I’ve read a lot of articles about how physicians should manage their social media profiles, but I haven’t seen too much on how they should manage their non-work-related TV appearances. Amar Shere MD, a cardiology fellow at Saint Louis University School of Medicine, was selected to complete on the NBC show “Dancing With Myself.” Shere appeared in his white coat, but was cut after the fourth round. He has used TikTok to share his dance skills along with patient education and eating tips. He’s also a fitness instructor with an interested in promoting heart health in the community. Kudos to Dr. Shere for putting himself out there, and I hope his patients enjoy his care as much as it sounds like he enjoys delivering it.

Many physicians are watching carefully to see what happens to telehealth provider Cerebral as it has come under fire for deceptive business practices and poor patient care. I’ve seen a number of patients in the brick-and-mortar urgent care world who were trying to get refills on their prescriptions after being denied ongoing treatment due to billing disputes. Cerebral is accused of pushing patients to take controlled substances in an effort to increase patient loyalty. The company used flexibility in telehealth rules to prescribe highly regulated medications without any in-person care. Pharmacies were seeing so many prescriptions they stopped filling orders from the company and flagged its business practices for scrutiny.

Cerebral is no longer starting new courses of therapy with controlled substances and patients who are already under treatment have to transition to other drugs or different providers by mid- October. Given the severe shortage of physicians willing to take over these prescriptions, my clinical employers included, it’s going to be rough for patients who are trying to figure out how to continue treatment. The company has been removed from insurance networks and patients are left holding the bag while they go on waitlists for psychiatrists and call from urgent care to urgent care looking for anyone willing to give a 30-day prescription.

Speaking of brick-and-mortar urgent care practices, I’ve been receiving harassing emails and phone calls from a particular insurance company as they try to recredential me to deliver care at an organization where I haven’t practiced for more than a year. Apparently, their calls and emails to my former employers weren’t managed in a timely fashion (not surprising given the overall turnover in the organization), so they decided to contact me personally. They tracked down personal email addresses that I never would have used on a credentialing application and also used several emails associated with the LLC that I use for my consulting business (but never for clinical care). I finally convinced someone to understand that I don’t want to be recredentialed so they can stop trying, but it took several phone calls and quite a bit of frustration. Supposedly they’ve been trying to reach me for months to see if I wanted to remain on the plan. You’d think they’d be able to look at their own claims data and see that I haven’t submitted anything in a year, but that would require coordination within the organization. I’m less than thrilled that they spent patients’ premium dollars exploring my personal websites, but I guess they consider it trying to be engaged with their providers.

Monkeypox has arrived in my state and medical misinformation is running rampant. I’ve seen comments on local news articles suggesting that transmission is limited to certain sexual behaviors, complete with links to bogus articles blaming this “scourge” on immorality. News flash from infectious disease specialists – monkeypox is spread through contact with body fluids, monkeypox sores, contaminated clothing or bedding items, and through respiratory droplets. It’s been a long two and a half years dealing with patients who have decided that social media is more believable than their own physicians, and I sure wish we could mandate public health and hygiene classes in schools. The World Health Organization plans to rename the disease to reduce stigma and racism, but unfortunately people’s attitudes aren’t going to be easy to adjust.

I just finished reading the novel “Hamnet” by Maggie O’Farrell. It’s a fictionalized account of the life of William Shakespeare’s son, who died at age 11 at 1596. The book’s subtitle clearly says it’s “A Novel of the Plague” and there’s an underlying story about the child’s mother being a healer and her encounters with the medical establishment of the times as the bubonic plague reaches her family. My book club has a way of selecting less-than-cheery readings at times, but I enjoyed the book and found it to be a relatively quick read. Within a day or two of finishing it, I came across an article that summarizes findings about the origin of the Black Death, which ravaged Europe for hundreds of years. Researchers propose that the Black Death began in the late 1330s in North Kyrgyzstan, based on analysis of DNA extracted from skeletons found in the region.

I wonder what historians in the future will say about our current pandemic when they’re looking back at us. They’ll probably think we were similar to what modern medicine thinks about medieval “plague doctors” who wore bird-beaked masks stuffed with herbs as a way to ward off disease. Hopefully, our next book club selection is a little lighter read, but I’m always looking for summer reading suggestions whether I have the ability to make them truly a beach read or not.

What’s on your summer reading list? Leave a comment or email me.

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