First Westerner Government Member Victim from the Middle East Turmoil

The current French foreign minister, Michèle Alliot-Marie, is expected to be shacked from the government in a mini cabinet reshuffle tomorrow. She has been a member of French government without interruption since 2002. She is being blamed for having close ties with the former Tunisian dictator, Ben Ali. Her fault was that she was vacationing in Tunisia during the civil unrest and suggesting France support the then incumbent leader of Tunisia with riot police support, and for sending tear gas to Tunisia.

According to Le Figaro:

 

The departure of Michele Alliot-Marie is expected. Remains the most difficult for the chief of state: tell her because "it is not at all in her frame of mind."

WSJ Letters to Editor regarding to "Where Have the Good Men Gone?

If a modern, successful woman wishes to know why men are such failures these days ("Where Have the Good Men Gone?," Review, Feb. 19), perhaps she should look in the mirror.

I'm a white male, heterosexual, Christian conservative Republican, Vietnam veteran, married 38 years with four kids. When I was young, we were supposed to get busy and stay busy, get part-time jobs, finish high school and, if qualified, go on to college and beyond. We were taught that it was our responsibility to take care of our families, which meant a wife and kids. All that began to change in the 1960s when women became "liberated" and were given equal access to what had been a man's domain. Like it or not, there are only so many jobs to go around. Given quotas, young men in the workplace no longer had an even playing field.

There are many other factors contributing to young men being overgrown post-pubescent losers: a lifetime of leftist, feminist indoctrination in the schools, a cheapening of the proper meaning of the male-female relationship and the suspension of the draft.

Miss Kay S. Hymowitz (I hate that phony term "Ms.") asks nothing of women, so let me do the job for her: When are women going to accept their God-given roles of being wives and mothers? Men and women are different; let's keep it that way. Feminists may not like my prescription, but then again, they don't like men from the get-go.

Andrew J. MacDonald, Fanwood, N.J.

Ziona Chana, a man with 39 wives, has the largest family in the world.

An Indian man from Mizoram in Kolkata, northern India has the largest family in the world with 39 wives, 94 children and 33 grandchildren, according to Malaysia Nanban.

Ziona Chana, 66, and his family live in a 100-room, four-story house set amidst the hills of Baktwang village in Mizoram.

Understanding Insurance: Will a Public Option or Co-op Get Us Where We Want?

Editorial by Debra A. Smith, DO, MIHM, MBA

Dr Smith is president-elect of the American Osteopathic College of Occupational and Preventive Medicine, and adjunct assistant professor at the University of North Texas Health Sciences Center— Texas College of Osteopathic Medicine in

 A “public option” (ie, allowing individuals to purchase government run health insurance) has been proposed as a solution for achieving universal health coverage in the United States. Politicians have told us not to fear a public option because government-run programs such as Medicare work well—without any of the dreaded rationing of care that critics claim would occur. Recent town hall meetings have demonstrated that many elderly Americans are satisfied with their Medicare coverage and will fight fiercely to protect it.

Medicare does provide good benefits—with the working population paying for current retirees. Today, however, Americans are living an average of 4.3 years longer than they were in 1965, when the program started.1,2 In addition, the percentage of the US population receiving benefits has jumped from 9.5% at the program’s inception to 13% today3—a 37% increase.

As more and more “baby boomers” retire, the Medicare-eligible population is projected to expand to 16% by 2020 and to 19.3% by 2030.3 According to a May 2008 speech by Richard W. Fisher, president and chief executive officer of the Federal Reserve Bank of Dallas, the present value of unfunded liabilities for Medicare Part A (hospitalizations) is $34.4 trillion; for Medicare Part B (physicians), $34 trillion; and for Medicare Part D (drug benefits), $17.2 trillion.4 These numbers represent a grand total of $86 trillion of unfunded entitlements that our children and grandchildren will be paying for us.4

Increased longevity and demographic shifts account for part of the funding dilemma. The continued expansion of benefits and increased demand for costly new medical technology account for the rest of the problem. Given the extent of our current obligations, is the proposal of another publicly funded healthcare program responsible?

There are three things that people want in any health plan. First, the plan should be responsibly administered and financially solvent. Second, it should provide good coverage at an affordable

price. Third, the plan should not bankrupt the country, the insurance companies, or the individuals paying

for it. A key issue to keep in mind is that a public program must be underwritten correctly or it will lose money. Nationwide, health insurers have been operating with only about a 2% profit margin in recent years.5,6 Although we want everyone covered, do we really believe that government is more efficient than

the private sector?

Nonprofit and For-Profit Private Options

Where is the money in private health insurance going? About 85% of each premium dollar goes to pay claims (ie, the medical-loss ratio), and roughly 10% goes to administrative costs.7Highmark Blue Cross Blue Shield, a nonprofit insurer based in Pittsburgh, Pennsylvania, has an explicit policy to keep its

medical-loss ratio near 90%.7 Nonprofit insurers are granted this special tax status because they provide a

needed public service. Nonprofits are good for the insurance industry because they help keep the for-profit insurers honest in premium pricing. Conversely, the for-profit insurers have incentive to reduce administrative costs to remain competitive in the marketplace and eke out a profit. The for-profit competitors force the nonprofits to keep their administrative costs from ballooning.

Politicians claim that public health programs have cheaper administrative costs than programs in the private sector. An examination of the evidence, however, casts doubt on that assertion.

via Journal of Osteopathic Medicine: Understanding Insurance: Will a Public Option or Co-op Get Us Where We Want?

                   
                                                              http://healthcaresolved.net/

State CME Requirements for MDs and DOs

Source from AMA

American Academy of Ophthalmology: Kentuckians’ Vision Jeopardized with Governor’s Stroke of Pen

Despite an aggressive campaign waged by a coalition of medical groups to educate him on the inherent risks contained in the optometric surgery legislation that flew through the Kentucky legislature, Gov. Steve Beshear turned a blind eye to the dangers and signed SB 110 into law this afternoon. Beshear claims three reasons as the basis for signing the legislation into law, despite the vehement opposition of the Academy, the Kentucky Academy of Eye Physicians and Surgeons and the Kentucky Medical Association and so many of you who contacted him. His reasons for signing SB 110:

• “Access to quality health care across the state”
• The overwhelming, bipartisan vote
• The “little or no fiscal impact on the Medicaid budget”

The bill arrived on Gov. Beshear’s desk after the Kentucky House of Representatives voted last Friday to approve the legislation, which threatens the vision of all Kentuckians; the Senate took similar action the previous week. SB 110 grants optometrists authority to perform:

• Laser procedures, including laser trabeculoplasty, peripheral iridotomy, iridoplasty and capsulotomy, YAG capsulotomies, LASEK and laser “only” clear-lens extraction, as well as other laser procedures
• Scalpel procedures, with exceptions
• All methods of administering pharmaceutical agents including injection procedures, except schedules I and II
• Anesthesia, except general anesthesia
• Emergency inoculations, as requested by the commissioner of health

Tây Sơn (西山): the history behind the name

The name of Tây Sơn (西山) is used in many ways to refer to the period of peasant rebellions and decentralized dynasties established between the eras of the Later Lê and Nguyễn dynasties in the history of Vietnam between 1770 and 1802. The name Tây Sơn is used to refer to the leaders of this revolt (the Tây Sơn brothers), their uprising (the Tây Sơn Uprising) or their rule (the Tây Sơn Dynasty or Nguyễn Tây Sơn Dynasty).^[1]

Emperial Seal

Nguyễn Huệ was the second eldest of three brothers from the village of Tay Son in An Khe District, Nghia Binh Province in Central Vietnam. He was the most talented and famous among the three brothers and took the name Quang Trung when he proclaimed himself as Emperor. He distributed land to poor peasants, encouraged hitherto suppressed artisans, allowed religious freedom, re-opened Vietnam to international trade, and replaced Chinese with Vietnamese written script called Chữ Nôm, as the official language.

Despite the short reign of less than 4 years (1788-92), he has remained the most well-known and revered by vietnamese people for his genius military and administrative skills. His victory over the Chinese invasion is still celebrated yearly in Vietnam as the Dong Da citadel victory, in which he was able to recruit and trained 100,000 men in less than a month and repelled the Chinese invasion force of 200,000 men out of North Vietnam in less than a week.

The ambitious character of Quang Trung is legendary in Vietnamese history. He ordered the melting of Vietnamese coins to make cannons, and hoped to "restore" the Chinese provinces of Guangxi and Guangdong to Vietnamese sovereignty. Several stories tell of his ambitious plans and indirect challenge to Qian Long. Quang Trung even proposed to marry one of Qian Long's daughters, an indication of his intention to claim Chinese territory.

In early 1792, Quang Trung planned the final assault on the remaining base of Nguyễn Ánh's around Saigon, both by sea and land. While waiting for the seasonal winds to change direction into a tailwind to propel his navy, he suddenly collapsed and died of unknown causes at the age of 40. Many Vietnamese believe that if he had ruled for another ten years, the fate of the country would have been significantly different.

Sources from Wikipedia: Tây Sơn Dynasty and from Quang Trung/Nguyen Hue

Vietnam Magzine:The First Tet Offensive 1789/ The First Shock and Awe in History

"In January 1789 the Vietnamese defeated a Chinese army and drove it from Vietnam. What might be called the first Tet Offensive is regarded as the greatest military achievement in modern Vietnamese history. "

"Modern-day Vietnamese know this campaign by a variety of names-the Victory of Ngoc Hoi-Dong Da, the Emperor Quang Trung's Victory over the Manchu, or the Victory of Spring 1789. Today it is still celebrated in Vietnam as the country's greatest military achievement."

'Quang Trung profited from Chinese errors. Instead of continuing his offensive to destroy the Tay Son, Sun Shi-yi had halted. Confident of his superior numbers, he had underestimated his adversary and relaxed discipline. But Quang Trung had carefully prepared his campaign. As historian Le Thanh Khoi noted, in the course of a 40-day campaign, Quang Trung had devoted 35 days to preparations and only five to actual battle. His lieutenant's wise decision to retreat from the north had freed up sufficient troops. Another key was the attitude of the civilian population, which rallied to the Tay Son in their march north, providing food, material support and tens of thousands of soldiers. This gave Quang Trung the resources needed to take the offensive. He also managed to preserve military secrecy until the time of his attack. Being on the offensive also helped offset his 2-to-1 numerical inferiority. And his attack on the eve of Tet was a particularly brilliant stroke because it caught the Chinese off guard, when they were getting ready to celebrate the lunar new year."

"Once launched, Quang Trung's offensive went forward without pause over five days. Attacks were usually launched at night, to create maximum confusion for the enemy. Days, meanwhile, were spent on preparations. Quang Trung reportedly organized his forces into three-man teams, two of whom would carry the third in a hammock. They would then change places periodically to minimize march time. The rapid and simultaneous nature of the attacks prevented the Chinese from bringing up reserves, added to their confusion and kept them from shifting their resources."

"Counting the retreat from Thang Long, his troops covered 600 kilometers in only 40 days. Considering the state of Vietnamese roads at the time, this was an astonishing achievement. The offensive, concentration of force, excellent training, effective use of combined arms and rapid mobility gave the Tay Son victory. Numbers were not as important as morale; the attackers were clearly motivated by the strong desire to free their country from foreign domination."

"Quang Trung's offensive covered nearly 80 kilometers and took six forts-a rate of 16 kilometers and more than one fort a day."

Via Vietnam Magazine for full reading of the First Tet Offensive 1789

Ophthalmology: Differences between D.O.s and M.D.s are not as important as what we can accomplish together.

An often asked question: What's the difference between an M.D. and a D.O. ophthalmologist? Some D.O. ophthalmologists would reply: "Practically speaking, very little, or nothing". My own reply, and the intent of this article are to go beyond the "practically speaking" response, and offer another perspective.

Personal History

My osteopathic heritage begins with my father, a 1952 graduate of Kirksville College of Osteopathic Medicine (where osteopathy originated). He received his postgraduate training in orthopedic surgery at the Detroit Osteopathic Hospital, lovingly referred to as the "mecca" of osteopathic specialty training.

My own path started at Michigan State University College of Osteopathic Medicine, followed by an osteopathic internship. Ophthalmology residencies were scarce in the D.O. world when it was my turn to apply — only two openings were available in the entire United States. I was fortunate to have been accepted to the Kresge Eye Institute. Having just married a D.O. ophthalmologist whose medical educational route mirrored that of my father's, I found myself in a unique position to compare the educational experiences and philosophical differences.

Osteopathic principles and philosophy were founded by Andrew Taylor Still, M.D., toward the end of the 19th century. He noted that the medical treatments of the day were killing more people than they were curing.

He felt strongly that the body has an inherent ability to heal itself, and that structure and blood supply are vital to that healing process. He developed manipulative techniques that strive to restore skeletal alignment and improve blood/lymphatic flow throughout the body. One of the many tenets of osteopathic medicine states that the body has the potential to make all substances necessary to insure its health. No medical approach can exceed the efficacy of the body's natural defense systems if those defenses are functioning properly. Teaching the patient to care for his own health and to prevent disease is part of a physician's responsibility.

An Eye M.D.'s perspective: Practicing Another Brand of Medicine

 

If I brag about one of my sons, it wouldn't surprise or necessarily impress any of you, because we're all proud of our children, and we all think they are special (for the most part). But let me brag anyway for just a moment.

My middle child, Michael, has been a great kid to raise. He excelled in sports, was a natural leader in many areas, went on several medical mission trips with me, and was very gifted academically. He finished college in 3 years with a 4.0 GPA. But he, like so many, struggles on standardized tests … including the MCAT. So while his MCAT scores were respectable, they fell just shy of what the major medical schools sought. The allopathic medical schools, that is.

The Alternative

It turns out there's a whole other brand of medical school, the osteopathic variety, about which many of us "M.D.s" and our patients know precious little. It seems they also look at MCAT scores, but don't consider them the rigid screening criteria our traditional M.D. programs do. They focus more on your grade pattern over the years, your character and the kind of doctor you'll turn out to be. Let's face it — when you were in medical school, you saw some of your fellow students who, while brilliant, seemed, well, socially maladjusted. And those students are now doctors! Surely we can strike a balance between intelligence and a good ability to interact with patients.

Personal Appeal Letter to TCOM alumni and DO fellows

Dear TCOM alumni and DO fellows:

I would like to apologize to you again for taking the liberty of contacting you regarding the direction of our beloved institution, UNTHSC/TCOM, which may lead to the demise of TCOM and also affect the growth of our profession and our brand name. Somehow, I don’t know why I have been so involved into this issue. As you may recall of the letter I emailed you last August explaining the reasons, that letter is in the attachment.

I am writing to you on my own behalf as TCOM graduate of class 2002 and not on any anyone else’s behalf (Texas Osteopathic Medical Association or American Osteopathic Association.) Yes, I am a member of those associations, but do not hold any leadership position or do not seek any leadership position in a future because I don’t have the charisma and my English is broken in three. I am using the email list from the TOMA directory CD-Rom, previously mailed to all the members.

On Wednesday February 23^rd, 2011, I will join the DOME day in Austin for the first time in my life from Peoria, IL. I am currently in my second year of practice, but Texas has a special place in my heart as I had lived and worked for a total of 14 years: Houston, Austin, College Station, Fort Worth, Corpus Christi, Kingsville, Aransas Pass, Beeville, McAllen, Harlingen, Brownsville, Rio Grande Valley, and Eagle Pass.

Healthcare Reform: Civic Education Needed

The following excerpt from the book "Healthcare Solved-Real Answers, No Politics" by Debra A. Smith, DO

Office visit vs. urgent[1] vs. emergent[2] care

Health classes have failed to teach our citizens what is and is not an emergency. Too many people with urgent or emergent problems wait until their doctor’s office opens or worse yet until the office secretary gives them an appointment. Far too many people, without urgent, let alone real emergencies, go to the emergency room for care. More than once while working in the ER, a person has come in requesting a Band-Aid for a small cut on his finger, insisting that he had a right to treatment. In England, he would have been thrown out; here he will be seen. No country can afford this kind of access.

I will not attempt to go through a list of real emergencies here, but a good rule of thumb is anything that interferes with basic bodily functions, such as airway, breathing, circulation (heart beat/chest pain), for starters, or anything that causes an excessive loss of any bodily fluids from an orifice (natural or man-made), particularly the wrong bodily fluids (other than what would normally be expected), is an emergency.

While covering the emergency room at Deaconess Hospital in Cincinnati, a patient came in via squad with his family in what is referred to as agonal breathing, also known as the death rales or rattles.[3] As the name suggests, it is typical of the type of breathing that occurs close to death; the patient is not conscious of their environment at that point. I asked the patient’s wife how long he had been like this. She answered a few hours. When a person is not breathing well and is not arousable, this should immediately indicate a problem. Our people do not need to be great diagnosticians to learn the basics of what is or is not an emergency. Our schools should be teaching this. Schools should also teach students how to find a family physician, how to make an appointment, and when to use an urgent care center[4] vs. an emergency room. Too many emergency rooms have beds tied up with non-emergency care, such as sinus infections, urinary tract infections, sexually transmitted diseases. In my experience, easily two-thirds of the care is non-emergent.

Access to care and the “lack” of it

Medicine Buddha

As I left Vietnam for France when I was 12, I have learned so many gods of medicine in Greek mythology and Christ is a great healer in Christianity. Recently, I have started exploring my Buddhist roots and have found that there is a Medicine Buddha. In vietnamese, he is called Duc Phat Duoc Su.

Even though he achieved Buddhahood or Total Enlightment, which would have allowed him to enter into Nirvana, he refused to become Buddha and chose to remain a bodhisattva. The bodhisavatta state allows him to remain among us in order to answer to people's prayers. During his spiritual journey for Englightment, he made the 12 great vows if he achieved the Buddhahood.  He became the Buddha of the eastern realm of Vaidūryanirbhāsa, or "Pure Lapis Lazuli". There, he is attended to by two bodhisattvas symbolizing the sun and moon respectively: Suryaprabha and Candraprabha.

The Twelve Vows of the Medicine Buddha upon attaining Enlightenment, according to the Medicine Buddha Sutra are: