Volume V, Issue 45

Nov. 5, 2018
When Western Medicine Fails Patients and Clinicians
Kimberly Rogers, MD writes about the failings of western medicine in a Nov. 3, 2018 KevinMD post. She asserts that:

We physicians are being failed...by a broken fee-for-service healthcare system that squeezes us with 10-15 minute visits, which does not allow us the necessary time to have...crucial conversations with our patients and does not reimburse appropriately for...preventive service. We're being failed by a system that forces us to choose the fastest option to treat a problem - the prescription pad.

Dr. Rogers also notes that:
By purposefully increasing my emphasis on healthy eating and weight loss, I have been successful in helping patients wean off PPIs, diabetic medications, and anti-hypertensives. It always blows my mind to discover that so many people don't understand that many of their chronic conditions are treatable and preventable through improvements in diet, nutrition and physical activity. 
After provider uproar, CMS steps back from major E/M revamp
Tony Abraham reports for Healthcare Dive on 11/2/18:

CMS has finalized the Physician Fee Schedule for 2019, pushing back a controversial flattening of E/M codes to 2021 after a backlash from providers and physicians. The rule also cuts some E/M documentation requirements and removes duplicative notation requirements...The overwhelming majority of hospital and provider groups opposed the proposal, many banding together under the auspice of the American Medical Association to request CMS push the rule back and instead convene a stakeholder group to devise an alternative solution.

According to Mr. Abraham:

CMS has listened to widespread industry feedback on its E/M proposals by streamlining some evaluation and management requirements while holding off on controversial proposal to flatten E/M codes in 2019. The agency pushed that plan back to 2021 in order to "work with stakeholders and get their input," CMS Administrator Seema Verma said on a call with reporters Nov. 1.
Northwestern Researchers Discover Cancer 'Kill Code' 
Arlene Weintraub reports for FierceBiotech on Oct. 29:
Scientists at Northwestern University have discovered a "kill code" in every cell of the body that's triggered by chemotherapy and that causes cancerous cells to self-destruct. What's more, they've learned enough about the code that they've figured out how to trigger it without chemo-a finding that they believe could lead to new therapies. The discovery, reported in the journals Nature Communications and eLife, is a code that's found in both large and small ribonucleic acids (RNAs). The researchers also have early evidence that the small RNAs, called microRNAs, can be introduced into cells to trigger the kill switch. 
"My goal was not to come up with a new artificial toxic substance," said lead author Marcus Peter, PhD, a professor of cancer metabolism at Northwestern's Feinberg School of Medicine, in a statement. "I wanted to follow nature's lead. I want to utilize a mechanism that nature developed."



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