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After 39 years, countless doctors, and a list of diagnoses that rivals Santa’s list I have had more surgeries, invasive and noninvasive procedures, traditional an non traditional therapies than the average person. Over the years I have become very jaded when it comes to the medical community. I have been left to wonder if doctors really care. Do they really care about our wellbeing or do they care about the money and seeing the maximum number of patients possible every day. I had a chance to speak with Dr. Leah Houston, CEO of the Human Physicians Empowerment Community (HPEC). Recently, Dr. Houston wrote an article published in the medical community regarding the Self-Sovereign Identity for patients. In the time I spent with her my eyes were opened to what is really happening in the medical community and where the breakdown really is. When I asked Dr. Houston why she was doing this, she responded that she got to a point where she didn’t care about her job anymore. She cared more about ethics and truly being able to help people which is why she became a doctor in the first place. A self proclaimed “nerd” in school who was drawn to math and science becoming a doctor she felt was the best way to use her knowledge and do what she loved and help people without spending her days in a lab. It breaks her heart to think people don’t think their doctors care about patients or patient care. Most doctors don’t have the luxury of being able to speak up. Some are either “drinking the kool-aid” and do think the current way is the right way but most are just like the rest of us and have bills to pay and mouths to feed on top of nearly $200,000 of debt. Becoming a physician is the only trade/career in which you must undergo three to eight years of training as a resident after four years of undergraduate training and four years of medical school- the pipeline is long and the hourly pay works out to be less than minimum wage. So, what exactly is the problem? Third parties such as big corporations, insurance companies and and pharmaceutical companies along with patients not having access or control over their own medical records. How did we get to this point? Understanding legislation put in place up until now is the first step. When health insurance was first developed around the 1930’s it was meant for catastrophic events, injuries and illness. Just as you would not use your auto insurance to replace your oil or buy new tires for your car, health insurance was not meant to be used for routine checkups and flu shots. In the mid 20th century employers began commonly adding health insurance is a benefit, at this point the medical community began to catch on that if a third party is involved it was easier to allow to create polices that would allow healthcare to be exempt of anti-kick back laws as well as monopoly laws, It is because of this that we pay exorbitant amounts for an aspirin in the hospital and why large corporations have been able to essentially take over entire suburban areas which don’t always allow for a patient to truly seek the treatment they need by searching for a physician they are comfortable with and respect. Advancements in medicine have contributed to the inflation in cost but the bureaucracy of healthcare industry third parties are also drastically inflating healthcare cost and inhibiting doctors to give adequate care and thus patients feel they are suffering or being neglected. While the U.S. may have the largest healthcare system, it is arguable if it is the best. To put the amount of money the industry generates, it is the fifth largest economy in the the world. The top five ranking economies in the world are as follows: the U.S. at number one, followed by China, Germany, Japan and the U.S. Healthcare system at $3.6 trillion and 1/3 of that goes to administrative waste. There is no argument on either side that everyone should have access to affordable healthcare but privatized healthcare as well as Medicare and Medicaid have both played a part in duping the doctor as well as the patient. Medicare and Medicaid promised the doctors fair reimbursement and HMOs did the same with companies. We have gotten to a place where we have no choice but to use health insurance for all of our healthcare needs rather than for catastrophic occurrences. How do we fix it? Dr. Houston’s goal fo HPEC is to restore physician autonomy and trust in the doctor/patient relationship by using new secure technology via the SelfSovereign Identity. Currently, records and charts are stored on a centrally managed blockchain controlled typically by a hospital. We do want it to be well documented that we are insulin dependent, have medication allergies or have medications that could cause a reaction. We have a right to an unbiased second opinion not allowing a doctor to be influenced by a previous doctor. In one part, according to Dr, Houston allowing doctors to have control of the treatment they provide and getting third parties out of the exam room who are monitoring the entire doctor/patient relationship down to how many minutes a visit lasts is causing the current breakdown. Currently, the patient chart serves a dual purpose for documenting important facts about the patient for the doctor but is also being used for third parties for billing and so-called efficiency purposes. A Self-Sovereign Identity would allow the physician more control as well as giving the patient access. A second part would be something called “Direct Primary Care Management”, not to be confused with “Concierge Medicine” as “Direct Primary Care Management” is much more affordable to the average person. This would allow you to have more direct access to your doctor and cut back expensive ER or Urgent Care visits, starting the process of getting third parties out of the exam room giving doctors the opportunity to dedicate more time to their patients and less time doing paperwork. In a nutshell giving doctors back the power to treat instead of an administrator without a medical degree. Where doctors spend years getting formal education in healing and take an oath to, ‘first do no harm”, the people dictating your level of care have an MBA in doing what is best for the bottom line of the insurance company, hospital, drug company etc. To learn more about HPEC, their mission and how you can help visit https://hpec.io/
By Kelli Sprague-Baker
When the opioid crisis began sweeping the country, the Centers for Disease Control and Prevention issued guidelines to physicians regarding prescribing pain medication and the Drug Enforcement Agency began targeting doctors who prescribed pain medication. The result was doctors greatly reduced or stopped prescribing narcotics for pain management and those living with conditions that cause chronic, intractable pain were left reeling from the fallout. The American Pain and Disability Foundation started several years ago. According to Melissa Lerner, a board member who lives in Nappanee, the foundation wanted to create a place where people in chronic pain can have their needs treated, whether through finding pain specialists or rheumatologists or just being able to chat online with others dealing with similar issues. “A lot of people didn’t know the first place to look,” Lerner said. The board for the American Pain and Disability Foundation is spread across the country. The foundation recently launched a new website and is serving people in Indiana, Michigan, Kentucky, Ohio, Florida, Arkansas and Texas. The hope is to have representation from all 50 states. The foundation is actively working with legislators to change the law regarding opioids. “If you look at those taking pain meds and overdosed, it’s less than 1%,” Lerner said. She, herself, has sat in on approximately 300 narcotics anonymous meetings to see what leads people to illicit drug use. “A lot had childhoods with abuse or some type of trauma,” she said. “What happens in childhood plays a great deal in how you deal with stress as an adult.” For Lerner, pain medication is a necessity, or she isn’t able to function. In order to get the pain medication she needs, she has to be drug tested once a month to prove she doesn’t have an illicit drug problem. A portion of the fees she, and others like her, pay for those drug tests goes toward addiction care. “The doctors are tired of being targeted with paperwork they have to do. They know every month you won’t get better,” she said. So the foundation is working with legislatures to back off doctors who are pain specialists. She pointed out most don’t prescribe narcotics as the first treatment for chronic pain. For example, her doctor has prescribed yoga and water therapy along with pain medication to help Lerner be able to function on a day-to-day basis. The American Pain and Disability Foundation is in favor of the DEA going after “pill mills” that prescribe medication indiscriminately, but Lerner noted the DEA has also raided and seized pain medication from pain specialists with 30 years of experience. “If doctors could come together, they could put a stop to this,” she said about the DEA’s heavy handedness in dealing with the situation. But many doctors are also concerned because they do see patients becoming addicted. “People have a responsibility to take medications as prescribed. If you don’t need it, don’t take it,” she said. The American Pain and Disability Foundation would like to work with the addiction community to better address the issue. “If anyone wants to reach out, that would be great. We’re all trying to deal with the issue,” Lerner said. In addition to dealing with legislative issues, the foundation is also raising money to assist with intractable pain patient needs such as paying for medication, paying for Uber rides to doctor’s appointments and even replacing a refrigerator for a homebound patient. The foundation also tries to help those on disability with services such as food delivery. The American Pain and Disability Foundation also works with suicide prevention organizations since many pain patients have a “plan B.” While the foundation does not have a suicide hotline or a counselor on call, it does put people in touch with those who can help. “People have to have hope and I think this group gives them hope,” Lerner said.