TOP

DJP Update 6-12-2016: Unable to attend AMA Annual Meeting; this video contains the message I would have shared to anyone interested in my views.

DJP Update 6-12-2016: Unable to attend AMA Annual Meeting; this video contains the message I would have shared to anyone interested in my views.

For multiple reasons, including my recent neck injury secondary to being in a car accident when our car was stopped and another car crashed into the rear of our car, I am not at AMA Annual Meeting.

This 24 minute speech captures what I try to teach medical students, doctors, and lawmakers in addition to the importance of medical liability reform.

Leadership in Medicine: Tales from The Little Red Book of Leadership Lessons – YouTube from Donald Palmisano’s Tweet

Alternative link:
https://t.co/ZuKEu8S7ip

DJPNEWS
Unable attend @AmerMedicalAssn ann. mt; 1st time in 33 yrs. My message: Med Ethics key. ⬇️Gov in Med; more: https://t.co/ZuKEu8S7ip #AMAmtg
6/11/16, 9:32 AM

Thanks to AAPS for posting video in a tweet on Memorial Day to honor Bud Lomell and other heroes.
AAPSonline
This D-Day rewatch Leadership in Medicine talk by @DJPNEWS. Includes lessons learned from Normandy hero Bud Lomell. https://t.co/9D3oXDbx13
6/6/16, 11:57 PM

————
Tired of PPACA (ACA)? Frustrated by MACRA? Wish you could spend more time with patients rather than electronic medical records designed by regulators for other purposes? ADVOCATE for the right to balance bill what the patient and doctor agree regardless of the payor of insurance (long-standing AMA policy). Stop going along to get along. Withdraw support for failed government policies distorting the practice of Medicine. Review my 6 Commandments of Medicine.

Stay well and be safe. Unfortunately the world is becoming more dangerous as obvious by terror attacks. Increase your vigilance and protect your loved ones.

We have been the land of the free only because of the brave. Never forget that.

Donald

AMA President 2003-2004

Donald J. Palmisano, MD, JD, FACS
DJP@intrepidresources.com
504-455-5895
www.intrepidresources.com
www.onleadership.us

DJP Updates: www.DJPupdate.com
Twitter: @DJPNEWS
YouTube: http://www.youtube.com/user/IntrepidResources/videos

Read More
TOP

DJP Update 9-28-2014 1- AMA Ethics Award Recipient Dr. Ezekiel Emanuel’s article “WHY I HOPE TO DIE AT 75”. 2- DJP Updates

DJP Update 9-28-2014 1- AMA Ethics Award Recipient Dr. Ezekiel Emanuel’s article “WHY I HOPE TO DIE AT 75”. 2- DJP Updates

The article by Dr. Ezekiel Emanuel is published in THE ATLANTIC September 17, 2014 with the title:

 Why I Hope to Die at 75

H/T to Dr. Art Fougner for the alert about article in the listserv he moderates “Speaking As An Individual” and via his Twitter account: @sonodoc99

Dr. Emanuel’s article is at: http://www.theatlantic.com/features/archive/2014/09/why-i-hope-to-die-at-75/379329/

You have to read his entire article to get his message.  Here is one excerpt re his approach to treatment as one gets older:

“This means colonoscopies and other cancer-screening tests are out—and before 75. If I were diagnosed with cancer now, at 57, I would probably be treated, unless the prognosis was very poor. But 65 will be my last colonoscopy. No screening for prostate cancer at any age. (When a urologist gave me a PSA test even after I said I wasn’t interested and called me with the results, I hung up before he could tell me. He ordered the test for himself, I told him, not for me.) After 75, if I develop cancer, I will refuse treatment. Similarly, no cardiac stress test. No pacemaker and certainly no implantable defibrillator. No heart-valve replacement or bypass surgery. If I develop emphysema or some similar disease that involves frequent exacerbations that would, normally, land me in the hospital, I will accept treatment to ameliorate the discomfort caused by the feeling of suffocation, but will refuse to be hauled off.

“What about simple stuff? Flu shots are out. Certainly if there were to be a flu pandemic, a younger person who has yet to live a complete life ought to get the vaccine or any antiviral drugs. A big challenge is antibiotics for pneumonia or skin and urinary infections.”
————

Bio from article:

Ezekiel Emanuel is director of the Clinical Bioethics Department at the U.S. National Institutes of Health and heads the Department of Medical Ethics & Health Policy at the University of Pennsylvania.

——

Of course, AMA Delegates and the AMA Board know Dr. Emanuel well as he received the AMA Foundation’s “2013 Isaac Hays, M.D. and John Bell M.D. Award for Leadership in Medical Ethics and Professionalism” at the June 2013 Annual AMA House of Delegates.

See: http://www.ama-assn.org/ama/pub/news/news/2013/2013-11-18-ama-foundation-honors-physician-for-ethics-leadership.page

Comments by others on Dr. Ezekiel Emanuael’s article:

sonodoc99
@AmerMedicalAssn @DJPNEWS Dr. Emanuel stands Primum non nocere on its ear. http://t.co/4iO51DLCra
9/21/14, 8:16 AM

http://nypost.com/2014/09/24/a-pathetic-case-for-stopping-life-at-75/

http://pjmedia.com/ronradosh/2014/09/19/dr-ezekiel-emanuel-to-me-and-others-dont-live-past-75/?singlepage=true
…….

DJP editorial comment:  I disagree with Dr. Emanuel.

Dr. Emanuel’s article is his opinion.  But if the government adopts such an approach though the IPAB (Independent Payment Advisory Board) of PPACA or some other scheme yet to be devised, then we have a problem!  Dr. Emanuel is a chief architect of PPACA/ACA and you already know my views on that law: http://www.intrepidresources.com/html/PEJLSMS2010.pdf

My answer to Dr. Emanuel’s view is in my 6 Commandments of Medicine: S-E-C-C + 2.

Science – Ethics — Compassion – Courage and the +2 =

Is this in the patient’s best interest?

Do I have my patient’s informed consent?

I included the 6 Commandments in my commencement speeches to graduating medical students and other medical professionals at Tulane University Health Sciences Center (May 22, 2004), LSU Health Sciences Center New Orleans (May 18, 2002), LSU Health Sciences Center Shreveport (May 29, 2004), and Oklahoma University College of Medicine (May 27, 2006).

See one of my speeches containing the 6 Commandments at:

http://www.intrepidresources.com/html/commencement_address.pdf

May 18, 2002 LSU Health Sciences Center Commencement Address

Also published in Vital Speeches of the Day; 9/15/2002, Vol. 68 Issue 23, p764

These speeches were delivered during my time on the AMA Board 1996-2005 and as AMA president 2003-2004 and after.

I am 75 years old and I tell the medical students I teach at Tulane if some future government edict states people my age should be ignored and put on a gurney in the corner of the emergency department if they are in an auto accident, don’t follow the rule.  Show courage and leadership and follow the 6 Commandments.  I remind them it is the least they can do for a clinical professor who teaches them for free and it is the ethical act to do what is in the patient’s best interest, not the government or insurance company!

Throughout history there are people who seek to control, command, and remove liberty from others or use their view of ethics to justify their actions. America’s response has been to fight for freedom and individual self-determination.  Visit Arlington National Cemetery, the National Cemetery of the Pacific in Hawaii, or the Normandy American Cemetery and Memorial for powerful reminders of the price we paid for Liberty..  Remember, LIBERTY is the absence of coercion.

As for various views of ethics and how different results can be obtained using different ethical models, see my 1998 speech:  Hippocratic Oath:  Discarded Relic Or Living Soul of Medicine:

http://haciendapublishing.com/medicalsentinel/hippocratic-oath-discarded-relic-or-living-soul-medicine

Read the entire speech.  Here is an excerpt about the ethical models:

———-Excerpt——–
Let us not go quietly into this abyss, this new Dark Age, a Dark Age of medicine. Let us stand on principle. A revival of the Hippocratic Oath with reasoned discussion of what it means is a step away from the abyss.

We must understand what ethics mean. Never accept blindly a statement that something is ethical without reviewing the analysis that led to that conclusion.

For example, consider the following different ethical models:

• Deontological: rightness is not defined in terms of their consequences; violate no rights.

• Teleological: goal or consequence oriented.

• Social utility: greatest good for the greatness number.

After selecting one of these reasoning models, was an analysis done that considered the following? Autonomy, Nonmaleficence, Beneficence, Justice.

Each of these analyses has additional choices to make in order to complete the analysis. For example, to do the justice analysis, one must decide which of the following theories one will use: Egalitarian, Communitarian, Libertarian, Utilitarian.

Thus it is obvious that it is possible to reach different conclusions as to what is ethical and what is not depending on the ethical model used.

—————- End of Excerpt———–

If Dr. Emanuel is serious about the statements in his article, it would be a good idea for him to do a legal document, an “Advance Directive” (sometimes called a “Living Will”).  This gives instructions regarding medical treatment in the event an individual becomes incapacitated and is unable to instruct the doctors on treatment choices (or no treatment).  Others who wish to have relatives or a trusted friend make medical decisions also execute a “Durable Power of Attorney for Healthcare”.  Such a document turns comments in an article into reality.

2- DJP UPDATES:

Some doctors have contacted me and asked if they fell off my DJP Update blog because they have not received a DJP Update since July 7, 2014.  I informed them that I have not sent any since July 7.  I have been very busy and my spare time writing is on my novel plus Twitter postings, now up to 12,144 tweets as of September 26, 2014.  See @DJPNEWS

Remember, you always can view previous DJP Updates at http://djpupdate.com/

Another reason some individuals don’t receive the DJP Updates is because emails that have thousands of recipients frequently go to junk mail.  That can be avoided by selecting my DJP@intrepidresources.com email as a favorite and thus one not destined for junk mail.  Of course, if you want to get off of my DJP Updates, just put REMOVE in reply subject line.

—————
Stay well.

Donald

Donald J. Palmisano, MD, JD, FACS

Intrepid Resources® / The Medical Risk Manager Company

5000 West Esplanade Ave., #432

Metairie, LA 70006

USA

504-455-5895 office

DJP@intrepidresources.com

www.intrepidresources.com

www.onleadership.us

(Author of ON LEADERSHIP (2008, 2011 2nd edition) and THE LITTLE RED BOOK OF LEADERSHIP LESSONS (2012 & in bookstores and AMAZON now!)

DJP Updates:  www.DJPupdate.com

Twitter:  www.twitter.com/DJPNEWS

YouTube: http://www.youtube.com/user/IntrepidResources/videos  Check out the videos.

This DJP Update goes to over 2300 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.

You can share it with your members and it has the potential to reach 800,000 physicians.

To join the list, send me an email stating “Join DJP Update”

To get off the list, state ” Remove DJP Update” in subject line.

Read More