Wednesday, December 23, 2009

Customers at the hospital or at the doc's office

In the US, we have witnessed a change of view regarding health care. We are no longer considered "patients," although that is what we have to have in order to get through the medical maze. We are now considered "customers." Meaning we are entering a business relationship when we enter the hospital or go to doctor's office. We present our credit cards or cash (quick care clinics do not take checks) and we may get two or three minutes of undivided attention for our medical problems. As customers, the motto is "let the buyer beware." But the problem is as customers we don't know the language of the seller, nor does the system seemingly allow the buyer any negotiating power. The customer is often in a powerless position of pain and fear. Sometimes the customer is a child or a baby. A child or a baby is even more powerless than an adult upon entering our health care system. Sometimes the child or baby is caught between the medical system of "knowing best" and the parent who believes they know the "best." Add to this mix, our health care system which is now powered by "business" principles. Customers, or patients as they use to be called, believe they have entered a system of care. The reality is they have entered the marketplace. But not a marketplace of choices. Your healthcare professional speaks Greek to you and has a fixed gaze upon his or her watch--you have 15 minutes. Your chart they hold, looks like a Webster's Dictionary that seems to have the answers entombed within the pages. Solutions seem fixed upon drugs, vaccinations, and surgical procedures. You may spend hours in the waiting room. In fact it has the feel of the hours you spent at the auto dealers negotiating for a car. You feel trapped by their time warp. They give you minutes but hold you for ransom in their offices for hours. A pathetic system disabling to all, encluding the health care profession.
I suppose many think that this health care bill will be enabling to all of us, "customers." Instead I fear, that it will be more of the same, only worse. If we are perceived as customers in healthcare then it would seem imperative that we have full disclosure of how the people in healthcare and their institutions receive funding. If we are customers, then we should have more choices not less. Yet the healthcare system creates a helpless customer. How can the buyer beware at the doctor's office or at the hospital, when the buyer does not understand the language nor the rules? We call it Healthcare but it is just another business.
Copyright 2009 Valerie W. McClain

Tuesday, December 22, 2009

Job Fair--wanted infant formula or breast pump reps

I just happened to run across an advertisement for a job at JOBcentral entitled, "neonatal academic sales associate" for Mead Johnson. The job requirements eliminate me. It would not be a job I would ever consider, nor would the infant formula industry want me. I would be a poor sales person--I don't schmooze very well. Anyway the requirements are a BA/BS degree--got that!! Minimum 2 years medical sales--nope, not even successful selling lemonade on a hot day. They are looking for a neonatal dietician, RD, Pharm D or NICU RN preferred. I think I'd make a good neonatal dietician--breastfeed, breastfeed, breastfeed. Wait a minute I don't think that's what they want?? Besides they prefer a NICU RN. In the job description it says, "develope and cultivate business relationships with a wide range of key decision makers and targeted customers within the Hospital setting." WOW...schmoozing 101. Not my style...yeah my style is to irritate the hell out of friends and enemies alike.
Another statement, "Build profitable business in the NICU and Academic Hospital Community which will maximize long term revenue goals, increase sales, and market share growth for nutritional and pharmaceutical products."
Here's another job description statement, "Understand the role of Professional Services and network with appropriate HCP's (healthcare professionals) to grow attendance at Mead Johnson Nutrition's national and regional sponsored events." So......this explains to me why NICU babies don't breastfeed. Oh yes need I forget, they do sometimes human milk feed. (yes I know there are many wonderful people out there working to help moms breastfeed their premmie babies--but they are out-gunned by industry). Medela (breast pump company) recently announced their "Virtual Human Milk Collection Campaign Awards." Medela donates $20,000 in Neonatal Human Milk Support Products to Neonatal Intensive Care Units in Mississippi, Oklahoma, Pennsylvania and New Mexico. Human milk support products, human milk support products, human milk support products, human milk support products---think they mean bras??? Oh yeah I sure am silly this morning, I guess they are talking about all the gadgets to "help" the medical staff or maybe mothers humanmilkfeed babies. Don't need products to breastfeed, no not really although we have created a culture of women who believe they need "products." Sounds to me like the NICU is the target of a vast sea of industries selling their wares--how the heck do medical people get their work done. Oh yeah, the target is the power brokers in the hospital. I would be interested in seeing data on breastfeeding rates (initiation, duration) of NICU babies. By breastfeeding I do not mean humanmilkfeeding. Funny, I use to think hospitals were about saving people from medical disasters. I never ever thought about the sales force behind the decision making of products in the hospital. What drug you get, what bandage you receive, what infant formula or humanmilk supplement your baby gets is dependent on what industry has the best sales force. Ever met an infant formula rep or breast pump rep? They all are good-looking, well-dressed, and very intelligent and they know how to schmooze.
Yep, I can't look at a hospital without seeing the legends of sales men and women waltzing through the doors. I can't look at a doctor without thinking about who is her or his favorite sales person. That does not negate that their are life-saving products. Just that we should be aware that health care is an industry like any other industry. Let the buyer beware.
Copyright 2009 Valerie W. McClain

Sunday, December 13, 2009

World Health Organization: hiv and breastfeeding

In November of 2009, the WHO (World Health Organization) issued a document called, "HIV and infant feeding: Revised Prinicples & Recommendations." There was alot of jubilation from breastfeeding advocates who believe this is a breakthrough document encouraging hiv positive mothers to breastfeed exclusively. Well..................yes, the recommendation is, "mothers known to be HIV infected (and whose infants are HIV uninfected or of unknown status) should exclusively breastfeed their infants for the first 6 months of life, introducing appropriated complementary foods thereafter, and contine breastfeeding for the first 12 months of life." But the recommendations also state that "HIV infected mothers to either breastfeed and receive ARV interventions or avoid all breastfeeding." This recommendation is not directed at developed nations like the US. In fact there is a scary comment regarding "highly resourced countries." "In some of these countries (highly resourced) infants have been removed from mothers who have wanted to breastfeed despite being HIV infected and even being on ARV treatment. In these settings, the pursuit of breastfeeding in the presence of safe and effective alternatives may be considered to constitute abuse or neglect." So if you are a hiv-infected mother living in Africa you can breastfeed your baby as long as you take meds. If you are a hiv-infected mother in the USA, you will be considered abusive or neglectful if you breastfeed your baby. Geography is the key to recommendations regarding breastfeeding and hiv. Does this make any logical sense? Does this clarify the situation? One way or another, this issue makes enormous profits for the pharmaceutical and infant formula industry (which often are one and the same companies). For information on studies regarding the safety of these drugs for mothers and babies readers may want to go to the website of Alberta Reappraising AIDS Society:
I would highly encourage breastfeeding advocates to read the beginning of this document regarding the declared interests of the writers of this document.
The writers and researchers have financial ties to: Nutriset, Bristol Myers (infant formula and pharm company), Centoceor, Johnson & Johnson, Ortho Biotech, Ortho-McNell Janssen, Purdue Pharma, Roche, Sanofi-Aventis, Schering Plough. But boldly they state, "The Group unanimously agreed that none of the declared interests were likely to influence the discussions of the meeting." So by making this statement the readers are to believe that how one is funded makes no difference? Years ago, I believe no one could have gotten away with such statements. But now one can make such statements and the document gets hailed as a breakthrough because it recommends that hiv positive women in resource-poor nations breastfeed. Of course they can only do so as long as they take meds. And now we have an international document that states that hiv-infected mothers in resource rich nations are abusive if they breastfeed. I call this a serious step backwards and one that needs to be questioned. Why should we believe that this decision was not influenced by the pharmaceutical and infant formula industries?
Copyright 2009 Valerie W. McClain

Saturday, December 5, 2009

Dr. Luc Montagnier, human milk, and oxidative stress

"Immunotec Congratulates 2008 Nobel Prize Winner in Medicine, Dr. Luc Montagnier." He won the prize for his 1984 discovery of hiv. Immunotec is a company that sells a product called Immunocal, which is a protein isolated from whey. see
In this long advertisement, they mention that Montagnier (along with two others) edited a book called, "Oxidative Stress in Cancer, AIDS and Neurodegenerative Diseases," (1997) A chapter in this book is called, "Nutriceutical Modulation of Glutathione with a Humanized Native Milk Serum Protein Isolate." Humanized native milk??? Hm.....methinks they are talking about human milk proteins (made by a cow)? Cloned milk? One way to get human milk proteins is to genetically engineer the embryo of a dairy cow to produce such substances as lactoferrin, alpha-lactalbumin, etc. Normal cows make very little lactoferrin or alpha lactablumin. One biotech fix for that is to create a cow that makes human proteins.
So we have a nobel prize winner in medicine, whose name is being used by a company to support the use of whey proteins in the treatment of hiv/aids. exactly why aren't hiv positive mothers allowed to breastfeed in the USA? Oh yeah, I forgot, we have a man-made genetically engineered whey protein that imitates human milk proteins to treat hiv/aids. The belief is that breastfeeding transmits disease? The scientists say that the mammary gland manufactures proteins to prevent or treat disease. Yet somehow when it comes to hiv/aids that system doesn't work and instead we should buy the imitation human milk proteins. Fascinating how we debunk nature/breastfeeding and place our beliefs on the altar of our science gods. So we go out and buy us some denatured whey protein but we spurn breastfeeding.
Copyright 2009 Valerie W. McClain

Pregnancy, Florida law, hiv tests, and informed consent

Florida Statute 381.004
Back in 2005 the Florida legislature created a law in which informed consent for testing of sexually transmitted diseases (hiv in particular) is not a requirement. This was not directed at all people in Florida but at certain people. First on the list was "persons convicted of prostitution or procuring another to committ prostitution, then inmates, and then pregnant women. Also mentioned was that a medical examiner did not need informed consent for autopsies or investigations. Thus in the land of Disney World, a paradise of sand & sun, tropical flowers and fruits, pregnant women are denied informed consent along with convicts and prostitutes. What does that say about Florida legislators and their belief systems? Do we believe that pregnant women are not deserving of informed consent because they need to be controlled like convicts and prostitutes? If you carry another human being in your body, the state feels you have no legal right to informed consent? Is pregnancy a deviant behavior--since the list includes people who break the law? What were these legislators thinking? Shouldn't a pregnant woman be informed that because she is pregnant she is more likely to have a false positive hiv test? If you break the law and are convicted, it is understandable that you would lose your civil liberties for a time. But how does a pregnant women fall into this category of law-breakers?
Copyright 2009 Valerie W. McClain