nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
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Monday, January 19, 2009


Army relied on unlicensed mental-health counselors to evaluate soldiers.


The AP (1/15, Hefling) reports that the Army relied "on unlicensed counselors before" its "policy was changed to exclude them in 2006." During "the early years of the war, the Army rushed mental-health counselors to the combat zone even if some weren't certified or fully qualified," and allowed "unlicensed psychologists and other examine soldiers provided they were supervised by licensed professionals."


Doc D: This is media hype.  ALL clinical psychologists in the United States, once they receive their degrees, must do a year of supervised care.  It’s just a requirement they have to fill before they can receive their certification.  Residency trained neurosurgeons have to do practice (unsupervised) for two years before they can take their board exams.  These psychologists aren’t “unlicensed”, they are in the process of earning it.  And they were supervised, just like they’re supposed to be:  this means that another doctor is looking over their shoulder to review their actions.  This is how patients get treated back home.  I’m not sure why the Army stopped sending them to the war zone; probably it’s a result of improved availability (or the Politics of Perception).


But notice the language the Associated Press used to report this…the scare words, trying to manufacture a controversy.


Rates of pneumococcal meningitis fell after introduction of vaccine, data indicate.

USA Today (1/15, Szabo) reports that data appearing in the Jan. 15 issue of the New England Journal of Medicine indicate that "meningitis cases have fallen sharply since the introduction of a vaccine for children in 2000." Specifically, "rates of pneumococcal meningitis, an inflammation of the membranes around the brain caused by bacteria, dropped 64 percent in children under age two from 1998-1999 to 2004-2005." But the vaccine's benefits are not just for infants, because "with fewer contagious babies to spread germs, fewer older kids and adults are getting sick," according to study co-author Nancy Bennett, M.D., of the University of Rochester School of Medicine and Dentistry.

        In fact, "incidence 54 percent in those older than 65," HealthDay (1/14, Gardner) added.


Doc D:  Vaccines are the number two most important medical advance in human history (after sanitation).  The benefits accrue not only to the immunized individual, but also to everyone else, as these data show.  This is not new, and is a standard principle in epidemiology.  But, we have to keep demonstrating this to the upscale, college-educated, New Age parent, who thinks that only “natural” (a poorly defined term) is good.  That’s right, the folks who fight hardest against vaccination are not the poor and ignorant, but those who should know better.  For some reason, they are the ones who are most vulnerable to “nutritional” cures for cancer, pyramid power, bogus reports of vaccine “horrors”, and treatments with magnets.  They’re the ones most likely to credit the sound bite scare tactics (Remember Meryl Streep on the use of alar to preserve fruit?  “These are your children!”)  Back in the 1950’s there was free-floating anxiety about The Bomb and invisible radiation.  Now, there’s a similar worry, containing the same paranoid component, about the government, and synthetic products.  What the next generation will see as The Big Threat, I don’t know.  Cyberspace, maybe.


In my opinion, parents who don’t have their children vaccinated, on time and on schedule, should be prosecuted.  I recognize no legitimate religious exemption or civil liberty that allows them to harm their children, or the rest of us, through their inaction.  The only exception is demonstrated (not “fear of”) life-threatening allergy…something I’ve never seen, but admit may occur.


Child health bill would benefit, and cost, Texas


Texas stands to gain more than any other state from the plan quickly making its way through Congress to boost the number of children who have health insurance. But the measure would also hit thousands of Texans hard in the pocketbook because it's being paid for with one of the biggest cigarette tax increases in history.


Doc D:  This is the Democrats’ SCHIP legislation, endorsed by the President.  For non-smokers, taxing cigarettes is a no-brainer.  The complication is that the data show that the cigarette tax hike hits the poor much harder than anyone else, since they tend to be the ones more likely to smoke.  If that isn’t a problem for you, then consider that it’s not clear that smokers will make a rational choice between their cigarette habit and paying for food, clothing, shelter and healthcare for themselves and their families.  They don’t call these “addictions” because they’re choices.


I don’t object to so-called “sin” taxes, or Value-Added Taxes (VAT) that are used world-wide (except US).  We just need to think through WHO we are taxing.  Put a tax on yachts, if you want to.



Medical quote of the Day:

If he [my next-door neighbor] is to be allowed to let his children go unvaccinated, he might as well be allowed to leave strychnine lozenges about in the way of mine. –Thomas Huxley [1825-1895]


Doc D

Opinions are entirely my own.  Quotations from Kaiser Daily Health Policy Report ( © Kaiser Family Foundation), PND News Briefs – Texas Edition ( © 2008, Physician's News Digest, Inc.), AMA Morning Rounds (© U S News Custom Briefings), and other sources in the public domain.  As always, you may share this column, with appropriate attribution (here and in the text) included.





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