NEW YORK (MainStreet) — When Doug Pitman, M.D., sold his private practice to a hospital group 16 years ago, he had to see more patients, which meant less time with them. Eventually, he moved on and became a concierge doctor.
“There is no substitute for time spent with patients,” Pitman says. But this time squeeze is all part of a larger trend.
“Hospitals continue to acquire primary care practices at an increasing rate,” says Chip Harvey, a sales and service consultantat Corporate Benefits Service, a third-party administrator of employer sponsored health benefit plans.
Acquiring practices increases the clout of hospital-owned physician practices “and their negotiating power withinsurance companies,” Harvey says. However, as a consequence, these primary care doctors “lose their independence because they are required to refer patients who need specialist treatment or diagnostic services … only to specialists and diagnostic centers that are also owned by the hospital,” he says.
That close tie appears to affect how much patients are billed.
Researchers at Stanford University examined about 2.1 million claims from non-elderly privately insured individuals from 2001 through 2007. They found that hospitals that owned physician practices had higher prices. The study was published in the journal Health Affairs.
The researchers note that “hospitals may still be sharing profits with physicians who opt to treat patients at more costly facilities or with more costly procedures than is medically appropriate.”
Thestudy didn’t look at the effect of hospital-owned physician practices on patient health outcomes.
Actor Robert Downey Jr. has enjoyed a four-decades-plus career with two Academy Award nominations, three Golden Globe wins, numerous other award nominations and wins, notably starring as Tony Stark in Iron Man, Sherlock Holmes in Sherlock Holmes, and he is currently married to Susan Downey and has two sons (one from a previous marriage).
Downey Jr. has had a troubled history of his own with addiction issues. Early on in 1982, he dropped out of Santa Monica High School to pursue acting full time. His father, Robert Downey Sr., himself a drug addict, exposed his son to drugs at a very early age, and Downey Jr. would go on to struggle with drug abuse for decades. The actor’s drug-related problems escalated from 1996 to 2001, leading to numerous arrests, rehab visits and incarcerations, and he was eventually fired from the TV series “Ally McBeal.”
” To a large extent, his [Robert Downey Jr.] myriad problems were the legacy of a recklessly liberal upbringing by his parents, underground film-maker Robert Downey[Sr.] and Elsie, his actress mother, in bohemian Greenwich Village, New York…His father cast his son in his first film, the avant-garde comedy Pound, at the age of five…But Downey Sr was a notorious drug addict and one day, as he watched the eight-year-old Robert drinking the white wine he had given him, he offered to let him try a cannabis joint.”
Emerging clean and sober in 2003, Downey Jr. climbed out of that big hole and built up his career with Gothika, Good Night, and Good Luck. A Scanner Darkly, Tropic Thunder and the films of the Iron Man, Avengers and Sherlock Holmes franchises.
In 2005, Downey Jr. married Susan Downey, who gave birth to their son, Exton Elias Downey, on February 7, 2012. Downey also has another son, Indio Falconer Downey, born September 7, 1993, from his first marriage to Deborah Falconer, from whom he was officially divorced in 2004.
Sadly, TMZ reports that the oldest child of Robert Downey Jr., Indio, has been arrested. Downey Jr. released the following statement to TMZ:
“Unfortunately there’s a genetic component to addiction and Indio has likely inherited it. Also, there is a lot of family support and understanding, and we’re all determined to rally behind him and help him become the man he’s capable of being. We’re grateful to the Sheriff’s department for their intervention, and believe Indio can be another recovery success story instead of a cautionary tale.”
Robert Downey Jr.’s son was arrested for cocaine possession in West Hollywood Sunday afternoon, law enforcement sources tell TMZ. Indio was observed smoking something out of a pipe according to the website.
An L.A. County Sheriff’s deputy pulled the car over, did a search and allegedly found cocaine in Indio’s possession. He was arrested and taken to jail for possession of cocaine.
Indio, 20, posted the $10K bail and was released just after midnight Sunday.
Frequent contributor to Monsters and Critics in the area of addiction is expert Akikur Mohammad, M.D., the CEO and founder of Inspire Malibu Treatment Center. Dr. Mohammad is a board-certified psychiatrist with a second board certification in addiction medicine. In addition to his role as Inspire Malibu’s CEO, Dr. Mohammad is Adjunct Clinical Associate Professor at Keck School of Medicine at USC where he is active in teaching medical students and residents the subject of addiction medicine and psychiatry.
Dr. Mohammad tells Monsters and Critics: “Robert Downey’s Jr.’s son drug possession arrest underscores that drug addiction is a chronic disease. Numerous scientific research studies support the fact that drug, and alcohol, addiction is a chronic disease with a strong genetic component, just like every other chronic disease including asthma, diabetes and heart disease.
“It’s disheartening that the young man’s disease is being sensationally publicized. After all, would we be throwing him into the limelight if it were discovered he had diabetes?
“The bottom line is that alcohol and drug addiction are chronic diseases. The debate on whether they or not is over. All the leading health and medical organization in the U.S. and worldwide support this contention, including the American Medical Association and the World Health Organization. But like every chronic disease, substance abuse addiction can be successfully managed with evidence-based treatment that includes medication, counseling and lifestyle modification. Robert Downey, Jr., is the greatest testament that a sufferer of alcohol-drug addiction can lead a successful, productive life.”
In the course of the 11 years writing for Monsters and Critics, I’ve interviewed top board certified plastic surgeons such as Dr. Constantino Mendieta, considered the finest butt man around and the author of the Art of Gluteal Sculpting. Dr. Nicholas Nikolov of Beverly Hills, whose deft hands gave many Hollywood stars beautiful noses and breasts.
They both told me the same thing, a great deal of their work was revisional surgery from botched procedures by other doctors, often times cosmetic surgeons who were unqualified. They saw heartbreaking things and did their best to restore bodies to a normalcy for their patients. It was their most satisfying work next to fixing a child’s face from congenital deformity or someone battered or scarred in an accident.
Enter a reality TV series that stars two of LA’s top board certified plastic surgeons, Dr. Paul Nassif and Dr. Terry Dubrow, who we came to know in “The Swan” and “The Real Housewives of Beverly Hills.” These two talented physicians have joined forces for E!’s new series “Botched” which premieres Tuesday, June 24 at 9:00pm.
You will see some retreads from TLC’s Strange Addictions, the Plastic Surgery freakshow Barbie Boy who has money coming from somewhere (he lives in his underwear so you do the math), a poor woman with her frustrated husband tired of her uniboob, and other unfortunates who bet the farm and pulled up weeds.
World renowned doctors Paul Nassif and Terry Dubrow
World renowned doctors Paul Nassif and Terry Dubrow — the best of the best and leaders in their field — will be tasked with some of the most difficult operations of their careers when they try to reverse the effects of horrendous plastic surgeries.
For the first time on television, plastic surgery nightmares become dreams come true when “Botched” premieres Tuesday, June 24 at 9:00pm ET/PT only on E! and moves to its new day/time Sundays beginning June 29 at 10:00pm following plastic surgery fans “Keeping Up With the Kardashians.”
In the premiere episode airing Tuesday, June 24 at 9pm, both doctors team up to fix some of California’s worst surgical results when they set their sights, and their scalpels, on Alicia, a woman suffering from what’s known as a “uni-boob,” and Michelle, an actress who’s had six surgeries in search of the perfect nose. Plus, the doctors make a house call to one of the Internet’s most talked about plastic surgery addicts, the human doll, Justin Jedlica.
Episode Description: Human Dolls (6/24/14)
Plastic surgeons Terry Dubrow & Paul Nassif treat a woman with a uni-boob, an actress who’s had 6 surgeries in search of the perfect nose, and make a house call for Justin, a self-proclaimed human doll.
Clip 2: Meet the doctors
Clip 3: Alicia “uniboob” meets the doctors for her consultation.
Clip 4: The doctors’ visit Justin “human ken” at his home to go over his possible surgery.
Pope Francis, born Jorge Mario Bergoglio of Argentina, was elected the 266th pope of the Roman Catholic Church in March 2013, becoming Pope Francis. He is the first pope from the Americas.
Now he is speaking out on something that is troubling him, the growing relaxation of marijuana laws in the western world especially in the USA.
“Drug addiction is an evil, and with evil there can be no yielding or compromise,” he told participants at the International Drug Enforcement Conference in Rome.
But like the church’s hardline stance on divorce, many Americans are not in agreement with Rome. Public sentiment isn’t with him; most Americans are voting in favor of legalization. In South America, countries like Uruguay have legalized marijuana.
Colorado and Washington state have made marijuana use legal, and in California, Nevada, Oregon, Maine, Massachusetts, Vermont, Connecticut, Rhode Island and Alaska it is legal if you get a doctor’s approval and the laws for pot were reduced. Several other states, cities and countries have decriminalized its use or have announced plans to do so. There are states like Texas and Florida where pot is illegal still.
Akikur Mohammad, M.D., is the CEO and founder of Inspire Malibu Treatment Center. Dr. Mohammad is a board-certified psychiatrist with board certification in addiction medicine, Psychiatry and Neurology. He tells Monsters and Critics, “Smoking is generally a poor way to deliver medicine. As a doctor, I assure you that it is almost impossible to administer safe, regulated dosages of medicines in smoked form. Morphine, for example, has proven to be a medically valuable drug, but no responsible physician endorses smoking opium or heroin.”
“However, to address the Pope’s statement regarding recreational marijuana… addiction has been around as long as humankind. It is a typical religious approach that addiction is EVIL, but science had proven that all addiction is a brain disease. However, in some patients, spirituality or religion may help to manage and overcome their addiction. I always advocated decriminalization but not complete legalization of drugs like marijuana.”
Dr. Mohammad adds, “Nicotine is legal around the world and the most common preventable cause of death worldwide, Nicotine kills more people than alcohol and all other drugs combined. Let’s educate the public!”
The golden years, a time for easy living and to kick back and enjoy the slower pace deserved after a lifetime of schedules and the 9-to-5 treadmill.
But did you know that for many people, deviating from this routine of work, managing the home and raising children to one with lots of unstructured time on their hands can present some huge problems especially if those people are predisposed to addiction issues and never fully realized it until their senior years?
Addiction specialist Dr. Akikur R. Mohammad, MD sees many patients over the age of 55 who find out the hard way that they cannot handle alcohol or pain medicine and maintain their sobriety.
They turn to him for medically supervised detoxification and learn how to manage time, activities and their social lives so that they do not fall into bad habits and relapse.
Dr. Akikur Mohammad, M.D.,
Dr. Mohammad, founder of Inspire Malibu, considered an elite medically-based addiction rehabilitation center, tells Monsters and Critics’ readers to watch for these five flashpoints and offers some recommendations:
UNSTRUCTURED TIME
“When someone has no routine, they get lazy and slip into bad habits, letting physical routines slide and sleeping too much. A little structure can go a long way,” says Dr. Mohammad.
ISOLATION
“Letting social situations and friendships slide and go by the wayside. This is the time to reconnect and join groups and clubs, reach out and volunteer. Extend yourself, get involved with your church or synagogue or civic center. Find a cause, whether it is helping tutor children with special needs, fostering abandoned animals, communal gardening or volunteering at the local library or museum, these activities will net new friendships and keep your brain active.” says Dr. Mohammad.
DAILY DRINKING
“Not having to work tomorrow lets many retirees drink every day; for those who are prone to addiction it all catches up with them. Don’t look for excuses to minimize alcohol consumption. Daily drinking is an insidious and harmful habit. Drinking alone is another dangerous habit,” says Dr. Mohammad.
DEPRESSION
“The worry, fear and progression of age, illnesses, and the older you get the more your close relations pass away, leaving you to feel badly about it. It’s not easy, but don’t let yourself succumb to negative news about parents, uncles and aunts, siblings, childhood friends. Try and keep your network of friends and social outlets up to date and work at keeping in touch with people, even when you don’t feel like it, it does help to talk,”says Dr. Mohammad.
PAIN
“Living with chronic pain and aches takes a toll. The lack of mobility, the lack of quality sleep and constant pain are a huge issue. Senior ailments such as painful hips, knees, arthritis all offer an opportunity to abuse addictive pain medications. There are gentle exercise treatments like Tai Chi and Yoga that can help eradicate pain and in time strengthen atrophied muscles. Massage and swimming also are excellent options to explore,” says Dr. Mohammad.
Dr. Mohammad suggests that all seniors keep connected through family and community and faith groups, and buddy up in their neighborhoods. There are senior centers in many cities, and he urges adult children to actively help their parents find and connect with these useful resource hubs that are excellent directories for even more information and qualified help:
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