August 10, 2011

LCT breaking new ground in cell therapies

Rather than reprinting the newsletter, I will direct you to it and let your read it. Living Cell Technologies is fast out pacing the rest of the world in cell therapies for diabetes and may soon have products in Japan, China, and other countries.

The biggest plus is the lack of need for the use of any immunosuppression. As a person with type 2 diabetes, this is still very exciting news and especially for those that are type 1 and hypoglycemically unaware.
I am posting this on both of my blogs.

August 9, 2011

Access to Urgent Psychiatric Care Severely Limited

Even with good medical insurance, medical care in the USA is becoming more difficult to obtain. Discrimination is part of the cause as shown by my blog here. Now the state of Massachusetts is coming up wanting and this in the field of psychiatric care. See my blog here about concerns of the psychiatric profession. If this is the actions of the psychiatric profession, they may end up with more problems than they can deal with.

While this is only a preliminary study, it points out what is happening in the medical community. Outpatient psychiatric care for even those with good private insurance can go wanting when it comes to treatment. Even if referred by other doctors or emergency departments, care is not always available – and this is the Boston area. So you can imagine what conditions can be like in other large metropolitan areas and then go to the more rural areas and it can only get worse.

To find out how bad conditions are, Dr. Boyd and his team posed as patients insured by Blue Cross Blue Shield of Massachusetts PPO, the largest insurer in Massachusetts. They called every in-network mental health facility within a 10-mile radius of downtown Boston, claiming that they had been evaluated in an emergency department for depression and then discharged with instructions to get a psychiatric appointment within 2 weeks.

The calls resulted in only eight appointments and of these only four were within the recommended two-week time period. Even more alarming 15 of the facilities never even called back, despite two telephone calls. Another 15 facilities were unavailable because they required that the patient be currently enrolled with a primary care physician affiliated with their psychiatric facility.

Psychiatric care is a money loser for institutions so they limit the amount of services they offer. I like the analogy Dr. Boyd used to compare psychiatric care to a hip replacement saying that the surgeons would fly you in from out of state to do the hip replacement.

Read the article here.

August 8, 2011

Depression – Under-diagnosed, Antidepressant Use Up

I am seeing a host of articles about diabetes and depression the last few weeks. While I am appreciative that diabetes and depression is receiving some of the attention that it needs, I am more than a little concerned about the article that appeared last week (August 4 and August 5). What is behind the study and what is the intention of psychiatrists?

Psychiatrists are concerned about the number of antidepressant prescriptions without a psychiatric diagnosis. The number of non-psychiatrist doctor visits where antidepressants were prescribed without a documented psychiatric diagnosis increased from 59.5% to 72.7% between 1996 and 2007, according to a new study published in Health Affairs.

Experts not affiliated with the study caution that there are many possible, and plausible, explanations for an increase, and that depression remains largely under-diagnosed and under-treated in the U.S. The study does include many conditions for which antidepressants are being prescribes such as diabetes, heart disease, and nonspecific pain symptoms.

The drugs prescribed to patients without a diagnosed mental health condition were more likely provided to white women between the ages of 35-64 and patients with public insurance and chronic medical conditions, such as diabetes and heart disease.
I am not surprised by this as it is what happened to me and I'll admit I rebelled, but my heart doctor was ready and willing to explain why he had prescribed them. With the number of people that have heart problems and diabetes that are at risk for depression, it was and is still a sound medical decision.

Now if the psychiatrists are going to insist on making a diagnosis before these medications are prescribed, I doubt many people will even go to that visit. I know that I would have passed. Depression was not something talked about in my family when I was growing up and one of my uncles firmly believed that these doctors were mislead and did not understand human nature.

If the psychiatric profession wants to continue to claim that depression is under- diagnosed and psychiatrists are under-utilized, then they have to do some serious image mending and change some ways that they do business. Mental health issues are finally coming out of the closet and being recognized as having some valid health concerns.

I will conclude by saying the psychiatric profession will do a lot of damage if they become contentious about non-psychiatrists prescribing antidepressants for conditions known to cause depression. True, not everyone with heart disease or diabetes suffers from depression or even 100 percent that have both chronic conditions. Still, I have to be concerned about psychiatrists becoming overly concerned and wanting a piece of the action when they are creating other problems.

Please watch for a coming blog tomorrow, titled “Access to Urgent Psychiatric Care Severely Limited”.

Read three articles about this here, here, and here.