And now:Ish <[EMAIL PROTECTED]> writes: As so many of our friends and relatives are dependent upon the reliable availability of medicines for diseases such as diabetes, I am sending the following information through to the news letter. Hopefully, with sufficient mail to the appropriate authorities laws may be stretched to allow more individual monitoring of personal medical necessaries.. Ish +++++++++++++++++ Category: Health_Care Date: 1999-02-09 09:36:29 Subject: Physician Seeks State Authorization to Prescribe Extra Drugs in 1999 Link: http://www.y2kdoc.com/ Comment: A Tennessee physician sees what y2k shortages could do to his patients. He is seeking authorization from the state medical board to prescribe extra supplies of medication to people who are worried about y2k's effects on supplies. Authorization should be given by every state. It is indicative of just how far behind awareness campaigns are that this has not been done already. The problem is, bureaucracies move slowly when they move at all. Bureaucrats fear innovation. They fear embarrassment in case things don't turn out as predicted. So, I would not bet my life that such authorization will come in time. Then there is political envy. "If everyone cannot buy medicines in advance, no one should be allowed to." Most people will not be able to buy. There are not enough physicians and not enough slots in their appointment schedules. But since most people will not take action anyway, so what? Politics, however, operates on the basis of symbolism. I do not expect such authorization to come. But if it comes in one state, you might want to take a little trip. I'll monitor this matter. I hope the y2kdoc.com lists all states that authorize such sales. * * * * * * * * * . . . Given my experience thus far in trying to start the practice y2kdoc for the purpose of helping people obtain medicines (primarily antibiotics) in the event of disruptions due to y2k, the general public will need to exert some pressure in an appropriate manner on the medical profession. Otherwise, it is possible that human antibiotics might not be available to most people next year. The best way to do this, in my opinion, would be to contact your and my state Medical Board and your state representatives. I realize that many of you are focused on more important preparations right now such as food, water, and heat and probably have not given a lot of thought to obtaining medicines. You might be thinking that you would just talk with your doctor later or that acquiring a prudent store of medicines would be prohibitively expensive or cumbersome. Let me clear up both misconceptions right off so as to motivate you to begin preparing for y2k from a medical standpoint. First, as I will explain later, most doctors are not going to be willing to prescribe what I would consider to be a reasonable quantity of medicines unless there is pressure to do so in the near future. This is explained in more detail later in this piece. You have to lay the ground work NOW because there most likely will be a substantial lag time between your addressing this issue and your actually receiving the medicines, unless one of your best friends is a physician. And basic medicines for your family are within the reach of most budgets. I was just about to start a practice that would provide a family of four with basic antibiotics for about $100. For approximately $50 more, such a family could have purchased medicines to treat potential side effects of these basic antibiotics along with a local anesthetic used in repairing lacerations. Of course, newer and more effective antibiotics would be more expensive, but as you can see a basic package is fairly economical. . . . The purpose of y2kdoc is to help you, the general public, prepare for y2k in the event it causes disruptions in medical services. . . . I believe that in the event of disruptions in medical care, you are better off having these supplies on hand with information on how to use them appropriately than you are if you do not have them and they aren't available. The risk of your not having these supplies to use when medically indicated, I believe, far exceeds the risk of your using them inexpertly. In other words, I believe that you will do yourself far more good than harm in the long run if on occasion you happen to take an antibiotic when it might not be medically indicated than if you don't have the antibiotic to use when it is indicated. Infections that go untreated can cause a lot of suffering and even death. Ear infections can lead to meningitis. Strep throat can lead to rheumatic fever and kidney failure. Simple bladder infections can spread to the kidneys then to the blood and cause sepsis which usually overwhelms a person if antibiotics aren't initiated. Pneumonia, which nowadays is typically treated as an outpatient particularly for those in good health, can cause death if not treated in an appropriate and timely fashion. . . . These medicines were organized as follows: basic inexpensive everyone-should-have-and-can-afford-if-their-priorities-are-in-the-right-pla ce antibiotics secondary antibiotics (good to have around but not as essential) new broad spectrum (and more expensive) antibiotics antibiotics for biological terrorism medicines to treat the side effects of antibiotics local anesthetics recommendations for adult packages to fit various budgets - $50, $75, $100, and $150 per person recommendations for pediatric packages starting at around $35 recommendations for women who might be pregnant or nursing during y2k. . . . I had begun drafting other material pertinent for the web site such as why I am concerned about y2k as an average citizen and as a physician. I was pouring myself into this even while working full time in the ER (my wife and our kids visited her family for two weeks during that time). I even stopped watching the impeachment process. So what happened? I talked with the director of the State Medical Board after he had time to review the letter. He does not have the authority to grant permission for such a practice - only the actual Board does. And they meet only several times a year. The next time that they would be able to attend to this matter is March 16. In the meantime, I am to prepare an "advisory ruling form" for their lawyer to review beforehand so as to advise the Board before that meeting. I am hoping to gain an audience with the Board at that time. The director was not optimistic about approval for any mail order practice. He was well aware of the precedents being set now with telemedicine giving patients access to medical specialists all over the country and with mail order practices selling Viagra and Propecia. Times they are a' changing. I can think of no more effective way to get these needed antibiotics into as many hands as possible until the supplies run out or y2k arrives than harnessing the power of the Internet. But I also respect the Board that I am bound to professionally and will respect whatever decision they make. y2kdoc.com - the web site So what is going to happen now? At this point I feel that the best that I can hope for is that they grant me permission to open a conventional local practice seeing patients in person and prescribing a limited store of medicine. I imagine that I will be able to treat people who come from out of state since I already do this now occasionally in the ER. Such a practice is not as good as mail order but it is better than nothing. . . . If disruptions are so severe that you can neither purchase medicines nor consult your doctor, it is unlikely that supplies will be available for laboratories or X-rays so that actual diagnoses for various symptoms can be made anyway. In other words in a time of severe disruptions, even doctors are going to have to treat patients without in most cases being able to make an actual diagnosis (they do this now in third world countries). . . . What can you do to increase your chances of having access to these medicines? Write or fax my state Medical Board, your state Medical Board, and your state representative. . . . The medical profession needs to be alerted that people might become desperate over the issue of medical supplies during y2k since their lives might literally depend on it. I do not want there to be a backlash against my profession. Help to alert the profession by writing my state Medical Board and yours. The director told me when I talked with him that the Board would look on my request more favorably if it were backed up by a lot of support from the public. You know, sometimes great things can be achieved with just mustard seed type faith and persistence. This is where you can make a difference. When you write to my Board, address it to: Board of Medical Examiners Re: y2k concerns 1st Floor Cordell Hull Building 425 5th Avenue North Nashville, TN 37247-1010 Fax: (615) 532-5369 You can find the address for your state Medical Board at http://www.fsmb.org/members.htm. In my opinion, if people do not literally bombard their state Medical Boards NOW with letters requesting that doctors be allowed to prescribe antibiotics now for possible future use, most people will not be able to get human antibiotics before y2k arrives. And please, bombard nicely, remembering that "the tongue of the wise makes knowledge acceptable." Let me explain why people will not be able to get these medicines before y2k. Some doctors might be willing to make an exception to a few of their close patients and prescribe a store of medicines to them. Yet prudent doctors will not make this a routine part of their practice. If they do, they will attract the attention of the local medical community who will likely report these practitioners to the State Medical Board. The Board would probably then discipline this doctor or perhaps even revoke his or her license. Even disciplining is a permanent blemish on a doctor's record and could affect hospital privileges now and the doctor's ability to obtain a license in another state in the future. Most doctors are not willing to take that risk, myself included. Besides this, there are many compelling other reasons that most doctors will not assist their patients in making preparations, some of which are listed below: Doctors are at least as far behind on the y2k information curve as the general population and most right now will consider patients making such requests a little whacko. The average doctor visit lasts only about 10 minutes. This is not enough time for patients to educate their doctor about y2k and certainly not enough time for doctors to prescribe 5 or 10 different medicines and educate their patients about how to use them. Doctors can't bill insurance companies for the visit as there would be no billing code for disaster preparedness. Some insurance companies even put restrictions on doctors' accepting payment outside of their plans. There is tremendous liability in prescribing these medicines and most doctors are not going to have their lawyer craft a carefully worded waiver of liability and present it to their patients. Certainly without promised impunity from the State Medical Board, no prudent doctor will make prescribing a store of medicines for their patients a routine part of their practice, especially considering the other reasons listed above. Many of you, I suspect, have recognized this and have already bought or plan to buy veterinary medicines, particularly antibiotics. This is certainly your choice, and if I didn't have access to human medicines I might consider doing the same. But I don't think it is right that you are put in the position of having to decide whether or not to give your children animal antibiotics. There is still time to convince the Medical Boards to go on record as permitting doctors to prescribe medicines in a professional and responsible manner for y2k preparation. But the Boards will not do this unless there is a public outcry for it. And in my opinion if this message doesn't get to them in the next several weeks, it will probably be too late because most Boards only meet several times a year and are notoriously slow in making such policy decisions. If Boards don't grant doctors impunity in prescribing stores of medicines, the advice that many y2k sites so easily give about "storing medicines particularly antibiotics" will not be achieved by most people. I beg you to do your little part as I am trying to do my little part. Link: http://www.y2kdoc.com/ &&&&&&&&&&&&&&&&&&&&&&&&&& Tsonkwadiyonrat (We are ONE Spirit) Unenh onhwa' Awayaton http://www.tdi.net/ishgooda/ &&&&&&&&&&&&&&&&&&&&&&&&&&
