Friday, July 26, 2013

An Open Letter to Patient's With Pre-excited Afib and Ischemic VT

Dear Mr. or Ms. Patient With Pre-excited Afib or Ischemic VT:

I just wanted to let you know, if you come to our ER, you are screwed.  Currently, our best drug to deal with your arrhythmias of pre-excited atrial fibrillation (afib) or ischemic ventricular tachycardia is not available anywhere: procainamide.  It seems the one drug company who makes this drug (Hospira) has a few manufacturing delays (oops), so the drug is on backorder

So come ready to have your heart shocked. 

Hopefully we'll have some analgesic or anesthetic drugs available in our pharmacy that aren't on backorder so you won't feel your cardioversion.

Wishing you the best, as always...

-Wes

5 comments:

  1. This has to be Obama's fault, right?

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  2. In response to "Anonymous": seriously? You want to blame the President because some people in a private company didn't take care of their company? We don't blame the President when their is bug in Microsoft Windows? Why is it when there is any problem in Medicine the first person everyone wants to blame is the President? Many problems can be traced to local management mistakes.
    I am glad that control of the business of medicine is being taken over by the business community. Last I checked, business management was not taught in medical schools. Why do physicians think that being an expert in one field (medicine) automatically makes them an expert in another field (business management)? We don't ask the accountant with an MBA to manage HIV treatments; why should an untrained person try to run the business of medicine? Maybe we should credential those who want to run the business side of medicine and then we will realize, "Hey they don't have the right training to do this." If a physician wants to run the business side of a practice, go get the training.

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  3. Actually, anon # 2, I think anon #1 was making a slight dig at Dr. Wes, who has made no secret of his concerns about the Affordable Care Act. His concerns are justified if one will remember one of the first comments made about the ACA: "We will read what is in this bill AFTER we pass it."
    With respect to the medicine/business relationship, I think after reading so many of this blogger's columns, I can safely say that it is NOT business running the business side of medicine that concerns him. It is the fact that a business mind set has crept into the medicine side of medicine. When a human being is viewed solely from a cost/benefit perspective, you will get denial of treatment, rationing, age/treatment discrimination..as in the following two examples: Birth defects? Abort because the child is going to be a financial drain on society. Hip replacement at 85? Why? You have already exceeded the actuarial chart estimations of normal age at death. Again..you will be a financial drain. These are legitimate concerns and, yes, the leader of a country has some responsibility for the consequences of all decisions, even if only to speak publicly about said consequences..intended or otherwise.

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  4. My wife is a home healthcare pharmacist, mostly preparing various IV drugs for people to infuse at home. There have been multiple shortages of a variety of drugs over the last year, from simple potassium solutions to important antibiotics. They end up doing a lot of extra work and running around trying to work around them. I know from my job that at least some of these shortages are caused by the manufacturer's efforts to have "just in time" delivery of their materials. There is no back up inventory to pull from. If delivery of a single item is late, the whole line stops. After all, inventory is a cost and that would reduce profits and that might effect the stock price and that in turn could reduce the value of the CEO's stock options.

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