July, 2013

Herded through the Grapevine

By Michael J. Katin, MD

Early this month, The Guardian published an interview with Edward Snowden, a technical contractor with the National Security Agency, revealing that for the past several years all of our conversations on Verizon and many other means of communication were being intercepted and studied by our government. This did not come as much of a surprise to the conspiratorially-minded among us, and maybe indicated that not all conspiracies theories are only theories.

Most of these revelations were missed by the American public due to the contemporaneous events surrounding the Kim Kardashian-Kanye West baby birth and the NBA playoffs. Of those people who actually heard about Edward Snowden, the consensus was that most conversations were banal to the point that it was not only fairly useless but also extremely painful to eavesdrop on them. This was especially true since any items of any relevance whatever were voluntarily being revealed on Twitter and Facebook anyway, meaning that the millions (or billions) of dollars spent by the NSA could have been better applied.

Is it actually troubling to learn at this time that the government wants to be in on all our conversations, text, and e-mails? After all, we have only a little more than another year until the deadline for implementation of electronic health records (EHR ) before penalties are assessed. At that point, unscrupulous persons will be more easily able to find out about everyone's medical history than about his or her credit card accounts. Of course, there will be safeguards to keep that from happening.

What is the main goal of this disruption of privacy? The main reason, of course, is to expedite the total domination of humans by reptilian aliens but is it possible that this will also allow more efficiency delivery of health care, and, particularly, treatment of cancer?

Initial estimates that EHR implementation would save at least $3.5 trillion dollars annually were somewhat optimistic. There have been many explanations for why things did not go as planned, ranging from the fact that there were too many incompatible systems, to the reluctance of practitioners and hospitals to accept change, to global warming. Remarkably, by 2011 about half of all practitioners were making efforts to convert to EHR, compared to not even 30 per cent of hospitals!

It was unexpected that Edward Snowden would divulge the NSA's activities and this may have set back efforts to know everything about us. It remains to be seen what happens to Mr. Snowden; certainly those of us in the medical field know how to take care of leakers. Nonetheless, once implementation of EHR is widespread it doesn't really matter if any other information is able to be accessed. Not only will all of our health records be available, but medical records may contain information on gun ownership, psychological disorders and unusual hobbies.

Until the NSA programs are curtailed, we as radiation oncologists may be able to benefit from accessing their information. It might be beneficial to be able to find out how we are regarded by medical oncologists, urologists, and other physicians as well as by hospital administrators when they speak with each other. Perhaps we can find if there is truly an effort by academics to wipe out community-based private practice. Wouldn't it be informative to know what equipment and pharmaceutical vendors truly think about their clients? Maybe some things are best left to the imagination.

In the meantime, I, for one, will continue to be as honest and outspoken as usual in my conversations, texts, and e-mails, content in the knowledge that we can depend on Janet Napolitano, the most intelligent and competent Secretary of Homeland Security in our nation's history, to safeguard our confidentiality. We can celebrate the fact that we will not have to have this concern while practicing medicine as we have been for years, for the good of the patient and without regard for our own self-interest or reward. As I mentioned in my telephone conversation at 8:44 pm on June 17, we will continue to use only cost-effective and evidence-proven techniques regardless of the way the fee schedule is set up and will not even consider the techniques that our colleagues in hospital-based practices use to exploit and abuse the system.

From: Mkatin@notmkatin.net
To: Schumer@senate.gov
Subject: Amazing
June 15, 2013 10:38 AM
Isn't it phenomenal what a fabulous job Marilyn Tavenner is doing as head of CMS? It's good to see she was finally confirmed by the Senate to get the job after she's been acting administrator for so long. It's remarkable how she can be so talented and knowledgeable. May I also mention what a fine job you're doing and please keep up the good work.

#ThirdTermPlease Is it true there's no Nobel Prize for Genius? I guess not, since President Obama would have won that one, too. Every year.