Monthly Archives: October 2009

President Obama’s Position on Health Care

10/6/09

Revised: October 5, 2009 @ 10:45am

Recently, I had the opportunity to listen to Barack Obama’s powerful speech on the topic of health care in the US. Although the American President has many detractors with regard to this and other programmes, I am increasingly impressed with his actions, articulated through his words.

Unlike most politicians, his messages are clear, consistent and realistic, despite the often rhetorical stylistic positioning of the media and the opposition.

Most importantly, he has instilled a “sense of reason” and expressed the need for action – “now”. In stressing these factors, he has managed to push special interest groups out of bounds or at least off centre stage. He is addressing issues that have been bounced around over the past century by almost every president on the election stump, items which generally die a rapid death shortly after elections are over. In the past, almost all US presidents have capitulated to vested interests, however Obama has made it patently clear that he will not follow that road. As is appropriate, he is insistent that the time to act on these issues is now and whereas solutions may be elusive and require time to achieve – a beginning is paramount. This appears to be his main focus and I concur with that sentiment entirely.

Last week, I had occasion to treat an ex-cabinet minister and impressed upon that individual the need for all politicians to address and resolve important issues, rather than speaking out of both sides of their mouths, while saying nothing. As most of us understand, politicians focus on the moment, i.e. the polls, getting elected, staying elected and doing what is expedient or politically correct. Moreover, they sometimes appear to be in political office only to pursue their own agendas, including generous pensions, prolonged vacations, extensive staffs and privileges, along with overly generous budgets for the purpose of self-indulgence.

Obama, in less than one year in office, has differentiated himself from the norm. Moreover, I am amazed by the energy and ongoing motion that he continually generates. As I frequently state to some of my co-workers, “to succeed, you must commit to your job, address issues, find solutions and implement them.” That is the formula for success. Unfortunately, in my experience, less than 10% of the workforce adheres to this code and it is refreshing to see a leader do so, particularly at the highest level. I feel that this is the impetus that the US and the entire world needs and as a global figure – he will establish a standard for others. Leadership must not only be seen but heard and to pursue and complete important agendas, rather than engaging in endless, non-focused discussion, is critical.

During his address, Mr. Obama stressed certain items that previously seemed to be perpetually lost in the shuffle. One – that insurance companies should not be practicing medicine, i.e. making decisions regarding best practice decisions, once upon a time determined by properly trained medical consultants. Two – that insurance companies could no longer make inappropriate exclusions for treatment, which are arbitrarily established unilaterally and brook no protest from the victims.

These two items alone have in large part prevented adequate medical care being provided to patients over the last fifty or more years. That insurance companies by fiat and other questionable methods (control of the purse strings) are able to enforce self-interest rules, while governments idly stand by is outrageous; therein lie many of the problems in health care systems throughout the world, no matter who controls, provides or administers. Ideally, health care services should offer the best possible therapy for the patient’s condition, to the exclusion of all other considerations. The Obama approach might not achieve that initially but will certainly be a major step in the right direction, one that has regressed significantly over the last twenty-five years, despite the plethora of technological advances.

As a final comment it should be noted that the increasing reaction to Obama’s directives, most of which I deem appropriate, including the health care solution is typical of how unpopular the truth has become. Indeed, it appears to have become almost unpalatable. This is demonstrated daily in the media, the courts and the prevalent political forums. Often, what we know to be the truth is so distorted or even repudiated that falsehoods become the norm. As has been previously stated, “The lie oft repeated becomes the truth.” Much of the opposition to Obama is based on that mentality and this too needs to change. Whereas I do not idolize individuals, I am still able to recognize the truth and will always support it. All those capable of thinking independently should be similarly inclined.

TREATMENT OF DEGENERATIVE OSTEOARTHRITIS OF THE KNEES

10/5/09

National Post Article

THE TREATMENT OF CHOICE FOR DEGENERATIVE OSTEOARTHRITIS
OF THE KNEES

October 2, 2009, Fred Kahn MD, FRCS(C)

I recently read the enclosed article in the Financial Post September 30, 2009. Whereas the article in its context
is largely correct and points out a significant number of alternative therapies for the treatment of degenerative
osteoarthritis of the knees, it misses out on the most important option of all.

Before I proceed with this commentary, I should state that degenerative osteoarthritis of the knees affects over
30%of the adult population over 50 years in age. It is particularly prevalent in athletes who have played contact
sports both at the amateur and professional level. In those instances, the process is accelerated and often
becomes symptomatic in the early and mid 40’s.

With all due respect, medications both oral and injectable have not provided a solution nor as the enclosed
article indicates, has surgery. Knee replacements, when they work, are more than satisfactory but in a significant
percentage of cases, they result in failure. (I.e. pain, inflammation and the ability to be ambulatory). Sometimes,
this is followed by the insertion of a replacement prosthesis, again with less than desirable results.
At our clinics, these unfortunate patients present, not infrequently and unfortunately it is not possible for them to
return to their pre-surgical state.

From the therapeutic perspective, we have been utilizing Laser Therapy over the past 15 years and out of over
200 knees treated on an average annualized basis, less than 3% have required replacement surgery. Often, we
see patients who are already scheduled for surgery and are allowed 3 to 4 weeks to prove the effectiveness of
Laser Therapy. Almost invariably, we succeed. Why this approach should not be more widely used is therefore
difficult to understand.

Several years ago, I circulated a letter to every provincial health minister in Canada requesting that their ministry
permit us to treat 100 knees waiting for knee replacement. I indicated that these could be rehabilitated at a cost
of less than $2,000.00 per patient, significantly less than continuing procrastination or pursuing the surgical
route. Not one health minister responded. Despite this, we continue to treat individuals suffering from this entity
on a daily basis and achieve consistent, outstanding results. Whereas I am exasperated with this current state
of affairs, I wonder what can be done to rectify this situation in a constructive manner.

In conclusion, I can state unequivocally that the treatment of choice for degenerative osteoarthritis of the knees
is Low Intensity Laser Therapy. Surgery, if required on rare occasions, can always be performed at a later date.