I am sitting here in my white lab coat with dirty sleeves (from use), thinking that there is no reason for a practicing physician to support the current health reforms before Congress.  Patients are going to have a rude awakening when their new insurance cards don’t give them the kind of access to doctors they are expecting. Doctors are too frustrated and marginalized to play ball with the president. Here are the reasons that every doctor I know is vehemently against Obamacare:

*  No comprehensive tort reform. Most surgeons I know are struggling with a constant fear of malpractice claims. Most have had at least two or three frivolous lawsuits in their careers to contend with. Most have spent hundreds of hours with lawyers going over the fine print of their records only to have the case settled. Most surgeons are now opting out of accepting insurances in order to afford their malpractice premiums which are often close to $100,000 yearly. Caps on pain and suffering are only one part of the problem.  32 states have some kind of tort reform already, but there needs to be a consistant federal mandate or doctors will hop from state to state.  In California, when caps of $250,000 were instituted, doctors’ premiums did not decrease until a second law compelled insurers to transfer savings to physicians. Nuisance suits can be blocked by creating boards of doctors and lawyers to review cases before they are brought (these boards already exist in Tennessee and Michigan). “Loser pays” statutes can be added (doctors win the vast majority of suits) so that liability insurance companies won’t force doctors to prematurely settle claims to avoid large legal fees.
*  The bills before Congress all include large Medicare cuts. The Baucus bill would cut Medicare by $500 billion over a decade. This will lead to cuts to hospitals who will then be compelled to cut patient services and doctor salaries. The moratorium for not cutting doctor reimbursements across the board by 21% as Congress is supposed to do is not likely to last. Medicare cuts to doctors will cause more to quit or game the system. A changeover from fee-for-service to bundled payments, as the Baucus bill envisions, will leave many doctors out in the cold when they are denied payment for a service that is considered unnecessary or redundant.
*  The growing doctor shortage – the Association of American Medical Colleges calculates we will be 125,000 doctors short by 2025 – does not leave us with the manpower to take care of an additional 30 to 40 million patients. Doctors will be more rushed than ever.          
*  The extension of Medicaid to 10 million more people as the Baucus bill proposes will be a disaster for doctors. Consider that Medicaid often pays doctors less than $10 per office visit. 50% of doctors don’t take Medicaid, and states have already been cutting Medicaid payments to hospitals because most states are having trouble funding Medicaid. Medicaid networks of services and service providers within hospitals are being cut, making it impossible for doctors like me to take care of these patients (we have nowhere to send them for services or procedures).

We doctors are being squeezed, marginalized, ignored, and criticized. Of course we aren’t happy. Of course we feel that it will impact our patients’ care.      

If there is a hardworking doctor out there who thinks the current health reforms are good for doctors or America, I don’t know her.

Dr. Marc Siegel is an internist and associate professor of medicine at the NYU School of Medicine. He is a FOX News medical contributor and writes a health column for the LA Times, where he examines TV and movies for medical accuracy. Dr. Siegel’s new Ebook: Swine Flu; the New Pandemic, will be published in early October. Dr. Siegel is also the author of “False Alarm: The Truth About the Epidemic of Fear“ and “Bird Flu: Everything You Need to Know About the Next Pandemic.” Read more at www.doctorsiegel.com

There are several reasons why I believe that most doctors are unhappy with the direction that health insurance reform is taking. I address several of these reasons in my oped in today’s NY Post (September 23rd, 2009). I will also outline them here. Suffice it to say that adding more patients to the health care turnstiles and promising them access to quality physicians when there is a growing doctor (and nurses) shortage and a growing doctor (and nurse) discontentment is problematic at best. The blanket of health insurance that Congress and the president envision is not long enough to cover the body of health care. If we pull it down to cover the toes, the head will be exposed. If we stretch it to cover the uninsured without dealing with cost or the doctor shortage, we will end up taking care away from those who currently have it and need it (the elderly and the disabled to name two groups who are endangered). Remember, physicians who aren’t functioning well have a negative impact on health care.

Reasons for doctor discontentment:

• No meaningful tort reform is included in any of the current bills under consideration in Congress. No shared liability with insurances or the government, no caps on pain and suffering, no review boards to limit nuisance suits, no “loser pays” allowance, despite the fact that physicians win the vast majority of suits.
• No significant subsidies to primary care education, despite the fact that there has been a decline in those choosing primary care of over 50% over the past decade.
• Big cuts to Medicare and Medicaid payments to doctors and hospitals of hundreds of billions of dollars in the bills, despite the fact that doctors are already cut to the bone in terms of increasing expenses and decreasing reimbursements.
• Cuts in payments for procedures and mechanical devices will put more pressure on doctors as patients express their (deserved) discontent, and there is nothing a doctor can do.

Dr. Marc Siegel is an internist and associate professor of medicine at the NYU School of Medicine. He is a FOX News medical contributor and writes a health column for the LA Times, where he examines TV and movies for medical accuracy. Dr. Siegel’s new Ebook: Swine Flu; the New Pandemic, will be published in early October. Dr. Siegel is also the author of “False Alarm: The Truth About the Epidemic of Fear“ and “Bird Flu: Everything You Need to Know About the Next Pandemic.” Read more at www.doctorsiegel.com

I read an interesting article today reporting the findings from a poll that seriously contradict what the White House and the AMA have been suggesting about the way medical professionals feel about the proposed bill to overhaul the health care system. And while I can’t say I’m surprised at the overwhelming negative response to the plan – the statistics speak volumes.

An IBD/TIPP poll found the following:

– 45% of doctors polled said they would consider leaving their practice or retiring early if the proposed health care bill was to pass

– 65% or 2 out of 3 practicing physicians polled say they oppose the plan

– 72% of doctors polled disagree with the administration’s claim that the government can cover 47 million more Americans with better quality care and at a lower cost

Click here to read the full article

I think there’s some truth to this study – and here’s why…

Right now, doctors are caught between a rock and a hard place and we have very few alternatives – many doctors have already started moving to other parts of the country where there is less government regulation on how they run their practice. What we are finding – and will continue to find with this health care bill looming – is that doctors have already started dropping their private practices and taking hospital jobs. Many are changing specialties or plan on not offering certain procedures because of strict government regulation once we move toward a universalized health care system – and for those doctors to perform procedure using local hospital facilities, well, that costs money, too. We’ve been facing a primary care doctor shortage for years now, and the numbers continue to drop. All of these things have a negative impact on the quality of care patients receive.

So I want to do a little research of my own. I want to hear what YOU think – especially if you’re a doctor or in the medical field. How do you feel about the proposed bill and do you think that it will cause doctors to leave the medical field?

Make your voice heard! I’ll be reading some of your comments on FOX & Friends tomorrow morning at 6:30 a.m. E.T., where we’ll be discussing this report in more depth.

In the current push for national health insurance, expensive overuse of technology based on the defensive practice of medicine by doctors is being overlooked. Yet doctors often over-order tests and treatments for fear of missing a remote diagnosis. Doctors are afraid of being sued by the same aggressive trial lawyers who lobby Congress against real reform. Keep in mind that it isn’t just a dreaded error like removing the wrong kidney that motivates doctors to practice defensively, it is the fear of lawyers and having to meet with them as part and parcel of responding to arbitrary lawsuits. Doctors who have done nothing wrong can be targeted with frivolous suits that drag them into the lawyer’s office. The process of having your records scrutinized in an effort to determine how well you’ve documented things and if you’ve made errors can be instructive, but it can also be humiliating. This process can alter the way a doctor practices as he or she struggles to avoid the nightmare of legal exposure in future.

Though 98,000 people die in U.S. hospitals every year from medical mistakes, at the same time according to a recent Harvard study, 40 percent of malpractice lawsuits are not legitimate, though they lead to 15 percent of the money paid out. Often times the doctors who are sued did nothing wrong, while those who make mistakes too often escape retribution.

Most malpractice cases are won by doctors, but not before they endure the protracted painful process of meeting with lawyers. Many doctors quit medicine or become even more defensive and order more and more unnecessary tests as a result. I remember when the best urologist and one of the top cardiologists at my hospital quit practice abruptly because of extended lawsuits where they weren’t at fault.

On the defense side, lawyers may milk doctors for billable time, and on the plaintiff side, ambulance chasers thrive, creating and exploiting frivolous cases for profit. Many patients get unnecessary operations because of defensive medicine. C-section is on the rise and is vastly overdone because of doctors fearing lawsuits. There is a culture of fear that motivates doctors to practice defensively, which causes costs to skyrocket.

With the possible rationing of care that may occur in the name of cost control under an expanded system, malpractice could skyrocket as more and more tests and procedures are denied yet doctors continue to be blamed when something goes wrong. It is especially problematic that neither insurers nor the government have direct legal responsibility while at the same time turning down tests. Most doctors are too busy and too scared of being singled out to band together to protest this uneven system.

What is the solution? One solution is to create state review boards like Michigan or Tennessee to limit frivolous lawsuits. Doctors and lawyers can serve on these boards together and provide a barrier to nuisance suits. More peer review in the hospitals is also a good idea, regular mortality and morbidity conferences where doctors behavior is examined without the direct fear of lawsuits.

Capping pain and suffering awards would seem like a simple enough solution, but some patients truly deserve a high reward if they’ve been badly mistreated by a physician (as when the wrong organ is removed or a diagnosis is blatantly missed). A better initial approach is to target nuisance suits for destruction.

It is estimated that tort reform can lead to an initial savings of 2% on health care costs, without even considering the billions of dollars that will be saved by decreasing the defensive practice of medicine (based on overuse). But even with tort reform, the current plans for health insurance reform combined with decreased reimbursements to hospitals and doctors will lead to more and more patients being seen in shorter periods of time. This will lead to more and more medical mistakes, and more and more malpractice.

There hasn’t been much of a push yet to combine tort reform with the current health insurance reform initiative being considered by Congress. This could change. The Democrats could decide to add some tort reform (probably Caps to pain and suffering) as a sweetener to a bitter pill (or bill). This might cause more physicians to support the current health reform, but would do nothing to correct the larger problem of physician dissatisfaction, overwork, attrition, and scarcity, all of which lead to medical mistakes.

Plus, simply capping pain and suffering is not a guarantee that doctors will see their liability insurance premiums lowered. In California in the 1980s, when a cap on pain of suffering to $250,000 was first initiated, there was no overall savings to physicians. Instead, the insurance companies made more profits. It took an additional law to ensure that the savings was transferred to physicians in terms of lower premiums.  

It is the current insurance-oriented climate for practicing medicine that must be changed before doctors (and their patients) will reach any kind of comfort level or be able to cut costs in a reasonable way. Insurance of both kinds (private and public) is the problem, not the solution. Costs spiral upward because of doctors’ fear of malpractice and rush to see more and more patients in a short period of time amid shrinking reimbursements. The easiest way to do this if you’re a primary care doctor is to quickly refer a patient to a specialist of for an expensive test, jacking up costs. At the same time, patients are inclined to overuse their health insurance because they don’t pay for each procedure or as many have put it, because patients don’t have any “skin in the game.”

Tort reform is essential and must include not only caps on pain and suffering and reflected decreases in liability premiums, but also a way to ferret out nuisance suites. I am in favor of more peer review in the hospitals as well as a lawyer and doctor staffed board in every state to review claims before they are brought. I strongly believe that private insurance companies as well as the government (Medicare and Medicaid), should incur liability themselves for tests they decline.

But I do not think that any of this should be done as a way to manipulate physicians to support a kind of health reform that is not in our best interest, or in the best interest of our patients.

Dr. Marc Siegel is an internist and associate professor of medicine at the NYU School of Medicine. He is a FOX News medical contributor and writes a health column for the LA Times, where he examines TV and movies for medical accuracy. Dr. Siegel is the author of “False Alarm: The Truth About the Epidemic of Fear“ and “Bird Flu: Everything You Need to Know About the Next Pandemic.” Read more at www.doctorsiegel.com

While the Obama administration pushes for national health insurance, expensive overuse of technology based on the defensive practice of medicine by doctors is not being considered at all. Doctors over order tests and treatments for fear of missing a remote diagnosis. Doctors are afraid of being sued by aggressive trial lawyers who lobby Congress against real reform.

Though 98,000 people die in U.S. hospitals every year from medical mistakes, at the same time according to a recent Harvard study, 40 percent of malpractice lawsuits are not legitimate, though they lead to 15 percent of the money paid out. Often times the doctors who are sued did nothing wrong, while those who make mistakes too often escape retribution.

Most malpractice cases are won by doctors, but they suffer a long-extended process first where they must meet with lawyers. I know many doctors who have quit medicine or become even more defensive and ordered more unnecessary tests as a result. I remember when the best urologist and one of the top cardiologists at my hospital quit practice abruptly because of extended lawsuits where they weren’t at fault.

On the defense side, lawyers milk doctors for billable time, and on the plaintiff side, ambulance chasers thrive, creating and exploiting frivolous cases for profit.

Many patients get unnecessary operations because of defensive medicine. C-section is on the rise and is vastly overdone because of doctors fearing lawsuits. There is a culture of fear that motivates doctors to practice defensively, which causes costs to skyrocket.

With rationing of care that is inevitable under the Obama health care reform, especially with a public option, malpractice will skyrocket because tests and procedures will be denied and doctors will be blamed. Yet we doctors are too busy and too scared of being singled out to band together to resist.

What is the solution? One solution is to create state review boards like Michigan has to limit frivolous lawsuits. Doctors and lawyers can serve on these boards together and provide a barrier to nuisance suits. More peer review in the hospitals is also a good idea, regular mortality and morbidity conferences where doctors behavior is examined without the fear of lawsuits.

Capping pain and suffering awards would seem like a simple enough solution, but some patients truly deserve a high reward if they’ve been badly mistreated by a physician (as when the wrong organ is removed or a diagnosis is blatantly missed). A better approach is to target nuisance suits for destruction.

Dr. Marc Siegel is an internist and associate professor of medicine at the NYU School of Medicine. He is a FOX News medical contributor and writes a health column for the LA Times, where he examines TV and movies for medical accuracy. Dr. Siegel is the author of “False Alarm: The Truth About the Epidemic of Fear“ and “Bird Flu: Everything You Need to Know About the Next Pandemic.”  Read more at www.doctorsiegel.com

On May 21, 2009, Linda Fleming, a woman with terminal pancreatic cancer, took a fatal overdose of medications prescribed by her physician to end her life.  She thus became the first person to commit suicide under the “Death with Dignity” law that passed the state legislature November 4, 2008 and took effect during March.

The law in Washington State is modeled after one that has been on the books in Oregon since 1997.  About 400 people have ended their lives through physician-assisted suicide in that state.

Under the assisted suicide law in Washington, a patient who is terminally ill and legally competent and who two physicians agree has only 6-months to live, can request lethal medication.  The request needs to be made verbally on two occasions, 15 days apart, followed by a written request witnessed by two people.  The medication is dispensed by a pharmacy.  Patients take the medication themselves, rather than having a doctor administer it to them.

I’ve counseled people battling fatal illnesses.  I’ve watched a friend struggle against cancer.  I’ve told family members in ICUs and ERs that their loved ones have died.  So I know how much pain can come at the end of life, when an illness takes hold. 

I understand where the desire for a law like Washington’s comes from.  It’s a tribute to human empathy that lawmakers resonated with the suffering of terminally ill patients enough to pass it.  But I wouldn’t have voted for it myself. 

Alleviating the suffering of 400 or so patients since 1997 in Oregon has carried a pretty high price tag.  It has opened the door to thinking of the medical profession not entirely as one devoted to prolonging life, but as one that is also empowered to help end lives.  And this can leave patients feeling as though they ought to consider suicide when they are given terminal diagnoses.  They ought to be reasonable, not just with what they are willing to go through, but with what they put their families and friends through.  They ought not expend health care resources needlessly in their final months.  Their clinicians aren’t only thinking about what treatment options to provide, after all.  They’re thinking about other patients who have elected to forego treatment and hasten death. 

I fear the law can also take away some of the motivation of doctors to “pull a rabbit out of a hat” and save a patient’s life.  There’s a reason you wouldn’t want soldiers going into battle who are also trained in the etiquette of surrender.  You’d worry it might unconsciously take away their edge, chip away a little bit at their determination to take that hill.

At present, the criteria which must be met under the Death with Dignity Law sound rational.  But laws are not static entities.  Now that the door to physician assisted suicide is open, the Death with Dignity law could be amended in the future, perhaps to include those who might not die for twelve months, or longer.  How about those who suffer unbearably from medical conditions that will only worsen over the years?  If we are willing to use the medical profession to help end the lives of those who have but six months to live, how about those who become quadriplegic and say they cannot bear it?

It is psychologically and spiritually perilous to do harm to the magnificent will to live that keeps us fighting for another day.  And it is no less dangerous to blur the mandate of physicians to try to win that fight, however daunting, however seemingly futile.  The physician’s white coat has meaning—to doctors and their patients.  It must remain a bright beacon of the healing powers of the profession, not a flag of surrender to the inevitable.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His newest book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement. Check out Dr. Ablow’s Web site at livingthetruth.com.

The topic of anal cancer has gotten a lot of media attention lately because of Farrah Fawcett’s very public battle with the disease. And it’s raised a lot of important questions about advances in cancer treatment and the future for patients fighting the battle of their lives.

What is anal cancer and who is at risk for it?

Anal cancer is characterized by the growth of a tumor around the anus ― which is opening at the end of the intestinal tract — and it’s completely different from colon cancer. A large proportion of anal cancers have tested positive for human papillomavirus (HPV), which is a sexually transmitted disease, but this isn’t the only cause.

Other patient populations at a greater risk for developing anal cancer include patients with multiple sexual partners, those who participate in anal intercourse, smokers, people with immunosuppressive diseases, such as HIV, and people with chronic inflammatory bowel diseases.

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What is the treatment for anal or intestinal cancer?

If it’s caught early, the most common treatment for anal cancer is surgery. But in patients whose cancer affects the anal sphincter, having surgery to remove the tumor and cancerous cells can lead to fecal incontinence causing the need for a permanent colostomy. So often for these patients, radiation and chemotherapy may be the preferred course of treatment. For later stage anal cancers, doctors treat patients with a combination of radiation and chemotherapy.

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What is the cure rate for anal cancer?

Well ― like any cancer, early detection greatly increases the chance of survival. If it’s caught in the early stage, there is an 86 percent five year survival rate. If the cancer has spread to the lymph nodes, the survival rate decreases to 54 percent. Up to 10 percent of patients treated for anal cancer will develop cancer elsewhere in the body.

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What kind of advances are we making in cancer research?

We have made advances with regard to the surgical treatment of cancers by offering minimally invasive surgeries. In some cases, we’re able to provide surgical treatments with less negative side effects and shorter recovery time. Clinical studies have shown that other treatments like radiation and chemotherapy may be just as effective as surgery without many of the negative side effects.

With regard to medical treatments, there have certainly been advances in the kinds of treatments we’re using. New medical technologies are making it possible for doctors to individualize a patient’s treatment by studying the genetic makeup of their particular cancer — ultimately decreasing the chances of recurrence or spread of the cancer, and increasing a patient’s survival outcome.

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What are the major milestones/accomplishments we’ve seen in cancer research recently?

Well again, one of the major milestones is being able to identify the genetic makeup of cancers individual to each patient.

The other advancement is the research that’s been done in molecular-targeted therapies. These therapies target the development of cancers by inhibiting the growth of the disease at the cellular level — which we hope will be able to limit or potentially even stop the cancer from spreading.

Molecular-targeted therapy is a more specific treatment than chemotherapy, because chemo treatment kills off not only the bad cells — but also the healthy cells in the body. So with a therapy that is very specific in its attack of cancerous cells, the hope is that it should more be effective in stopping the development of the cancer.

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What are some tips for preventing cancer?

We’ve all heard it time and time again — good health comes from making healthy choices. So my first tip would be stop smoking! I’m sure I don’t have to tell you, cigarettes are full of cancer-causing agents and have been linked to the development of many cancers in the body.

Second, everything in moderation including alcohol! If you’re the kind of person who enjoys a nice cocktail, make sure you do it in moderation, which means 1 or 2 glasses — preferrably of red wine — or else,  just avoid alcohol all together.

Make healthy dietary choices. Try to maintain a diet rich in omega-3 fatty acids and fruits and vegetables. Both provide essential nutrients and antioxidants which help ward off disease. Limit the amount of read meat you consume, since high levels of it have been linked to certain cancers.

Recent studies have shown that vitamin D may play an important role protecting against the development of certain diseases. Because exposure to small amounts of sunlight causes the body to produce healthy amounts of vitamin D, people who live in cold environments or places with extended seasons of darkness may want to consider getting their vitamin D levels checked and taking supplements.

And finally — know your family history so you can better determine your risk for other cancers, because your screenings for certain cancers may start earlier than what is recommended to the general population, and preventive therapies may be an option for you.

Dr. Cynara Coomer is an assistant professor of surgery specializing in breast health and breast cancer surgery at Mount Sinai Medical Center in New York City. She is a FOX News Health contributor providing medical expertise on a variety of topics in cancer research with a focus on women’s health, breast diseases and tips for healthy breasts at any age.

Infuriated by a deteriorating economy and blatant abuse of American taxpayers, the public is taking a strong stand to prevent banking executives from getting away with fiscal robbery. What many have failed to realize is that another industry — the health insurance industry — is getting away with murder, perhaps literally, by putting their bottom lines above your welfare, and this time it could be hazardous to your health.

Across the health care community from doctors to pharmaceutical companies to hospital organizations, steps have been taken to implement ethical standards. Codes of conduct are hardly a new idea. Most are self-imposed by professional organizations or trade groups on their members, often in an effort to voluntarily level up their members’ general behavior, especially in the wake of legal or political scrutiny. For example, the pharmaceutical industry substantially revised its code governing interactions with health care professionals after public and professional criticism. Managed care organizations, however, are the only remaining hold-outs that have not adopted a Code of Conduct, leaving them highly unsupervised. Sadly, the very companies Americans often think help pay their bills are undercutting the quality of American health care in their pursuit of a fatter bottom line.

The game works like this: Health insurers’ profits increase as outlays for patient costs decrease. One such way to keep patient costs down is by prescribing generic drugs over name-brand drugs. In a practice known as drug switching, patients are switched from more expensive, name-brand drugs to generics, even if the name-brand drug was working and the patient experienced no negative side effects.

Managed care companies go to great lengths to make sure the switch appears innocent — a doctor is trying to help a patient reduce his or her medical expenses, and therefore recommends the generic. However, behind the closed doors of invite-only dinners and receptions hosted by managed care organizations, many doctors are lured into drug switching programs that offer attractive fiscal incentives, and there is no mechanism in place to regulate these practices.

Doctors are paying the price as well. In a survey done by the Toledo Blade last year among Ohio doctors, ninety-five percent of respondents said insurers interfered with decisions about prescriptions, 91 percent with testing, 74 percent with referrals, and 69 percent with hospitalization decisions. Eighty-six percent said interference compromised patient care, 76 percent said it adversely affected their patients, and 65 percent said they were unable to successfully protest denials. Most shockingly, 14 percent believed interference from an insurer had contributed to the death or serious injury of a patient.

This prompted a response from our now President:

“I am deeply troubled by The Blade’s report of how insurance companies, not doctors and nurses, are making decisions about patient care,” said Senator Barack Obama in a statement to The Blade. “Medical decisions should be made based on what’s good for your health, not what’s good for an insurance company’s bottom line.”

As managed care organizations seek to maximize profits and survive the economic downturn, the public can likely expect increasing use of cost-driven practices. These aggressive tactics must stop, and a comprehensive Health Insurer Code of Conduct must be implemented by which managed care organizations agree to abide by ethical standards such as transparency, clinical autonomy and, most importantly, patient safety and welfare.

The best Rx for every American is access to quality health care and medicine. It’s time to ensure the health insurance industry puts your safety before profits.

For more information about the National Health Insurer Code of Conduct go to: www.insurepatientaccess.org.

Fox News Health Tips:

• Know your medicines. Talk to your doctor about your prescriptions. Are they generics or brand names? What are they supposed to do? Are there less-expensive options? What are the risks and benefits of taking the drug?
• Be on guard. If anyone wants to switch your prescription, ask why. Will the new drug interact with existing medications?
• Appeal. With your doctor’s help, use your health plan’s appeals process to seek coverage for your desired medication.

I can’t believe it took more than two years to charge the physicians involved in the case of Anna Nicole Smith’s death. It really shocks me that it took so long for these investigators to connect the dots.

Even from the preliminary data, it is evident that prescription medication had clearly played an important role in the cause of her death.

In fact, according to an Associated Press report, investigators found 11 prescription medications in her hotel room the day she died. More than 600 pills — including about 450 muscle relaxers — were missing from prescriptions that were no more than five weeks old when she died, and most of the drugs were prescribed in the name of Howard K. Stern, her lawyer-turned-companion. And actually, none of them were prescribed in Smith’s name.

So it makes me wonder, how is it possible that it took almost two years for charges to be brought on these doctors?

If you look at the confidential fax that was sent in September of 2006 by Dr. Sandeep Kapoor, the list of medications is a “who’s who” of narcotics, sedatives and sleeping medications and there is no scientific or chemical way that all of these drugs can be tolerated by the human body. These drugs are highly addictive and mixing them is basically the equivalent of a loaded gun in the hands of a child.

There’s a whole list of drugs she was on including: Four bottles of 2 mg Dilaudid; 2 milliliter bottles of Lorazepam (Ativan); two bottles of 350 mg Soma, a total of 180 tablets; one bottle each of 30 mg Dalmane and 400 mg Prexige, the latter a British drug; and one bottle of methadone, 300 5mg tablets. All of them are classified as different types of painkillers. Click here to see the confidential fax from Dr Eroshevich to Dr. Kapoor.

And clearly evident in the story written by FOXNews.com’s Roger Freidman Friday, are statements from Smith’s psychiatrist, Dr. Khristine Eroshevich, where she pleads with Dr. Kapoor to give Smith something to knock her out.

If Dr. Eroshevich felt Anna Nicole needed to be sedated, the proper procedure would have been to put her in a hospital setting where she could be monitored and cared for in a healing environment.

At the end of the day, it comes down to the fact that all doctors take an oath to “do no harm.” So how, in keeping with that sacred oath, could any doctor prescribe these medications knowing that the outcome could be deadly?

These are interesting times we’re in ― to say the least. Over the past couple of weeks, we have all been concentrating on “Octomom” from California, and with new developments in the story everyday, it’s easy to see why she’s been the topic of conversation. I was following the story too, calling for an ethical investigation of the fertility clinic from day one, but with the state of our economy and the country experiencing what could be one of the most pivotal moments in American history, I want to move past that story.

I think it’s time the media starts concentrating on the changes that the Obama administration will be proposing in the future and some of the ideas that have already been approved.

Now, let’s look at the facts … The American health care system needs help! Why? Well, because it is filled with inefficiencies and overpriced operational costs.

How did it get like that? Well, it’s possible the American health care system has seen a lot of the same issues as our financial sector ― which we all know by now is quite a mess. Our financial experts have given us many explanations for the current economic crisis: Many blame the banks for recklessly handing out loans and credit, some blame the public for borrowing more money than they could ever repay, then there’s all the greedy Wall Street executives making profits off back of funds that don’t even exist, and who can forget those elaborate Ponzi schemes that went unnoticed by federal agencies for years.

Well, believe it or not, we have a lot of the same things happening in health care. We have some patients that demand every test in the book on the basis of what they’ve read or seen on television, hospitals that have been enamored with demands because of technological advances and profit margins, and doctors that have concentrated on sub-specialty service, rather than primary care and prevention.

So now, we are all looking to President Obama’s stimulus bill to see how he will resolve these problems. Some of his proposed ideas are very interesting. Electronic medical records, for instance, provide us with computerized data entry on patients, a way to track symptoms, disease processes, a way to dramatically decrease the overutilization of certain tests, minimize medical mistakes both by physicians and hospitals. And down the road, it might even decrease costs.

But many critics worry about privacy issues. I totally agree that patient confidentiality should always be protected. I remember when the new HIPPA laws came into effect under President Clinton, I could not even discuss a patient’s medical condition or get a second opinion from a colleague without getting a written consent from the patient.

But I think that before we start throwing good money in to solve the problems bad money got us into, the way previous financial stimulus plans have, we need to really understand how our current health care system is working, and address the issues that got us here in the first place.

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