Author: Robert Moghim, M.D.

The ongoing debate about the use of marijuana as a medicinal therapy and recreational drug continues to rage in the halls of power and the public square, but, surprisingly, there is also a continuing back-and-forth among physicians and the scientific community.  Despite its presence in Western society since the 19th century, there is still a dearth of authentic and reliable science on its health effects.  It remains a proscribed substance in 26 of the U.S. states; it is available as a medicinal in the other states, with four allowing recreational use. Among the medical community, the most likely answer to the question, “Is marijuana safe?” is most likely “It depends…” On the spectrum of detrimental substances it probably ranks close to alcohol.  In terms of lethality, marijuana is less dangerous…

Keeping track of the latest drug craze can be exhausting, but occasionally, one of these drugs pushes the boundaries of typical street behavior and creates a serious public health concern. It happened with crack and crystal meth, and now a new drug is poised to shake up the American drug trade and cause an explosion in fatalities—fentanyl.  Doctors should already be familiar with this prescription painkiller often used in cancer treatment, but fentanyl is showing up on streets for the first time. Fentanyl—commonly known on the street as “China White” or “China Girl”—is an extremely powerful opioid that may have caused the recent death of singer Prince.  This is only the most high profile fatality in an epidemic that is still in its early stages, but one that could tax…

Although used for thousands of years, it wasn’t until the 1800s that the first medicinal opioid, morphine, was developed.  Since then, governments and medical authorities have implemented a patchwork of laws to govern the use of these powerful painkillers. Currently, non-medicinal opioid use is illegal, but many Americans are circumventing these laws by abusing pharmaceutical substitutes like Oxycodone, Fentanyl or Vicodin. Dependence upon medicinal opioids is a national epidemic with an estimated 8.2 million Americans abusing these prescription pills. The widespread misuse of prescription meds --more than 52 million Americans have used prescription drugs non-medically—has contributed thousands of more cases of opioid addiction on a daily basis. This culture of addiction has forced more physicians to question the use of prescription painkillers. Although chronic pain is a health issue that…

This November, Colorado voters will be able to strike down Proposition 69, a misguided ballot initiative that would help create the first single payer health insurance system in the nation.  The initiative calls for the abolition of health insurance premiums and replacing them with higher taxes.  Such a radical policy has inspired denunciation and political action from a wide variety of public interest groups. Amendment #69, also known as ColoradoCare, began as a statewide petition in 2015.  When the requisite number of signatures was obtained last year, the Colorado Secretary of State announced that Amendment #69 would be included on the November 2016 ballot.  The initiative proposes a 6.67 percent payroll tax hike that employers would pay in addition to a 3.33 percent employee tax increase. This 10 percent tax…

While greater access to healthcare has been the subject of political discourse for many years, it is only with the onset of the 2015 presidential election cycle that the subject of universal health care has risen in prominence.  Both Democratic candidate Senator Bernie Sanders and presumptive Republican candidate Donald Trump have spoken in support of universal health coverage, but there are still many secondary issues related to this topic that should be addressed. The most important issue related to a single-payer healthcare system is the cost.  Bernie Sanders favors a substantial tax hike to pay for implementation of a government-run healthcare system. He has argued that the additional taxes would be outweighed by the eliminated healthcare costs, leaving the middle class in a much improved financial position. He has proposed…

Locum tenens positions originated in the 1970s, and what was intended to be a stopgap solution for rural hospitals in dire need has become a commonplace fixture of modern medical organizations.  For much of the four decades since the establishment of the first locum tenens staffing agency in 1979, growth of the locum tenens industry has been strong but steady. That has changed radically in the years since the passage of the Affordable Care Act in 2008. Prior to ACA, almost 75 percent of hospitals hired temporary physicians for almost 600,000 days of service each year. Today, almost 90 percent of hospitals report using a locum physician.  In the decade since 2002, when there were 26,000 physicians working locum tenens assignments, that number has grown to more than 40,000.  An…

Unlike most other industries, health care utilizes an opaque, highly fluid pricing system that often puts consumers at a disadvantage.  The majority of these costs are covered by insurance which is why there is relatively little public outcry about these inequities.  That is beginning to change, however, as more hospitals and medical organizations are starting to offer significant discounts to patients willing to pay in cash. Just a few years ago, hospitals reserved their highest prices for patients without insurance coverage.  This is no longer the case due to federal and state laws that forbid hospitals from charging patients more than Medicare would. In order to make up these losses, medical organizations are now charging insurers much higher rates. In turn, insurers pass costs on to policyholders by raising out-of-pocket…

Few stories in the health care sector have been as shocking as the revelation that the Hollywood Presbyterian Medical Center paid almost $17,000 to hackers to restore their data network. The sheer brazenness of such a cyber-attack on a major Southern California hospital startled much of the medical community—and the general public. Coupled with the highly publicized admission from CEO Allen Stefanek that the organization conceded to the demands, this story highlights the increasing vulnerability of health care organizations to cyber-criminals. Although the nature of the crime and the hospital’s very public response sensationalized this story, cyber-criminals have been targeting the health care sector for some time. A report from KPMG found that 81 percent of health care organizations have been attacked by some form of cyber intrusion in the…

In the past few years, there has been considerable public scrutiny of health insurance costs for individuals and families, but much of the dialogue has ignored the growing economic burdens placed on working Americans. Over the past five years, the deductible for individual plan workers has grown seven times more than wages.  The average deductible is currently almost $1,077, significantly higher than $303 in 2006. Businesses have quietly shunted a greater share of the insurance plan costs to employees in an effort to minimize their financial responsibilities. This has, in part, been a response to the rapid rise in insurance premiums; a larger deductible enables companies to pay lower premiums. There is also a common belief that higher deductible plans will curtail medical care for low risk health issues. Many…

The beginning of the new year is often a time of heightened anticipation about what new discoveries the next twelve months have in store.  This is especially true for the health care community which produces technological and scientific breakthroughs on a regular basis. This coming year should produce new changes in the medical industry and wider society which will not only make health care more effective but considerably more accessible. Wearables and Mobile Apps It is impossible to discuss new advances in health care without including the growing proliferation of digital tools like wearables and mobile apps.  While this trend is not new to health care, 2016 should see a dramatic increase in consumer utilization of these increasingly important products.  Within this area, the promise of the Internet of Things…