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The vicar of virulence and his trailer-trash theology

9/10/2010 St. Petersburg Times
Columnist Dan Ruth says 9/11 should be a time for reflection on the evils of intolerance, not an excuse for inflaming it.

It's time for Democrats to grow up and stop waiting for Mr. Charisma

By Santiago Leon
9/9/2010 © Health News Florida
Miami insurance agent Santiago Leon tells fellow Democrats: "We face crisis after crisis. Teachable moments abound. However, there is no point in holding our breath waiting for a charismatic leader. We have only one president, and he is who he is. We are forced to make do with what we have."

Read the golden rule, Pastor Jones

9/9/2010 © Sarasota Herald Tribune
Tom Lyons writes that Gainesville pastor Terry Jones, who plans a Quran burning on Sept. 11, might not realize he has become a volunteer agent for anti-American groups in the Middle East.

'Outsider' Scott now seems like an insider

9/8/2010 © Miami Herald
Michael Putney writes that gubernatorial candidate Rick Scott is now courting the very power brokers and special interests he vowed to fight if he becomes governor.

Gulf spill puts deep-water organisms in danger

9/8/2010 © St. Petersburg Times
Peter R. Betzer, former dean of USF's College of Marine Science, writes that now that the well has been sealed, we should focus on addressing and monitoring the gulf ecosystems.

Rubio's half-right about Crist's health-care flip flops

9/5/2010 © Miami Herald
The PolitiFact team checks claims from Marco Rubio that Gov. Charlie Crist has six different positions on health-care reform. Rubio's right that positions have changed, but six is an exaggeration.

PolitiFact: Scott's attack on Alex Sink is false

9/2/2010 © St. Petersburg Times
The PolitiFact team checked Rick Scott's claim that Alex Sink wants to get rid of Medicare. Nothing to it.

Treating pledges like Abu Ghraib detainees

9/3/2010 © St. Petersburg Times
Daniel Ruth asks: Why would anyone want to associate themselves with a fraternity or a sorority after they have been beaten up, verbally humiliated, forced to drink hot sauce and pelted with rocks?

FL spends less than most states on mental health

9/1/2010 © PolitiFact
Bud Chiles, who dropped out of the governor's race this week, claimed that Florida is 49th in per capita spending on mental health. PolitiFact's research team says he's correct.

Crist flipping, flopping, fumbling and losing

9/2/2010 © Orlando Sentinel
Mike Thomas writes that the people most inclined to support Charlie Crist, moderate independents, are those most likely to stay home Election Day. It is the end, and ever the optimist, Crist doesn't realize it.

McCollum right to be skeptical of Scott

9/2/2010 © Miami Herald
Joy-Ann Reid writes that Bill McCollum now stands alone among his Tallahassee clique in refusing to take to one knee for Republican gubernatorial nominee Rick Scott. Is McCollum a sore loser? You bet. But he's right about Scott.

Children of Katrina still need help

9/2/2010 © Miami Herald
Dr. Irwin Redlener and Mark K. Shriver write that as much as Katrina was a disaster of unprecedented scale, it also revealed a nation woefully unprepared to respond to a large-scale disaster, especially in our failure to meet the needs of children.

Remembering Rick Scott's play for Tampa General

9/2/2010 © St. Petersburg Times
Business columnist Robert Trigaux recalls the mid-1990s, when the huge public hospital went through a messy investigation after almost becoming part of the Columbia/HCA empire.

FMA slams AMA for caring about patients

9/1/2010 © Tampa Tribune
Policy wonks Brian Klepper and David Kibbe note that the reason the Florida Medical Association is mad at the national group is because AMA no longer solely focuses on doctors' incomes and protectionism.

Hospital suitor may have stepped over the line in attracting doctors

8/31/2010 © Florida Today
Matt Reed writes that the company lined up to buy Wuesthoff Health Systems says it plans to start recruiting local doctors to join its organization. But did Health Management Associates go too far in those efforts elsewhere?

Party holds its nose and embraces Scott

8/30/2010 Miami Herald
Carl Hiaasen says Rick Scott's resume reeks from his health-care ripoff, but party leaders will embrace him anyway after zipping on their Hazmat suits.

Scott doesn't need media or party bigwigs -- just ads

8/29/2010 Orlando Sentinel
Mike Thomas says the media and party bigwigs all think Rick Scott is a crook and that those who vote for him are bigots. But as long as he can pay for 30-second ads, he can win.

The good, bad and ugly from the primaries

8/27/2010 © Orlando Sentinel
Scott Maxwell writes that although we were inundated with campaign mud, a handful of candidates stayed positive — and it worked.

Why Scott won, and why he could win again

8/26/2010 © St. Petersburg Times
Howard Troxler writes that if Rick Scott can start from scratch and knock out Bill McCollum, what will he do against Alex Sink in the governor's race?

No such tax in health-care law

8/26/2010 PolitiFact
An e-mail chain is spreading a rumor that the health health care law will impose a tax on real-estate sales. After doing research, the PolitiFact team says: Not so.

Reality springs a leak in BP spill coverage

8/26/2010 © Orlando Sentinel
Mike Thomas writes that the script for the BP oil spill is falling apart. There will be no environmental calamity. The gulf is healing itself faster than anyone imagined. Bad news for those pushing the story line of environmental devastation

Will business lobby switch sides? and 4 other things to watch

8/25/2010 © Times/Herald
Political reporters Adam C. Smith and Beth Reinhard pose 5 questions that Rick Scott's victory raise.

Florida is letting down its children

8/22/2010 © St. Petersburg Times
David Lawrence Jr., president and co-chair of the Children's Movement of Florida, writes that Florida ranks poorly in measure after measure in how we invest in our youngest, most vulnerable citizens.

New federal health website a start, but we need more

8/21/2010 © South Florida Sun Sentinel
Janet Trautwein, CEO of the National Association of Health Underwriters, writes that the government's new health Web portal is incomplete without including access to licensed insurance agents and brokers.

Tampa? You need to calm down

8/19/2010 © St. Petersburg Times
Robert Trigaux writes that a new study says Tampa Bay is the No. 4 metro area nationwide when it comes to being most stressful. So try and chill out, Tampa Bay, before we rank even higher on the list.

When science is inconvenient, just ignore it

8/18/2010 © Miami Herald
Fred Grimm writes of the great American paradox: We live bountifully off the fruits of scientific research while attacking scientific findings that offend religious or political ideologies. Or the bottom line.

Rick Scott can't recognize his own negative ads

8/19/2010 © Florida Times Union
Ron Littlepage writes that attack ads are the name of the game in campaigns, especially for rich candidates trying to buy an office. Taking part and then denying you are? Sounds like a typical politician to me.

Why is homeopathy still legal?

By Jann Bellamy
Special to Health News Florida
Tallahassean Jann Bellamy of the Campaign for Science-Based Healthcare wonders why lots of countries have found homeopathy worthless, yet allow it to continue.

Hysteria did the real damage in the Gulf

8/18/2010 © The Guardian
Simon Jenkins writes that from the BP leak to terror or ash clouds, politics has spurned its most precious responsibility: to react proportionately to danger.

Don't discount the power of hope

8/17/2010 The Doctor Weighs In
Retired oncologist Stanley Winokur of Singer Island, FL, talks about how to answer the question that most patients or their family members ask: "How long do I have to live?"

It's up to us to protect ourselves

8/14/2010 © Miami Herald
As columnist Casey Woods chews over some new concern about what her son eats, wears or plays with, she can tell her husband believes she is taking the research too far.

Divorced? Heavens, no! Zealots give religion a bad name

8/13/2010 © Orlando Sentinel
A far-right Christian group is targeting attorney general candidate Pam Bondi because -- hold the presses -- she's been divorced. Twice!

Oil in seafood? Claims don't seem to hold water

8/12/2010 © Orlando Sentinel
Columnist Mike Thomas does some digging and discovers there is little evidence to back up the scary first claims.

Scott's plan for Medicaid? Here's a clue

9/4/2010 © Orlando Sentinel
Columnist Aaron Deslatte finds a clue to Rick Scott's plans for Florida's Medicaid program in a 1994 newspaper interview, in which he said all government insurance programs and VA hospitals should be turned over to private companies.

With 'true believer' Rick Scott, it's buyer beware

8/11/2010 © WPLG
Political reporter Michael Putney says Rick Scott really believes government is always wrong and the private sector is always right. He would shake things up -- and tear a lot of things apart.

McCollum's sad pandering on gay parents

8/11/2010 © Orlando Sentinel
Columnist Mike Thomas says McCollum misled him in an interview on allowing gay foster parent Martin Gill to adopt. McCollum is so desperate to win the primary that he's pandering to everyone.

Voters prefer Gov. Fraud to Gov. Howdy Doody

8/10/2010 © St. Petersburg Times
Columnist Howard Troxler says voters know all about the Rick Scott fraud at Columbia/HCA, but they still like him better than that other guy.

Health-law supporters play to tough crowd

8/10/2010 © Florida Times Union
Health reporter Jeremy Cox says state officials are not very likely to listen to patient advocates who want Florida to start planning how to implement the federal health law.

Losing weight's hard, regardless of what Oprah says

8/10/2010 © Palm Beach Post
Emily Minor is fed up -- so to speak -- with overly simplistic formulas for losing weight or keeping it off. She's even mad at Oprah.

Medicaid Reform reduces fraud, improves care

Alan Levine says the bad actors at WellCare have been replaced by good people, and it would be a mistake to think Medicaid reform had anything to do with the fraud. In fact, he says, the opposite is true.

A peaceful death: Just what the doctor ordered

FSU geriatrics professor Marshall Kapp tells how health-care providers, caregivers and patient advocates can collaborate to prevent aggressive, pointless end-of-life resuscitation.

ANALYSIS & OPINION

Health News Florida takes no positions on issues or candidates; instead, we post links to editorials, columns and letters that appear in publications around the state. The cartoons also run the gamut of opinions; if you disagree with the one we’ve posted today, you may like the one we post tomorrow.

A peaceful death: Just what the doctor ordered

It happens all the time: Dying patients who sign papers saying they don’t want resuscitation or aggressive medical treatment get it anyway. When they go into cardiac arrest, their family or nursing-home staff calls 911. The EMS squad engages in a “full code,” with intubation and chest-pounding.

The death that comes then or in a few days is exactly the one the patient didn’t want.

A number of factors contribute, but one important explanation is health-care providers’ fear of legal repercussions if a “full-court press” is not initiated for every patient.

The result is wasted resources for society and diminished quality of life in the final hours for dying individuals, as well as emotional scars for family members and friends.
Now, an effort being coordinated by the Center for Innovative Collaboration in Medicine & Law at Florida State University hopes to change the way end-of-life care is managed by producing clear medical orders.

The POLST (Physician Orders for Life-Sustaining Treatment) Paradigm is intended to ensure that a patient’s wishes regarding the initiation, continuation, withholding, or withdrawal of life-sustaining medical interventions are honored across all health care settings, including the individual’s home.

Unlike advance directives, the POLST is actually the physician’s order, with the same power to direct the behavior of other involved health care professionals as it would in the hospital.

A POLST for a patient would only be written by the physician based on conversations with the patient and family, and would embody and enforce their wishes about end-of-life care.

The POLST instrument would not apply in situations such as that on display in the tragic Florida case of Terri Schiavo, where there was irreconcilable disagreement among family members about the appropriate medical care of a patient who could not speak for herself.

Neither would a POLST help when there are intractable differences between the patient and family or between them and the physician regarding the appropriate medical course to pursue.

Rather, the POLST would apply when there is agreement among the patient, family members or health care proxies, and attending physician. There, a POLST would serve the purpose of making sure the decision is followed.

Such cases should not be controversial, but are difficult to implement today because of the surrounding legal uncertainties and anxieties.

Kenneth Brummel-Smith, M.D., Chair of the FSU Department of Geriatrics, was instrumental in starting the POLST Paradigm while on the faculty at Oregon Health Sciences University.

He has been working informally with Tracy Christner, executive director of Project GRACE (Guidelines for Resuscitation and Care at End of Life), an affiliate of the Suncoast Hospice in Clearwater, to implement and promote the POLST Paradigm in Florida. Their ad hoc efforts now will be coordinated through the Center for Innovative Collaboration in Medicine & Law at Florida State University.

The first major event in this coordination effort will be a meeting on Sept. 20 at the Orlando Regional Campus of the Florida State University College of Medicine. At that meeting, interested individuals from around the state will have the opportunity to brainstorm a detailed strategy for implementing POLST in Florida.

There is no charge. To register or obtain information, contact Alyson Odom at Alyson.odom@med.fsu.edu or 850-645-9473.

Marshall B. Kapp, J.D., M.P.H.
Director, FSU Center for Innovative Collaboration in Medicine & Law
and Professor of Geriatrics
Tallahassee