Hospitals & Asylums
Family Opinions on the Patient Physician Relationship HA-14-4-11
By Anthony J. Sanders
Rendered for the Passover Seder sunset 18-25 April and Easter Egg Hunt 24 April 2011
To better respect the AMA Code of Medical Ethics 10.00-10.05 Opinions on the Patient-Physician Relationship, Opinions 10.06-10.10 are appended to espouse the ideals of family medicine, caregiving, social work, family law and victim compensation[1]. The Secretary of State instantly got the AMA Code of Medical Ethics back online after a report of censorship was made in 2009. Whereas she has spared her husband adultery on several memorable occasions, the Secretary of State may opt to oversee this e-Motion regarding the hypocrisy of the “Personal Medical Home” of the American Academy of Family Practitioners in elaboration upon the Patient-Physician Relationship as it pertains to the Family to the AMA Council on Ethical and Judicial Affairs[2] by law (1 Timothy 3:2), (Proverbs 5:8) and (Mark 10). I adjure you by God, do not torture us (Mark 5:7)[3].
While writing this document I achieved 50 non-consecutive pull-ups, to compliment 100 push-ups, 100 sits ups and 4 mile run daily, took a short course of Ampicillin 500 mg, ordered Doxycycline 100 mg, the once a day antibiotic, for 15 cents a pill, and stopped eating sugar in 2011, after giving up animal products in 2010. Said the wisdom teeth to the first maxillary molar, “drink your coffee black or not at all” like my mother, the unemployed family physician, who paid for my recent visit to the dentist. To honor her father, Will, I wish to dedicate this document to the free, automatic and permanent use of the Maiden name for professional practice after divorce as commanded by Moses in (Exodus 20:7 12) and (Deuteronomy 5:11 & 16) directed in (Deuteronomy 24:1-4) and inspired by the Good News regarding the Virgin Mary (Mathew 1:18-21) (Luke 1: 26-55) (Matthew 28), (Mark 16) and (Luke 24).
Opinions on the Patient-Physician Relationship 10.06-10.10
Opinion 10.06 Family Medicine, In General
Opinion 10.07 Caregiving for Children, Elders and the Disabled
Opinion 10.08 Social Work, the Psychiatric Inheritance
Opinion 10.09 Family Law: Maiden Name, Support and Probate Avoidance
Opinion 10.10 Compensation for Torture, Biological Experimentation and Work
Endnotes
Opinion 10.06 Family Medicine
Family medicine is a medical specialty devoted to comprehensive health care for people of all ages. It is a division of primary care that provides continuing and comprehensive health care for the individual and family across all ages, sexes, diseases, and parts of the body. It is based on knowledge of the patient in the context of the family and the community, emphasizing disease prevention and health promotion. According to the World Organization of Family Doctors (Wonca), the aim of family medicine is to provide personal, comprehensive and continuing care for the individual in the context of the family and the community[4]. The American Academy of Family Practitioners (AAFP) defines quality healthcare in family medicine as the achievement of optimal physical and mental health through accessible, safe, cost-effective care that is based on best evidence, responsive to the needs and preferences of patients and populations, and respectful of patients’ families, personal values, and beliefs[5]. Until antibiotics are made available Over-the-counter the role of the family physician, other than administering childhood vaccines, shall be primarily to prescribe broad spectrum antibiotics, the best medicine of the 20th century, and to evaluate and implement the best practice of specialties and discard the endless symptom treating and unnecessary operations of high priced specialists[6].
The portion of the Hippocratic Oath (late 5th century B.C.) relevant to family practice is: To consider dear to me, as my parents, those who taught me this art; to live in common with them and, if necessary, to share my goods with them; To look upon the children of others as my brothers, and to teach them this art. I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone. Family medicine has moved to the office, house calls are rare and hospital visitations are performed by hospitalists rather than family physicians. This decadence is reflected in the AAFP definition of personal medical home that is so immoral as to incite homicide, a crime of genocide (18USC(50A)§1091(c)), and needs to be prohibited[7] by incorporating into the AAFP definition of personal medical home, the clause from the Hippocratic Oath whereby, In every house where I come I will enter only for the benefit of my patients, keeping myself far from all intentional ill-doing and seduction… furthermore, the practice of sending medical bills to people’s homes is frowned upon and the practice of serving patients as a personal medical mailing address for hospital bills, laboratory results, Internet pharmacy purchases and medicine related correspondence, is promoted[8].
Family medicine is the natural evolution of historical medical practice. The first physicians were generalists. For thousands of years, generalists provided all of the medical care available. They diagnosed and treated illnesses, performed surgery, and delivered babies. Germ Theory developed in the 1600s by Dr. Girolamo Fracastoro was proven with the application of the microscope to observe microscopic organisms by Antoni van Leeuwenhoek in 1674. Sterilization advanced one step with Louis Pasteur beginning in 1857 and took two steps back with the disgrace, wrongful imprisonment and death in a psychiatric institution of hospital hygienist Dr. Ignaz Philipp Semmelweis in 1965. With World War II, despite the marketing of broad spectrum antibiotics, discovered by Alexander Fleming in 1929, specialization began to flourish. In the two decades following the war, the number of specialists and subspecialists increased at a phenomenal rate, while the number of generalists declined dramatically. The concept of the generalist has been reborn and has yet to learn to walk to visit patients in hospitals and their homes and make recommendation to ensure their living environment is hygienic[9].
When flour was first ground around 10,000 BC the number of caries in the dental record rose from 2% to 10%. Since sugar was introduced in the 1600s the number of people with significant caries rose to 95%. Tobacco, salt, sugar, baked goods, caffeine, alcohol, fat, particularly trans-fat, all animal products, namely dairy and eggs and other unnecessary recreational, addictive and dangerous substances should be avoided completely[10]. The consumption of fat, protein and carbohydrate macronutrients should be eliminated or minimized to speed up digestion and absorption from 3 weeks for beef, 1 week for chicken and 3 days for fish, to less than one day for the micronutrients found in fruit, vegetables and whole grain. The preference for fresh fruit, vegetables and whole grains is that they do not betray the animal kingdom to flesh eating bacteria and their fiber is excreted efficiently[11]. Clean water, sanitation, antibiotics and vaccines were successful in eliminating or reducing the danger from most infections[12]. Since the decadence of the automobile and television the number of people struggling with obesity and the related chronic diseases of diabetes, heart disease and cancer have risen[13]. Some progress has been made in reducing cancer deaths with public knowledge regarding environmental carcinogens, diet, exercise and religious aftercare. Public knowledge regarding the bacterial, dietary and sedentary causes of diabetes and endocarditis must be disseminated to the public with refillable prescriptions for antibiotics, vegan diet and exercise[14].
The basic regimen prescribed for longevity is to be vaccinated by a physician as a child, take antibiotics to treat infections, sleep on your side, drink purified water, brush your teeth at least twice a day, shower daily and after exercise, maintain good personal and environmental hygiene, wash your hands and food before eating, wear proper protective gear and use disposable gloves when touching patients, eat only fresh fruits, vegetables and whole grains, with rice for digestion, and exercise daily. Exercise can be minimized by running a 3 mile cross country course daily or two hours walking will be needed, especially if you are employed in a sedentary occupation, like watching television. Elders often use anti-fungal foot powder. Stretches are useful for treating rheumatism, reducing injury from more energetic exercises, and getting some exercise throughout the day[15]. Strength exercises such as push-ups, sit-ups, pull-ups and weight lifting are popular[16]. To afford a sedentary lifestyle the human body must be engaged in some sort of physical activity no less than 24 hours a week including cooking, cleaning and gardening. One should be exposed to sunlight for around 30 minutes a day or a multivitamin containing Vitamin D should be taken to prevent and treat osteoarthritis[17]. Vitamin C, found in in high quantity in citrus, is highly effective at preventing and treating viral infections[18].
The pneumococcal vaccine for 24 of 97 serotypes of Streptococcus invented in 1977 is the most promising experimental treatment for American sufferers of pneumonia, meningitis and endocarditis[19]. Pneumococcal sensitive bacterial endocarditis is ten to twenty times more prevalent than cancer, and in the new millennium, edged ahead of viral and chemical sensitive cancer, as the leading cause of death. Pneumonia is the leading cause of the innocent transmission of disease vectors from one human to another. Bacterial infections can be treated with antibiotics whose resistance is mitigated by the practice of metronidazole, the unfortunately carcinogenic antibiotic of first resort in dentistry and abdominal infection. Chronic disease results from necrotic tissue that is susceptible to bacterial infection and must be sterilized with courses of antimicrobial agents, as needed, while the wound heals over extended periods of perfect living that might be hastened when stem cell treatments come into use[20]. The Author-Doctors of the Hippocrates shall sterilize their medical libraries, cite their sources and email prescriptions for the benefit of the sick, with an absolute minimum of non-medically necessary physical and social contact, in pursuit of the restoration of hospital visits, house calls and mutual financial freedom from well written legal briefs that cite both statute and medical literature to ensure immunity from all forms of epidemics[21].
Opinion 10.07 Caregiving for Children, Elders and the Disabled
The goals of caregiving are (1) to maintain a healthy lifestyle, (2) to promote independent physical functioning to the highest level possible, (3) to promote independent mental functioning to the highest level possible, (4) to promote a feeling of self-worth, (5) to provide a safe environment, (6) to provide for privacy, (7) to provide for social contact with friends and relatives, (8) to provide for a nurturing and caring environment. These goals serve to emphasize and enhance the overall mission of caregiving. Establishing specific plans to meet these general goals will do much to foster the functioning and well-being of the person[22]. Caregivers help the elderly, disabled, ill, and mentally disabled to live in their own homes or in residential care facilities instead of in health facilities. Most personal and home care aides work with elderly or physically or mentally disabled clients who need more extensive personal and home care than family or friends can provide. Caregivers are domestic partners, also called personal and home care aides, homemakers, companions, and personal attendants, they provide house-keeping and routine personal care services. Caregivers clean client's houses, do laundry, change bed linens, plan meals (including special diets), shop for food, and cook, a vegan diet is prescribed for longevity. Weekly manicures and pedicures are given and the liberal use of antifungal foot powder is recommended for elders. When necessary caregivers help clients get out of bed, bathe, toilet, groom, dress and eat. Caregivers often accompany clients to doctors' appointments or on other errands and provide instruction and physical education to their patients and may also advise families on nutrition, exercise, cleanliness, contagious disease and household tasks[23] .
Talking with understanding is fundamental to creating a nurturing and loving home environment, particularly when dealing with dementia, where everyone is informed and reminded of problems and opportunities, on a daily basis. Talking about health matters in the home is of primary importance to healthy cohabitation. Caregivers, in consultation with physician, should be able to diagnosis and treat the common cold (rotovirus) with Vitamin C, influenza with Theraflu, pertussis and pneumonia with antibiotics to fend off new infections. They say pneumonia is an elder’s best friend and caregivers must always be on the alert for contagious disease. Caregiving begins in utero when the mother eschews vices, eats healthy food and consumes a folic acid multivitamin, in consultation with a doctor. Births in America are usually performed under the supervision of an obstetrician in a hospital however skilled midwives can perform home births. Nursing mothers, famed for post-partum depression, do most of the caring for babies. As the child develops the body grows, baby teeth come in, crawls, walks, talks, is weaned and the father becomes more important. Vaccines are administered by pediatricians and family physicians until age 7. Permanent teeth begin coming in around age five when children start their formal schooling and the wisdom teeth arrive when it is over, around age 18. Through this entire period of childhood parents, as caregivers, are expected to provide a nurturing and loving home. Children of low income families are entitled to free medical and dental care until age 18[24].
Persons with disabilities include those who have long-term physical, mental, intellectual or sensory impairments which may hinder their full and effective participation in society on an equal basis with others. The family is the natural and fundamental group unit of society and persons with disabilities and their family members, are entitled to receive necessary protection and assistance by society and the State, to enable families to contribute towards the full and equal enjoyment of the rights of persons with disabilities. Persons with disabilities have the right to the enjoyment of the highest attainable standard of health without discrimination on the basis of disability. State shall take effective and appropriate measures, including through peer support, to enable persons with disabilities to attain and maintain maximum independence, full physical, mental, social and vocational ability, and full inclusion and participation in all aspects of life [25]. For the purposes of social security disability insurance, An individual shall be determined to be under a disability only if his physical or mental impairment or impairments are of such severity that he is not only unable to do his previous work but cannot, considering his age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy (Title II §223(d)(1)(A) of the Social Security Act (42USC(7)II§423(d)(1)(A))