Thursday, December 16, 2010

RIP: A Friend, of Complications of Diabetes

Frank Patterson, aka plantsman, a good friend from the Eschaton boards, died of a heart attack following a period of poorly controlled diabetes. He was a good, gentle, generous soul, a landscaper who wanted nothing more than to coexist with the beauties of the earth. We'll miss him.

The vascular complications of diabetes (including heart attacks), and not the sugar lability, are what kill most patients with the disease. The complications can be prevented, to some extent, by meticulous, ongoing, management by committed, accessible primary care docs working with equally committed patients with the money and intelligence to comply. This, of course, is precisely what every incentive in the US health care system militates against:

The vogue for such specialties (ENT, plastic/cosmetic surgery, dermatology, radiology, anaesthesia and others--ProfW) is part of a migration of a top tier of American medical students from branches of health care that manage major diseases toward specialties that improve the life of patients — and the lives of physicians, with better pay, more autonomy and more-controllable hours.

“It is an unfortunate circumstance that you can spend an hour with a patient treating them for diabetes and hypertension and make $100, or you can do Botox and make $2,000 in the same time,” said Dr. Eric C. Parlette, 35, a dermatologist in Chestnut Hill, Mass. (an affluent Boston suburb--ProfW), who chose his field because he wanted to perform procedures, like skin-cancer surgery and cosmetic treatments, while keeping regular hours and earning a rewarding salary.

--Go ahead. Click on the link and read the damned thing, while you're thinking about Frank's death. Just don't expect it to add to your equanimity.

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