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DJP Update 3-7-2010 Critical evaluation of British National Health Service by 3 organizations (IHI, JCAHO Int. & Rand) invited by British Gov to investigate; Lessons for U.S. Congress?

DJP Update 3-7-2010 Critical evaluation of British National Health Service by 3 organizations (IHI, JCAHO Int. & Rand) invited by British Gov to investigate; Lessons for U.S. Congress?

Below is tweet I sent out in early hours of this day as soon as the article came out in London.

“..ugly truth National Health Service” #NHS – Congress should read this article in #Times in UK http://tinyurl.com/yhdjy4c

——–

Alternative link to National Health Service story in the United Kingdom: http://www.timesonline.co.uk/tol/news/uk/health/article7052606.ece

Here is headline and some excerpts from article by Lois Rogers in Times of London. Read the entire article.

Labour hid ugly truth about National Health Service (NHS)

(DJP comment: This article is based on 3 reports from different organizations evaluating the NHS. The reports were obtained under a Freedom of Information request. The organizations: IHI of Massachusetts, JCAHO International, and the third report, by the US-based Rand Corporation)

DAMNING reports on the state of the National Health Service, suppressed by the government, reveal how patients’ needs have been neglected.

They diagnose a blind pursuit of political and managerial targets as the root cause of a string of hospital scandals that have cost thousands of lives.

The harsh verdict on the state of the NHS, after a spending splurge under Labour between 2000 and 2008, raises worrying questions about the future quality of the health service as budgets are squeezed.

One report, based on the advice of almost 200 top managers and doctors, says hospitals ignored basic hygiene to cram in patients to meet waiting-time targets.

It says “several interviewees” cited the Maidstone and Tunbridge Wells [NHS Trust in Kent where 269 deaths during 2005-6 were caused by infection with Clostridium difficile bacteria].

“Managers crowded in patients in order to meet waiting-time targets and, in the process, lost sight of the fundamental hygiene requirements for infection prevention,” the report stated.

There were subsequent failings at health trusts in Basildon in Essex, and Mid Staffordshire. Filthy wards and nurse shortages led to up to 1,200 deaths at Stafford hospital.

Lord Darzi, the former health minister, commissioned the three reports from international consultancies to assess the progress of the NHS as it approached its 60th anniversary in 2008. They have come to light after a freedom of information request.

The first report, by the Massachusetts-based Institute for Healthcare Improvements (IHI), identified the neglect of patients as a serious obstacle to improving the NHS. “The lack of a prominent focus on patients’ interests and needs … represents a significant barrier to shifting the trajectory of quality improvement in the NHS.”

——-

Some subheadlines in the article:

A damaging rift between doctors and managers.

Pointless new structures.

A culture of fear and slavish compliance.

——-

Note that the reports by IHI of Massachusetts and JCAHO International and Rand Corporation were done at the request of the British Government.

The IHI report, whose interviewees included Lord Crisp, chief executive of the NHS between 2000 and 2006, also described a system of self-assessment where only 4% of trusts are externally inspected.

———

A similar picture emerges in the second report, by the US-based Joint Commission International. It says the “quality and integrity of [NHS] performance data is suspect”.

Dennis O’Leary, its lead author and an international expert on patient safety and improvement…

——–

A Department of Health spokesman maintained that the three reports were never intended for “wider circulation” …

———

DJP Comment: Lessons for U.S. Congress to learn?

————-

Stay well,

Donald

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates.

Also, recent selected DJP Updates can be found at: http://www.donaldpalmisano.com/html/djp_update/

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@donaldpalmisano.com
www.donaldpalmisano.com
www.onleadership.us

This DJP Update goes to 2207 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

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DJP Update 3-4-2010 A message from 70,000 physicians to Congress about Medicare Payment System & The Right to Privately Contract without Penalty; and a few more things!

DJP Update 3-4-2010 A message from 70,000 physicians to Congress about Medicare Payment System & The Right to Privately Contract without Penalty; and a few more things!

The letter below was sent today to the U.S. House of Representatives. The same letter was addressed and sent to the Senate Majority Leader Senator Harry Reid and the Senate Minority Leader Senator Mitch McConnell plus the entire Senate.

The message in the letter is long-standing AMA policy (since 1993) and among the highest advocacy issues of AMA as voted by the policy-making body of the AMA, the House of Delegates. (Reformatting of the names and addresses for this email)

The message also respects Liberty which has been the policy of These United States of America since 1776.

Stay tuned as the health system reform debate is nearing the holiday break of Congress and the sponsors of the senate and house bills are pushing for passage of these bills with disaster in the details prior to the March 29 – April 11 recess.

The focus is on the House of Representatives at the moment and you can be certain that a vote will be taken the moment the whip count shows enough votes for passage regardless of the day or hour. Lots going on behind the scenes in Washington, DC!

Call everyone you know in the House of Representatives and tell them not to pass the Senate bill! The vote could be very close.

March 4, 2010

The Honorable Nancy Pelosi

Speaker

The Honorable John Boehner

Minority Leader

United States House of Representatives

Washington, DC 20515 Washington

Subject: Medicare Physician Payment System and Private Contracting

Dear Speaker Pelosi and Minority Leader Boehner:

For nearly a year, the Coalition of State Medical and National Specialty Societies, representing more than 70,000 physicians, has expressed deep concern with the country’s broken and unsustainable medical payment system. Congress’ failure to adopt a permanent solution to prevent draconian cuts in Medicare payments to physicians affirms our concerns. Clearly, the current system is not financially sustainable. To help stabilize the Medicare system and ensure that seniors have timely access to care by the physician of their choice, we urge you to repeal the Sustainable Growth Rate and replace it with a new payment system that allows patients and physicians to privately contract without penalty.

The right to privately contract is a touchstone of American freedom and liberty and all patients should have the right to choose their doctor and negotiate the fees for those services without penalty. Medicare patients should not be required to forego the value of their Medicare insurance benefit because they privately contract with the physician of their choice; nor should physicians who privately contract with Medicare patients be required to opt-out of Medicare altogether for two years. Furthermore, in some instances, under current law it is actually illegal for a physician to waive or reduce his or her fee. By allowing patients to privately contract with their physicians, patients will have access to a greater number of physicians. In addition,

Congress can obtain budget certainty by establishing payment rates and giving physicians and patients the freedom to privately contract for any difference.

In closing, we believe that empowering patients and physicians with the right to privately contract is both an optimum and sustainable solution when it comes to the Medicare funding crisis. Please contact David Cook, Executive Director of the Medical Association of Georgia (dcook@mag.org 678-303-9251), if you have questions, need additional information or would like to discuss this concept in greater detail with the members of our coalition.

Thank you for considering our request.

Sincerely,

Medical Association of the State of Alabama

Medical Society of the District of Columbia

Florida Medical Association

Medical Association of Georgia

Kansas Medical Society

Medical Society of New Jersey

South Carolina Medical Association

American Academy of Facial Plastic and Reconstructive Surgery

American Association of Neurological Surgeons

American Society of General Surgeons

Congress of Neurological Surgeons

Daniel H. Johnson, Jr., MD

AMA President 1996-1997

Donald J. Palmisano, MD, JD, FACS

AMA President 2003-2004

William G. Plested, III, MD, FACS

AMA President 2006-2007

cc: Members, United States House of Representatives

——–

A few other items you may find of interest:

— Watch Senator Blanche Lincoln’s new TV ad. She says she doesn’t answer to the Democratic Party. Interesting.

https://secure.democratsenators.org/o/40/p/wfc/dscc/senators/lincoln/donate?donate_page_KEY=6518

— Read the transcript of the exchange between Paul D. Ryan of Wisconsin, ranking Republican on the Budget Committee, and President Obama at the Health Summit

Congressman Ryan is full of facts. The CQ transcript is posted at the Washington Post.

http://www.washingtonpost.com/wp-dyn/content/article/2010/02/25/AR2010022504074.html

— Some recent tweets you may enjoy; click on the links for the articles:

http://twitter.com/djpNEWS

#TomHanks toasts #NewOrleans”…most special place on planet”#NOLA.com at#WWIIMuseum movie ThePacific http://tinyurl.com/yjc3brk

about 12 hours ago via Echofon

Via #TheSaints New Orleans Saints turn New Orleans into America’s City – NOLA.com: http://tinyurl.com/ylomebx

about 14 hours ago via Echofon

Like a Greek tragedy play RT @washingtonpost #DavidBroder: The fable of Emanuel the Great: http://bit.ly/9WvXGi #Obama

about 14 hours ago via Echofon

RT @TheEconomist #BarackObama unveils his final strategy for pushing health reform in America http://econ.st/aXVugy#economist

about 14 hours ago via Echofon

Advantage of using #Twitter for news even when you don’t post tweets #NYTimes http://tinyurl.com/ygmbtqk

3:08 PM Mar 3rd via web

Stay well,

Donald

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates.

Also, recent selected DJP Updates can be found at: http://www.donaldpalmisano.com/html/djp_update/

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@donaldpalmisano.com
www.donaldpalmisano.com
www.onleadership.us

This DJP Update goes to 2207 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

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DJP Update 3-2-2010 Breaking news: SGR decrease delayed one month; H.R. 4691 temporary extension act passes; now goes to President for signature

DJP Update 3-2-2010 Breaking news: SGR decrease delayed one month; H.R. 4691 temporary extension act passes; now goes to President for signature

http://twitter.com/djpNEWS

DJPNEWS

#Senate delays #SGR doctor payment cut 1 month with passage H.R. 4691 via @SenateFloor http://bit.ly/a8T3illess than 5 seconds ago via web

This temporary extension act also includes SGR in Section 5

Section 5 – (of H.R. 4691) summary

Amends title XVIII (Medicare) of the Social Security Act to extend through March 31, 2010: (1) the 0% update to the conversion factor in the Medicare physican payment computation; and (2) the Medicare physical therapy services caps exceptions process.

——

Full text of Sec. 5: http://www.govtrack.us/congress/billtext.xpd?bill=h111-4691

SEC. 5. INCREASE IN THE MEDICARE PHYSICIAN PAYMENT UPDATE.

Paragraph (10) of section 1848(d) of the Social Security Act, as added by section 1011(a) of the Department of Defense Appropriations Act, 2010 (Public Law 111-118), is amended–

(1) in subparagraph (A), by striking ‘February 28, 2010’ and inserting ‘March 31, 2010’; and

(2) in subparagraph (B), by striking ‘March 1, 2010’ and inserting ‘April 1, 2010’.

Senate Floor tweet:

On Passage – Senate – H.R. 4691: Bill Passed 78-19, 3 not voting. Bipartisan support. Go to Bill Status : H.R. 46…http://bit.ly/9wsWsV

http://www.govtrack.us/congress/vote.xpd?vote=s2010-32

Senate Vote On Passage: H.R. 4691: Temporary Extension Act of 2010

Number:

Senate Vote #32 in 2010 [primary source]

Date:

Mar 2, 2010 8:56PM

Result:

Bill Passed

———–

Stay well,

Donald

Also, recent selected DJP Updates can be found at: http://www.donaldpalmisano.com/html/djp_update/

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@donaldpalmisano.com
www.donaldpalmisano.com
www.onleadership.us

This DJP Update goes to 2211 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

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DJP Update 3-1-2010 Press release about physician payment cut of 21% Medicare and a little more

DJP Update 3-1-2010 Press release about physician payment cut of 21% Medicare and a little more

Don’t forget the liberty right of contracting with patients for any differences that government pays, a right physicians do not have now unless the physician gets out of Medicare for two years! In my view, that should be part of every medical organization’s message to Congress and the American public. Price-fixing throughout history always leads to loss of access to service or product.

Press release follows:

FOR IMMEDIATE RELEASE Contact: media@protectpatientsrights.org

March 1, 2010 (703) 405-9407

MEDICARE BEING CUT TODAY

Biggest story in healthcare isn’t the reform bill, it’s that already-below-market physician reimbursement rates are being cut 21% today

WASHINGTON, DC – Due to Congressional inaction, Medicare’s reimbursement rates to doctors for their care of our nation’s elderly population will be cut a staggering 21 percent today. This is a result of an unwillingness or inability – pick your poison – to permanently secure the Medicare payment formula system or to even temporarily extend the patchwork fix already in place (the Sustainable Growth Rate formula or SGR). The Coalition to Protect Patients’ Rights supports a strong Medicare and a fair formula that will provide physicians with the resources they need to treat America’s seniors and also allow patients and physicians to negotiate any differences in cost to ensure patients get the care they need.

Former president of the American Medical Association and current spokesman for the Coalition to Protect Patients’ Rights, Dr. Donald Palmisano, made the following statement on the Medicare payment cuts:

“What are physicians to do? What are senior citizens to do?

“As Congress debates, seniors are at peril of losing the medical care they desperately need. Doctors are already providing care to the nation’s seniors at a reduced rate, but this latest cut makes treating those on Medicare financially impossible for doctors, nurses, and hospitals.

“And a one-time patch isn’t going to fix the problem for long. Although more than 40 million Americans rely on Medicare for their well-being and as enrollment is expected to explode as baby-boomers age and retire, Congress has recently proposed gutting Medicare – to the tune of $500 billion. There’s no way Medicare can be cut and still provide the medical service our most vulnerable populations need. Congress must fund Medicare so that it becomes solvent, pays physicians for the work and treatments they provide, and give seniors the peace of mind they deserve.

“Unfortunately, when medicine is subject to the limits of government-control and price-fixing, patients suffer. This isn’t just the case for Medicare, but also for Medicaid, or any other government controlled healthcare system – no matter what it’s called. Congress must do what it can to empower patients and physicians in healthcare, while limiting the role of bureaucrats.”

Dr. Palmisano is also available for interviews from New Orleans, LA, today. Please contact CPPR for more information (703) 405-9407.

About the Coalition to Protect Patients’ Rights

The Coalition to Protect Patients Rights is a non-partisan, grassroots coalition made up of over 10,000 doctors, healthcare providers, advocacy groups, and concerned citizens who are dedicated to the implementation of patient-centered healthcare reform that will improve patient care. For more information, visit the Coalition to Protect Patients’ Rights website at www.protectpatientsrights.org.

###

—————-

Meanwhile, others talk of the “the growing market power of hospitals and physicians to negotiate higher payment rates-”

DJP: The overwhelming majority of physicians have no market power!

The context of the market power of physicians comes from this article:

—————

http://content.healthaffairs.org/cgi/content/abstract/hlthaff.2009.0715

While the high cost of private health insurance has drawn plenty of attention in the health reform debate, an underlying driver of higher insurance premiums–the growing market power of hospitals and physicians to negotiate higher payment rates–has gone largely unexamined, according to a Center for Studying Health System Change (HSC) study published online Feb. 25 by Health Affairs.

Funded by the California HealthCare Foundation, the study examines the growing market power of many California hospitals and physicians, finding that providers are using various strategies, such as tighter alignment of hospitals and physician groups, to negotiate significantly higher payment rates from private insurers. The authors point out that California offers a cautionary tale for reform proposals that encourage hospitals and physicians to form tighter relationships through accountable care organizations.

“Health insurers have been squarely in the crosshairs and blamed for the high cost of private insurance, while the role of growing hospital and physician market power has escaped scrutiny,” said HSC Senior Consulting Researcher Robert A. Berenson of the Urban Institute, a coauthor of the study with HSC President Paul B. Ginsburg and Nicole Kemper, a former HSC research analyst.

—————–

Stay well,

Donald

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates.

Also, recent selected DJP Updates can be found at: http://www.donaldpalmisano.com/html/djp_update/

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@donaldpalmisano.com
www.donaldpalmisano.com
www.onleadership.us

This DJP Update goes to 2211 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

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DJP Update 2-26-2010 Gov Price-Fixing: the end result

DJP Update 2-26-2010 Gov Price-Fixing: the end result

Quick update as boarding plane at plane change in Phoenix.

See AMA press release below.

The 21% fee cut for physicians for Medicare and Tricare takes place March 1.

Yet Congress departs!

Why would anyone want government more involved in the health system?

With the price-fixing and FORBIDDING of private contracting without penalty, it is the patients who will suffer!

Does Congess really care?

Every senior in America should loudly protest. And we all know the families of our brave military do not need any more stress with the Tricare coverage.

Shame on Congress. Why was this crisis not discussed at the Summit?

So much for Organized Medicine’s negotiating approach over this past year and “seat at the table”.

Time for a new game plan. Time for return to Liberty!

Stay well. Have to board plane.

Donald

Begin forwarded message:

From: HOD Advocacy Update <hod.advocacy.update@enews.ama-assn.org>

Date: February 26, 2010 11:27:53 AM MST

To: djp@donaldpalmisano.com

Subject: FW: AMA News: Senate Inaction on Medicare Hurts Seniors, Military and Boomers; Drastic 21% cut on March 1

Reply-To: terri.marchiori@ama-assn.org

The AMA press release on the Senate in action…

FOR IMMEDIATE RELEASE February 26, 2010

SENATE INACTION ON MEDICARE HURTS SENIORS, MILITARY AND BOOMERS

Drastic 21 percent Medicare physician payment cut will take place on Monday, March 1

WASHINGTON, D.C. – A Medicare meltdown now seems certain, as the U.S. Senate has left early for the weekend, abandoning seniors, military families and baby boomers. The Senate failed to repeal the Medicare physician payment formula that will cause a drastic 21 percent payment cut to physicians who care for Medicare and TRICARE patients. On Monday, the 21 percent cut goes into effect, forcing many physicians to limit the number of Medicare and TRICARE patients they see in order to keep their practice doors open.

“Our message to the U.S. Senate is stop playing games with Medicare patients and the physicians who care for them,” said AMA President J. James Rohack, M.D. “It is shocking that the Senate would abandon our most vulnerable patients, making them the collateral damage of their procedural games.”

Already, about one in four Medicare patients seeking a primary care physician is having trouble finding one, according to MedPAC, Congress’ advisory body on Medicare. Physicians have told AMA that steep Medicare cuts will force them to limit the number of Medicare patients they treat. A new 2010 survey of neurosurgeons found that about 60 percent are already reducing the number of Medicare patients in their practices, and cuts will force nearly 40 percent to decrease the number of new Medicare patients they see. More than 18 percent of neurosurgeons will no longer take new Medicare patients.

“The Senate had more than a year to repeal the formula and ensure the security and stability of Medicare and TRICARE, but that opportunity has been squandered,” Dr. Rohack said. “This drastic cut will hurt our senior, disabled and military patients, as well as baby boomers who start entering the Medicare program next year.”

“Last November, the U.S. House passed legislation (H.R. 3961) that would repeal the broken formula and better update payments to reflect the increasing cost of care,” Dr. Rohack said. “AARP and the Military Officers Association of America (MOAA) have joined with the AMA in calling on the Senate to act, but the Senate has turned its back on America’s seniors, military families and baby boomers.”

###

Contact:

Brenda Craine, Director, AMA Media Relations

202-789-7447

Follow AMA on Twitter at https://twitter.com/AmerMedicalAssn

About the American Medical Association

The American Medical Association helps doctors help patients by uniting physicians nationwide to work on the most important professional and public health issues. Working together, the AMA’s quarter of a million physician and medical student members are playing an active role in shaping the future of medicine. For more information on the AMA, please visit www.ama-assn.org

Brenda Craine

Director, Media Relations

25 Massachusetts Avenue, NW

Suite 600

Washington, DC 20001-7400

P: (202) 789-7447

F: (202) 789-7472

brenda.craine@ama-assn.org

AMA news on Twitter at: https://twitter.com/AmerMedicalAssn

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@donaldpalmisano.com
www.donaldpalmisano.com
www.onleadership.us

This DJP Update goes to 2210 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

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DJP Update 2-25-2010 p.m. edition Health Summit – opinions from various sources; LAGNIAPPE: Former Astronaut Dr. James P. Bagian joins The Doctors Company (TDC) board

DJP Update 2-25-2010 p.m. edition Health Summit – opinions from various sources; LAGNIAPPE: Former Astronaut Dr. James P. Bagian joins The Doctors Company (TDC) board

Here are selected quotes from the Senate_GOP, Washington Post, and Senate Democrats, and more PLUS a link to the tweets #hcr and #healthsummit

Republican selection of quotes from the news:

http://republican.senate.gov/public/index.cfm?FuseAction=Blogs.View&Blog_ID=51c7d4ac-bb81-44eb-8022-6ada4a581ba9&Month=2&Year=2010

WHAT THEY ARE SAYING ABOUT THE HEALTH CARE SUMMIT

“Republicans Certainly Showed Up Ready To Play” “Came In With A Plan,” “The Best Day They Have Had In Years,” “Strong Day”

CNN’S DAVID GERGEN: “Intellectually, The Republicans Had The Best Day They’ve Had In Years. The Best Day They Have Had In Years.” (CNN’s “The Situation Room,” 2/25/10)

· CNN’s DAVID GERGEN: “The Folks In The White House Just Must Be Kicking Themselves Right Now. They thought that coming out of Baltimore when the President went in and was mesmerizing and commanding in front of the House Republicans that he could do that again here today. That would revive health care and would change the public opinion about their health care bill and they can go on to victory. Just the opposite has happened.” (CNN’s “Live,” 2/25/10)

NPR’S MARA LIASSON: “I Think That The Republicans Made Their Arguments Very Well.” (Fox News, 2/25/10)

CNN’S WOLF BLITZER: “It Looks Like The Republicans Certainly Showed Up Ready To Play.” (CNN’s “Live,” 2/25/10)

· CNN’S WOLF BLITZER: “And The Republicans Had Less Speaking Time, But They Took Full Advantage Of Every Minute They Had.” (CNN’s “The Situation Room,” 2/25/10)

THE HILL’S A.B. STODDARD: “I Think We Need To Start Out By Acknowledging Republicans Brought Their ‘A Team.’ They had doctors knowledgeable about the system, they brought substance to the table, and they, I thought, expressed interest in the reform. I thought in the lecture from Senator John McCain and on the issue of transparency, I thought today the Democrats were pretty much on their knees.” (Fox News’ “Live,” 2/25/10)

CNN’s GLORIA BORGER: “The Republicans Have Been Very Effective Today. They Really Did Come To Play. They Were Very Smart.” (CNN’s “Live,” 2/25/10)

· BORGER: “They took on the substance of a very complex issue. … But they really stuck to the substance of this issue and tried to get to the heart of it and I think did a very good job.” (CNN’s “Live,” 2/25/10)

· BORGER: “They came in with a plan. They mapped it out.” (CNN’s “Live,” 2/25/10)

POLITICO: “By The Afternoon, However, Both Sides Took A More Substantive Approach That Played To The Republicans’ Benefit, given Democratic attempts to portray them as unreasonable and partisan.” (“Six Hours Later, Stalemate Remains,” Politico, 2/25/10)

FOX NEWS’ CHARLES KRAUTHAMMER: “The Republicans Really Helped Themselves. The argument against them, it’s the party of no, they have no ideas, they are against anything, they’re nihilists. In fact, they spent seven hours, I think, presenting a very strong case. They’re knowledgeable. They have ideas. They are interested in reform, but they have differences. Lamar Alexander was dazzling, Paul Ryan was rapier sharp in rebutting all of the smoke and mirrors that the democrats had presented.” (Fox News, 2/25/10)

JAMES CARVILLE: “First, In General, You’d Have To Say, By The Most Part Most Of These People Were Pretty Knowledgeable, They Had Done Their Homework … I Thought That Senator Alexander And Senator Coburn Did Great…” (CNN’s “The Situation Room,” 2/25/10)

FOX NEWS’ BRET BAIER: “Republicans Had A Strong Day Making Their Points.” (Fox News’ “Live,” 2/25/10)

WASHINGTON POST’S MICHAEL GERSON: “The Democrats’ Health-Care Ambush Failed”(Michael Gerson, Op-Ed, “The Democrats’ Health-Care Ambush Failed,” The Washington Post, 2/25/10)

———-

Washington Post

http://voices.washingtonpost.com/thefix/white-house/winners-and-losers-from-the-he.html?hpid=topnews

After spending our day watching the high-stakes or, at the very least, high-profile health care summit at Blair House, we came up with a list of our winners and losers from the proceedings.

Those who we think soared and bored are below. Have your own thoughts? The comments section is open for business.

WINNERS

Tom Coburn: The Oklahoma senator is among the most conservative voices in Congress but his remarks emerged as a — rare — rallying point during the day. Coburn’s comments on the necessity of eliminating waste and fraud from the health care system drew nods from the president and kudos from a handful of Democratic and Republican politicians gathered at Blair House. In a room dominated by politicians trying to score political points or vamp for the cameras, Coburn stood out.

President Obama: Did the president solve the problem of passing a health care bill today? No. But, there was never a reasonable expectation on either side that he would. What Obama did do was paint himself — for anyone who was watching — as someone genuinely interested in compromise and genuinely interested in engaging with his Republican colleagues. (Whether that was a facade or the real thing remains a major point of debate between partisans.) Obama also didn’t let Republicans run rough-shod over him either. He clashed with Sens.Lamar Alexander (Tenn.) and John McCain (Ariz.) — showing a feistiness (albeit a measured feistiness) that is likely to be well received by the party’s base. Obama’s performance saved, to our mind, what could have been a disastrous day for his party as he got relatively little help from his party’s representatives in Congress throughout the day.

Process: While President Obama sought repeatedly to keep the focus on future-oriented policy solutions, the discussion repeatedly devolved into process. Sen. John McCain (Ariz.) dedicated the majority of his remarks to detailing the deals cut during the health care debate while Senate Majority Leader Harry Reid (Nev.) spent much of his time defending the idea of reconciliation to pass major measures of the bill. Senate Minority Leader Mitch McConnell (Ky.) even brought process to the Blair House discussion — noting that Democrats had been given more time to talk than Republicans. (Obama shot back that he had not counted to his own speaking time in the total since he is the president.) The more process coverage, the worse for Democrats who have been hamstrung to date by the focus on how the bill becomes a law rather than the policy guts of the proposal.

The Senate: There was roughly an equal number of House and Senate members gathered at Blair House but it felt very much like a debate between senators. With the exception of Rep. Paul Ryan (R-Wis.) — the GOP’s dedicated policy guy — there was very little serious engagement in the talks from the House side.

Paul Ryan: Speaking of the Wisconsin Republican, it was clear that the president regards him as a serious thinker and adversary while his GOP colleagues often deferred to him on matters of health care and budget policy. Ryan helped burnish his credentials a rising star within the Republican party; he was partisan but drove his attacks using data rather than pure political rhetoric.

C-SPAN: What a day for the Fix’s favorite television network. Full coverage of the summit as well as a flawless Internet feed for those not close to a television. Well done.

LOSERS

Harry Reid: Reid is the consummate behind the scenes player. And, today he reminded us again of why. Reid, who spoke within the summit’s first hour, was extremely combative — a tone that seemed out of step with the overall tenor of the meeting in which most attendees tried to pay at least lip service to the idea of bipartisanship before launching into the attacks. Not Reid. “Let’s make sure we talk about facts,” Reid scolded Sen. Lamar Alexander (R-Tenn.). Later, he interrupted Coburn and said the Oklahoma Senator was trying to “filibuster.”

John McCain: From the start of his remarks around mid-day, McCain seemed on the verge of losing his temper and threw several rhetorical jabs (including one about Obama breaking his campaign promise about holding the health care hearings on C-SPAN) into his speech. (“We’re not campaigning anymore,” Obama shot back at McCain. “The election is over.”) Later, McCain hit Obama again for the special carve out for Florida in the health care bill. Obama agreed with the McCain critique, a move that caught the Arizona Republican off guard and left him speechless. In truth, McCain’s target audience today was not people in the room or the national media but rather conservative Republicans in his home state — the people he needs to beat back a challenge from his ideological right from former Rep. J.D. Hayworth.

Genuine Discussion: With a few exceptions, the bulk of the summit — not surprisingly — was focused on the rehashing of talking points rather than a serious engagement on the issues. Obama repeatedly attempted to keep speakers (of both parties) on topic but the conversation felt like politicians talking at — rather than to — one another. The idea of a serious policy debate was probably sacrificed the moment the summit was televised. But, it was jarring to watch what was purported to be a discussion devolve into a series of (semi)connected stump speeches.

Public Option: House Speaker Nancy Pelosi (Calif.) and House Majority Leader Steny Hoyer (Md.) were the only ones to mention the issue that dominated the health care debate for months on end last fall — and that was in the context of it being sacrificed as a compromise to Republicans. And, as Fix colleague Alec MacGillis pointed out, Obama was very careful to emphasize that people shopping for coverage on the new health insurance exchanges he is proposing would be choosing only among ‘private plans.'”

Cable Networks: With the exception of the Obama-McCain tête à têete, the day was largely devoid of the sort of made-for-TV moments that help drive ratings.

By Chris Cillizza | February 25, 2010; 5:21 PM ET

Senate_GOPs Tweet:

Final #hcrsummit talk tallies: Dems and Obama: 233 minutes; GOP: 110 minutes http://bit.ly/ag6jv0 #tcot #sgp

Senate Democrats statement of Senator Reid: http://democrats.senate.gov/newsroom/record.cfm?id=322570&

February 25, 2010

Reid Statement On White House Health Summit

Washington, DC— Nevada Senator Harry Reid released the following statement at the conclusion of the bipartisan, bicameral White House Health Reform Summit today:

“Today’s meeting was an important exchange that allowed the American people to hear different ideas and I applaud the President for bringing us together. Health reform is not about process or sound bites; it’s about real people like Jesús Gutierrez in Reno who struggle with a health system that too often stands between them and the care they need and deserve. Ideological differences will always exist, but unless we act health care costs will continue to skyrocket and thousands of Americans will continue to lose their coverage or be denied treatment every day.

“I still believe that we can work together and am hopeful that we reach the bipartisan solution to health reform that we’ve always preferred. We are serious about delivering meaningful health reform to the American people, and all options remain on the table to accomplish that.”

———–

To see the tweets happening this very moment, go to Google and type in #hcr

or

#healthsummit

and then scroll down to the tweets and click on that. Here is the URL for one.

Example: http://www.google.com/search?q=%23healthsummit+site%3Atwitter.com&tbs=mbl:1&tbo=1&hl=en&client=safari&rls=en&sa=X&ei=nS-HS7_pKMeNlAeZkdTPAQ&ved=0CCMQsQcwCA

——–

AP at Yahoo News:

Excerpt: http://news.yahoo.com/s/ap/20100225/ap_on_bi_ge/us_health_care_overhaul

By RICARDO ALONSO-ZALDIVAR and JENNIFER LOVEN, Associated Press Writers – Thu Feb 25, 6:23 pm ET

WASHINGTON – After a day of debate and disagreement, President Barack Obama concluded Thursday’s unprecedented live talkfest on health care with the bleak assessment that accord between Democrats and Republicans may not be possible. He rejected Republican preferences for seeking a step-by-step solution or simply starting over.

Obama strongly suggested that Democrats will try to pass a sweeping overhaul without GOP support, by using controversial Senate budget rules that would disallow filibusters. And then, he said, this fall’s elections would write the verdict on who was right.

“We cannot have another yearlong debate about this,” Obama said at the end of a 7 1/2-hour marathon policy session.

———–

And the stories go on and on.

By the end of April, any attempt to push the current bills through using reconciliation will stop. Meanwhile, you can bet the folks who are doing polls will be very busy. Much action in Congress will depend on the polls. The eyes always are on the ballot box. But sometimes the racing car fails to make the turn and goes off of the cliff. We shall see.

Stay well. Live long. Exciting times are unfolding.

LAGNIAPPE: Former Astronaut Dr. Jim Bagian joins The Doctors Company (TDC) board (www.thedoctors.com). TDC has a wonderful board and it was a pleasure to see Dr. Jim Bagian join the TDC board today as a new board member. Many of you know Dr. Bagian’s work in patient safety. Of course he is a multitalented leader — an engineer, physician, pilot, and astronaut. After the 1986 CHALLENGER space shuttle explosion, he supervised the capsule’s recovery from the ocean floor, personally diving ninety-five feet into the Atlantic Ocean and discovering the bodies. I feature him as one of the leaders in chapter 16 of my book, “On Leadership – Essential Principles for Success”. I always learn something from Jim and today was no exception as I listened to him during breaks when I attended the TDC board meeting that concluded today.

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates.

Also, recent selected DJP Updates can be found at: http://www.donaldpalmisano.com/html/djp_update/

Will be in the air most of tomorrow heading home form California!

Have a great weekend!

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@donaldpalmisano.com
www.donaldpalmisano.com
www.onleadership.us

This DJP Update goes to 2210 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

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DJP Update 2-18-2010 More analysis and less spin needed in Health System Reform debate – one example of analysis by John Goodman (see link below to his article)

DJP Update 2-18-2010 More analysis and less spin needed in Health System Reform debate – one example of analysis by John Goodman (see link below to his article)

DJP comments: Health System Reform. The Upcoming Summit. “Trick” or good faith attempt to gather ideas for workable health system reform? That is the essence of comments in the media now.

What is needed is careful reading of the details of any bill and analysis of the consequences if passed into law. Distinguish experiment from proven performer. Use the techniques of the scientific method and challenge assumptions and claims.

We need less spin from Washington, DC and the talking heads on TV and more analysis. Below is one example of an important example of analysis by John Goodman. You can agree or disagree but if you disagree, don’t attack but instead give cogent analysis of what is wrong, if anything. One of the problems with the current debate is the failure to give proof of error in analysis and instead the person who made a proposal is attacked with name-calling and smears.

Americans are not stupid! Soon they will send a loud message and possibly vote everyone in Congress out of office and start anew. Americans may consider term limits for Congress. They did it for the presidency and Congress is next, in my view. Earlier than the Lord Acton quote in 1887 about the corrupting influence of power is this comment by William Pitt the Elder in a House of Lords speech in 1770:

“Unlimited power is apt to corrupt the minds of those who possess it; and this I know, my lords, that where laws end, tyranny begins.”

DJP comment: Decades in office certainly can lead to arrogance and inability to feel the pain of the Citizens. What about limit of 6 years in the House (Three 2 year terms) and 12 years (two 6 year terms) in the Senate? Think about that!

——-

EXCERPT FROM JOHN GOODMAN’S ARTICLE IN HIS HEALTH POLICY BLOG:

Obama might then say, “Since we agree on the fundamentals, why can’t we iron out the details?”

The answer is that these similarities are only superficial. Although it’s always hazardous to generalize about political parties, if you dig a bit deeper, you will discover a huge gulf separates most Republicans from most Democrats on health reform. Three issues in particular illustrate that fact….

GO TO THE LINK BELOW TO READ THE ENTIRE ARTICLE. If desired, you can place a comment about the article on the blog site as I did.

———–

Here is my tweet about John Goodman’s article of today:

———

http://twitter.com/djpNEWS

DJPNEWS

Need analysis like this & no spin by Congress-Why Repubs & Dems can’t get together #hsr by #JohnGoodman http://tinyurl.com/yzm7fdp

———-

Conventional link is: http://www.john-goodman-blog.com/why-cant-republicans-and-democrats-get-together-on-health-reform/?utm_source=newsletter&utm_medium=email&utm_campaign=HA

LAGNIAPPE: Reminder that I will do interview on health system reform and upcoming health summit this Saturday morning 2-20-2010 on the Rob & Cari Show in Steamboat Springs, CO on KBCR (11:00 a.m. Eastern; 10:00 a.m. Central; 9:00 a.m. Mountain etc.)

You can listen in live at the Website: http://www.cariandrob.info/listen-live-now

—-

Stay well,

Donald

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates.

Also, recent selected DJP Updates can be found at: http://www.donaldpalmisano.com/html/djp_update/

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@donaldpalmisano.com
www.donaldpalmisano.com
www.onleadership.us

This DJP Update goes to 2210 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

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DJP Update 2-13-2010 Some fun! Saints parade photos; Lagniappe: a special connection

DJP Update 2-13-2010 Some fun! Saints parade photos; Lagniappe: a special connection

I posted a few of the photos I captured at the Saints parade on 2-9-2010, two days after the World Champion Saints won the Super Bowl.

You can view them at:

http://twitpic.com/photos/DJPNEWS

Here is the tweet:

DJPNEWS

My #photos of #Saints parade #NewOrleans 2-9-2010 after #SuperBowl win!http://twitpic.com/photos/DJPNEWS See #SeanPayton etc

LAGNIAPPE: We all know that the trophy in Coach Sean Payton’s hand in the photo I took is the LOMBARDI TROPHY, the trophy named after the famous Coach Vince Lombardi. It is given to the National Football League’s winner of the Super Bowl Championship Game.

But did you know that Vince Lombardi’s grandson, Joe Lombardi, is the Saints quarterback coach! More background info about this at:

http://www.greenbaypressgazette.com/article/20100205/PKR01/100205021/Grandson-of-Vince-Lombardi–New-Orleans-Saints-quarterbacks-coach-Joe-Lombardi–gets-his-shot-at-Super-Bowl

The Lombardi connection is another wonderful part of the Who Dat Nation story that gave a city hope. I also want to share what I recorded from Steve Sabol, head of NFL film and a man who has filmed all 44 Super Bowls, as he spoke on TV immediately after the game:

“Tell me the truth and I will believe; Tell me a fact and I will learn; But tell me a story and it will live in my heart forever. This Super Bowl goes instantaneously into American folklore. It is triumph that symbolizes a city’s rebirth, the growing stardom of Dree Brees, and the bravado and the fearless decision-making of the coach, Sean Payton.”

Amen! Happy Mardi Gras! This year will be a photographer’s delight.

Stay well and more on the health system summit soon!

Donald

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates.

Also, recent selected DJP Updates can be found at: http://www.donaldpalmisano.com/html/djp_update/

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@donaldpalmisano.com
www.donaldpalmisano.com
www.onleadership.us

This DJP Update goes to 2210 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

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DJP Update 2-10-2010 late night Breaking News: The Coalition of State Medical & Specialty Societies Charter & Mission

DJP Update 2-10-2010 late night Breaking News: The Coalition of State Medical & Specialty Societies Charter & Mission

This Charter & Mission approved tonight.

——————————–

THE COALITION OF STATE MEDICAL AND NATIONAL SPECIALTY SOCIETIES

CHARTER AND MISSION

The undersigned State Medical Societies and National Specialty Societies hereby come together as a Coalition with a common commitment to preserve the practice of medicine as a profession, and to preserve the time-honored patient-physician relationship keeping it free of outside interference. In furtherance of these objectives, all members pledge to publicly and actively promote the basic principles of this Coalition as defined herein.

The Right to Privately Contract: Access to quality health care can only be ensured by fundamentally reforming our broken medical payment system. The right to privately contract for services is a touchstone of American freedom and liberty. Patients and physicians must be allowed to freely exercise this right without third party interference or penalty.

Determination of Quality Medical Care. The determination of the quality of medical care must be made by the profession of medicine, not by the government or other third party payers.

Medical Liability Reform: Medical liability reform is essential to ensure access to quality, affordable health care for all patients. Such reform should be based on proven policies.

Membership in the Coalition: Any state medical society or any national specialty society that is a recognized component of the American Medical Association House of Delegates may become a member of the Coalition. With the approval of a majority of the members, individuals may also be invited to participate as an associate of the Coalition.

Governance: Each member organization in the Coalition shall designate one person as its representative and be entitled to one vote. The representatives will elect a chairman who will conduct the meetings of the Coalition and serve as its primary spokesperson.

Financing: Member organizations shall pay dues as determined by the Coalition. An annual accounting of expenditures shall be made.

Dues

Dues for 2010 shall be $1,000.

——————–

Contact Person for more details and to join:

David A. Cook

Executive Director/CEO

Medical Association of Georgia

1849 The Exchange, Suite 200

Atlanta, Ga. 30339

678-303-9251

dcook@mag.org

www.mag.org

———————–

Stay well,

Donald

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates.

Also, recent selected DJP Updates can be found at: http://www.donaldpalmisano.com/html/djp_update

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@donaldpalmisano.com
www.donaldpalmisano.com
www.onleadership.us

This DJP Update goes to 2203 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

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DJP Update 2-10-2010 recent & upcoming radio interviews by DJP re White House Health Summit; Lagniappe

DJP Update 2-10-2010 recent & upcoming radio interviews by DJP re White House Health Summit; Lagniappe

Here is an update on some of the recent and upcoming radio shows I am doing on health system reform. Some you can listen to them live regarding of where you live by going to Website or downloading “WUNDERRADIO” IPhone App. The App is terrific.

Also, most of the stations post PodCasts of the interviews.

Meanwhile, another missed opportunity for our AMA to mention Private Contracting without Penalty. See my tweet and link to AMA comments:

DJPNEWS tweet posted at: http://twitter.com/djpNEWS

No mention PrivContracting?! RT AMAblog: AMA Pres J. James Rohack, MD, ..need Medicare’s #SGR formula to be repealed. http://bit.ly/drAe43

—–

Radio Interviews:

TUESDAY

Date: Tues Feb 9

Time: 2:00 ET

Show: Inga Barks on KERN in Bakersfield, CA

Topic: Health care summit

Website: http://www.kernradio.com/pages/5860237.php?

Date: Tues Feb 9

Show: Greg Corombos, Radio America

Topic: Health care summit

Website: http://dateline.radioamerica.org/?page_id=2

PODCAST of interview is at: http://dateline.radioamerica.org/index.php?submit.x=41&submit.y=18&s=palmisano

WEDNESDAY

Date: Wed Feb 10

Time: 4:20pm ET

Show: Steve Malzberg on WOR in NYC

Topic: Health care summit

Website: http://www.malzbergtalk.com/site/?page_id=17

Date: Wed Feb 10

Time: 7:30 PM ET (20 mins, call-ins)

Show: Lars Larson, Guest host: Mike Siegel

Info on Mike Siegel: http://info.jpost.com/C002/Supplements/AmericasVoices/msl_01.html

Lars’ website: http://www.larslarson.com/

SATURDAY 2/20

Date: Saturday Feb 20

Time: 11:00am ET

Show: Rob & Cari in Steamboat Springs, CO on KBCR

Topic: Health care summit

Website: http://www.cariandrob.info/listen-live-now

——-

LAGNIAPPE: Have you seen the news reports and email traffic that the Saints will win the Super Bowl when Hell freezes over? Then there is a photo of the Saints winning the Super Bowl following by the freeze and snow storm covering Washington, DC. Also noted is an Igloo home for Vice-president Gore near the Capitol. “Sen. Inhofe, the ranking Republican on the Senate Environment and Public Works Committee, told Roll Call newspaper that his family’s ironic tribute to Gore was “really humorous.” Lots of controversy on many issues!

Meanwhile, free discussion of issues difficult in some places around the world. This just in with an Iraniam official stating government control action on Internet in Iran is meant to build trust. With “Big Brother” watching you, can it be far behind that someone knocks on your door if you have a dissenting view? Long live America and Freedom of the Press! Express your view and back it up with facts, not spin.

Technology Alert

from The Wall Street Journal

Iran’s telecommunications agency announced what it described as a permanent suspension of Google’s email services, saying a national email service for Iranian citizens would soon be rolled out.

It wasn’t clear late Wednesday what effect the order had on Gmail services in Iran. Iranian officials have claimed technological advances in the past that they haven’t been able to execute.

Google didn’t have an immediate comment about the announcement.

An Iranian official said the measure was meant to boost local development of Internet technology and to build trust between people and the government.

The measure was announced on the eve of the culmination of celebrations to mark the 31st anniversary of the Islamic Republic. Competing plans for pro-government and antigovernment demonstrations have set the stage for clashes between authorities and opposition protesters, who have taken to the streets repeatedly since contested presidential elections in June.

http://online.wsj.com/article/SB10001424052748704140104575056972514372994.html?mod=djemalertTECH

———-

Finally, Saints parade last night was wonderful! I attended and got some fun photos. The city continues to party and the costumes on Mardi Gras will be fascinating this year! Mardi Gras (Fat Tuesday) will be February 16 this year.

Stay well,

Donald

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates.

Also, recent selected DJP Updates can be found at: http://www.donaldpalmisano.com/html/djp_update/

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@donaldpalmisano.com
www.donaldpalmisano.com
www.onleadership.us

This DJP Update goes to 2205 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

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