Brian Sweeney Jr. is an opinionated gastroenterologist in Anchorage.
The Smokescreen of Screening - 11/21/2009 7:27 pm
Rocking Out In The Church Of Begich - 11/18/2009 11:16 pm
To Boldly Go... - 11/14/2009 9:31 pm
Doctors Are Not Clones - 11/8/2009 8:38 pm
A Nation Has Got To Know Its Limitations - 11/5/2009 8:41 pm
The Enemy of Better: Worse - 10/31/2009 7:49 pm
Obama: Nobel Prize For Intolerance - 10/23/2009 9:55 pm
Downside of Blind Justice - 10/18/2009 9:54 pm
Have Another Doghnut Koharski - 10/14/2009 8:17 pm
Weapons of Financial Destruction - 10/6/2009 12:44 am
Cheeseburger, Cheeseburger. No Coke, Pepsi. - 9/27/2009 7:11 pm
Killing Us Softly With Mandates - 9/22/2009 9:40 pm
Physicians, Begich, and Moving Forward - 9/19/2009 8:55 pm
Some Things Never Change, Democrats and the Race Card - 9/16/2009 9:45 pm
Here We Go Round - 9/13/2009 6:55 pm
Wanted: Fiscal Sanity - 9/6/2009 10:18 pm
Who Wants To Be a Doctor? - 9/1/2009 11:49 pm
Even Howard Dean Gets It - 8/28/2009 10:06 pm
Masters Who Are The Jack of All Trades - 8/26/2009 11:23 pm
Culture Reform - 8/22/2009 6:41 pm
Doctor, Heal Thyself - 8/19/2009 10:03 pm
Let There Be Anger - 8/16/2009 2:42 pm
NOVEMBER 21, 2009 - 7:27 PM
In medical school I was taught that a screening test should have 3 characteristics. It should have a high sensitivity and specificity. It should be inexpensive. It should be low risk.
It gets considerably more complicated in the real world. The standard that has been most often applied has been cost per year of life saved. That theoretically takes all of the desired characteristics into account.
When the thought leaders in a field sit down to make recommendations they have to weed through immense amounts of data. It can come from studies of varying validity and biases.
NOVEMBER 18, 2009 - 11:16 PM
My health insurance premiums have not gone up 50% in the last 6 years but my property tax sure did.
It is a bit of a paraphrase but that was a comment made by an attendee at Senator Begich's town hall meeting at Bartlett High School. It seemed completely appropriate after Marky Mark seemed so concerned about the rising cost of health care premiums.
Perhaps it has escaped Begich that housing is a bigger expense for US households than health care. For people with higher incomes, taxes are the biggest expense.
NOVEMBER 14, 2009 - 9:31 PM
Liberal friends of mine used to love to watch The Left Wing. Oh wait, I mean The West Wing. They would dream of what it would be like to have a liberal president. Some of them, especially the physicians, now know to be careful what to wish for.
Hollywood has a left wing slant. It is reinforced with a politically correct attitude. Any movie dealing with political issues is immediately "critically acclaimed." It is the same way if an actor dies in production or the film deals with homosexuality. It will immediately receive accolades. Bonus points if you insult religion.
NOVEMBER 8, 2009 - 8:38 PM
No organization or group governs my opinions. In the same way, I would never claim to represent any group with my opinions.
When the American Medical Association (AMA) stopped generally representing what I believed was best I gave up my membership. That was over 10 years ago.
The American College of Physicians (ACP) stopped representing what was good for US heath care about 2-3 years ago. I stopped paying dues and am no longer a member.
My stance on that has drawn ire from some of my Internal Medicine colleagues. I have been told by their leadership that the ACP does some good things clinically and in research. That is true. The problem is their policy statements, in my opinion, would be detrimental to health care in this country.
NOVEMBER 5, 2009 - 8:41 PM
The first time I realized how real the uniform I wore in the Air Force was was back in 1997. I was at a training course designed to help health care professionals understand how to operate in war zones. A fellow physician, a colleague of mine from an officer indoctrination course, gave a presentation on what happened after the bombing of the Khobar Towers. He had gone the route of being a flight surgeon and two years out of medical school was one of the first physicians on that horrific scene.
Most people remember where they were on 9/11/2001. The news hit me while I was on my way to Elmendorf AFB for work. It was a day that changed life in the Air Force.
OCTOBER 31, 2009 - 7:49 PM
A half a dozen Medicare patients a week that have no primary care physician come through my office. Some of them come from Emergency Department referrals. Some are patients that used to have a physician that dropped them when they turned 65. Some of them are bouncing around from sub specialist to sub specialist piecing together care.
Contrary to public belief most primary care physicians in town do have Medicare patients. Many offices will not take new Medicare but will keep patients when they become Medicare beneficiaries. There are also a few clinics that still will take on Medicare patients although it often overwhelms them.
OCTOBER 23, 2009 - 9:55 PM
I remember hanging out in The Dartmouth Review office in college and taking bets on what angle The New York Times education page was going to come at us from next. On one occasion it was attacking a column by John Sutter comparing the Dartmouth administration to Nazi Germany. No matter that Jake Tapper, now with ABC news, had used a cartoon to compare The Review to Nazism less then a year before in the main college paper.
Dan Rather used a forged document to try and damage George W. Bush and influence a presidential election. 60 Minutes has been an institution of left wing hatchet jobs for years. Who knows how many frauds were hoisted on the American public by that program before an alternative media was available.
OCTOBER 18, 2009 - 9:54 PM
In 1999 Ryan Matthews was convicted of murder in a convenience store robbery gone wrong. He was sitting on death row in Louisiana in 2004 when DNA evidence identified the man who actually committed the crime.
There are 130 people that have been taken off death row since 1973 because they were wrongfully convicted.
You can never truly make up for convicting someone for a crime they did not commit but the death penalty takes away any chance.
OCTOBER 14, 2009 - 8:17 PM
Iraq war veteran Dr. Jason Newsom returned home to Panama City, FL after his service. He took a job running the Bay County Health Department. He became a one man soldier against junk food.
All was okay when he posted attacks against hamburgers, french fries, and sweet tea on an electronic sign. It was even fine when he went after Kentucky Fried Chicken.
Alas, he unwisely decided to put doughnuts in the cross hairs. "America dies on Dunkin' " was his harsh remark. It turns out a county commissioner owns a doughnut shop. Even worse, two lawyers own a local Dunkin' Donuts.
OCTOBER 6, 2009 - 12:44 AM
Liberal friends of mine often complain that Bill Clinton was the best Republican president ever. They hate the fact he eliminated welfare for the most part and allowed Newt Gingrich to pass 80% of the Contract With America.
It turns out George W. Bush was the best Democrat president ever. He expanded social spending and the role of government.
No Child Left Behind (NCLB) is an example of why we should not have a Department of Education. It is an issue best left to the states because one size clearly does not fit all. It is government intervention at its worst judging educators for the actions of people they have almost no ability to change.
SEPTEMBER 27, 2009 - 7:11 PM
Twice in the last month I have written prescriptions for triple therapy to treat H. Pylori in Alaska Medicaid patients. Part of this therapy is a medication called a proton pump inhibitor (PPI) . The available drugs on the Medicaid formulary are Nexium (esomeprazole) and Prevacid (lansoprazole).
I choose Nexium for H. Pylori therapy because it is FDA approved for single daily dose in the treatment as opposed to twice a day. It should cost half as much. The problem is Medicaid will not give any patient a PPI without prior authorization despite formulary status.
SEPTEMBER 22, 2009 - 9:40 PM
This morning I snared a couple of polyps out of a patient on a screening colonoscopy. There was a time when the procedure would not have been covered in Alaska. That all changed with a bill passed in 2006.
Rep. Norm Rokeberg made the best point of the day when I testified for that Alaska bill. He pointed out his concern with mandates. At the time, I knew he was right. I justified my support based on what was already being mandated in Alaska.
The Council for Affordable Health Insurance reported in 2007 that there were 28 health care mandates in Alaska. That is twice the number of mandates that there are in Idaho (14) but less than half of the number (60) in Maryland.
SEPTEMBER 19, 2009 - 8:55 PM
This morning I went to the town hall meeting that Senator Mark Begich held with health care providers. This is going to be a simple recap of what got discussed.
Tort Reform
This is clearly on the mind of physicians. It was brought up at least a half a dozen times. One physician pointed out they pay $60K in malpractice insurance. Another pointed out the cost of malpractice insurance to do obstetrics in New York keeps family medicine physicians away from the delivery room.
The case of a man who claimed to have a surgery done that was never performed by a surgeon who had never met him was discussed. The cost to all of us was $10K. I do not know who the lawyer was who filed that case and clogged the Alaska system with it but he should be disbarred.
SEPTEMBER 16, 2009 - 9:45 PM
The most ineffective president of the 20th century thinks opposition to President Barak Obama is racism. Jimmy Carter now joins New York Times columnists Maureen Dowd and Paul Krugman in his assessment.
It is an old Democrat trick when things are not going as planned. Pull out the race card. It is the scare tactic they have used for decades to get a stranglehold on 90% of the African American vote.
SEPTEMBER 13, 2009 - 6:55 PM
Some of my most memorable near death experiences happened driving on rotaries in the state of Massachusetts. I remember one rainy morning circling around one near Faulkner Hospital. A large truck zoomed out in front of me. Somehow with a quick yank of the steering wheel I managed to avoid a collision, do a near 360, and end up in the right place.
Massachusetts installed many rotaries in the 1940s and 1950s. Most residents curse them. Governor William Weld began a program to eliminate the traffic menaces in the 1990s. The last time I visited some of the more dangerous ones had already been ripped out and replaced.
SEPTEMBER 6, 2009 - 10:18 PM
Anchorage has been living the "good vibrations" of Marky Mark and the Funky Bunch for the last 6 years. The problem is, much like the real Marky Mark, Begich moved on to something different. The real Marky Mark has given us Entourage while our version has become merely a little fish in the DC spending pond.
Dan Sullivan cannot spend his time as mayor blaming the Church of Begich for Anchorage's ills. We already saw that play out with 6 years of whining about Wuerch. Sullivan needs to figure out how to get the city moving forward with a long term financial plan.
SEPTEMBER 1, 2009 - 11:49 PM
There was a time when call every other night barely phased me. I did it when I was in the ICU as a resident. It was an odd existence to show up at work at 8 AM one day and leave at 1 PM the next.
I would go home and hit the crib, wake up about 10 PM, catch Jay Leno and then slip back off to sleep. During those months the rest of the world just passed by. It is a good thing residents are in their 20s because it would kill me now.
In 1994-95 I had 2 weeks off and roughly about 20 other days off in a year. Yes, that means I worked most Saturdays and Sundays. I averaged about 90 hours a week in the hospital. I had no complaints because at least I was not a surgery resident.
AUGUST 28, 2009 - 10:06 PM
What kind of idiot would say such a thing? It must be some evil conservative, probably a doctor. Well, the man is a physician and many Alaskans would say he is an idiot. A conservative? No, that quote is from Howard Dean.
AUGUST 26, 2009 - 11:23 PM
There were 13 doctors in my internal medicine residency class. We produced 2 cardiologists, 2 oncologists, 2 nephrologists, 2 gastroenterologists, a pulmonologist, a rheumatologist, and an infectious disease specialist. Amazingly, there were 2 that stayed in general internal medicine.
Many general internists who do not specialize now are becoming hospitalists. It may only be a matter of time before it becomes its own recognized sub-specialty. The days of the internist working as a primary care physician in the office setting appear to be ending.
The number of medical school graduates choosing primary care specialties (internal medicine, family medicine, pediatrics) has been falling for some time now. This is complicated by the facts that physicians are aging and by 2020 we are projected to be producing only 5 doctors per 100K of population.
AUGUST 22, 2009 - 6:41 PM
Anchorage Police Officer Anthony Rollins is going to be given a public defender. He made over 140K last year. The ADN reports between him and his wife they have made over a million dollars in the past five years.
Rollins made bad choices with his money. He has rental properties worth less than the mortgage; he has credit card debt and two liens on the family home. He is like many Americans, drowning in debt when he should not be.
Judge Volland is just following the typical behavior of our government. Sign on to a bad home loan and the government will save you. Drown yourself in credit card debt and the government is there to say it is not your fault. Need a new car and Obama rides in on his white horse. We all know what Obama wants to give everybody next, government health care.
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