Quebec’s health insurance board has the power to investigate clinics

CBC News

Over the course of two years, the number of inspections Quebec’s health insurance board (RAMQ) has done at medical clinics dropped by half, according to documents obtained by Radio-Canada.

The check-ups help uncover whether private clinics are charging illegal fees to patients, among other things.

In 2015, the RAMQ did 298 inspections and found that 35 clinics were charging patients for services that are covered by the public health insurance plan. In 2017, only 150 inspections were done; 12 clinics were found to be charging illegal fees.

A law passed in 2016 gave teeth to the RAMQ’s inspectors — before, inspections were more preventive in nature. Inspectors weren’t able to invoke laws and dole out fines.

In an email, a spokesperson for the RAMQ explained that the new powers bestowed upon the board’s 25 inspectors makes the inspection process more complicated, notably because they increased the standard of proof needed to write up lawbreakers.

The spokesperson also said the inspectors’ work was delayed last year due to the passing of a new law that forbids doctors from charging certain fees to patients. Staff had to undergo training in order to be able to apply it properly.

Worrisome drop, says watchdog

Dr. Isabelle Leblanc heads a group of Quebec doctors and medical students who work to preserve the universal nature of Quebec’s health care system.

She says the drop in inspections is cause for concern because it’s up to the RAMQ to make sure that doctors are following the rules.

“Inspections that aren’t based on complaints, just going to check out what’s going on in the clinics, are important because we know that due to the power imbalance, there are many patients who don’t want to file a complaint against their doctors,” she said.
Leblanc questioned whether the government made sure the RAMQ had the necessary resources to carry out inspections and investigations when it decided to increase their powers.
A Daily Journal Could Change Your Life: The 10-minute routine

A Daily Journal Could Change Your Life: The 10-minute routine

“Never go to sleep without a request to your subconscious.”  — Thomas Edison

Excerpted article was written by Benjamin P. Hardy

Here’s why.

10 minutes before going to sleep:

It’s common practice for many of the world’s most successful people to intentionally direct the workings of their subconscious mind while they’re sleeping.

How?

Take a few moments before you go to bed to meditate on and write down the things you’re trying to accomplish.

Ask yourself loads of questions related to that thing. In Edison’s words, make some “requests.” Write those questions and thoughts down on paper. The more specific the questions, the clearer your answers will be.

While you’re sleeping, your subconscious mind will get to work on those things.

10 minutes after waking up:

Research confirms the brain, specifically the prefrontal cortex, is most active and readily creative immediately following sleep. Your subconscious mind has been loosely mind-wandering while you slept, making contextual and temporal connections. Creativity, after all, is making connections between different parts of the brain.

In a recent interview with Tim Ferriss, Josh Waitzkin, former chess prodigy and tai chi world champion, explains his morning routine to tap into the subconscious breakthroughs and connections experienced while he was sleeping.

Unlike 80 percent of people between the ages of 18 and 44 who check their smartphones within 15 minutes of waking up, Waitzkin goes to a quiet place, does some meditation and grabs his journal.

In his journal, he thought-dumps for several minutes. Thus, rather than focusing on input like most people who check their notifications, Waitzkin’s focus is on output. This is how he taps into his higher realms of clarity, learning and creativity—what he calls, “crystallized intelligence.”

If you’re not an experienced journal writer, the idea of thought-dumping might be hard to implement. In my experience, it’s good to loosely direct your thought-dumping toward your goals.

Consider the requests you made of your subconscious just before going to bed. You asked yourself loads of questions. You thought about and wrote down the things you’re trying to accomplish.

Now first thing in the morning, when your creative brain is most attuned after its subconscious workout, start writing down whatever comes to mind about those things.

I often get ideas for articles I’m going to write while doing these thought-dumps. I get ideas about how I can be a better husband and father to my three foster children. I get clarity about the goals I believe I should be pursuing. I get insight about people I need to connect with, or how I can improve my current relationships.

To be sure, you’ll need to practice this skill. It might take several attempts before you become proficient. But with consistency, you can become fluent and automatic at achieving creative and intuitive bursts.

2. Journaling accelerates your ability to manifest your goals.

As part of your morning creative burst, use your journal to review and hone your daily to-do list. Review and hone your life vision and big-picture goals.

As you read and rewrite your goals daily, they’ll become forged into your subconscious mind. Eventually, your dreams and vision will consume your inner world and quickly become your physical reality.

3. Journaling creates a springboard for daily recovery.

People struggle drastically to detach from work. More now than ever, we fail to live presently. Our loved ones are lucky to experience a small percentage of our attention while they’re with us.

But utilizing your journal can curb this mismanagement. At the end of your workday, reopen your journal and review your to-do list from that day. If your morning journal session was excellent, you’ll have likely gotten everything done you intended to do. Private victories always precede public victories.

Journal sessions are your post-work reflection time. Account to yourself what you got done that day and what needs to be moved to tomorrow. Write the things you learned and experienced.

Lastly, direct your subconscious by writing about things you want to focus on tomorrow. As you put work behind you for the evening, your subconscious will be preparing a feast for you to consume during your next morning’s creative and planning session.

This end-of-day journal session doesn’t need to be as long as the morning session. Greg McKeown, author of Essentialism, recommends writing far less than you want to—only a few sentences or paragraphs at most. This will help you avoid burnout.

A primary objective of this session is to mentally turn off work mode. Just as in physical training, you need to rest and recover between workdays to get stronger.

Use this session to completely unplug and detach from work. This is your time to recover and be present with your loved ones—because there is more to life than work. The higher quality your recovery, the more potent and powerful your creative sessions will be.

4. Journaling generates clarity and congruence.

This keystone habit has so much power. By journaling in the morning and evening, you’ll quickly see what is incongruent in your life.

You’ll clearly see what needs to be removed and what should be included in your life. Journaling is a beautiful and powerful facilitator of self-discovery. My own journaling is how I’ve come to form my sense of identity and path in life.

Not only will you have more clarity about your path in life, but journaling improves your ability to make small and large decisions along the way.

On the pages of your journal will be the future world you are creating for yourself. You are the author of your life’s story. You deserve to be happy. You have the power to create whatever life you want. As the designer of your world, get as detailed as you desire.

5. Journaling clears your emotions.

Several research studies found that writing in your journal reduces stress. These benefits include:

  • Reducing scatter in your life
  • Increased focus
  • Greater stability
  • Deeper level of learning, order, action and release
  • Holding thoughts still so they can be changed and integrated
  • Releasing pent-up thoughts and emotions
  • Empowerment
  • Bridging inner thinking with outer events
  • Detaching and letting go of the past
  • Allowing you to re-experience the past with today’s adult mind

When you are in an intensely emotional mood, journaling can help you more fully experience and understand those emotions.

After you’ve vented on the pages of your journal, you’ll quickly find a release. Objectivity will return and you’ll be able to move forward.

Without a journal, intense emotional experiences can be crippling for hours, days and even years. But an honest and inspired journal session can be the best form of therapy—quickly returning you better and smarter than you were before.

6. Journaling ingrains your learning.

Humans are bad at retaining information. We forget most of what we read and hear. However, when you write down the things you’ve learned, you retain them far better. Even if you never reread what you’ve written, the simple act of writing something down increases brain development and memory.

Neurologically, when you listen to something, a different part of your brain is engaged than when you write it down. Memory recorded by listening does not discriminate important from unimportant information. Writing creates spatial regions between important and unimportant pieces of information, which allows your memory to target and engrain the important stuff you want to remember.

Furthermore, the act of writing allows your subconscious mind to work out problems in unique ways, intensifying the learning process. You’ll be able to work out problems and get insight while you ponder and write about the things you’re learning.

7. Journaling increases your gratitude.

Even if you start a journal session in a bad mood, the insight writing brings has a subtle way of shifting your mind toward gratitude.

When you start writing what you’re grateful for, new chambers of thought open in the palace of your mind. You’ll often need to put your pen down and take a few breaths. You’ll be captivated not only by the amazing things in your life, but by the awe and brilliance of life in general.

As part of your morning and post-work journaling sessions, be sure to include some gratitude in your writing. It will change your life orientation from scarcity to abundance. The world will increasingly “become your oyster.”

Gratitude journaling is a scientifically proven way to overcome several psychological challenges. The benefits are seemingly endless. Here are just a few:

8. Journaling unfolds the writer in you.

I became a writer through journaling. While I was on a mission-trip, I wrote in my journal for one to two hours per day. I got lost in flow and fell in love with the writing process.

If you want to become a writer one day, start by journaling. Journaling can help you:

  • Develop strong writing habits.
  • Help you discover your voice.
  • Clear your mind and crystalizes your ideas.
  • Get closer to the 10,000 hours Malcom Gladwell says are required to become world-class at what you do.
  • Produce gems you could use in your other writing.

9. Journaling records your life history.

I started journaling in 2008 after reading an article about the importance of journal writing. In the article, the author described how much journaling had changed her life. She said after all these years, she now has 38 recorded volumes of personal and family history.

After finishing that article, I have never stopped writing in my journal. In my family room on a bookshelf are 20-plus journals filled with my thoughts and experiences. I’m certain they will be cherished by my ancestors as I’ve cherished the writing of my loved ones who have passed on.

This post originally appeared on BenjaminHardy.com.

 

New way of defining Alzheimer’s aims to find disease sooner

By Marilynn Marchione

THE ASSOCIATED PRESS

Government and other scientists are proposing a new way to define Alzheimer’s disease _ basing it on biological signs, such as brain changes, rather than memory loss and other symptoms of dementia that are used today.

The move is aimed at improving research, by using more objective criteria like brain scans to pick patients for studies and enrol them sooner in the course of their illness, when treatments may have more chance to help.

But it’s too soon to use these scans and other tests in routine care, because they haven’t been validated for that yet, experts stress. For now, doctors will still rely on the tools they’ve long used to evaluate thinking skills to diagnose most cases.

Regardless of what tests are used to make the diagnosis, the new definition will have a startling effect: Many more people will be considered to have Alzheimer’s, because the biological signs can show up 15 to 20 years before symptoms do.

“The numbers will increase dramatically,” said Dr. Clifford R. Jack Jr., a Mayo Clinic brain imaging specialist. “There are a lot more cognitively normal people who have the pathology in the brain who will now be counted as having Alzheimer’s disease.”

He led a panel of experts, working with the Alzheimer’s Association and the National Institute on Aging, that updated guidelines on the disease, published Tuesday in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.

ABOUT ALZHEIMER’S

About 50 million people worldwide have dementia, and Alzheimer’s is the most common form. In the U.S., about 5.7 million have Alzheimer’s under its current definition, which is based on memory problems and other symptoms. About one-third of people over 70 who show no thinking problems actually have brain signs that suggest Alzheimer’s, Jack said.

There is no cure current medicines such as Aricept and Namenda just temporarily ease symptoms. Dozens of hoped-for treatments have failed, and doctors think one reason may be that the studies enrolled patients after too much brain damage had already occurred.

“By the time that you have the diagnosis of the disease, it’s very late,” said Dr. Eliezer Masliah, neuroscience chief at the Institute on Aging.

“What we’ve realized is that you have to go earlier and earlier and earlier,” just as doctors found with treating cancer, he said.

Another problem: as many as 30 per cent of people enrolled in Alzheimer’s studies based on symptoms didn’t actually have the disease they had other forms of dementia or even other medical conditions. That doesn’t give an accurate picture of whether a potential treatment might help, and the new definition aims to improve patient selection by using brain scans and other tests.

BETTER TESTS

Many other diseases, such as diabetes, already are defined by measuring a biomarker, an objective indicator such as blood sugar. That wasn’t possible for Alzheimer’s disease until a few years ago, when brain scans and spinal fluid tests were developed to do this.

They measure certain forms of two proteins amyloid and tau that form plaques and tangles in the brain _ and signs of nerve injury, degeneration and brain shrinkage.

The guidelines spell out use of these biomarkers over a spectrum of mental decline, starting with early brain changes, through mild impairment and Alzheimer’s dementia.

WHAT TO DO?

People may be worried and want these tests for themselves or a family member now, but Jack advises: “Don’t bother. There’s no proven treatment yet.”

You might find a doctor willing to order them, but spinal fluid tests are somewhat invasive, and brain scans can cost up to $6,000. Insurance usually does not pay because they’re considered experimental outside of research. A large study is underway now to see whether Medicare should cover them and when.

Anyone with symptoms or family history of dementia, or even healthy people concerned about the risk can consider enrolling in one of the many studies underway.

“We need more people in this pre-symptomatic stage” to see if treatments can help stave off decline, Masliah said.

$175,000 Non-Pecuniary Assessment for Brain Injury Leading to Early Onset Dementia

Source: Erik Magraken: BC Injury Law and ICBC Claims Blog

Reasons for judgement were released today by the BC Supreme Court, Vancouver REgistry, assessing damages for a traumatic brain injury.

In today’s case (Weaver v. Pollock) the Plaintiff was injured in a 2010 collision that the Defendants accepted responsibility for.  The Plaintiff suffered a traumatic brain injury and ultimately was diagnosed with early onset dementia linked to this injury.  In assessing non-pecuniary damages at $175,000 Mr. Justice Burnyeat provided the following reasons:

[100]     I am satisfied that it is now established that mild traumatic brain injury or subdural haematoma can lead to Alzheimer’s disease, frontotemporal dementia, or an increased risk of dementia.

[101]     In his December 1, 2010 statement to ICBC, Mr. Weaver indicated that he had lost consciousness after the Collision. In his report, Dr. O’Shaughnessy assumes that Mr. Weaver lost consciousness but does not indicate how he arrived at that conclusion. On the other hand but without attribution, the notes of Dr. Burtt and Ms. Hubbard indicate no loss of consciousness.

[102]     I find that Mr. Weaver has proven on a balance of probabilities that he was unconscious for more than a several seconds as a result of the Collision. In this regard, I am satisfied that what Ms. Cotton observed when she came to the side of his truck is accurate and that Mr. Weaver was “kind of like waking”. I am satisfied that what Ms. Cotton observed was Mr. Weaver regaining consciousness.

[103]     Even if I am found to be incorrect in arriving at the conclusion that Mr. Weaver lost consciousness for a short period, I am satisfied that he did suffer a traumatic brain injury. In this regard, I adopt the indicia set out by Dr. Kiraly that a traumatically induced psychological disruption of brain function (a traumatic brain injury) can be manifested by “at least one” of any period of loss of consciousness, of loss of memory for events immediately before or after the Collison, and of alteration in mental state at the time of the Collision. I find that Mr. Weave manifested all three of those factors.

[104]     Taking into account the age of Mr. Weaver, I give very little weight to the decisions in Nahal, Goguen, and Watkins relied upon by the Defendants. I find that the decision in Wong, supra, most closely represents the facts presented by the effects of the collision on Mr. Weaver even though there was finding in Wong that the accident accelerated the onset of dementia. Here, I could find that there was no pre-disposition to dementia so that an award of non-pecuniary damages here should take that into account but not the advanced age of Ms. Wong.

[105]     Taking into account the increased risk factors in the future as set out in the opinion of Dr. Kiraly, the severity and duration of the pain at the back of his head, his shoulder and his chest, the impairment of his life, the impairment of his mental abilities, the loss of his lifestyle, the failure of his memory and ability to concentrate, the susceptibility and greater risk associated with Stage Four dementia, the impairment of his social, occupational, recreational function, and his age, I am satisfied that an assessment of non-pecuniary damages of $175,000 should be made.

Opioid addiction costs employers $2.6B a year for care (U.S.)

A new report shows large employers spent $2.6 billion to treat opioid addiction and overdoses in 2016, an eightfold increase since 2004. More than half went to treat employees’ children.

The analysis released Thursday, April 5, 2018 by the nonpartisan Kaiser Family Foundation finds such spending cost companies and workers about $26 per enrollee in 2016.

Employers have been limiting insurance coverage of opioids because of concerns about addiction. The report finds spending on opioid prescriptions falling 27 per cent from a peak in 2009.

Researchers analyzed insurance claims from employers with more than 1,000 workers. Most are self-insured, meaning they assume the financial risk.

Workers share the costs. Steve Wojcik of the National Business Group on Health says for every $5 increase, employers typically cover $4 and pass $1 to workers.

California Judge: Coffee needs cancer warnings

A Los Angeles judge has ruled that California law requires coffee companies to carry a cancer warning label.

Superior Court Judge Elihu Berle said in a proposed decision Wednesday, March 28, 2018 that Starbucks and other coffee companies failed to show the threat from a chemical compound produced in the coffee roasting process was insignificant.

A non-profit group had sued coffee roasters, distributors and retailers under a state law that requires warnings on a wide range of chemicals that can cause cancer. One is acrylamide, a carcinogen present in coffee.

The coffee industry had claimed the chemical was present at harmless levels and should be exempt from the law because it results naturally from the cooking process to make the beans flavourful.

Proposed California judicial decisions can be reversed but are reversed rarely.

Subscribe To Our Newsletter

Join our mailing list to receive the latest news and updates from ILSTV

You have Successfully Subscribed!

Pin It on Pinterest