Monthly Archives: December 2015

Idea: Free mobile phone access for the medically-fragile poor

Here’s one of those ideas born out of a frustrating clinical scenario, one we’ve all been in.

You have a fragile diabetic, with insulin compliance a major issue, and you’re working towards getting glycemic control back in order. Calling the patient every few days to refine the regimen. Then suddenly one day, you call, and the number is no longer in service. Or the voicemail box is full. Days go by, weeks go by, finally they reappear, back to square one, sugars completely out of whack. They couldn’t afford their cell phone bill.

This is not an uncommon occurrence, and not only in diabetes, but in a number of chronic diseases that require regular follow-up.

My idea is simple, and patterned loosely after similar programs that exist in the United States, like Lifeline and SafeLink. The government partnering with mobile providers to supply a free phone (an inexpensive older model) with free unlimited local minutes (and unlimited voicemail capability), to individuals who are deemed by a health care professional to be medically fragile.

Certainly there would be the concern that this type of program could be easily abused, but I’ll throw in a few caveats. One, the application would have to be initiated by a physician who has personally had difficulty reaching that patient for medical reasons. I realize there is an inherent bias there that would favour those with access to regular primary care, but since the goal of the program is to increase medically-relevant communication, I think this is a fair criteria. Specialists, walk-in doctors, and ER physicians would also be able to file an application. Make the application non-billable to OHIP. If physicians think it will make their life easier to track down a patient, they’ll complete the application regardless of remuneration. A narrative would be included as part of the application providing the details of how communication has fallen apart in the past.

The argument could be made that all low-income families could benefit from mobile phone subsidies, but let’s focus on the low-hanging fruit that we can all agree on for now. Interrupted communication with our medically-fragile patients is a direct threat to their health, and costs the system huge sums in down-stream medical management.

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Would Donald Trump actually be the healthiest president ever?

We were all treated yesterday to the greatest unintentional parody of 2015, when Donald Trump’s personal physician, Dr. Harold Bornstein, provided a letter detailing that Mr. Trump “would be the healthiest individual ever elected to the presidency”.

He described that his “laboratory test results were astonishingly excellent”. Not just good. Not just excellent. Astonishingly excellent. I called Lifelabs this morning, and they have yet to adopt this standard of describing lab results in Canada.

“His physical strength and stamina are extraordinary”. Only in the United States would a billionaire receive his primary care from a gastroenterologist who then comments on degrees of cardiovascular fitness. Makes sense.

One wonders what would result if I used the same hyperbole on the next insurance form I complete. “Mr. John Smith is in such perfect health, that his perfection cannot be quantified by current medical technology. You should consider yourself fortunate to be offered the opportunity to insure him.”

So the entire letter from Dr. Bornstein is what we would generally expect from the physician of Donald Trump. Grandiose, overstated claims, creating the image of a demagogue.

But would Trump truly be the healthiest president? Spend a few minutes perusing this terrific site from Dr. Zebra, and you’ll quickly realize that the competition is not exactly that fierce. Affliction after affliction that could never have affected a man of Trump’s constitution.

George H.W. Bush and George W. Bush were both treated with cryotherapy (liquid nitrogen) for actinic keratosis (sun-damaged spots) during their presidencies. Trump has cleverly avoided the sun through his regular use of fake tanning spray.

Barack Obama suffered measles as a child in Indonesia. Trump will likely never meet the same fate, as he wouldn’t dare visit the country with the world’s largest Muslim population.

Ronald Reagan was known to be nearsighted, which disqualified him from serving in combat units in World War II. Trump’s myopia only applies to matters of foreign policy.

John F. Kennedy, Jr. was diagnosed with Addison’s Disease (adrenal insufficiency). Trump heard from Dr. Oz that adrenal fatigue can be easily treated by an extract available over the counter at GNC. JFK was clearly in bed with the pharmaceutical companies (no Marilyn Monroe jokes, please).

John Q. Adams was the product of consanguinity, as his father, John Adams, and his mother, Abigail were 3rd cousins. Trump finds that repulsive, unless….

Franklin D. Roosevelt suffered with polio, which Trump doesn’t actually hold against him. He considers polio to be a lesser evil compared to the inevitable autism that results from today’s deadly vaccines.

On paper, Trump may be able to manufacture a ludicrous argument that his absence of disease should aid his presidency campaign. But the letter from Dr. Bornstein conveniently omits a major medical diagnosis of Trump’s, one that any armchair psychiatrist can make in this case. And we need not look any further than the DSM-V for the details.

Bottom line, based on health, Donald Trump is no more qualified to be president than Montgomery Burns.