The Advisor

Issue No. 5

February 2010

Haiti: An Anesthetist's 10-day Mission
Doctors Without Borders

Dr. Philippe Touchard, an anesthetist, is head of emergencies at the Pasteur Hospital in Langon, near Bordeaux. Forty-eight hours after the January 12 earthquake, he flew to Haiti to reinforce MSF's surgical teams in Port-au-Prince. Here are exerpts of his journal of this short mission.

Day 1, Wednesday, January 13: Just a few hours to decide
"I hear about the disaster on Wednesday morning, and the first phone call come through at the hospital a few hours later. MSF wants to know if I can leave for Haiti right away. I've already been there on mission twice, in 2006 and 2008, working in MSF's trauma center in Port-au-Prince. The next day, I'm at Mérignac Airport, along with a coordinator, another anesthetist and two logisticians. We'll travel in a cargo plane carrying the supplies needed for a field hospital. We finally take off on Friday morning, with a landing in Port-au-Prince planned for the next day."

Day 4, Saturday, January 16: Landing Permission Refused in Port-au-Prince
"We circle the capital for two hours, waiting for the control tower's permission to land. We finally start our descent. But at that moment, the pilot is told to pull the head around and head for small airport on the tip of Santo Domingo. There is nothing we can do about it. We are pulling our hair out. We end up landing in Samana, in a small airport that wasn't remotely geared up to receive a plane like ours. A departure is announced for that evening. But once again, landing permission in Port-au-Prince is refused. So everyone jump into action-the Dominicans are incredibly helpful. We offload the 25 tons of supplies from the plane and transfer them on to 5 trucks. On Sunday, at 6pm, we are on the road, heading for Port-au-Prince."

Day 6, Monday, January 18: Arrival in Port-au-Prince
"We arrive at the border at 4 a.m. Two hours later, we are finally let through, and the nightmare seems over. But we pile into another humanitarian aid traffic jam, and find ourselves snared up in a convoy of nearly 200 vehicles organised by the United Nations. We inch our way forward at three kilometres (1.8 miles) an hour. At some point, one of our trucks is stopped without us noticing, and we are separated, without any news. Then another truck breaks down. We finally reach Port-au-Prince on Monday at midday, with three trucks out of five, even though we need every one. And then our taxi breaks down.
We leave by foot, in the heat, picking our way through the rubble.

To read the rest of Dr. Philippe Touchard's accounts, Click Here

You can also get all of the latest updates, including podcasts and videos, at www.doctorswithoutborders.org

When making travel arrangements, visit
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Doctors Without Borders.

Red Flags Rule
Another Unfunded Mandate for Physicians

A young professional prepares to buy her first home and presents her mortgage application to the bank. She clearly qualifies for the loan but there is a problem. Her credit report shows over $9,000 in unpaid medical bills! The problem is that they are not her bills. This scenario is playing out more and more frequently as medical identity theft becomes a growing problem.

Red Flag

The FTC estimates that imposters using forged or stolen identity documents to secure medical care account for as much as 3% of identity theft in the U.S. - nearly 250,000 cases each year. And of course this problem affects all the victims of the crime including the doctors, hospitals, insurance companies and the individual.

The FTC has taken action to address the problem and the impact on doctors can be substantial. A new regulation called the "Red Flags Rule" took effect this past August. Within the medical community, the new rule will require Read More

You've Got Mail...From Your Doctor

One does not need advanced math to project that with the growing national shortage of physicians, and with politicians committed to bringing health insurance to the masses, many doctors will have less time to spend with their patients. As a result, some are turning to the Internet and E-mail to leverage their post exam follow-up communications. Some are even going so far as to conduct virtual office visits. AMA communication guidelines are available to assist physicians in protecting themselves when e-mailing patients. But many baby-boom generation doctors who did not grow up in an Internet age have trouble composing, formatting and addressing e-mails. Here are some useful tips to writing safer, more effective e-mails:

Use your subject line wisely. You have approximately 30 letters to get your point across. Let your reader know what to expect, but don't try to accomplish too much.
Only use CAPS to bring attention to the subject, as in "REMINDER" and "DECISION NEEDED". Make sure not to extend CAPS into the email itself. Modern spam filters dislike CAPS and may block your message.
Get to the point. If you are looking for the patient to take action, let them know within the first couple of lines. Like a research paper, state your thesis and then elaborate.
1st time E-mails with attachments are often flagged by SPAM filters. An effective strategy is to send a brief intro Email, letting your patient know that there will be a follow-up message with important attachments. Ask them to clear your E-mail address with their filter.
It is almost impossible to safely convey humor or sarcasm through e-mail. Don't even try. Stay on topic and save the medical humor for the patients next appointment.

E-mails are often archived by medical practices. It is wise to approach your computer with the thought in mind that any thing you type can and will be used against you in a court of law.

Bursting Bubbles

Robert Bartley, Bartley Financial Advisors