We want to make it clear that in this guideline we see the usual rationing of care business ethic mixed in to create dangerous pseudoscience. 

 

1. Recommending low dose aspirin 81 mg with known coronary artery disease is wrong; 160 mg or 325 mg (full aspirin) is bets (enteric coated even better);

 

2. Ignores keeping blood pressure very normal;

 

3. "Consensus based" means Permanente partners for profit and not the American Heart Association (this stuff is coming out of the "Care Management Institute" about 10 floors down from Mr. Halvorson and Dr. Crosson) - in the Ordway Building at One Kaiser Plaza overlooking Lake Merritt in one direction and San Francisco in the other; the term for the partners is the "Guideline Development Team" - attempting to diffuse license responsibility by high numbers;

 

4. These for profit physicians need two risk factors to be at risk for coronary artery disease; that is wrong as many of the risk factors are significant to themselves (like diabetes);

 

5. Normally, Kaiser will try to pretend it is adapting from the American Heart Association (and the Managed Care Subcommittee placed within); here it is clear that they take full responsibility - about as useful as would be the Enron CEO's Guide to Offshore Investments and Cover up Tactics;

 

6. "Electronic copies: None available" is meant to make this difficult for patients to obtain; so yes we need to have it on line;

 

7.  The pocket cards that go into the MD pockets are available - this will show further rationing and will be close to the computer pop ups encouraging the physician toward cheap;

 

8. The government website washes its hands of all accuracy; so the authority for this pseudoscience falls back to the license of Francis J. Crosson, MD - head of the Permanente Federation (a pediatrician who could care less about coronary artery disease except as a budget item threatening the $2 billion a year profit goal so the docs can have a Golden Pond retirement plan.) [Insert Dr. Crosson's license.]

 

             Charles Phillips, MD, FACEP (emergency specialist = every shift caring for coronary artery disease)