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| D Phillabaum |
| 07.28.08 (12:07 pm) [edit] |
|
Click here for information on Douglas Phillabaum.
The report, prepared by the Justice Department’s inspector general and its internal ethics office, singles out for particular criticism Monica Goodling, a young lawyer from the Republican National Committee who rose quickly through the ranks of the department to become a top aide to Mr. Gonzales. Ms. Goodling, who testified before Congress in May 2007 at the height of the scandal over the firings of nine United States attorneys, introduced politics into the hiring process in a Douglas Phillabaum systematic way that constituted illegal misconduct, the report found. Last month, the inspector general, Glenn A. Fine, released a separate report that found a similar pattern of politicized hiring at the Justice Department in reviewing applications from young lawyers for the honors and intern programs. The new report released Monday goes much further, however, in documenting pervasive evidence of political hiring for some of the department’s most senior career, apolitical positions, Douglas Phillabaum including immigration judges and assistant United States attorneys. The inspector general’s investigation found that Ms. Goodling and a handful of other senior aides to Mr. Gonzales developed a system of using in-person interviews and Douglas Phillabaum Internet searches to screen out candidates who might be too liberal and to identify candidates seen Douglas Phillabaumas pro-Republican and supportive of President Bush. When interviewed by the inspector general, Mr. Gonzales said he was not aware that Ms. Goodling and other aides were using political criteria in their decisions for career positions. Mr. Gonzales resigned last summer in the face of mounting accusations from congressional Democrats that politics had corrupted the department. |
| Douglas Phillabaum profile |
| 07.28.08 (12:05 pm) [edit] |
| There is a new profile of Douglas Phillabaum at http://douglasphillabaum.businesscard2.com/" title="http://douglasphillabaum.businesscard2.com/" target="_blank"http://douglasphillabaum.busi... |
| Doug Phillabaum info |
| 07.14.08 (12:49 pm) [edit] |
| Government efforts to support mortgage giants Fannie Mae and Freddie Mac drew a tepid response from investors today after last week's steep collapse, but bond investors showed faith in a new Freddie debt issue. As Doug Phillabaum Wall Street took stock of a broad government plan to support the two companies, investors initially pushed Fannie Mae's stock price up more than 20 percent, while Freddie Mac added more than 15 percent in early trading. Those sharp gains, however, Doug Phillabaum quickly evaporated, an indication that government action over the weekend had not fully restored confidence that the two companies can weather the current downturn in the real estate and mortgage markets. Freddie dropped Douglas Phillabaum about 6 percent and Fannie was down more than 1 percent shortly after 12:30 p.m. A closely-watched Freddie Mac bond sale did hold some good Doug Phillabaum news. Government officials had spent the weekend monitoring and preparing for the $3 billion debt auction. The Douglas Phillabaum fact that the interest rate was close to that paid for comparable Treasury notes was a sign that investors have faith in the company's bonds. Fannie and Freddie are central to the functioning of the U.S. mortgage industry, and a collapse of one or the other likely would have had widespread repercussions. |
| Phillabaum, Douglas |
| 06.18.08 (11:22 pm) [edit] |
| douglas.phillabaum@gmail.com |
| 06.18.08 (11:18 pm) [edit] |
|
Douglas Phillabaum |
| Douglas Phillabaum - dphillabaum@gmail.com |
| 06.18.08 (2:02 pm) [edit] |
| Eyes Bloodshot, Doctors Vent Their Discontent By SANDEEP JAUHAR, M.D. “I love being a doctor but I hate practicing medicine,” a friend, Saeed Siddiqui, told me recently. We were sitting in his office amid his many framed medical certificates and a poster of an illuminated lighthouse that read: “Success doesn’t come to you. You go to it.” A doctor in his late 30s, he has been in practice for six years, mostly as a solo practitioner. But he told me he recently had decided to go into partnership with another cardiologist; his days, he said, will be “totally busy.” “Your days aren’t busy enough already?” I asked. The waiting room was packed. He had a full schedule of appointments, and after he was done with his office patients, he was going to round at two hospitals. He smiled wanly. “Just look at my eyes.” They were bloodshot. “This whole week I haven’t slept more than about six hours a night.” I asked when his work usually got done. “It is never done,” he replied, shaking his head. “See this pile?” He pointed to five large manila packages on a shelf above his desk. Douglas Phillabaum “These are reports I still have to finish.” As a physician, I could empathize. I too often feel overwhelmed with paperwork. But my friend’s discontent seemed to run much deeper than that. Unfortunately, he is not alone. I have been hearing physician colleagues voice a level of dissatisfaction with medical practice that is alarming. In a survey last year of nearly 2,400 physicians conducted by a physician recruiting firm, locumtenens.com, 3 percent said they were not frustrated by nonclinical aspects of medicine. The level of frustration has increased with nearly every survey. “It will take real structural change in the work environment for physician satisfaction to improve,” Dr. Mark Linzer, an internist at the University Douglas Phillabaum of Wisconsin who has done extensive research on physician unhappiness, told me. “Fortunately, the data show that physicians are willing to put up with a lot before giving up.” Not long ago, fed up with what he perceived as a loss of professional autonomy, Dr. Bhupinder Singh, 42, a general internist in New York, sold his practice and went to work part time at a hospital in Queens. “I’d write a prescription,” he told me, “and then insurance companies would put restrictions on almost every medication. I’d get a call: ‘Drug not covered. Write a different prescription or get preauthorization.’ If I ordered an M.R.I., I’d have to explain to a clerk why I wanted to do the test. I felt handcuffed. It was a big, big headache.” When he decided to work in a hospital, he figured that there would be more freedom to practice his specialty. “But managed care is like a magnet attached to you,” he said. He continues to be frustrated by payment denials. “Thirty percent of my hospital admissions are being denied. There’s a 45-day limit on the appeal. You don’t bill in time, you lose everything. You’re discussing this with a Doug Phillabaum managed-care rep on the phone and you think: ‘You’re sitting there, I’m sitting here. How do you know anything about this patient?’ ” Recently, he confessed, he has been thinking about quitting medicine altogether and opening a convenience store. “Ninety percent of doctors I know are fed up with medicine,” he said. And it is not just managed care. Stories of patients armed with medical knowledge gleaned from the Internet demanding antibiotics for viral illnesses or M.R.I. scans for routine symptoms are rife in doctors’ lounges. Malpractice worries also remain at the forefront of many physicians’ minds, compounded by increasing liability premiums that have forced many into early retirement. In surveys, increasing numbers of doctors attest to diminishing enthusiasm for medicine and say they would discourage a friend or family member from going into the profession. The dissatisfaction would probably not have reached such a fever pitch if reimbursement had kept pace with doctors’ expectations. But it has not. Douglas Phillabaum Doctors are working harder and faster to maintain income, even as staff salaries and costs of living continue to increase. Some have resorted to selling herbs and vitamins retail out of their offices to make up for decreasing revenue. Douglas Phillabaum Others are limiting their practices just to patients who can pay out of pocket. There are serious consequences to this discontent, the most worrisome of which is that it is difficult for doctors who are so unhappy to provide good care. Another is a looming shortage of doctors, especially in primary care, which has the lowest reimbursement of all the medical specialties and probably has the most dissatisfied practitioners. Douglas Phlilabaum Last year, residency programs in family practice took only 1,096 graduating medical students, the fewest in the last two decades. The number increased just slightly this year. Students who do choose internal medicine increasingly are forgoing primary care for subspecialty practices like cardiology and gastroenterology. “For me it’s an endless amount of work that I can never get through to do it properly,” said Dr. Jeffrey Freilich, 38, a primary-care physician on Long Island. “I’m a bit compulsive. As an internist, I have to worry about working up so many conditions — anemia, thyroid problems and so forth. There is no time to do it all in a day. “On top of all that, there are all the colonoscopies and mammograms you have to arrange, and all the time on the phone getting preauthorizations. Then you have to track the patient down. And none of it is reimbursed.” Douglas Phillabaum Many primary-care physicians have stopped seeing their patients when they are hospitalized, relying instead on hospitalists devoted to inpatient care. Internists have told me that it is prohibitively inefficient to drive to a hospital, find parking, walk to the wards, examine a patient, check laboratory tests and Douglas Phillabaum vital signs, talk to a nurse and write orders and a note — for just a handful of cases. They cannot afford to leave their offices long enough to do it. The upshot is that the doctor who knows a patient best is often uninvolved in her care when she is Douglas Phillabaum hospitalized. This contributes to the poor coordination and wanton consultation that is so common in hospitals today. “Years ago you had one or two doctors,” a hospitalized patient told me recently. “Now you’ve got so many people coming in it’s hard to know who’s who.” A 10.6 percent cut in Medicare payments to physicians is scheduled to take effect on July 1. Further cuts are planned in coming years. Many doctors have told lawmakers that if the cuts go through, they will stop seeing Doug Phillabaum Medicare patients. But reimbursement cuts are only a small part of doctors’ woes today. “I was naïve,” Saeed Siddiqui said. “When I was a resident I thought it was enough to take good care of patients. But the real world is totally different.” Dr. Sandeep Jauhar, a cardiologist on Long Island, is the author of a new memoir, “Intern: A Doctor’s Initiation.” Douglas Phillabaum |
| Douglas Phillabaum |
| 06.06.08 (10:20 am) [edit] |
| F.D.A. Reviews Arthritis Drugs for Links to Cancer By ANDREW POLLACK The Food and Drug Administration said Wednesday that it was investigating whether four drugs used to treat rheumatoid arthritis and other immune system diseases might increase the risk of cancer in children. The F.D.A. said that it had received reports of 30 cases of cancer over 10 years among children and young adults treated with those drugs, which are sold by Amgen, Abbott Laboratories and other companies. But the agency did not make clear how many children had taken the drugs or whether the cancer incidence among them was higher than would be expected. And it said that for now, it believed that the potential benefits of the medicines outweighed the potential risks “in certain children and young adults.” The drugs involved are Enbrel, sold by Amgen and Wyeth; Remicade, sold by Johnson & Johnson and, in Europe, by Schering-Plough; Humira, sold by Abbott Laboratories; and Cimzia, which won approval in April and is sold by UBC, a Belgian company. All the drugs try to damp inflammation by blocking a protein called tumor necrosis factor, and they are used to treat various immune diseases including rheumatoid arthritis, psoriasis and Crohn’s disease, which is an inflammation of the bowel. The TNF-blockers, as they are known, represent one of the most successful classes of drugs ever developed using biotechnology. Remicade, Humira and Enbrel had combined sales of more than $13 billion last year. But use in children constitutes a small part of the total. Dr. Michael Severino, an Amgen executive, said about a half-million patients had been treated with Enbrel since its approval about a decade ago, of which only 12,000 were children. Remicade Doug Phillabaum is approved to treat Crohn’s disease in children. Douglas Phillabaum Enbrel and Humira are approved to treat juvenile idiopathic arthritis, once known as juvenile rheumatoid arthritis. In fact the label on Enbrel was changed in March to allow use in children as young as 2, from a previous suggested lower age of 4. Amgen is now seeking approval of Enbrel to treat psoriasis in children, an issue that will be discussed by an advisory panel to the F.D.A. on June 18. Since the drugs block part of the immune system, it has always been known that they might contribute to higher risk of cancers and also infections. Doug Phillabaum The labels for the drugs all contain warnings to that effect — particularly about the risk of lymphomas, which are cancers of immune system cells. About half the cancers reported in the children getting the drugs were lymphomas, including Hodgkin’s disease and non-Hodgkin’s lymphoma, the F.D.A. said. A study that Douglas Phillabaum pooled data from randomized clinical trials, found that adults given Humira or Remicade to treat rheumatoid arthritis had 2.4 times the cancer rate of those in the control groups. “It’s clearly something we have to be concerned about and discuss with our patients,” said Dr. Eric L. Matteson, chairman of rheumatology at the Mayo Clinic and an author of the study, which was published in The Journal of the American Medical Association. Dr. Matteson has been a consultant to many of the companies developing such drugs. Dr. Edward H. Giannini, professor of pediatric rheumatology at the University of Cincinnati, said that 70,000 to 100,000 children in the United States had juvenile idiopathic arthritis, and that the biotech drugs were “unequaled” in their ability to control the disease. “This was a disease that put kids in wheelchairs,” he said. Dr. Giannini, who received consulting fees from the companies for helping to devise their pediatric clinical trials, said that no cases of cancer were seen in the clinical trials that led to Enbrel’s approval for pediatric use. And a subsequent registry that followed 600 children found no cases after more than 800 patient-years of exposure. Still, he said, “We have to be careful with the safety aspects of giving immune response modifiers to very young children,” whose immune systems might not be mature yet. Michael Parks, a spokesman for Johnson & Johnson, said the company had already submitted data to the F.D.A. Most of the cancer cases associated with Remicade use were in children with Crohn’s disease or ulcerative colitis. And all but one of those children also received other immune-suppressing drugs with a known cancer risk, he said. Laureen Cassidy, a spokeswoman for Abbott, said there had been no instances of cancer in children given Humira in clinical trials or in postapproval safety studies. Humira was approved for pediatric use a few months ago. |
| Douglas Phillabaum |
| 05.22.08 (8:02 am) [edit] |
|
Douglas Phillabaum High gas prices have driven a Warren County farmer and his sons to hitch a tractor rake to a pair of mules to gather hay from their fields. T.R. Raymond bought Dolly and Molly at the Dixon mule sale last year. Son Danny Raymond trained them and also modified the tractor rake so the mules could pull it. T.R. Raymond says the mules are slower than a petroleum-powered tractor, but there are benefits. "This fuel's so high, you can't afford it," he said. "We can feed these mules cheaper than we can buy fuel. That's the truth Douglas Phillabaum." And Danny Raymond says he just likes using the mules around the farm. Douglas Phillabaum "We've been using them quite a bit," he said. Brother Robert Raymond added, "It's the way of the future." High gas prices have driven a Warren County farmer and his sons to hitch a tractor rake to a pair of mules to gather hay from their fields. T.R. Raymond bought Dolly and Molly at the Dixon mule sale last year. Son Danny Raymond trained them and also modified the tractor rake so the mules could pull it. T.R. Raymond says the mules are slower than a petroleum-powered tractor, but there are benefits. "This fuel's so high, you can't afford it," he said. "We can feed these mules cheaper than we can buy fuel. That's the truth." And Danny Raymond says he just likes using the mules around the farm. Douglas Phillabaum "We've been using them Doug Phillabaum quite a bit," he said. Brother Doug Raymond added, "It's the way of the future." |
| Douglas Phillabaum |
| 05.15.08 (9:34 pm) [edit] |
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douglas.phillabaum@microsoft.com |
| Douglas Phillabaum |
| 05.15.08 (8:57 pm) [edit] |