Toms River Internal Medicine Specialist, Dr. Prabhat Sinha Awarded As NJ Top Doc EIN News
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Against Physician-Assisted Suicide: A Physicians Letter to His Legislator – Word on Fire
Home Articles Against Physician-Assisted Suicide: A Physicians Letter to His Legislator
The committee hearings begin today, January 25, 2024, on the End-of-Life Option Act (SF 1813/HF 1930). If passed, this bill would allow residents in Minnesota access to physician-assisted suicides.
To whom it may concern:
My name is Tod Worner, and I am a practicing internal medicine physician in the Minneapolis area. I live in Plymouth, MN, and vote in District 43A. I am opposed to the proposed bill legalizing physician-assisted suicide.
I find myself in a curious position. As a physician who has spent decades trying to heal patients, I find myself imploring my duly elected representatives not to usher in the most seismic cultural and ethical transformation in modern medical practicethe act of taking life instead of comforting or saving it.
As you know, there are currently ten states (to date) in which physician-assisted suicide is legalized (California, Colorado, Oregon, Vermont, New Mexico, Maine, New Jersey, New Mexico, Hawaii, and Washington) and Washington, D.C. Montana has legalized it by court ruling. Furthermore, a number of them have weakened residency requirements so as to encourage a grim form of medical suicide tourism. Physician-assisted suicide is also legalized (to date) in Canada, Belgium, Luxembourg, Spain, Germany, Switzerland, and the Netherlands. Pediatric euthanasia has already been carried out in Belgium, the Netherlands, and is being pursued by interest groups and legislators in Canada, among other locales. And now, alas, physician-assisted suicide is, once again, knocking on Minnesotas door.
What are we becoming? What does it mean to heal?
Lest we find ourselves reassured by a burgeoning tendency to legalize this dark practice, let me borrow from Mark Twain when he said, Whenever you find yourself on the side of the majority, it is time to pause and reflect.
Indeed.
George Orwell once sighed, We have now sunk to a depth at which restatement of the obvious is the first duty of intelligent men.
And so let me begin.
As a physician,mydaily practice is to heal the sick and prevent disease. In so doing, I try to uphold thedignity of eachpatienttreating them with respect while working in partnership to achieve a rich quality in concertwith a reasonable quantity of life. Of course, I recognizethe value of autonomy to afford patient choice, but that means a choice insofar as it simultaneously comports with the practice of safe, sound, and ethical medicine. To be sure, patient choice must be just and the care they receive beneficent, but that same choice must notby slippery euphemism and crafty manipulation, emotional appeal and legal maneuveringsI repeat, must not compel a physician to commit a maleficent act, especially one that runs against centuries of common law and customs, statutory law and social contract, as well as the sacred conscience and sound judgment of the physician in the relationship.
So what does this mean when it comes to physician-assisted suicide?
In a few words, it means that a patient has many rights, but he does not have the right to demand that I assist him in killing himselfany more than he can demand I prescribe himunnecessary narcotics, unwarranted antibiotics, or ill-considered surgery. To demand these measures indiscriminately would be to violate the dignity of the patient with risky (or fatal) outcomes as well as compromise my dignity (and conscience) as a trained and seasoned physician to thoughtfully consider the best care for the patient.
That is why, as a physician, I am opposed to physician-assisted suicide. Furthermore, allow me to offer these threearguments against this concerning practice:
When Julius Caesar illegally ledhis army into Italy in defiance of the Roman Senate, he had topass through a river known as the Rubicon, which separatedItaly from the province of Gaul. When he crossed the Rubicon and became a traitor to his state, he uttered the die is cast and knew there was no going back. Once medicine has transformed itself from a vocation whose first and only priority is to heal and comfort into a profession that is willing to kill, we will have crossed the Rubicon. We will have wandered away from the oath to First, do no harm and to give no deadly medicine to any one if asked, nor suggest any such counsel. Henceforth, the consequences would be both unintended and grave to patients, physicians, and society. We must stop, once again, and reconsider just what it means to be physicians, to be healers. And we must remember what it means to be human. If we forget the fundamental, uncompromising, and ineradicable value intrinsic to human life, can we still call ourselves physicians?
The popular press, judicial activists, and enterprising legislators have grown increasingly sympathetic to the physician-assisted suicide movement. As such, anecdote after anecdote highlight people with grave medical maladies offering poignant interviews or writing last letters articulating their sincere fears of unremitting pain and incomparable suffering. They see only two alternatives: one is to suffer a prolonged, painful, and humiliating death, while the other is to proactively commit dignified suicide under the sympathetic eyes of their physician. Thats it. What is striking, however, is how little conversation there is about Palliative Care and Hospice.
Designed fully around the notion of providing dignity, autonomy, and symptom management in the face of terminal illness, Palliative Care and Hospice provide extraordinary end-of-life care to the very people who feel they have no fate but suffering ahead. These physicians and clinicians are well-trained and deeply committed to the care of those very patients that physician-assisted suicide advocates specifically target. In over two decades of practicing internal medicine, I have had a number of patients enroll in these services. I have yet to find one family who didnt gratefully describe the profound dignity, loving kindness, and tender management of pain, anxiety, and symptoms they witnessed in the waning days of their loved ones life. Surely, that is not to say that there cant be patients with symptoms that could be difficult to manage. But does that mean that we should then move to a widespread, systemic legalization of physician-assisted killing? With the oft untapped and unrecognized virtues of Palliative Care and Hospice, I think we are rushing to providea dangerous solution desperately in search of a problem.
Invariably, when legislation such as physician-assisted suicide is considered, concerns are raised about the slippery slopethat is, the unintended consequences and abuses that result from permitting such a policy at all. Enlightened minds that know better shake their heads and tut-tut that our concernsare overreactions. We would have safeguards against abuses, we are told, We would craft laws protecting minors or the mentally ill or the demented or the handicapped or others without terminal illness from ever being considered for physician-assisted suicide. It would be a rare event. Economics (a patients draining resources, the burden on the medical system) would never be a factor in a merciful act devoted to preserving the dignity of the individual.
2024 Lenten Gospel Reflections
To be sure, all of these reassuring arguments sound good and have been made in countries and states that have legalized physician-assisted suicide. And, too often, they have been wrong. People with mental illness and no terminal disease have been allowed to die. Minors in Belgium and the Netherlands have died under this policy. Physicians have been more aggressive in utilizing this option in the ill, but not terminally ill. Patients have reported fear of being hospitalized lest they become victims to a crusading doctors zeal. Exploding costs for end-of-life care and budgets groaning under the weight of the perpetually ill have a conscious or unconscious impact on a system where physician-assisted suicide is an option.
As far as being rare, according to the BMJs Journal of Medical Ethics (10/27/2023), there was an over sixteen-fold increase in physician-assisted suicide cases in Oregon from 1997 to 2022 while there was a drop in coinciding psychiatric assessments (evaluating the patients emotional state for such a decision) from 31.1% to 1.1%. The author of the paper, David Albert Jones, concludes, We now have twenty-five years of data from Oregon and data from an increasing number of other states with similar laws. However, the more we know, the less reassuring the Oregon model of assisted suicide seems to be. Nonetheless, those promoting this law will reassure us. Weve thought of these concerns and, if need be, we will enact further laws to protect patients from abuse. To this reasoning, I would ask, How will the small laws protect us, when the big law (against physician-assisted suicide) has been able to fall? When it comes to the institutionalization of physician-assisted suicide, mark my words, telling us that everything will be okay is a misguided, if not dangerous, philosophy.
For the last twenty-four years, it has been an honor and privilege to practice internal medicine. I love my patients, enjoy my colleagues, and cherish my calling. But that calling will fundamentally change if we devolve from a vocation that heals to a vocation that kills.
Most of what I have written today in opposition to physician-assisted suicide is fairly obvious. And I am here, simply and sadly, to restate it.
In having to do so, it is hard not to ask,What are we becoming? What does it mean to heal?
Heaven help us if we dont know the answer.
Thank you for your time and consideration.
Tod Worner, MD
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Against Physician-Assisted Suicide: A Physicians Letter to His Legislator - Word on Fire
Medical Mystery Case: What Landed This Pregnant Woman in the Hospital? – Medpage Today
Internal medicine and rheumatology specialist Siobhan Deshauer, MD, reviews the case study of a pregnant woman who was hospitalized.
Following is a partial transcript of the video (note that errors are possible):
Deshauer: Hey, guys. I'm Siobhan, an internal medicine and rheumatology specialist. Today, I'm going to tell you about Emma. She is a 31-year-old woman who landed her dream job, first violinist in a prestigious orchestra, and she has never had any health issues until recently.
Emma and her husband have been struggling to get pregnant over the past 2 years and she is now seeing a fertility specialist. Anxious to find a treatment that would work for her, Emma also started seeing another health practitioner who recommended various supplements that she was told were safe and effective. Unfortunately, she has been hiding this from her doctor and little did she know that decision would land her in the hospital and change the next few years of her life.
Over the past few weeks, Emma has had abdominal pain, nausea, and vomiting. She had a glimmer of hope thinking she might be pregnant, but the tests kept coming back negative. Her symptoms just kept getting worse and it was starting to affect her ability to perform at the orchestra. She was sure that her colleagues were starting to notice. After one particularly poor performance, she decided to go to the doctor. Her doctor checked her vitals, ordered some blood work, along with an abdominal ultrasound. Everything looked fine, so her doctor thought it might just be stress from the new job, but the pain and nausea worsened to the point that she was barely able to eat anything.
Finally, after a horrible episode of vomiting, her husband brought her to the emergency department. Her blood work showed mild anemia. Her red blood cells were a bit too low. After her vitals were normal and her imaging was normal, she was sent home with an iron supplement and told to follow up with her family doctor in about 2 weeks.
Over the next few days, her symptoms just continued to progress. She had to call in sick from work and was spending most of the day in bed exhausted and in pain. But Emma didn't want to go back to the hospital, wait for hours, and then just get sent home again. Then one day she was getting out of bed, she became so dizzy that she fell to the ground on her knees. Her husband heard the sound, ran upstairs and found her on the ground. That was it. They were heading back to the hospital.
In the emergency department, her heart rate was a little bit fast, but it was her blood work that was alarming. Emma's hemoglobin was much lower than before, so low that she required a blood transfusion. Emma was actually relieved to hear that they had found something to explain her symptoms, but the question remains why was her hemoglobin dropping so dramatically? The emergency doctor explained that she might be bleeding from her stomach. That would explain her abdominal pain and the drop in her hemoglobin. The plan this time was to admit her to hospital.
A few hours later, a tired-looking internal medicine resident came to assess Emma. When asked about medications, Emma responded that she is taking levothyroxine, a thyroid supplement, and follitropin alfa injections for infertility. When asked about supplements, she only mentioned her prenatal vitamins.
Now, remember Emma is also taking supplements for infertility, but she didn't want to tell the doctor because she was worried about being judged and she couldn't imagine that it was relevant in this situation. Emma's blood tests not only showed that she was anemic with too few red blood cells, but that the cells were too small. We call this microcytic anemia. In situations like this, her bone marrow should be going into overdrive, pumping out as many new red blood cells as possible, but another test called the reticulocyte count proved that this wasn't the case for Emma.
When I see a patient like this with microcytic anemia, a whole bunch of causes come to mind. But by far, the most common cause is iron deficiency, especially in a young woman. Think about iron deficiency like this: either you're not eating enough iron, your body is not absorbing that iron, or you're bleeding and then losing the iron.
Emma's blood work is consistent with iron deficiency with a ferritin level lower than expected. This suggests that she has a low amount of iron stored away in her body and maybe the bone marrow wasn't creating enough red blood cells because it didn't have enough iron available. But iron deficiency itself doesn't cause abdominal pain, so her doctors wondered if she might be bleeding somewhere in her abdomen, maybe a bleeding peptic ulcer.
In the emergency department, Emma already had a CT scan of her abdomen and an ultrasound, both of which were normal. You may be surprised to learn that often a CT scan or an MRI won't actually find the cause of a GI bleed. Often the bleeding is coming from an erosion in the protective layer of the gut and you really need to camera down the GI tract to be able to see that.
The next day she was wheeled down to the endoscopy suite and sedated. First, a camera was inserted into her throat, no signs of bleeding. Then she had a colonoscopy and again totally normal. Okay, so no bleeding in the GI tract where we can see.
Another thing we have to consider in a woman who is having abdominal pain and unexplained anemia is endometriosis, which is a disease where tissue similar to the lining of the uterus grows elsewhere in the body. Just like the uterus does, the tissue thickens up, breaks down and then bleeds with each menstrual cycle. This could be a hidden source of blood loss. It can also cause severe pain, especially in the pelvis, and it can also cause infertility. This could actually tie together all of Emma's symptoms including her recent diagnosis of infertility. Endometriosis is notoriously difficult to diagnose and it can be missed on imaging, which is why surgery is often needed to help make the diagnosis. Emma agreed to go ahead with the exploratory laparoscopy and a few days later she was taken to the operating room.
She was put under general anesthetic and the surgeons got to work. They poked small holes in her abdomen and inserted a small tube with a light and camera attached. They also insert another tube that pumps air into the abdomen. This raises up the abdominal wall so it's possible to look around at the organs and then operate if necessary.
The surgeon carefully examined each of Emma's organs, looking for any signs of endometriosis, which would look something like this. But they only found one abnormality, a simple cyst on her ovary, far from a slam-dunk diagnosis and probably unrelated to her symptoms. But nonetheless, the surgeons took a biopsy of the cyst and sent it off to the pathology lab to be examined. But if it doesn't look like endometriosis, what else could it be?
Emma's medical team went back to the drawing board to rethink her case. She eats a diet containing enough iron. She has no signs of malabsorption and they couldn't find any signs of bleeding, so maybe the blood work showing iron deficiency is just a red herring and there is another cause for her anemia that hasn't been considered. Could this be a production problem, an issue stemming from the bone marrow where the red blood cells are made? Well, there is only one way to find out, going straight to the source.
Emma was prepped for a bone marrow biopsy where a needle is inserted into the bone to take a sample of the semi-solid tissue inside. Making over 500 billion blood cells per day, our bone marrow is constantly working hard to keep us alive. Now, it's a waiting game. The results from the bone marrow won't be back for a few weeks, so Emma was discharged home with a diagnosis, anemia NYD (not yet diagnosed). But on a positive note, her abdominal pain had improved and as she was leaving the hospital she was told to restart her usual home medications and to come back if things got worse. When she got home, she restarted her fertility injections and those fertility supplements again.
Emma was still really tired and soon she developed a new headache and she was never someone to get headaches. Plus, tinnitus, that high-pitched ringing in her ears that just wouldn't go away. She kept track of her symptoms until she had her follow-up appointment 2 weeks later. Hearing about her new neurological symptoms, the internal medicine team decided to expand their diagnostic search to include another rare cause, porphyria.
This is a very rare group of conditions that affects how your body makes heme, an important part of hemoglobin, and some patients experience porphyria attacks, which can include anemia, neurological symptoms, and abdominal pain. It was a stretch and they knew it. But if you never look for those rare causes, you'll never find them, so her doctors ordered a urine test to screen for the disease.
Two weeks later Emma had another follow-up appointment to go through results. She was nervous, but hopeful that she might walk away with some answers this time. First, the surgical biopsy. It was normal, no endometriosis or cancer. Good. Next, the bone marrow results. It showed some increase in iron stores, but it was otherwise normal, so again no diagnosis.
Then a result that finally gave them a lead, Emma's porphyria screening show high levels of copper porphyrin III and delta-ALA. Okay. Now, porphyria screening is a whole can of worms that we don't have time to unpack right now, but the key point is that this particular result really narrows things down to either porphyria or lead poisoning.
Emma was sent back to the lab this time to have her blood lead levels drawn. Two days later, Emma got a phone call from her doctor's office. Her blood lead levels were off the chart. Finally, she has a diagnosis. Emma is suffering with lead poisoning. This explains all of her symptoms: abdominal pain, nausea, and vomiting. These are classic, early signs of lead toxicity.
Neurological symptoms take some time to develop, which explains why her headache and tinnitus came on later. This also explains her anemia. Lead accumulates in the bone marrow, blocking certain enzymes that produce heme, an important part of hemoglobin. Less heme means smaller red blood cells and it also limits the bone marrow's ability to create more cells, ultimately causing hypoproliferative microcytic anemia.
But why did her porphyria testing come back positive? Well, as lead blocks important enzymes that produce heme, that leads to a buildup of byproducts. Think of it like the conveyor belt in the factory that's making heme is broken and as a result there is a buildup of raw materials. Those raw materials are copper porphyrin III and delta-ALA. That's why her porphyrin screening came back positive. It's so cool, right? Everything leads back to lead poisoning. Had her doctors ordered a blood lead level earlier, it would have saved Emma so many needless investigations.
Siobhan Deshauer, MD, is an internal medicine and rheumatology specialist in Toronto. Before medicine, she was a violinist, which is why her YouTube channel is called Violin MD.
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Medical Mystery Case: What Landed This Pregnant Woman in the Hospital? - Medpage Today
NYU Langone Health in the NewsWednesday, December 27, 2023 – NYU Langone Health
News from NYU Langone Health
Xenotransplantation Can Change the Paradigm Around Organ Donation Scripps News December 23 -Robert Montgomery, MD, DPhil, the H. Leon Pachter, MD, Professor of Surgery, chair, Department of Surgery, Division of Transplant Surgery, NYU Langone Transplant Institute
Owning a Pet May Slow Rate of Cognitive Decline, Study Suggests UPI December 26 -Thomas M. Wisniewski, MD, the Gerald J. and Dorothy R. Friedman Professor of the Alzheimers Disease Center, Department of Neurology, professor, Departments of Pathology, and Psychiatry
Envisioning AI That Expands Civil Rights Politico December 22 -Pasquale E. Rummo, MPH, PhD, associate professor, Department of Population Health
Remembering Betty Rollin, Who Told Her Breast Surgeon That Post-Operative Appearance Mattered to Her and Other Women STAT News December 27 -Barron H. Lerner, MD, professor, Department of Medicine, Division of General Internal Medicine & Clinical Innovation Faculty, and Department of Population Health
Medical Tattoos Serve a Purpose Bigger Than Body Art The Grio December 26 -John Belanich, chief radiation therapist, Department of Radiation Oncology
Winter Skin Woes? Heres What to Do and What Not to Do WebMD December 26 -Julia E. Tzu, MD, clinical assistant professor, the Ronald O. Perelman Department of Dermatology
What to Know About Colored Contactsand Why You Shouldnt Buy Over-the-Counter Brands Elle December 22 -Brieann K. Adair, OD, clinical instructor, Department of Ophthalmology
Can Sleeping with a Fan on Make You Sick? What Experts Have to Say Good Housekeeping December 23 -Purvi S. Parikh, MD, clinical assistant professor, Department of Pediatrics, Division of Pediatric Allergy & Immunology, and Department of Medicine, Division of Infectious Diseases, Allergy and Immunology
Many Consider Weight-Loss Drugs to Support New Years Resolutions TODAY December 26 -Natalie E. Azar, MD, clinical associate professor, Department of Medicine, Division of Rheumatology
Live Longer, Sleep Better, Feel Calmer with Best Health Hacks of 2023 TODAY December 22 -Natalie E. Azar, MD, clinical associate professor, Department of Medicine, Division of Rheumatology
What Is Holiday Heart Syndrome And How To Avoid It (Subscription required) National Geographic December 22 -Shaline D. Rao, MD, assistant professor, Department of Medicine, the Leon H. Charney Division of Cardiology, chief of medicine, NYU Langone HospitalLong Island
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NYU Langone Health in the NewsWednesday, December 27, 2023 - NYU Langone Health
Internal Medicine Specialist Discusses Weight-Loss Medication – News On 6
Weight-loss drugs have been promoted and advertised much more recently, but are they right for you?
Tuesday, December 26th 2023, 9:37 am
By: News On 6
Weight-loss drugs have been promoted and advertised much more recently, but are they right for you?
Internal Medicine Specialist Doctor Stacy Chronister with OSU Medicine joined the News On 6 at 9 to discuss weight-loss medication.
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Internal Medicine Specialist Discusses Weight-Loss Medication - News On 6
Adoption of Internal Medicine Milestone Ratings and Changes in Bias Against Black, Latino, and Asian Internal … – Annals of Internal Medicine
Beebe welcomes award-winning infectious disease specialist – CapeGazette.com
Beebe Healthcare announced the appointment of Jimmy Chua, MD, to the hospitals medical staff. He is recognized as an award-winning infectious disease specialist, trained to treat a wide range of complex clinical conditions.
Chua sees patients at the Margaret H. Rollins Lewes Campus and Beebe Medical Groups Infectious Disease and Travel Medicine office on Savannah Road in Lewes.
Chua treats all forms of surgical infection, along with complicated skin and soft tissue infections, HIV infection, sexually transmitted diseases, pneumonia, endocarditis, osteomyelitis, meningitis, sepsis, viral hepatitis and other infections related to the liver. He also addresses all forms of infection related to viruses, bacteria, fungi and parasites.
Chua is a fellow of the American College of Physicians, the Infectious Diseases Society of America, and the American Association of the Study of Liver Diseases. His clinical and leadership experience is extensive. In 2001, he founded a medical practice in southeastern Washington state, at which time he launched the annual Whats New in Medicine regional medical education conference for medical practitioners. The Washington Chapter of the ACP repeatedly recognized Chua as a role model and ultimately honored him with its Internist of the Year Award in both 2005 and 2023, citing his excellent clinical skills, dedication to patients, enthusiasm for the practice of medicine and outstanding leadership.
The ACP also presented Chua its laureate award, an honor bestowed upon senior physicians with acknowledged excellence and peer approval in the field of internal medicine. Chua also served as a faculty member at the Pacific Northwest University of Health Sciences and at the WSU Elson S. Floyd College of Medicine.
My motto in practice is to do my best with Gods guidance, to help each patient manage and overcome their medical condition, said Chua, who was born and raised in Manila, Philippines. I am grateful for the opportunity to practice medicine at Beebe, which allows me to live in close proximity to my family.
Chua earned his medical degree from the University of Santo Tomas, recognized as the oldest university in Asia. After practicing in Manila, he relocated to Marshfield, Wis., to pursue internal medicine residency training at the Marshfield Clinic. His clinical training concluded at the Cleveland Clinic in Ohio, where he completed fellowships in both infectious disease and clinical microbiology. In his free time, Chua enjoys swimming, traveling with his family, taking care of his aquarium, harvesting his vegetable garden, listening to audiobooks and playing chess. He speaks multiple languages including English, Tagalog, Mandarin, Taiwanese and Spanish.
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Beebe welcomes award-winning infectious disease specialist - CapeGazette.com
People rally around doctor who refused to provide medical assistance on flight for a valid reason – Upworthy
They say, "An apple a day keeps the doctor away." However, in this story, there's something else that keeps a doctor away from treating a personduring a flight. In many cases, emergencies on a flight are usually sorted out by the doctors who are on the flight. Sometimes, a few unfortunate situations may require the flight to be landed mid-way. Given the importance and necessity of profession, u/ThrowAwayFoodie22, an internal medicine hospitalist, never ignored such requests from the cabin crew. This time, he had a valid reason. While his co-passenger found his lack of response inconsiderate, the internet came to his rescue, saying he made the right choice.
The doctor was on a long-haul international flight and decided to enjoy his waking hours by utilizing the in-flight entertainment and free drinks. "I had already been drinking even before the flight while I was in the lounge. I was not slurring or excessively drunk, but I was feeling a strong buzz," he explained in the post. During his flight, the mid-30s doctor chatted a little with his co-passenger, exchanging pleasantries about each other's work. A while later, when he was enjoying his movie, the cabin crew made an announcement requesting a doctor.
"Normally, I would present myself to the cabin crew and help out, but after several hours of on-flight boozing, I was pretty drunk," the doctor wrote and added, "I was not able to think clearly and probably would have done more harm than good in such a situation. I didn't react to the announcement at all." As he continued with his movie, the co-passenger insisted he respond to the call. "I replied that someone else would help or they would get instructions from the medical team on the ground," mentioned the doctor.
The 30-something-old lady, unaware of his reason for ignorance, said that he would be the reason if the person died. "I said, 'Listen, lady, just because I'm a doctor doesn't mean I'm not on call 24/7 to provide medical care on demand. I work when I'm at the hospital, outside, I'm just like everyone else and I'm entitled to drink and relax,'" he explained.
The physician didn't want to engage anymore with the woman. Since there were no more announcements after that, he assumed the person who required medical assistance was safe. "In my mind, I'm very clear that since I was intoxicated, I could not provide medical assistance," the doctor clarified. Pointing his right to a relaxed journey, the physician said, "I was drinking on my own time and there was no expectation that I would need to be sober. Doctors get to enjoy life too, I can't stay sober on every flight just in case there's an emergency." However, having been called an a*****e by his co-passenger multiple times, the doctor was concerned if he made the right decision and many backed him up.
"The crew would not have used you in your capacity as a doctor as you were intoxicated. By law, they cannot as you are well aware. They would've gotten assistance from another sober doctor on board and the ground medical team. Your fellow passenger is TA for saying those things to you. Hopefully, after the flight, she learned that couldn't have helped because you were drinking," commented u/Affectionate_Face_71. "NTA, but I could see why she'd think so. You were right for not responding to the call as you were impaired, but why wouldn't you explain this to the woman? As far as she could tell from your response, you were just being apathetic and hoping someone else would handle it," pointed out u/lessthandave89. "You did the right thing but the way you presented yourself sucks," wrote u/Hazz3r.
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Adventist Health Tillamook welcomes new top Internal Medicine Provider – Tillamook Headlight-Herald
December 5, 2023 (Tillamook, Ore.) Adventist Health Tillamook is proud to announce another enhancement to healthcare services in Tillamook County with its exceptional team of local, community-focused internal medicine providers, including Tana Haynes, MD, Amy Echelberger, MD, and the newest addition, James Borden, MD, FACP, starting January 2 at Adventist Health Medical Office Plaza in Tillamook at 1100 Third Street in Tillamook.
Meet Our Internal Medicine Providers
Dr. James Borden, board-certified with over 30 years of primary care experience in Northwest Portland, is known for his compassionate care and transparent communication. His approachable nature and dedication to building patient connections make him an invaluable asset to our community.
Dr. Tana Haynes, who began her tenure in 2020 at Adventist Health Medical Office Plaza, is a board-certified internal medicine physician with experience in both inpatient and outpatient settings. Passionate about individualized care, she specializes in preventive and wellness care as well as managing complex medical issues.
Dr. Amy Echelberger, joining Adventist Health Medical Office Manzanita in 2021, is a board-certified internal medicine specialist with roots in Idaho. Having graduated from Southern Illinois University School of Medicine and completed her residency at Wayne State University, Dr. Echelberger brings a wealth of knowledge and dedication to the Oregon Coast.
What is Internal Medicine?
Internal medicine provides comprehensive care for adults, encompassing preventive services, wellness care and the diagnosis and management of complex medical conditions. Our providers are committed to understanding each patients unique health needs and goals, offering a holistic approach to healthcare.
Enhancing Community Health
With these skilled physicians, Adventist Health Tillamook continues its commitment to providing top-tier medical support, focusing on the unique healthcare needs of coastal communities. This expansion underscores our dedication to ensuring residents receive the best possible care from providers who work and live in the community.
For more information about our internal medicine services and the exceptional care provided by Drs. Haynes, Echelberger, and Borden, please visit our website at adventisthealthtillamook.org or call to schedule an appointment at 503-815-2292.
Since 1973, Adventist Health Tillamook is a faith-based, nonprofit healthcare organization that includes: a 25-bed critical access medical center located in Tillamook, Oregon; the largest hospital-based ambulance service in Oregon with four stations located throughout Tillamook County; and rural health clinics and urgent care medical offices serving the northern Oregon coast as well as the communities of Sheridan, Vernonia, Estacada and Welches. Adventist Health Tillamook employs over 550 associates and healthcare providers and is part of Adventist Health, a faith-based, nonprofit integrated health system serving more than 80 communities in California, Hawaii and Oregon. For more information about Adventist Health Tillamook, visit AdventistHealthTillamook.org.
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Adventist Health Tillamook welcomes new top Internal Medicine Provider - Tillamook Headlight-Herald
Perceived Preparedness of Internal Medicine Interns for Residency and the Value of Transition to Residency Courses – Cureus
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