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Pennsylvania Gags Physicians

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  • Pennsylvania Gags Physicians

    This is part 1 of a three part series started today. I'm curious what you all think about this.

    A new Pennsylvania law endangers public health by forbidding health care professionals from sharing information they learn about certain chemicals and procedures used in high volume horizontal hydraulic fracturing. The procedure is commonly known as fracking.

    Fracking is the controversial method of forcing water, gases, and chemicals at tremendouspressure of up to 15,000 pounds per square inch into a rock formation as much as 10,000 feet below the earth’s surface to open channels and force out natural gas and fossil fuels.

    Advocates of fracking argue not only is natural gas “greener” than coal and oil energy, with significantly fewer carbon, nitrogen, and sulfur emissions, the mining of natural gas generates significant jobs in a depressed economy, and will help the U.S. reduce its oil dependence upon foreign nations. Geologists estimate there may be as much as 2,000 trillion cubic feet of natural gas throughout the United States. If all of it is successfully mined, it could not only replace coal and oil but serve as a transition to wind, solar, and water as primary energy sources, releasing the United States from dependency upon fossil fuel energy and allowing it to be more self-sufficient.

    The Marcellus Shale—which extends beneath the Allegheny Plateau, through southern New York, much of Pennsylvania, east Ohio, West Virginia, and parts of Maryland and Virginia—is one of the nation’s largest sources for natural gas mining, containing as much as 500 trillion cubic feet of natural gas. Each of Pennsylvania’s 5,255 wells, as of the beginning of March 2012, with dozens being added each week, takes up about nine acres, including all access roads and pipe.

    Over the expected life time of each well, companies may use as many as nine million gallons of water and 100,000 gallons of chemicals and radioactive isotopes within a four to six week period. The additives “are used to prevent pipe corrosion, kill bacteria, and assist in forcing the water and sand down-hole to fracture the targeted formation,” explains Thomas J. Pyle, president of the Institute for Energy Research. However, about 650 of the 750 chemicals used in fracking operations are known carcinogens, according to a report filed with the U.S. House of Representatives in April 2011. Fluids used in fracking include those that are “potentially hazardous,” including volatile organic compounds, according to Christopher Portier, director of the National Center for Environmental Health, a part of the federal Centers for Disease Control. In an email to the Associated Press in January 2012, Portier noted that waste water, in addition to bring up several elements, may be radioactive. Fracking is also believed to have been the cause of hundreds of small earthquakes in Ohio and other states.

    The law, an amendment to Title 52 (Oil and Gas) of the Pennsylvania Consolidated Statutes, requires that companies provide to a state-maintained registry the names of chemicals and gases used in fracking. Physicians and others who work with citizen health issues may request specific information, but the company doesn’t have to provide that information if it claims it is a trade secret or proprietary information, nor does it have to reveal how the chemicals and gases used in fracking interact with natural compounds. If a company does release information about what is used, health care professionals are bound by a non-disclosure agreement that not only forbids them from warning the community of water and air pollution that may be caused by fracking, but which also forbids them from telling their own patients what the physician believes may have led to their health problems. A strict interpretation of the law would also forbid general practitioners and family practice physicians who sign the non-disclosure agreement and learn the contents of the “trade secrets” from notifying a specialist about the chemicals or compounds, thus delaying medical treatment.

    The clauses are buried on pages 98 and 99 of the 174-page bill, which was initiated and passed by the Republican-controlled General Assembly and signed into law in February by Republican Gov. Tom Corbett.

    “I have never seen anything like this in my 37 years of practice,” says Dr. Helen Podgainy, a pediatrician from Coraopolis, Pa. She says it’s common for physicians, epidemiologists, and others in the health care field to discuss and consult with each other about the possible problems that can affect various populations. Her first priority, she says, “is to diagnose and treat, and to be proactive in preventing harm to others.” The new law, she says, not only “hinders preventative measures for our patients, it slows the treatment process by gagging free discussion.”

    To read the rest of the article follow the Source.
    PGY4 Nephrology Fellow

    Out beyond ideas of wrongdoing and rightdoing there is a field. I'll meet you there.

    ~ Rumi

  • #2
    All I know is that fracking ruins water sources.

    It's a bad thing in my book.
    Wife to Hand Surgeon just out of training, mom to two lovely kittys and little boy, O, born in Sept 08.

    Comment


    • #3
      Im in Ohio very close to the PA boarder and we have had many earthquakes because of this fracking going on. Luckily I never felt any of them but people in this area have. If its causing them then it cant be a good thing.

      Comment


      • #4
        Fracking is a really, really bad thing. Locally, the companies are mining the region for the sand that is needed to do the fracking. Some people are thrilled because their land suddenly became much more valuable, but the environmental impact both here and where the fracking occurs is devastating.
        Kris

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        • #5
          I find it interesting that even with all the energy company marketing and spin, almost no one believes their BS that fracking is less damaging to the environment or health than other forms of energy resource retrieval.

          Comment


          • #6
            In a similar vein, DH was ranting the other day about new legislation in some state allowing docs to NOT tell pregnant mothers test results if they fear it might lead to abortion. WTF? Talk about wanting the government to stay out of health care... Next they'll be saying a cancer doc doesn't have to tell you you staged poorly because it might lead to suicide. What's the point of seeking healthcare?

            Rant AND high jack over...
            Angie
            Gyn-Onc fellowship survivor - 10 years out of the training years; reluctant suburbanite
            Mom to DS (18) and DD (15) (and many many pets)

            "Where are we going - and what am I doing in this handbasket?"

            Comment


            • #7
              And that would be AZ. Land of Jan Brewer and good ol' boy Sheriff Joe Arpaio. Asshats in equal share.

              Comment


              • #8
                My parents live in a community that sits on the Barnett Shale--this issue comes up over and over and over...we have natural gas drilling everywhere. I don't know enough about it to say whether I believe it is particularly harmful or not. Basically, I'm wary, but not entirely convinced it is the end of the world.

                Honestly, I'd like to see the actual wording of the bill before deciding this is 100% a conspiracy. This article/source in particular doesn't really inspire confidence in me, though that doesn't mean there isn't something to it.
                Last edited by SoonerTexan; 03-19-2012, 03:46 PM.
                Married to a newly minted Pediatric Rad, momma to a sweet girl and a bunch of (mostly) cute boy monsters.



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                • #9
                  Originally posted by Sheherezade View Post
                  In a similar vein, DH was ranting the other day about new legislation in some state allowing docs to NOT tell pregnant mothers test results if they fear it might lead to abortion. WTF? Talk about wanting the government to stay out of health care... Next they'll be saying a cancer doc doesn't have to tell you you staged poorly because it might lead to suicide. What's the point of seeking healthcare?

                  Rant AND high jack over...
                  That's what I was thinking, and where is this leading when physicians take and oath to first do no harm?

                  Originally posted by SoonerTexan View Post
                  My parents live in a community that sits on the Barnett Shale--this issue comes up over and over and over...we have natural gas drilling everywhere. I don't know enough about it to say whether I believe it is particularly harmful or not. Basically, I'm wary, but not entirely convinced it is the end of the world.

                  Honestly, I'd like to see the actual wording of the bill before deciding this is 100% a conspiracy. This article/source in particular doesn't really inspire confidence in me, though that doesn't mean there isn't something to it.
                  The source provides the link to the law among others. All you have to do is click on them.
                  PGY4 Nephrology Fellow

                  Out beyond ideas of wrongdoing and rightdoing there is a field. I'll meet you there.

                  ~ Rumi

                  Comment


                  • #10
                    Originally posted by diggitydot View Post
                    And that would be AZ. Land of Jan Brewer and good ol' boy Sheriff Joe Arpaio. Asshats in equal share.
                    I am always deeply troubled by the fact that this state elected her!!!! She inherited her 1stint as Gov. when Napolitano took a cabinet position. It BLOWS my mind how the uber conservatives of this state only opposes govt. in their lives except when they advocate for it!!!!! Hypocrites!

                    Arpiao gets totally riled up about a bestiality case because he's such an animal lover but FAILS to even investigate over 1,000 sex crime cases regarding humans!!!! GAHHH!


                    I Don't doubt that these two colossal idiots share a lot of supporters!
                    Last edited by Momo; 03-20-2012, 03:02 AM.

                    Comment


                    • #11
                      The source provides the link to the law among others. All you have to do is click on them.
                      I did. And it is pretty much what I expected.

                      The actual legalese:

                      (10) A vendor, service company or operator shall
                      identify the specific identity and amount of any chemicals
                      claimed to be a trade secret or confidential proprietary
                      information to any health professional who requests the
                      information in writing if the health professional executes a
                      confidentiality agreement and provides a written statement of
                      need for the information indicating all of the following:
                      (i) The information is needed for the purpose of
                      diagnosis or treatment of an individual.
                      (ii) The individual being diagnosed or treated may
                      have been exposed to a hazardous chemical.
                      (iii) Knowledge of information will assist in diagnosis or treatment of an individual.

                      (11) If a health professional determines that a medical
                      emergency exists and the specific identity and amount of any
                      chemicals claimed to be a trade secret or confidential
                      proprietary information are necessary for emergency
                      treatment, the vendor, service provider or operator shall
                      immediately disclose the information to the health
                      professional upon a verbal acknowledgment by the health
                      professional that the information may not be used for
                      purposes other than the health needs asserted and that the
                      health professional shall maintain the information as
                      confidential. The vendor, service provider or operator may
                      request, and the health professional shall provide upon
                      request, a written statement of need and a confidentiality
                      agreement from the health professional as soon as
                      circumstances permit, in conformance with regulations
                      promulgated under this chapter.
                      The article's interpretation:

                      Physicians and others who work with citizen health issues may request specific information, but the company doesn’t have to provide that information if it claims it is a trade secret or proprietary information, nor does it have to reveal how the chemicals and gases used in fracking interact with natural compounds. If a company does release information about what is used, health care professionals are bound by a non-disclosure agreement that not only forbids them from warning the community of water and air pollution that may be caused by fracking, but which also forbids them from telling their own patients what the physician believes may have led to their health problems. A strict interpretation of the law would also forbid general practitioners and family practice physicians who sign the non-disclosure agreement and learn the contents of the “trade secrets” from notifying a specialist about the chemicals or compounds, thus delaying medical treatment.
                      Any maybe I'm missing something, but I don't see any support for this at all:

                      Physicians and others who work with citizen health issues may request specific information, but the company doesn’t have to provide that information if it claims it is a trade secret or proprietary information
                      Are there potential problems here? Yes. But the article is definitely making a lot of assumptions. What are the trade secret standards for other similar industries? There has to be some protection of trade secrets. I'm not sure if this is a standard or even acceptable way to do it, but the fact that they are seeking some sort of trade secret protection doesn't mean they are inherently evil and trying to hide something.
                      Last edited by SoonerTexan; 03-19-2012, 05:18 PM.
                      Married to a newly minted Pediatric Rad, momma to a sweet girl and a bunch of (mostly) cute boy monsters.



                      Comment


                      • #12
                        Interesting, I hadn't considered trade secrets as being something inherently evil before. Though I have to disagree that they aren't trying to hide something. The word "secret" implies they want to keep something hidden. The word "trade" implies it is related to their business. I assume it is mainly for the protection of their business. Maybe someone who speaks legalese can come in and help us with the interpretation of a gag order as described in the article.

                        I'm unsure about the item you pointed out about the line including, "physicians and others who work with citizen health issues...", as I don't know the procedures for who gets involved when there are potentially life threatening health and environmental issues surrounding a business.

                        It seems the start of this three part article is to discuss if fracking is ethical by pointing out their environmental impact with the evidence that it causes earthquakes. And to inform the general public that the business is keeping their methods secret and gag ordering physicians so there may be potentially more harmful effects with the chemicals used that could pollute the water and air supply. In addition to that the article also explains that if this business is harming others and physicians are seeing that trend they are being put under a gag order to not reveal how it is harming the community because they can't reveal the trade secrets.

                        It seems like a conflict of interest. This business may be bad for your health but they won't confirm it. Doctors treat people in surrounding communities of this business for health related problems but can't give them a diagnosis and explain why they have it if it is related to the business. If things go south I wonder if somebody will realize they need to call Erin Brockovich.
                        PGY4 Nephrology Fellow

                        Out beyond ideas of wrongdoing and rightdoing there is a field. I'll meet you there.

                        ~ Rumi

                        Comment


                        • #13
                          Maybe I'm oversimplifying here, but wouldn't the information the doctor gathered PRIOR to contacting the company be available to the patient and anyone else who needs it? The only protected information would be what was obtained from the company after the verbal agreement. I don't see this as gagging physicians. It's the companies who are forced to cough up information as needed for patient treatment.

                          Now whether or not fracking is a good idea for the environment and public health is an entirely different issue...
                          Cristina
                          IM PGY-2

                          Comment


                          • #14
                            Originally posted by MissCrabette View Post
                            Maybe I'm oversimplifying here, but wouldn't the information the doctor gathered PRIOR to contacting the company be available to the patient and anyone else who needs it? The only protected information would be what was obtained from the company after the verbal agreement. I don't see this as gagging physicians. It's the companies who are forced to cough up information as needed for patient treatment.

                            Now whether or not fracking is a good idea for the environment and public health is an entirely different issue...
                            I think you're probably right. They're not bound by anything unless they contact the company and sign the non-disclosure agreement. The company doesn't have to release the trade secret to them but if a doctor needs the information for treatment they have to sign the agreement. Then they are gagged. It seems once they know the secret they can't share it even if the implications could have wider ramifications for the environment and public health. The article also explains that consulting with specialists about the chemical compound can delay medical treatment for a patient. I assume because of the non-disclosure agreement also having to be signed by whoever else needs to be involved for continuing care of a patient.

                            I wonder how that would work. If one doctor signs the paperwork it doesn't cover the entire hospital but would the information go into the patients chart? Could doctors consult among each other about the care of a patient or patient(s) if the hospital administration signed the non-disclosure agreement thus covering them under an umbrella similar to the HIPPA regulations? What if the specialist is in another State?
                            PGY4 Nephrology Fellow

                            Out beyond ideas of wrongdoing and rightdoing there is a field. I'll meet you there.

                            ~ Rumi

                            Comment

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