NCPA Blog: What's On Our Mind

October 14, 2017 - My Autistic Son Has Been Waiting Over 200 Hours in the ER for a Psych Bed in North Carolina


What I Mean When I Say “My Autistic Son”

Liam. He’s eleven. From day one, he was different. In fact, the first two weeks of his life were marred by a mysterious bout of sepsis that “just happened.” As a baby he was, as his father-in-law dubbed him, “a worm in hot ash.” While he was a very good communicator when he was calm, when Liam started to get emotional — too excited, too angry, too uncomfortable, too hot, too cold, too thirsty — he’d go into what we called his Fugue State. This, we learned later, is an autistic meltdown.

By six he had a little sister and a diagnosis for autism spectrum disorder, which was later accompanied by a mood disorder, dysgraphia, anxiety, and more violent outbursts. In spite of medication, a private school with the most amazing staff in the universe, therapy (through TEACCH and others), day to day work with him, and even being waitlisted at a part-time residential facility, it all came to a head on a beautiful day in October 2017.

My husband called me on the phone, his voice wavering through tears. “Liam has lost it at school. They can’t control him. We’re going to have to take him to the ER.” More on that in a moment.

Four grown men could barely contain him. When I drove up to the school, Liam was trying to bolt for the street.

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October 12, 2017 - Group of 6 Statement on President Trump's Health Care Executive Order

Our organizations, which represent more than 560,000 physicians and medical students nationwide, look forward to further analyzing the Executive Order issued today by President Donald J. Trump. It is important that policies proposed be thoroughly evaluated to determine their impact on individuals and our health care system more broadly. We look forward to submitting more formal comments through the rulemaking process as the Administration seeks to establish the regulatory framework to implement the goals of today’s Executive Order. However, our initial review raises serious concerns about its impact on our patients.

Our organizations share the President’s goal of increasing access to affordable health care coverage for more Americans and offering greater choice through a more competitive insurance marketplace so long as coverage, benefits, and patient protections are not undermined. We agree that the cost of health care coverage is prohibitive for too many families and we too are concerned that out-of-pocket costs from rising co-pays and deductibles are separating individuals that have health insurance from being able to afford health care services.

However, the proposal put forth by the President, in our initial review, raises many concerns. The Executive Order instructs federal agencies to promulgate regulations allowing small employers to purchase low-cost health insurance plans that provide coverage for an inadequate set of benefits to organizations representing a group of individuals – commonly referred to as association health plans or AHPs. It also proposes that individuals be able to purchase bare-bones policies for an extended period of time that, under current law and regulation, can only be used as a bridge toward buying coverage that meets current law essential benefit requirements. This will also destabilize the marketplace by incentivizing younger, healthier people to purchase cheaper bare-bones policies, leaving sicker individuals in an increasingly expensive market.


October 4, 2017 - Wilmington Area Faces Psychiatrist Shortage


A national shortage of mental health professionals has hit the Port City in recent years.

Dr. Tom Boeker feels badly every time he’s forced to turn away a potential psychiatric patient. But he knows that patient feels much worse.

“Every time I say, ‘I’m sorry, I can’t take a new patient,’ I feel guilty,” he said. “They’re desperate.”

One in five Americans experiences mental illness in his or her adult life, according to the National Alliance on Mental Illness. In New Hanover County, that means roughly 44,000 of your neighbors -- maybe even you -- are likely coping with depression, anxiety or other issues.

But getting onto a psychiatrist’s couch in the Wilmington area can be hard. A national shortage of mental health professionals has hit the Port City in recent years, and finding needed help means a lot of phone calls and waiting.

WebMD’s physician directory lists 55 psychiatrists practicing in Wilmington, including two at Physician Alliance for Mental Health (PAMH) and all but one of the nine psychiatrists at New Hanover Regional Medical Center. At least two doctors listed in the directory retired this year, and many offices say they are no longer accepting patients.

According to county health rankings, for every 275 people in New Hanover County there is one mental health provider (including psychiatrists, psychologists, social workers, therapists and others). But in Brunswick and Pender counties it’s well over 1,200 and 1,300 to one, meaning many patients from those areas must head to Wilmington for help.

“Over the past several years, there have been less providers available, and it seems like the population and the need and the desire to access services seems to grow,” Coastal Horizons Vice President of Clinical Services Kenny House said. “It’s hard to find people, and that means that people tend to have to wait longer to see a provider.”

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