Eideard

The event reminder on Melissa Weinblatt’s iPhone buzzed: 15 minutes till her shrink appointment.

She mixed herself a mojito, added a sprig of mint, put on her sunglasses and headed outside to her friend’s pool. Settling into a lounge chair, she tapped the Skype app on her phone. Hundreds of miles away, her face popped up on her therapist’s computer monitor; he smiled back on her phone’s screen.

She took a sip of her cocktail. The session began.

Ms. Weinblatt, a 30-year-old high school teacher in Oregon, used to be in treatment the conventional way — with face-to-face office appointments. Now, with her new doctor, she said: “I can have a Skype therapy session with my morning coffee or before a night on the town with the girls. I can take a break from shopping for a session. I took my doctor with me through three states this summer..!”

Since telepsychiatry was introduced decades ago, video conferencing has been an increasingly accepted way to reach patients in hospitals, prisons, veterans’ health care facilities and rural clinics — all supervised sites.

But today Skype, and encrypted digital software through third-party sites like CaliforniaLiveVisit.com, have made online private practice accessible for a broader swath of patients, including those who shun office treatment or who simply like the convenience of therapy on the fly…

Still, opportunities for exploitation, especially by those with sketchy credentials, are rife. Solo providers who hang out virtual shingles are a growing phenomenon…

Other questions abound. How should insurance reimburse online therapy? Is the therapist complying with licensing laws that govern practice in different states? Are videoconferencing sessions recorded? Hack-proof?

Another draw and danger of online therapy: anonymity. Many people avoid treatment for reasons of shame or privacy. Some online therapists do not require patients to fully identify themselves. What if those patients have breakdowns? How can the therapist get emergency help to an anonymous patient? “A lot of patients start therapy and feel worse before they feel better,” noted Marlene M. Maheu, founder of the TeleMental Health Institute, which trains providers and who has served on task forces to address these questions. “It’s more complex than people imagine. A provider’s Web site may say, ‘I won’t deal with patients who are feeling suicidal.’ But it’s our job to assess patients, not to ask them to self-diagnose.” She practices online therapy, but advocates consumer protections and rigorous training of therapists.

RTFA. Some of it is hilarious. Yes, I realize we’re discussing mostly legitimate needs and mostly legitimate practices designed to sort them.

If I didn’t have so much fun blogging I might wander into the shrink-wrapped Skype therapy trade. Though I’d hate the record-keeping required to keep the IRS and insurance companies happy.

Daylife/AP Photo used by permission

Two sisters wanted in a $9.1-million Medicare fraud investigation into their Dearborn clinic have been arrested in South America and will be returned to Detroit to face charges…

Clara Guilarte, 56, and Caridad Guilarte, 54, missing since February 2007, were on a federal most-wanted list for Medicare fraud. They were apprehended Sunday as they tried to get on a plane in Colombia, said Kathleen Sebelius, secretary of the U.S. Department of Health and Human Services.

Tom Spokaeski, an investigator with the federal fraud task force in Detroit, said the sisters were arrested after tipsters called a national Medicare fraud hotline.

They are charged with committing fraud at the Dearborn Medical and Rehabilitation Center, a drug infusion clinic they opened that served people with AIDS and HIV, hepatitis C and other chronic conditions…

Clara and Caridad Guilarte, who had been involved in questionable clinic activities in Miami, came to Detroit in 2005 to flee the heightened federal scrutiny there, federal court records show.

They filled out a simple form to establish a Michigan corporation — paperwork that essentially requires little beyond the name of the registered agent for the company — found a doctor who was certified to bill Medicare and opened the Dearborn Medical and Rehabilitation Center.

Like the ones the sisters were associated with in Miami, the Dearborn facility was a drug infusion clinic for people with AIDS, hepatitis C and other health conditions. They are charged with $9.1 million in fraudulent Medicare billings.

HHS is ramping up internal methods – also available to states and regional bodies – to spot and track suspicious billing patterns. IMHO, one of the best tools to rely upon is nosy old farts like me who just might spot a fraud in progress. That’s what happened in this case.

To report questionable billings, call 800-633-4227; to report fraud, call 800-447-8477.

More than 500 veterans in Ohio are being contacted by a clinic where they may have been exposed to hepatitis and HIV during routine dental work, according to Ohio Veterans Affairs communications officer Todd Sledge.

The Dayton, Ohio, VA clinic is contacting 535 veterans who received treatment during an 18-year period from a dentist who admitted to not washing his hands or changing gloves between patients. There are 100 to 130 additional patient records still to review, according to Sledge.

“We’re taking a very aggressive approach and a well-planned intervention to make sure that we’re contacting these folks,” Sledge said…

Individuals sought by the center are known to have been treated directly by the clinician between January 1, 1992, and July 28, 2010, according to a release by the medical center.

The center is offering free tests to those involved and the clinic will provide all necessary care and treatment without charge should a veteran test positive for the viruses, Sledge said.

While Sledge said the testing stemmed from “invasive procedures … done by one single clinician,” He did not identify that clinician and he did not release specifics about the clinician’s health…

Last year the clinic closed for a month for “re-education on infection control standards” for the staff, Sledge said.

That’s a polite way to say, “you lazy SOB’s have been putting our patients in danger!”

Fred Hargesheimer, a World War II Army pilot whose rescue by Pacific islanders led to a life of giving back as a builder of schools and teacher of children, died on Thursday morning. He was 94…

On June 5, 1943, Hargesheimer, a P-38 pilot with the 8th Photographic Reconnaissance Squadron, was shot down by a Japanese fighter while on a mission over the Japanese-held island of New Britain in the southwest Pacific. He parachuted into the trackless jungle, where he barely survived for 31 days until found by local hunters.

They took him to their coastal village and for seven months hid him from Japanese patrols, fed him and nursed him back to health from two illnesses. In February 1944, with the help of Australian commandos working behind Japanese lines, he was picked up by a U.S. submarine off a New Britain beach.

After returning to the U.S. following the war, Hargesheimer got married and began a sales career with a Minnesota forerunner of computer maker Sperry Rand, his lifelong employer. But he said he couldn’t forget the Nakanai people, who he considered his saviours.

The more he thought about it, he later said, “the more I realised what a debt I had to try to repay…”

In the decades to come, Hargesheimer’s U.S. fund-raising and determination built a clinic, schools and libraries in Ea Ea, renamed Nantabu, and surrounding villages.

In 1970, their three children grown up, Hargesheimer and his late wife, Dorothy, moved to New Britain, today an out-island of the nation of Papua New Guinea, and taught the village children themselves for four years. The Nantabu school’s experimental plot of oil palm even helped create a local economy, a large plantation with jobs for impoverished villagers.

Since the war, this sort of tale has been part of my life. Remembering the war, friends and relatives who fought and survived, often with the aid of those who risked their lives to save members of the Allied Armed Forces. Remembering the debt. Remembering the war – and maintaining a commitment to fight against all the unjust and unjustified wars that followed.

Contradictions to the history and bravery of those who fought in World War 2.