Sunday, April 13, 2014

Patient Grades

When I strolled into the surgeons lounge I saw one of our best surgeons sitting there with her head in her hands.  I sat down and asked if she needed to talk to someone.  Usually when I see a surgeon like that she just had to give someone bad news or no matter what she did he could save the patient and they were going to die.  Its a lonely place and sometimes it helps to be able to talk to a colleague to get it all out.

I wasn't prepared for what she had to say.  A few months before she had saved a patient from certain death, a bad mesenteric ischemia with perforated bowel.  The patient had a rough course but pulled through.  The patient was an IV drug abuser and the bowel infarction was a septic emboli.  Because the surgeon would not give the patient all the narcotics he wanted and instead set him up in a treatment program, the patient went on HealthGrades and slandered the surgeon up and down.  This is now the first thing you see when you google her name.  I did my best to console her but all I could think of is "We need a PatientGrades where we can list all the drug seekers, psychopaths and Munchhausen's patients!"

Sunday, April 6, 2014

Lordy Lordy, we just hit 40!

Just finished a week on call where I cover several emergency departments.  On average there will be about 60 consults for "emergencies".  In the past one third would be uninsured.  This week it was 2/3rds.  Worse 7 had insurance but had to drop it because it became too expensive. 

I guess I'm confused, I thought Obamacare was going to cover the uninsured and make it affordable.

Monday, March 17, 2014

McCarthy Orchitis

As of this morning there were 23 cases of mumps at Ohio State University with the epidemic expected to increase as the result of so many students that have not been vaccinated.  I wonder how many of them are also following Jenny McCarthy's other areas of advise and smoking E cigs?

Going Postal

I had to renew my passport and went to the Post Office where I thought I could get the picture and mail it right away as that is where I got the last one.  When I got there a sign was posted that said they had met their passport quota for the day and  were now closed.  I went to a  nearby shop that took the photo and I attached it to my application and went back to the post office to mail it.  When I got there, the passport window was now open!  I asked the person, "I thought that you had met your quota for the day?".  He said, "Oh, we put that up when we go to lunch".  I was about to ask "why don't you put a sign that says gone to lunch" but then the answer hit me.  People would line up and wait for them to come back.  By saying "quota met", people would just leave.  Gotta to love the Federal work ethic!

Friday, March 14, 2014

The Sound of Silence

I was called to a code last night, luckily everything turned out ok but it was one of those things that make me just wonder about the people.  A patient with bad lungs secondary to COPD was in the hospital secondary to an exacerbation.  He was on oxygen and a pulse oximiter.  The patient had a family member who decided to stay with him that night but they couldn't sleep because the oximeter alarm would go off if the patients sats dropped below 89%.  So they could sleep better, they silenced the alarm on the pulse ox.  Luckily for the patient, the nurse saw the sats go to 70 and she was able to get him on 100% O2 about the time he went brady.

Obama Math

In our area we had a huge increase in the cost of health insurance and big changes in health care plans as the insurance companies prepare for the costs of Obamacare.  As a result, we are seeing patients come to the office where their office copay is more than the cost of the visit! Talk about a disincentive to seek medical care!  Some insurances allow us to then refund the difference to the patient but if the insurance is one of the "Obama Compliant" plans we have to send the difference to the insurance company!

As near as I can figure it the math works this way "The Affordable Care Act saves you money by costing you more!"

Saturday, March 8, 2014

F20.1

I saw Harry Reid's take on Obamacare and I was relieved.  Did you ever notice that his affect is getting more and more flat with fleeting of ideas?  Anyway, It let me tell the patient who cant have his surgery because his insurance premiums, deductible and out of pocket costs have tripled that its "all a lie".  I was able to tell the uninsured patient that he really has insurance, that its "all a lie".  I was able to tell the patient who had their policy cancelled and now they can no longer afford insurance, its "all a lie".  I was able to tell the college student that he is covered by his parents insurance but their costs have went up so much that none of them have insurance, that these problems are "all a lie".  I was able to tell the medical oncology nurses, physical therapists that they are not being fired because of the medicare cuts, that its "all a lie".  I'm glad all these Obamacare horror stories are lies.  Oh, wait a minute, it may just be Harry Reid's schizo/delusional disorder.