Sunday, August 17, 2008

Hereditary Entitlementiasis

I had one of those episodes in the office that sums up the entitlementiasis that seems so epidemic these days. I had grandma who was 42 and on disability for "fibromyalgia" and daughter who was 22 and on disability for "bipolar" who were requesting that I fill out forms for grandaugher to have full disability for her now resolved skin infection. Both had knowledge of the whole disabilty process that would make most attorneys jealous. I gave them my usual answer, that is , I said "I am not a disabilty doctor and I really dont think you would like me to fill out those forms."

Right after they left I had another patient who is on full disabilty. He is not impaired in anyway that I could determine, in fact I had seen him climb out of his jacked up moster 4X4 truck with a 4 wheeler in the back. Turns out he was on full disability for his back. I wonder if he got it after loading his ATV in the back of the truck.

I dont understand diability, the disabled patients all drive themselves to their appointments, why cant they get jobs as drivers? I guess I haven't caught entitlementiasis yet, it must be all that alcohol had cleanser that we use.

Friday, August 15, 2008


(two MDs consulting on a case) I wish everything in medicine was cut and dried like it is on TV. Sometimes though, you have to scratch your head and take a SWAG. (scientific wild ass guess). To help figure it out you call on partners, collegues and whoever you can get. The problem usually is that they are guessing too. It is one thing to sit back and guess from the sidelines, but having to act on the guess is a totally different thing because it is not you who will pay the price if you are wrong. Just recently we had a case where there is really not a good answer that has been determined for what to do with this type of cancer. My partner and I each had different opinions, two docs with a paradox. We tried to explain the diffent options and then the patient looked at me and said, do what you think is best. Luckily, they did well.

The Innocent Pay.

Our legal system always amazes me. We have the criminal system where one is innocent until proven guilty and the tort system where one is guilty no matter what it just depends on how much you want to pay. Well here is yet another example. I have a patient who was shot in a drive by shooting. As he is ready to leave the hospital he will need some supplies and equipment for his trach and tube feedings. He has to pay for these out of his own pocket as he does not have insurance. He will also be responsible for his other medical bills. There is a slight possibility he may get some money refunded from the victims fund. The guy who shot him however crashed his car and is in custody. His full medical expenses are covered. The victim can not work and may well be paralysed. The guy who shot him has a free court lawyer already working at getting him off on a technicality not to mention trying to get him disability.

Saturday, August 9, 2008

Pertinent Findings

Our medical students and new residents are awesome but sometimes I have to cut off their patient presentations. They want to describe and report all the normal stuff like blood pressure, HR, number of toes and rectal tone. I have to try to get them to go to the pertinent findings like blood in the abdomen or a C6 fracture. I wish we could do the same with the news! Today the headlines were John Edwards affair, Caylee missing in Orlando, the Olympics and Starbucks closing a few shops and offering a refill on a double latte. Oh, by the way, if you looked for the pertinent stuff, Russia has just invaded Georgia, it looks like Iran already has enough fissable uranium for bombs and oil is plummenting as speculators are worried that we might drill. This stuff is at the end of the hour and almost not even mentioned.

I know our news is all about the ratings, but isn't it also how we get info to decide on who and how to vote for? I know that facts tend to not be sexy, but then again, they are facts and they tend to be good things to know. I sometimes wonder if our national politics and congress are part of a big soap opera that is scripted by the media. I had a wonderful opportunity to live overseas where the news was just people reading what happened that day. There was no editorials, there was no fancy commentary. It was just what happened. They did have a comedy segment, it was usually about US politics.

Sunday, August 3, 2008


(Airway, Breathing, Circulation). I was going through the new ATLS (Advanced Trauma Life Support) texts and then my mind began to wonder. In any trauma we always want to ensure that the airway is open, that we are breathing and that there is circulation. I couldn't help but have the TV on in the background as it eases my ADD and of course if was all about the election. I began to wonder what would be the ABCs that I would want in politics as the result of this November. In fact the question was so bothering to me that I even brought it up in the surgeons lounge the next day. The discussion was worthy of our founding fathers! While everyone was debating, one of our older urologists happened to walk in and said three things that shut us all up. He said, "term limits, The Fair Tax, and line item veto".

We were amazed, he then added "its easy, I want the things that every career politician fears!"