Friday, August 20, 2010

Red dab of health!

I was sitting in the lounge when somebody brought up MRSA infections and saw that WhiteCoat did a geat article on it in his blog. I wondered.

Did anybody notice that the superbugs began to emerge at the same time the FDA banned mercurochrome? It is extremely active against all strains of staph and gram negs. In fact, it is one of the most effective topical agents.

The FDA banned it because of the mercury which was never shown to be absorbed to any degree or to lead to any problems. Just like the thermosol scare, mercurochrome became the enemy. Even though it is now proven to be very safe, no one will produce or sell it because of fear of lawsuits.

Like many sureons, I add a bit of bleach to the bath water every now and then to help decrease staph colonizations but I think I am also going to bring back some mercurochrome from our next mission trip! (That it, with the way things are going with healthcare, the next medical mission trip may be to Washington DC!)

Tuesday, August 17, 2010

Whoop, there it is!

California so far has had over 1700 reported cases of pertusis with 7 infant deaths so far. This does not count those that have died that there was no post on. 2700 confirmed cases so far. Since it is very hard to test for the number is probably far more. This is the worst epidemic in at least 50 years. So where is Jenny McCarthy and the dont vaccinate your kids groups? Where are all the attorneys that tried to sue claiming that vaccines caused autism? There are at least three schools in California (according to NPR) where 80% of the have not been vaccinated. Just wait until those schools have an 80% rate of polio.

Saturday, August 14, 2010

If Doctors were paid like attorneys

I think it is interesting to hear attorneys argue about how doctors should get paid. I wondered what it would be like if we were paid like attorneys. First, you would call the office to see if the doctor would consider your case. After talking for a bit with a paramedical you might get an appointment to discuss your possible case with the doctor. After consideration, he might agree to take your case for a retainer and then a cost structure of so much per hour (hours that only he can determine and not verify) plus expenses. You would also have to sign an arbitration contract. Any calls to him would cost at least $200 and then $200 for each 15 minutes. There would be additional charges for documentation, travel, etc. The retainer would have to be paid up front of course.

In the event of a serious problem or one in which the patient client does not have the cash, the doctor could take the case on a contingency agreement where if the patient survives, the doctor gets 1/3 of all future earnings, plus expenses, time etc.

Better yet, lets pay attorneys like doctors. If you show up at the court house, they have to take care of you regardless of your ability to pay and you can sue them at any step.

Wednesday, August 11, 2010


Got a call that one of my partners patients was a bit somnolent and hard to arouse after the family decided he was hurting in his sleep and got a bit agressive with his PCA. When I got he was holding his sats with a facemask but I wasnt sure how much was the morphine vs something else going on. To help determine this I asked for some Narcan. Turns out there is a shortage. Two of the companies that made it have stopped. It was going to cost them too much to jump through all the FDA hoops. Another company did not say why they stopped making it. The last said it wasnt sure if it was going to increase production or even continue to make it.

We stole some and got the pateint better. Good thing the FDA has stepped in to make it so hard now to produce generic drugs and to make it so easy to sue!

Friday, August 6, 2010

Camión Basculante

Our county hospitals are going bankrupt. One of the main reasons is the number of illegals flooding their EDs. To stay afloat they have had to resort to new techniques. The technique is EMTALA. It is so hard to prove an COBRA violation that the small hospitals will immediately create some reason that they can not provide the care for the patient. All illegals who are pregnant get transfered becuase of lack of prenatal care and probable high risk. Of course all traumas, and everything else they can make up gets sent on the camion busculate to the university. Somebody has to pay the bills, so pass the buck!

Sunday, August 1, 2010

Tomcat Social Economics

Our accountants moved into an old historic building (for tax reasons, but that is another rant). One of the first things they noticed was for an old building, there was not a mouse to be found. They soon discovered that a small Tomcat was living just behind the building in a small crawl space. Some of the people decided it would be nice so they started feeding the Tomcat. Before they knew it, they had mice everywhere. You couldn't leave your lunch uncovered while you went to the restroom because a mouse would be there. The Tomcat got fatter and fatter. Infact, if you didnt feed it, it would go from window to window crying until it got something. Then it wanted to be fed more and more. Soon, there was not only the one tomcat, but a whole bunch of cats. They were everywhere! All whining for food. The original tomcat was so fat, he couldnt catch a mouse if he tried! Becuase there were so many cats the cat poop was everywhere! The accounting group had to have a called staff meeting about the cats. The cost of the exterminators to take care of the mice was astronomical. Clients were offended by the cats and the odor. In the meeting the people who were the ones who started it all complained that they just couldnt stop feeding the cats, somebody had to take care of them! When all was said and done, the group decided that no one was to feed the cats, if someone felt strong enough that the cats needed support, they could take them home!

Interesting thing. The cats mewed at everyone and screamed through the windows for what seemed like weeks, and then went away. The exterminators caught up with the mice. A few weeks later there were couple of cats living in the crawl space. They could be seen in the morning hunting mice. No one saw any mice in the building.