Happy Valentine’s Day!

There’s excellent explanations of this most Hallmark of days at the History Channel site.

Go and educate yourself, then baffle your sewwtie with your knowledge of the day!

Medical Bills are NOT the leading cause of Bankruptcies

A must-read from National Review Online dissects last weeks’ headline news that medical bills are a leading cause of bankruptcy filings.

That study, released February 2nd pronounced, in part “…About half cited medical causes, which indicates that 1.9?2.2 million Americans (filers plus dependents) experienced medical bankruptcy…” I didn’t really believe that so I didn’t put any thought into it.

NRO did. They looked at the study and found weird methods:

…For example, the study classifies “uncontrolled gambling,” “drug addiction,” “alcohol addiction,” and the birth or adoption of a child as “a medical cause,” regardless of whether medical bills are involved. Yes, there may be situations in which a researcher might legitimately want to classify those conditions as “medical,” but a study that is being used to prove that Americans are going bankrupt as a result of crushing medical bills is not one of them. A father who has gambled away his family’s mortgage payment is not likely the victim of crushing medical bills. Similarly, new parents who find they can no longer afford their previous lifestyle now that one of them has to stay home with the baby will usually find the obstetrician’s bill the least of their problems. Babies are a financial hardship even when hospitals give them away free.

Maybe that’s why only 28.3 percent of the surveyed debtors themselves agreed with the authors that their bankruptcy was substantially caused by “illness or injury.” The rest put the blame elsewhere, even when the study labeled their problems as at least in part “medical.”

Unsurprisingly, there’s an agenda:

At least one of the authors ? Dr. Steffie Woolhandler, a Cambridge Hospital internist and associate professor of medicine at Harvard, makes it clear that she does indeed have an agenda ? health-care coverage that is universal and comprehensive. “Covering the uninsured isn’t enough. We must also upgrade and guarantee continuous coverage for those who have insurance,” she said in a statement. She went on to condemn employers and politicians who advocate what she called “stripped-down plans, so riddled with co-payments, deductibles and exclusions that serious illness leads straight to bankruptcy.”

Yes, some people are pauperized by medical bills to the point they need bankruptcy protection, I understand that. However, medical bills are not causing half the bankruptcies in the US.

via MedPundit

Chest Xrays in the ED

…and why we should wait until the patient is off the helo stretcher before getting one.

Look closely and you can see the mechanism for raining and lowering the head of the stretcher

Another in a series of helpful hints.

Another Helmet Success Story

The helmet did its job

Excuses for being distracted

Many excuses for the paucity of posts, and the lack of thought in them. Essentially, I’ve had just enough things on my plate that the content has slid.

Mainly, we’ve had the house shambilized by HVAC demo, removal, reconstruction then installation of the faster newer and better system. Then the troubleshooting to find out why the system wasn’t working. Now it’s working for heat, and we’ll find out about the AC later.

During this I decided to monkey with the templates. Picture a thousand monkeys typing code thinking they’re approximating literature and you’re on the right track. And I have a job, too, which means I’m trying to sleep when the new construction is going on, troubleshooting bad template mods while tired and distracted.

Anyway, the majority of that’s behind me, thank heaven. More ramblings soon.

Minor Site Redesign; Oh, and I’m Selling Out

Today I have launched a minor site redesign. The links you’re used to finding in the right sidebar are all still here, but now they’re on the left.

The reason for the new design is to add a new sidebar over on the right, which will accept ads. I’ve applied a medical maxim to this decision: never be the first, and never be the last. It applies to medical procedures and medicines, and now to medical blogs.

As this has entailed new templates, if you find something broken, please email me.

Update: Thanks to all who pointed out bizarre behaviors. I think these are all behind us now (one of the comment templates seems to be calling for something it cannot find, then pouts). It’s been replaced with the original model, which seems to work just fine, thanks.

Lifelong Learning and Self Assessment

LLSA is the newest certification requirement from my specialty board, ABEM. It’s a yearly test (called Emergency Medicine Continuous Certification, “EMCC”) over a set of articles meant to review topics relevant to emergency medicine. I have to take them in order to be eligible to retest for board certification in about 9 years.

I just finished the first test (released in 2004, and available for 3 years, so it’s not very deadline-driven), and it was a fair test of the material. Although there’s no CME associated with the test itself, I used a review course to prepare, and that did come with CME, so it’s covered.

I wonder, though, as more and more medical specialties go to LLSA, will the states look at passage of the LLSA as either a) a sign of adequate CME, or b) a requirement for continued licensure? I’m all for the former, but against the latter.

LLSA is, by the way, a really horrible acronym. EMCC is a little better.

Apollo Panorama

This is the coolest thing I’ve seen all year. People have stitched together the Apollo mission moon photos into panoramas, and they’re just astounding to see. Apollo 11 – 17 Mission First man on the Moon – Fullscreen QTVR photo from panoramas.dk

Scroll down to the “click to see panorama button(s), and enjoy the free show.

Google Maps

Sell your Mapquest stock, Google Maps (beta) is here. I like it, but don’t take my word for it, play with it yourself.

Medblogs Grand Rounds XX

medmusings: Grand Rounds XX
Another excellent roundup, by a doctor on vacation!

As I read earlier today, read it all, or you will not have read it all.

The ED Doc as Sisyphus

It’s well known that Americas’ ED’s are very busy, and getting busier through a confluence of factors. The fabulous people who work there really work for a living, and recently I’ve been just amazed that they keep coming back.

A colleague remarked to me once that “…we work like there’s an end to it, like we can get it done, but there is no end.” I think that’s a good explanation of the task.

Some days I feel like Sisyphus in Hades, rolling the rock up the hill, but never quite getting it done. All my colleagues work harder than me, and I salute everyone who does the job.

The Joy of CSS

Remind me just to put my thumb into my eye instead of trying to fix both CSS and templates at the same time.

Yes, there’s a (minor) site redesign coming up someday, and no it won’t be too much different from this.

Right now I’m trying to figure out why the least ‘standards compliant browser’ (Internet Explorer) is the only one that renders the comments javascript well when both Opera and Firefox push it to the bottom.

The joys of design.

Update: nevermind.

Fake Botox Roundup

symtym has an excellent roundup on the recent bootleg botox case that’s caused harm (hey, doc, what about that primum non nocere?).

The best compilation of info I’ve seen about it.

Marines go to Super Bowl

courtesy of the Cleveland Browns! CNN.com – Marines get free Super Bowl tickets – Feb 5, 2005

CAMP LEJEUNE, North Carolina (AP) — Fifty Marines got a special thanks for their service from the NFL’s Cleveland Browns — a free trip to Sunday’s Super Bowl.

The Browns donated 50 tickets to Sunday’s championship between the Philadelphia Eagles and New England Patriots for Marines who have served or will serve in Iraq or Afghanistan.

Some of the tickets that cost $500 and $600 each were passed out to stunned Marines on Friday at Camp Lejeune, the East Coast’s largest Marine Corps base. Tickets also were given out at Parris Island, South Carolina, Reserve Command in New Orleans and Central Command in Tampa, Florida.

The lucky Marines will sit around the 50-yard line.

I already know who won the Super Bowl: the Cleveland Browns organization!

My Magic Wand

Today, one of the nurses gave me a gift.

I DO have a magic wand

I will often tell people that “I wish I had a magic wand, I’d wave it and make you all better…” followed by a more earthly plan of action. This is sometimes amusing to the staff.

Not as amusing as giving an EM doc a magic wand in a busy ED. Much conversation ensued. The funniest had to do with a conversation amongst the techs about where to store it. “With the anoscopes” was the answer, and I hope they were kidding.

Now, if I only had the power to wield it!