Archives for July 2006

Weekend in Wierdness: A High School Reunion Tale

This weekend I was “off”, in that I didn’t need to show up for work, which was a nice change. OTOH, I was ‘on’ in that I was the spouse of a High School Reunion attendee. It was weird.

My wife decided she wanted to go to her HS reunion (the exact number isn’t terrifically important, and might get me grief around the house, but let’s say it’s beyond 20) for the first time. Due to the shifts of the non-nuclear family, there’s no family left in her High School town, so there’s been no reason to go back. Until now.

Plans are made, and the school has worked hard to contact all their year-group grads they could. Spouse wants to go, so we do. She spent time reading her HS Annual, and reminiscing fondly (and not-so) over the pictures therein.

It’s the weirdest thing to spend a weekend in a city you know nothing of with people you have virtually nothing in common. Safe conversations: weather, travel to, and the amusing story you’ve been cleared to tell about your spouse.

I’m debating whether the attendees were there because they were good school-minded people or whether HS was the best time of their lives; I don’t have a good answer to that.

I do know that all the grads I met there were having a good time, and their escorts (like me) were good sports about the whole thing.

And I still have no interest in going to my own. Character deficit, probably.

US News releases their 2006 edition of America’s Best Hospitals

In an email today from US News and World Reports:

Now in its 17th year, Americas Best Hospitals is widely considered the most authoritative hospital guide, screening over 5,189 hospitals and medical centers around the country. The guide ranks 176 hospitals and medical centers in 16 specialties: cancer; digestive disorders; ear, nose, and throat; endocrinology; gynecology; heart and heart surgery; kidney disease; neurology and neurosurgery; ophthalmology; orthopedics; pediatrics; psychiatry; rehabilitation; respiratory disorders; rheumatology; and urology.

Choosing the right hospital is critical, said Brian Duffy, Editor of U.S.News & World Report. U.S. News annual hospital guide provides consumers with a comprehensive assessment to choose the best hospital specific to their needs. Although this years Honor Roll is an elite group, hospitals around the country are excelling in a variety of fields.”

Of the 176 medical centers that are ranked in this year’s edition of America’s Best Hospitals, 14 earned Honor Roll status by ranking at or near the top in at least six specialties, a demonstration of unusually broad expertise:

1. Johns Hopkins Hospital (Baltimore)
2. Mayo Clinic (Rochester, MN)
3. Cleveland Clinic
4. Massachusetts General Hospital (Boston)
5. UCLA Medical Center (Los Angeles)
6. New York-Presbyterian University Hospital of Columbia and Cornell
7. Duke University Medical Center (Durham, NC)
8. Barnes-Jewish Hospital/Washington University (St. Louis)
9. University of California, San Francisco Medical Center
10. University of Washington Medical Center, (Seattle)
11. Brigham and Women’s Hospital (Boston)
12. University of Michigan Hospitals and Health System (Ann Arbor, MI)
13. Stanford Hospital and Clinics (Stanford, CA)
14. University of Pittsburgh Medical Center

The rankings weigh three elements equally: reputation, death rate, and such care-related factors as nursing and patient services. Virtually all short-term, acute-care hospitals in the U.S. were evaluated, and a total of 176 hospitals are ranked in one or more specialties this year.
This years Americas Best Hospitals guide also addresses the following topics:

· When to Head For the Very Best – Theres no need to dial up Mayo for an appointment for a hernia repair, or for many other routine procedures. So when should someone look for a highly regarded hospital?
· Finding Help Close to Home – Many surgeries, chronic care and ongoing treatments are handled very competently by non-elite community hospitals. Hometown hospitals provide a nice alternative to leaving family and friends behind. Is one in your town?
· Are You In or Out – Most people who visit the hospital are outpatients, even if they are having surgery. Is outpatient surgery as safe as inpatient surgery? Is it better?
· Easing the Culture Clash – The flow of patients into hospitals, especially in urban areas, is becoming a polyglot of languages and cultures. Understanding the implications is critical to good care. Hospitals are now responding with translators and mini-courses for staff to help ease the culture crash.

For more information, they’ve got a searchable site.
I’m off for the weekend, and recommend you take it off, too.

Update: link fixed.

CDC 2004 ED Visit Results

via AAEM:

The CDC released their annual report on emergency department (ED) care in the US. This report is based on 2004 visits from the National Hospital Ambulatory Medical Care Survey (NHAMCS) and the following ED statistics were notable.

Visit frequency
– Over 110 million visits were made in 2004, an increase of 18% over 10 years
– There were 38.2 visits per 100 persons, including one-fifth of all US adults in the past 12 months
– The total number of EDs in the US decreased by 12.4% over 10 years

Acuity measures
– Abdominal pain, chest pain and fever, all high-risk, were the most frequent chief complaints
– Medications were prescribed in three-quarters and procedures were performed in half of patients
– 15% arrived by ambulance
– 13% were admitted
– Of those classified, 15% of visits were emergent, 44% were urgent, 26% were semi-urgent and 15% were non-urgent

Overcrowding indices
– The mean time to see a physician was 47 minutes
– The mean time from arrival to admission or discharge was 3.3 hours
– About 2% left before being seen by a healthcare provider

To see a full copy of the report, go to For more information about the ED utilization from the National Center for Health Statistics (NCHS) Ambulatory Health Care, go to

So, I am working harder.

What did I do yesterday?

I’m glad you asked. I trephinated my own thumbnail.

Which would have been terrific, if that was what I was trying to do. What I was trying to do was drive a screw with a drill.

I did little hops, and used a couple of my sailor words.

I’ll be fine, and no permanent damage was done, but right now my thumb throbs, just a little, to remind me I’m fully mortal.

And a little stupid.

MedBlogs Grand Rounds 2:41

It’s an Independence-day Grand Rounds at Rangel, MD:

Welcome to my second go ’round as host for Grand Rounds of the Medical Blogosphere! I know it’s not really proper to discuss a person’s problems on their birthday but in this forum I thought that we should take the opportunity to focus on the problems with the US health care system and ponder any solutions.

First off, my editor’s choice goes to Dr. Henochowicz who appears to have the perfect top 5 list of things that need to be addressed. 1). Enact compulsory health insurance. 2). Promote primary care. 3). Fund the National Health Information Network. 4). Encourage consumerism. 5). Encourage physician involvement and leadership in health care policy. ABSOLUTELY! Every physician should have this “to do” list in his/her pocket.

Fixing the medical liability system

Yet another excellent Grand Rounds.

Oh, and I’d like to second the above 5 recommendations!

Happy Independence Day (very long weekend)


Have a safe and Happy July the 4th!

Photo originally used last year

Sen. Stevens Explains the Internet

via 27B Stroke 6

Senator Ted Stevens (R-Alaska) explained why he voted against the amendment and gave an amazing primer on how the internet works.

There’s one company now you can sign up and you can get a movie delivered to your house daily by delivery service. Okay. And currently it comes to your house, it gets put in the mail box when you get home and you change your order but you pay for that, right.

But this service isn’t going to go through the interent and what you do is you just go to a place on the internet and you order your movie and guess what you can order ten of them delivered to you and the delivery charge is free.

Ten of them streaming across that internet and what happens to your own personal internet?

I just the other day got, an internet was sent by my staff at 10 o’clock in the morning on Friday and I just got it yesterday. Why?
Because it got tangled up with all these things going on the internet commercially

I look forward to his explanation of polymerase chain reactions.

I have tried five different lines to end this, and none of them made me anything but morose. Basically, the guy’s an idiot, lacks even a fundamental understanding of the technology he helps regulate, and for some reason isn’t shunned by thinking people.

Dork. Not smart enough to be a nerd.

via InstaPundit