Archives for August 2008

Chicago Tribune Editorial on “Medical Credit Scores”

There’s an editorial by a physician in the Chicago Tribune today advocating for more federal oversight of hospitals as regards credit reporting and billing.  As I don’t work in the after-care billing side of medicine I’m not well versed to say anything about that.

I am very aware that his argument calling for this expanded role is, to put it mildly, so nonsensical as to be laughable.

Here’s the ‘scare’ he’s concerned about:

…An even more ominous threat would be prescreening patients before medical treatment is provided. A patient’s low health credit score could affect medical decisions or alternatively serve as a pretext for denying the patient care. Armed with a patient’s health credit score, an emergency room triage nurse or medical administrator could do a quick medical screening before registering a patient and decide to refer the patient to another hospital because he is a bad financial risk. (By not registering a patient, a hospital might be able to skirt federal laws that make it illegal for hospitals to refuse patients emergency care.)

The law he’s alluding to is EMTALA, which prohibits just such a financial screening.  There’s no cutout in EMTALA for ‘can I do a credit check on you before we register you for care’?  It’s a goofy premise.

The remainder of the above paragraph:

There are built-in protections for patients, including the Health Insurance and Portability and Accountability Act, and several credit laws offer protection to consumers.

And, again, EMTALA.  So, the big fear is that hospitals will do wallet biopsies using credit scores, except there are already legal prohibitions against it, so let’s insist on more oversight for a non-existent, daydreamed-maybe-future problem.

Interesting he’s refuted his own contention, yet still goes on to advocate for more governmental oversight in an adversarial role with hospitals.  Strange premise, a self-refuting argument then an unsupported conclusion, but other than that it’s fine.

Don’t waste your time.


For the last several days, my DSL connection has slowly been losing speed.  It’s been interesting to see it slowly slide from my normal 1200 or so downstream to about 650, and no amount of power cycling the modem will change it.

(I have a 2Wire DSL modem/wireless gateway that very conveniently shows speeds on its status page, so it’s not a subjective ‘things are getting slow’ thing, it’s an objective measure).

That doesn’t mean much to SBC/ATT; I was patiently running the Level 1 script earlier today, but balked at ‘restart your computer’: I refrained from being rude or angry, but did say that wasn’t going to happen, it was a line problem not a computer problem, and we agreed to stop there.

I find that techies at 0300 are either more knowledgeable or more likely to listen to people, so there’s now a repair scheduled after only 10 minutes on the phone, surely an AT&T record.

I’ll keep you posted.

Change of Shift: Volume 3, Number 3 // Emergiblog

Change of Shift: Volume 3, Number 3 // Emergiblog

Up, now.

The FDA approves 2008-09 flu vaccine –

The FDA approves 2008-09 flu vaccine –
WASHINGTON, Aug. 5 (UPI) — The U.S. Food and Drug Administration has approved the 2008-09 seasonal influenza vaccine that includes strains likely to cause flu in the United States.

The FDA changed all three strains for this year’s influenza vaccine — an unusual occurrence, as usually only one or two strains are updated from year to year.

They truly have a tough job: predict the future.  Get it right and nobody notices, get it wrong and there’s plent of fingers pointing at you.

Here’s hoping for an uneventful flu season.

MedBlogs Grand Rounds 4:46

Pure Pedantry : Grand Rounds Vol. 4 #46
… Thus, this particular edition of Grand Rounds will be South Park themed.

Kenny may or may not have been killed.

Medical blogs for doctors and patients alike – Los Angeles Times

Medical blogs for doctors and patients alike – Los Angeles Times

Here’s a roundup of some of the best-known medblogs. Go to the sites, however, and these doctors might introduce you to even more.

Incredibly flatering to be included in this list of excellent medical bloggers (there are more out there, but this is a good starting list).

For the record, I have never been a Marine Infantryman; I was a Navy doctor assigned to the USMC, and was very proud to serve with the green side.  I identify with the USMC more than the Navy (probably ‘gone native’).

Dr. Val: Accredited Journalist

The National Press Club… – Blogs – Revolution Health Many Congrats!

Perhaps she can use her journo prowess on these people.  (Fools).

The Happy Hospitalist: The Culture Of Fear

The Happy Hospitalist: The Culture Of Fear

Read the post, but at the end he’s found a very interesting development about the Joint (heh) Comission and their certifying authority…

What kinda skinny dogs are those, anyway?  Does he feed them?

Kevin, M.D. – Medical Weblog: The Happy Hospitalist: All for one and none for all

Kevin, M.D. – Medical Weblog: The Happy Hospitalist: All for one and none for all
The Happy Hospitalist: All for one and none for all
The following is a reader take by The Happy Hospitalist.

All for one and none for all. That is the state of the current government program called Medicare. The entitlement program that threatens the financial security of our nation. On March 25, 2008 the Boards of Trustees released their Annual Report of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds. In this 43rd edition, the Trustees note a government program covering just over 44 million people at an expense of $425 billion dollars during 2007. That equates to approximately $10,000 per beneficiary.

The Medicare Crisis has the potential to kill this economy, and something has to give.  Read the whole article: it’s well written, it’s a good prescription to avoid the oncoming disaster train, and there’s essentially no way it’s going to happen.

Too bad.  We’re all going to pay for this, literally and figuratively.

Los Angeles Times: Doctors talk shop on medical blogs

Yrs. Trly, KevinMD, OBGynKenobi and Notes from Dr RW are all mentioned.  I’ll disagree mildly (I think it’s more complicated than that) with the last sentence, but the reast is pretty good.

Los Angeles Times: Doctors talk shop on medical blogs

Web posts offer insight into the profession, but also raise patient privacy issues.
By Melissa Healy
Los Angeles Times Staff Writer

August 4, 2008

For physicians of a certain age, the weekly teaching session known as grand rounds is a ritual steeped in formality and tradition. Presided over by the profession’s graybeards, grand rounds are attended with white coats on and clinical details in hand.

Here, young physicians learn to accept their elders’ old-school admonishments with reverence and humility.

Grand rounds on the Internet, however, is another thing altogether. A weekly compilation of the Internet’s best medical blog postings, it is part classroom, part locker room, part group therapy session and part office party — a free-wheeling collection of rants, shop talk, case studies and learned commentary along with the occasional recipe, movie review or vacation slide show…

I’m always interested that I sound a little smarter in interviews than I do in actuality.  That’s a good thing.