Musings of a Dinosaur: Today is The Day

Musings of a Dinosaur: Today is The Day
Today is The Day

Today is the *official* release date for DECLARATIONS OF A DINOSAUR; 10 LAWS I’VE LEARNED AS A FAMILY DOCTOR. Not that this means much; Amazon has been shipping it for over a week. Still, the book is now officially out there.

Very neat!  Many congrats!

Happy 4th Blog Birthday to Emergiblog! And, a Grand Rounds!

Kim’s done an excellent job there, and is the moving force behind the BlogWorld Medblogger track.

Happy Birthday, Emergiblog!

While there, check out Grand Rounds

Welcome home, Captain Speicher

Find in Iraq solves mystery of Navy captain shot down in ’91 – CNN.com
WASHINGTON (CNN) — The remains of the first American shot down in the 1991 Persian Gulf War have been uncovered, the U.S. Department of Defense announced Sunday.

Rest is peace, and peace to his family.  After what they’ve been through, they deserve this closure, and rest.

Hoover Institution – Hoover Digest – Here’s a Second Opinion

Hoover Institution – Hoover Digest – Here’s a Second Opinion
Medical care in the United States is derided as miserable compared to health care systems in the rest of the developed world. Economists, government officials, insurers, and academics beat the drum for a far larger government role in health care. Much of the public assumes that their arguments are sound because the calls for change are so ubiquitous and the topic so complex. Before we turn to government as the solution, however, we should consider some unheralded facts about America’s health care system.

Some things you might not be hearing during this debate.

DB cannot help himself. He hates ER docs, and won’t stop talking about it

One way universal coverage can save costs | DB’s Medical Rants
An ER physician justifies an admission for expediency. This patient needed an outpatient evaluation, but our dysfunctional health care “system” make him consider inpatient evaluation the best option.

So this patient spent 3 days in the hospital, at an outrageous cost, to obtain the evaluation. Of course the ER physician justifies the admission.

This isn’t the first, or second, time he’s gone out of his way to cast aspersions on EM docs (see here and here), but this might be the dumbest.

I know nothing of this particular case, but I’ve been in the same situation: a patient who needs an eval by a good internist, or a specialist, but it’s the patient has no insurance/it’s a long holiday and the patient cannot wait/the patient is unlikely to follow up as an outpatient/ it takes little imagination to understand why this is occasionally done.  So, we get the patient admitted, usually to an overworked hospitalist who nonetheless understands the patients’ plight and admits them.

That’s right: it’s not the ER doc who admits patients.  It takes two to tango, and to admit.  The admission Dr. Centor is raving about here was done NOT by an EM physician, but an internist.  All any ER doc can do is plead their patients’ case, but it’s the internist who makes the decision.  Sounds like some displacement…

“Expediency”.  One persons’ expedience is anothers’ outstanding, expedited care.  Just because it’s inconvenient for Internal Medicne doesn’t make an admission wrong.  That the system is screwed up and costs several fortunes isn’t the fault of ER docs.

As there is a shortage of primary care docs in this country, his last paragraph (go read the rest) fails to impress.  We could go Single Payor/Universal care tomorrow and there would still be a primary care shortage for a decade, and that’s assuming primary care gets paid like they should.

DB is a very good blogger, and a terrible Emergency Medicine bigot.  Too bad, he’s missing out on the most interesting group of docs, personal and professional, ever.