Lesson Over a Latte // Emergiblog

Some of our patients are made, not born…

(The story you are about to read is true.)

The day was uncharacteristically warm.

via Lesson Over a Latte // Emergiblog.

There’s Aging Gracefully, Then There is This… A Timeline of the Democrats’ Health Care Bill | House Committee on Ways & Means – Republican

Hey, what’s actually in the Health Care bill?  This is from the ranking Republican member of the House Ways and Means committee:

To see how the next few years will go, click here.

via There’s Aging Gracefully, Then There is This… A Timeline of the Democrats’ Health Care Bill | House Committee on Ways & Means – Republican.

Knowledge is power.  Time is money.

In-Dentured servitude

Yeah, dumb pun: the article was sent to me by a dentist…

It’s a short post, so I grabbed it all (go read his, though, for the links to the source material, and to read a good blog by a Navy Dentist).

New Jersey Assembly Bill , A.B. 4175, introduced on 23 November 2009 will require physicians, dentists, and nurses to complete 30 hours of volunteer service in their respective fields as a condition for biennial registration.

Well…..Guess what New Jersey? This is the final straw. You just lost another provider. Happy? Whose going to treat all those folks with insurance now?

via Down in the Mouth: Involuntary Servitude.

So, this is one of those weird times where those potentially affected say ?wha?  Is there some pressing reason to command volunteerism in order to be licensed?

I’d be willing to bet you could find a few people in every medical profession who think they must never treat anyone for free, and barring some scheme like that proposed in NJ, they’d be legally right.  Morally, I don’t know.

This is one of the reasons EMTALA is widely derided in the emergency department world: the difference between generosity, giving your time and talent without expectation of reimbursement when it’s needed and you’re able , and State coercion, the taking of your time and talents whether you consent or not.

(“You can stop taking Medicare or quit your job” you say, and while the second is correct the first is not, as I’m hospital based and required to accept Medicare, and the strings attached).  Also, it’s quite a thing to be expected to quit ones’ job to avoid having my work literally taken from me by governmental fiat (thanks, Pete Stark).

I wonder what the NJ medical, nursing and dental societies thought of this?  I’d bet if they made a public statement it was at least mildly supportive (imagine saying “no”, and being pursued by some idiot with a camera and a mic yelling “don’t you care about the children?”).

For some reason if your job is thought of as one of compassion many people, governments included, expect you to be willing to do it for free.  I don’t get that.

(An aside for those of you with business outside medicine: you can write off bad / uncollectable debt; we can’t).  (No, I don’t know why, either).

Someday medicine is going to figure out how to explain that it’s not the bad guy, that we’re giving way more than we take.  And make it understandable to everyone.

FINALLY: The Difference between Nerd, Dork, and Geek Explained by a Venn Diagram

To all of you nerds and geeks who–like me–have been unfairly and inaccurately labeled “dorks,” only to then exhaustively explain the differences among the three to a more-than-skeptical offender, I say:

You’re welcome. This nerd/dork/geek/dweeb Venn diagram should save you a lot of time and frustration in the future.

via FINALLY: The Difference between Nerd, Dork, and Geek Explained by a Venn Diagram.

Really, that explains a lot.  Go there and see it.

via Instapundit.

Senate weighs bill proposing to shield emergency-room personnel from malpractice suits – Florida – MiamiHerald.com

Senate weighs bill proposing to shield emergency-room personnel from malpractice suits

A GOP-sponsored bill would make all emergency room medical providers — even at private hospitals — ‘agents of the state’ thus giving them sovereign immunity in medical malpractice lawsuits.

BY JOHN FRANK

Times/Herald Tallahassee Bureau

TALLAHASSEE — Even as the GOP assails President Barack Obama’s healthcare overhaul as a “government takeover”, top Florida Republicans are pushing a measure that opponents say would do the same for the state’s emergency rooms.

State Sen. John Thrasher, the Florida Republican Party chairman, is pushing legislation to make all emergency room healthcare providers — nurses, doctors and even paramedics — “agents of the state” and consequently immune from medical malpractice lawsuits.

Florida is a MedMal crisis state.  It’s not a big surprise different ideas are being floated to help those on the front lines.  I’m not a big proponent of Sovereign Immunity (or the Federal Tort Claims Act), as yes, a provider cannot be sued directly but there’s no free lunch; the Government that gives you immunity can then restrict your practice at their discretion.

Again: No Free Lunch.

And then, a weird bit of editorializing spin in a non-editorial:

So if a doctor at a private hospital makes a reckless mistake, the state would pay the claim, subject to the current sovereign immunity cap of $200,000. To recover more, victims would need to file a claims bill in the Legislature, a process that can take years.

via Senate weighs bill proposing to shield emergency-room personnel from malpractice suits – Florida – MiamiHerald.com.

So, if a doc at a public hospital makes a “Reckless mistake” that’d be okay for the government of Florida to cover?

Reckless mistake?  What the heck?  They didn’t say “Ambulance Chasing Attorney” to balance that out, even….

What ACEP Can Learn from the Federal Health Reform Process « The Central Line

This is just a very quick off the cuff, personal assessment, from many miles away from Capitol Hill, of what ACEP can learn from the health reform process we have just gone through.

via What ACEP Can Learn from the Federal Health Reform Process « The Central Line.

So, essentially we were represented, nobody listened, and the answer is to spend more money on the same arrangement to hope for a different outcome?

Color me skeptical.

Jane Hamsher: Fact Sheet: The Truth About the Health Care Bill

Congress may be too far down the road with this bill to change course. But before Democrats cast this vote which could turn “ban the mandate” into “gay marriage” for the GOP in 2010, they should consider the first rule of patient safety: first, do no harm.

Myth 1: This is a universal health care bill.

Fact: The bill is neither universal health care nor universal health insurance. According to the Congressional Budget Office:

* Total uninsured in 2019 with no bill: 54 million

* Total uninsured in 2019 with Senate bill: 24 million

via Jane Hamsher: Fact Sheet: The Truth About the Health Care Bill.

Relatively safe link to HuffPo.  Libs hate this bill, too, though for different reasons than me.

Pictured: amazing X-ray of Chinese teenager with 10 inch knife embedded in his head – Telegraph

The 16 year-old amazingly survived the attacked after a fight with a local gang at an internet café where he worked in Mishazi, Jilin province, China’s northeast.

via Pictured: amazing X-ray of Chinese teenager with 10 inch knife embedded in his head – Telegraph.

Don’t miss the photo of the xray.

Really redefines hacking…

20 Ways ObamaCare Will Take Away Our Freedoms

Think there’s a Unicorn under that manure pile that will soon be passed?  Investors.com has some information about what’s actually in the bill.  Brass tacks, and all that.

With House Democrats poised to pass the Senate health care bill with some reconciliation changes later today, it is worthwhile to take a comprehensive look at the freedoms we will lose….

11. If you are a physician and you don’t want the government looking over your shoulder? Tough. The Secretary of Health and Human Services is authorized to use your claims data to issue you reports that measure the resources you use, provide information on the quality of care you provide, and compare the resources you use to those used by other physicians. Of course, this will all be just for informational purposes. It’s not like the government will ever use it to intervene in your practice and patients’ care. Of course not. (Section 3003 (i))

via 20 Ways ObamaCare Will Take Away Our Freedoms.

Well, I feel much better now.

nhsblogdoc

After much thought, I have decided to end NHS BLOG DOCTOR.

via nhsblogdoc.

Farewell.  Thanks for the free entertainment!

Match Results: 2010 Fill Rate for Family Medicine Highest Ever — AAFP News Now — American Academy of Family Physicians

After a downturn in 2009, more U.S. medical students chose family medicine as their specialty this year, resulting in a fill rate of 91.4 percent, the highest percentage for family medicine ever, according to the results of the 2010 National Resident Matching Program, or NRMP, also known as the Match.

via Match Results: 2010 Fill Rate for Family Medicine Highest Ever — AAFP News Now — American Academy of Family Physicians.

Happy Match Day!  Today, Senior medical students all over the US opened their envelopes and found out where they matched for the next 1-7 years.  Congrats to all, I hope you got what you wanted and can live with what you get.

Interesting FP did well, I would have bet against it.

Local News | Walgreens: no new Medicaid patients as of April 16 | Seattle Times Newspaper

Seattle, Washington:

Effective April 16, Walgreens drugstores across the state won't take any new Medicaid patients, saying that filling their prescriptions is a money-losing proposition — the latest development in an ongoing dispute over Medicaid reimbursement.

via Local News | Walgreens: no new Medicaid patients as of April 16 | Seattle Times Newspaper.

Wow.  Interesting timing.

Again, Medicaid should be funded (or abolished); the current system isn’t actually fair to anyone.

Hyperbole and a Half: Boyfriend Doesn’t Have Ebola. Probably. *UPDATED*

Hyperbole and a Half: Boyfriend Doesn’t Have Ebola. Probably. *UPDATED*.

I’m glad her BF doesn’t have Ebola.

That gave her time to make some truly awesome pain-scales and faces.

Which I need to print out and paste in the ED, as The Joint Commission is coming soon.

amednews: Astrodocs: For these physicians, space is their workplace :: March 15, 2010 … American Medical News

Astrodocs: For these physicians, space is their workplace

Since 1973, 23 U.S. physicians have launched into space. They have taken part in spacewalks, treated fellow crew members and conducted medical research.

via amednews: Astrodocs: For these physicians, space is their workplace :: March 15, 2010 … American Medical News.

Good article, and I had no idea this many physicians had been into space.

Read the cautionary tale, though of 128 days in space requiring years of rehab…

Fixing Firefox 3.6’s tab blunder: Blogs – Null Pointer – ZDNet Australia

I’ve been playing around with a beta build of Firefox's 3.6 browser for some time, and while it’s been completely stable, its new tab behaviour has annoyed me.
via Fixing Firefox 3.6’s tab blunder: Blogs – Null Pointer – ZDNet Australia.

It’s the one think I don’t like about the newest Firefox release (3.6), opening a link from a tab puts it right next to the one you were reading, rather than off the right end like it used to (which I liked…).  Here’s a fix.

A like it: it’s simple and it works.