Archives for April 2011

Physician Employment Protections

The Art of Politics.

I’m not going to bang on the Texas Medical Association just yet, but wonder if this isn’t just spinning an inevitable loss:

Employment WITHOUT protections is the corporate practice of medicine. Employment WITH protections is part of the practice of medicine, and that’s what we stand for.

via Physician Employment Protections.

Basically, realizing hospital employment of docs was coming this session, the TMA apparently focused on making a deal that legislatively empowered the docs.


Also, why on earth would a hospital want to employ docs? I know it’s happening, I just don’t get it.

I’m not cut out for manual labor

Today I got a sunburn just watching it.

Attention ABEM Diplomates: LLSA now comes with (additional cost) CME!

This may be old news but I found out about it today, in an email from AAEM:


The “new” ABEM 2011 LLSA CME Activity is now available to Diplomates preparing to take the 2011 Lifelong Learning and Self-Assessment (LLSA) test. LLSA tests are one component necessary for maintaining certification with the American Board of Emergency Medicine (ABEM). Upon completion of the CME Activity and a passing score of 85, Diplomates will be able to earn “AMA PRA Category 1 Credit™.”

Here’s the complete ABEM press release as a .pdf file.

How much CME? 15 hours (.pdf file). It’s way better than nothing, which was what we got before, and the cost of this CME is an additional $30, so it’s very reasonably assessed.

The ABEM site is full of warnings that you MUST register for the CME FIRST in order to get it; start the LLSA, then remember you wanted the CME? Too bad.

Here’s a screenshot of my ABEM page, and I’ve highlighted the new CME box:

CME for the 2011 LLSA!

I added the highlights, but it’s not hiding, so as long as you know to do it in advance you’re better off than before.

Two more things: First, I’ve been pretty hard on ABEM for requiring these yearly tests with nothing but a self-printable certificate and the opportunity to take more tests, so this is a welcome change. It’s several years too late, but at least it’s here now, so a half-a-kudo to ABEM for getting this belatedly right.

Second, I haven’t said anything (I don’t think) but my favorite LLSA study course is the one given by Drs. Abrahamian and Lovato from UCLA-Olive view, called MEGA-LLSA. It’s well organized, entertaining, and they have it all figured out. I have done my last 4 or 5 years’ tests with them, and provided they have their March course in Disneyland again in 2012 I’ll be there for that one. I recommend it. (A caveat: their communication between paying for the course and the starting place/date/time is poor to non-existent; plan on having to scout out here in the hotel the course is yourself, and showing up early to ask when your class starts…).

Royal wedding’s lone American will guard Queen on horseback –

Good for him.

London (CNN) — Growing up on the streets of Manhattan, riding skateboards and listening to punk rock, Denton John never expected to find himself where he’ll be on Friday — on horseback, boots gleaming, as the only American in the royal wedding of Britain’s Prince William and Kate Middleton.

But that is just where he will be, in white gloves and red plume, as a member of the Household Cavalry Mounted Regiment, protecting Queen Elizabeth II as she leaves Westminster Abbey to return to Buckingham Palace.

via Royal wedding’s lone American will guard Queen on horseback –

There’s a joke here about looking at horses’ arses during the Royal Wedding, but I’m going to forgo it. Maturity and all.

amednews: Revised ‘don’t ask’ gun bill advances in Florida :: Apr 25, 2011 … American Medical News

Florida still hasn’t figured out they’re being played by the NRA:

Revised “don’t ask” gun bill advances in Florida

A compromise removes civil and criminal penalties for asking about gun ownership but would refer physicians to the medical board for “harassing” gun-owning patients.

via amednews: Revised ‘don’t ask’ gun bill advances in Florida :: Apr 25, 2011 … American Medical News.

It’s going to pass in Florida.

Wonder which special interest will want to punish speech they don’t like next?


XY SCRUBS | Mens Scrubs – XY SCRUBS.


A new scrub shop, started by a former Army Flight Surgeon (now a Surgery Resident).

Don’t know much more than that, but check it out.

» Features » helping patients make informed decisions since 2004.

» Features » helping patients make informed decisions since 2004..


Just go see.

Collins is first GOP senator to oppose Ryan budget proposal – The Hill’s Floor Action

An astonishingly unserious look at the budget problem.

Sen. Susan Collins (R-Maine.) said Friday that she will not support the 2012 budget passed by the House last week.

“I don’t happen to support Congressman Ryan’s plan but at least he had the courage to put forth a plan to significantly reduce the debt,” Collins said on “In the Arena” a program on WCSH 6, a local NBC affiliate in Portland, Maine.

Collins, who is one of several centrists in the Senate Republican Caucus, did not say specifically what she opposed in the House GOP plan, but she did say that she would like to begin moving the government towards solvency by eliminating ethanol and farm subsidies as well as funding for an extra engine for the F-35 fighter jet.

“There are lots of opportunities to consolidate and save money,” Collins said.

via Collins is first GOP senator to oppose Ryan budget proposal – The Hill’s Floor Action.

I’m not a policy wonk, but I know BS when I hear it.

The Ryan plan proposes to reduce 10 year deficits by 5.8 Trillion, so 580bn/year for 10 years (as an average).

Senator Collins’ proposal: kill off farm subsidies (20bn/yr), Ethanol subsidies (best number I could find was 6bn/year) and kill off the GE ‘second engine’ for the F35 project. I couldn’t find hard numbers for that cost (I suspect there aren’t any that are founded in reality), but found one site that said just futzing with the consideration was costing someone a million a week. Crummy assumption, so let’s say it’s costing that much every day rather than every week. It’s a place to start, so, $365M/year, as a low-ball number, before production. All these numbers may be way, way, off, but let’s use them for illustration.

So, 26.365Bn/yr x 10 years = 263.65 Billion dollars. Which is only 5.537 Trillion short of the Ryan plan goal. Or, to look at it another way, this would knock 4.5% off the Ryan 10 year total. Leaving another 95.5% of the total to be discovered elsewhere.

Perhaps she has a whole lot of consolidating in mind. Maybe she’s going to write a check to cover the balance. Whichever, this statement is politician speak for ‘I’m not going to be the naysayer without a plan, I’m going to point out the things I’d cut as a way of showing I have some ideas, too’. But it’s patronizing when you run the numbers, and discover she’s not the least bit serious.

I’ve been reading about our financial problems, and the idea that we can kill off government checks to NPR and Foreign Aid and we’ll be fine is nuts. It’s not that they’re not worth doing, but it’s such small change that it’s barely even a start. There are no easy answers.

Everyone’s ox gets gored before this gets fixed, and pretending we can cut some fluff or a program that only directly affects a few isn’t serious.

Wisconsin licensing panel investigating fake doctors’ notes during anti-Walker protests | Philip Klein | Beltway Confidential | San Francisco Examiner

Wisconsin’s physician licensing panel is investigating eight physicians who have been accused of writing phony doctors’ notes excusing anti-Scott Walker protesters from work while attending rallies at the state capital in February.

via Wisconsin licensing panel investigating fake doctors’ notes during anti-Walker protests | Philip Klein | Beltway Confidential | San Francisco Examiner.


Word to the Wise, one of a series

If you’re alleging assault, don’t get loud with the Officer there to take a report. Especially if you have Felony warrants.

Movin’ Meat: Medical Malpractice Self-Insurance — Is it right for your group?

ShadowFax is doing all EP’s a favor by explaining one of the more frustrating, and opaque areas of Emergency Medicine, group insurance. His group self-insures (apparently), and he knows way way too much about it:

One of the more painful elements of running a group practice is the ritual abasement before the god-like executives at the insurance company annual malpractice insurance re-bid. It’s kind of like a visit to the dentist: guaranteed to be uncomfortable and with the potential for a very unhappy surprise. Also, it leaves your face numb and drooling. The only thing that matches it in pain is writing the check every quarter, year after year, and then looking back at your actual, you know, losses, and seeing that you have paid for insurance way way more than you ever lost in liability claims. It’s got the all visceral satisfaction of lighting a pile of money on fire.

via Movin’ Meat: Medical Malpractice Self-Insurance — Is it right for your group?.

He’s got another, just as informative follow-on post, and the promise of at least one more. Frankly, it’s a primer for groups who are considering this (and AFIK, mine isn’t).

Politics mustn’t silence end-of-life talks –

I ask my patients this question, though not as often as I’d like. Talking about death may be uncomfortable, but it’s a conversation that needs to happen more often.

via Politics mustn’t silence end-of-life talks –

Kevin, MD continues his juggernaut to own the Social Media world.  Nice work.

Multitasking takes toll on memory, study finds | The Daily Caller – Breaking News, Opinion, Research, and Entertainment

A growing body of research shows that juggling many tasks, as so many people do in this technological era, can divide attention and hurt learning and performance. Does it also hinder short-term memory?

via Multitasking takes toll on memory, study finds | The Daily Caller – Breaking News, Opinion, Research, and Entertainment.

What’s important about this is…squirrel!


What was I talking about?

» Features » the cardiac cycle simplified.

» Features » the cardiac cycle simplified...

Pure. Genius.

When Harry met Sally 2

From Funny or Die.

Take 4 minutes and laugh yourself silly…