Forwarded by mom, one of those ‘the internet is your dad’ memes:
Ramblings of an Emergency Physician in Texas
In one of those things I don’t really get*, Texas requires a separate license from an unrestricted medical license to prescribe narcotics. As the price of this extra license has always seemed to be more ‘cover the cost’, nobody has seriously objected. It’s $25, in case you’re interested.
Since it’s a State license, it’s required if your job could even perceivably need to prescribe narcs in a hospital. (So, Radiologists and Pathologists are usually exempted). It’s never been an issue, as long as you don’t screw up.
From the Austin American Statesman:
The Texas Medical Association sent an email to doctors Wednesday alerting them that DPS had a backlog of 3,000 doctors waiting for certification, and 4,500 more would join that group in August. The email indicated that DPS was trying to fix a new computer program that seemed to be causing the delay.
But no one seems to be fully certain of the cause. Several doctors’ groups said they were told that phone problems, an office move and a new computer program all were factors.
DPS did not respond to questions about what might have caused the backlog or comment on the physicians’ letter to Perry. Spokesman Tom Vinger wrote in an email that DPS has processed all but 534 of the 3,064 certificate applications received this month. The rest would be processed today , he said, adding that the 4,800 doctors whose credentials expire Aug. 31 are encouraged to get their applications in “as soon as possible.”
So, mine expires at the end of August, I sent my renewal in a month ago, and it’s still not renewed. (My check was readily cashed). Hopefully the quote is correct, the computer-glitches have been tamed, and all will soon be right with the world.
*I don’t get this license, really, except as a way to allow docs with narcotic prescribing problems, or other reasons to restrict their licenses, to keep practicing. Except, I don’t get that. We’re also required to have a DEA license for the exact same purpose, so this State license is duplicative. Lose your DEA? I seriously doubt you’ll be getting a State narcotic license. Why not have a Full Unrestricted Medical, a Full Restricted Medical (no narcs), and then any other restricted ones (retired, etc).
Yes, I’m a dreamer. I dream of one license that makes sense. (No, I don’t want a National Medical License, thank you very much).
I think this is a good, if incomplete list. Good place to start, though.
Physicians will not achieve their highest potential for success if they lack the following 3 key traits. Successful physicians have these traits.
The sale of Chiappa firearms in the USA is about to plummet. They have just made the worst gun industry PR move of the decade.
National Impact Database
Adult Football Helmet Ratings – May 2011
A total of 10 adult football helmet models were evaluated using the STAR evaluation system for May 2011 release. All 10 are publicly available at the time of publication. Helmets with lower STAR values provide a reduction in concussion risk compared to helmets with higher STAR values. Based on this, the best overall rating of ‘5 Stars’ has the lowest STAR value. Group rankings are differentiated by statistical significance.
If you’re in the market to buy a loved one a football helmet, or just curious, go and have a look. It doesn’t take long, there are only 10 helmets on the list. Go to the list.
I got to this from ESPN’s Page 2:
For years, football players, coaches and the parents of young players have been in the dark about which of the many helmets on the market may reduce the risk of concussions. The NFL does not mandate helmet types, while many NFL teams refuse even to reveal which helmets their players wear. The National Operating Committee on Standards for Athletic Equipment, which certifies sports equipment, has been AWOL on the issue of helmets and concussions. There’s been no place for the player seeking helmet safety information to turn.
Now all that has changed. Researchers at Virginia Tech have produced the first brand-by-brand, model-by-model ranking for the likely concussion resistance of helmets. A star-rating system modeled on crash safety rankings for automobiles, the rankings clearly identify the best and worst helmets.
It’s a long, good article. It lays out the problems with helmets, concussions, athletes, etc. And it highlights some actual science for helmets.
Progress! Here’s hoping it helps.
Gastroenterologist Michael Kirsch put up a post on his blog that was then reposted over at ACP Hospitalist asking where the threshold for admitting a patient to the hospital should be.
He asserts that there should be more collaboration between medical colleagues to determine whether or not a patient needs to be hospitalized…
Another WhiteCoat tour de force.
I’m a mac-o-phile, and a late arrival. Lion on the MacBook Air? Awesome!
On my iMac? HATE that they decided my scroll wheel needed to change directions so my hand motions mimic those of the touchpad. Even though I’ve used a scroll wheel for about a decade, and have to use one on PC’s, so don’t need the cognitive dissonance. And I’m old and dislike fundamental change.
Here’s how to get back to reality:
“System preferences” -> “Mouse” -> see the pic:
And, normalcy is restored. Life is back to normal. The horizon is righted.
(Hat Tip to Nick Genes, who turned his back on Jobs just to tell me about this).
Dr. Edwin Leap (he of the excellently written and quite frequently updated EdwinLeap.com has started a second blog, to which he seeks submissions.
I think from the title of his new effort, Impeding progress, you can get a feel for what he’s after.
Interesting idea, and while it’ll give all of a place to vent our spleens, I find blogs that are all negative rants to be cringeworthy after a while. I’m sure Dr. Leap (whom I met at ACEP this year, and he didn’t know me from Adam), will do a good editorial job.
So, go hither and submit your case of impeding progress!
“Would any EMS unit that can leave, leave now? We’re out of bays.”
When you run out of EMS bays (and we have several), you’re having a bad day.
About a month ago I bought a micro-tractor to have around the micro homestead, which is a lot of fun. (It’s a Kubota BX25, which I’d link to but their site is apparently Flash based, and therefore stinks and is unlinkable).
So, a little tiny tractor with a tiny loader and backhoe. It’s stupidly fun. I had no idea digging things with a backhoe would be so satisfying. I’m not going to give up the day job to do it, but it’s really a barrel of monkeys.
Apparently part of having a tractor is the parts/accessorizing (yes, I concur that accessorizing is probably the wrong word for a macho tractor, but I’m new to this, remember)? So, I have bought bucket hooks and a light kit for it, from BXpanded, and they’re the object of this praise.
I tried the bucket hooks a week or so ago, and they didn’t fit as smoothly as the YouTube video made it look, so I sent them an email, and I got a response within an hour. On a Saturday afternoon. With an apology for taking an hour, as he had been mowing his lawn. Also, his advice worked perfectly.
So, great, one incident, one good outcome.
Then today, another problem. Their light kit looks terrific and went on well, but I couldn’t find the work light wires on the tractor. They’re on the wiring diagram, but I couldn’t find the wires. I called the dealer that sold it to me, and their service department gave me the wrong answer (‘it’s the power outlet’), so they proved their worth. Inexplicably I sent an email to the BXpanded folks, and then bothered to look on the innernut.
Yes the answer was there, and I hooked their nice kit up, and of course it worked. And as I parked the tractor there was a voice mail on my phone. (My sig line on emails from the phone has my cellphone number in it). It was the BXpanded fellow, who wanted to help me find the wires.
Yeah, the BXpanded guy called me to help, though I only sent an email asking for a general hint. It doesn’t get any better than that. And, the lights helped me a bunch tonight while using the backhoe.
So, BXpanded.com, recommended highly.
There is a minor downside to having a micro-tractor: My wife has taken to calling me Mr. Douglas. Yeah.
Fort Worth teen wins first Google Global Science Fair
Shree Bose, 17, found that a metabolic enzyme affects ovarian cancer cells that can cause them to become resistant to certain treatments and discovered a way to improve cancer treatment when such resistance happens.
The Fort Worth Country Day senior wins $50,000 in scholarships, a trip to the Galapagos Islands for her project and a three-day internship to the prominent European Organization for Nuclear Research near Geneva, known by its French acronym as CERN. Fair winners were announced last night at Google’s headquarters in Mountain View, Calif.
Bose was inspired to research cancer after her grandfather died from the illness two years ago. She has presented related work to various science fairs, winning some top honors in the Fort Worth Regional Science and Engineering Fair and the Exxonmobil Texas Science and Engineering Fair. She was one of 15 finalists in the Google competition.
Okay, a little snark for a gender switchup, but good for Ms. Bose!
Kudos to MedStar (our Fort Worth EMS provider) for their excellent work on this project:
The Community Health Program was started in 2008 after MedStar officials discovered that 21 patients were using a big chunk of ambulance and emergency department resources. Those patients triggered more than 800 ambulance calls and cost the system more than $962,000 in charges, most of which were never collected because the patients lacked health insurance.
Nine of the 21 were selected for the program. They experienced a 77 percent reduction in their need for services during a 30-day test.
I watch some TV (and essentially no commercials, thanks to DVRs) and have been enjoying some shows: Necessary Roughness and Covert Affairs. Yes, put a reasonably attractive female in the lead role of a show with some action and I might watch. Demographic shocker.
So, within the last two days I saw one completely egregious professional breach, and one exercise of pretty awful medical judgement (in an ED, which make it way worse for me), and I will now outline my concerns/gripes.
(Yes, I’m aware they’re TV shows, and are therefore not reality. What I’m unhappy with is the glib way in which these terrible decisions played out, like it’s not a big deal to act against the interests of your patient, even especially, on TV). (I think TV behavior, not the cartoon violence but the everyday mundane stuff, influences how regular people think, which is why I’m writing this: so the zero regular people who watch TV and read this blog have something to consider).