When healthcare is literally legislated

Hint: it’s not good. A terrific article from Weingart and Faust.


If the drafted CMS measure goes into effect, we are hosed. Because data will be collected retrospectively, hundreds of patients will be deemed severe sepsis who were never actually sick.

Government organizations do not invent this stuff. Behind every measure there is, somewhere, a group of physicians that made it happen. Just as medical malpractice would not exist without plaintiff witnesses, these measures would not exist without us. Let’s fight back before it is too late.

Hint: it’s too late. Enjoy the people who wrote the tax code legislating your care.

 

Dragonfly

I’m not a book reviewer but when I read one I want to share I’ll tell you about it. 

This is one for a small audience, those who are space junkies who don’t know a ton about the U.S. Mir space missions. It’s very well written and well sourced, the author having gotten a lot of access to NASA and Mir astronauts  and the myriad people who support them. 

I’m told by a friend who’s briefly mentioned in the book that the author began as a rah-rah angle but soured on NASA and that probably explains the more than warts and all presentation.  It’s not a hatchet job but it’s not a recruiting too either. It reads quickly, and the quirks of astronauts of both countries are very interestingly laid out. 

Oh, did I mention they had both a fire and a rapid decompression while NASA was aboard?

Well written, reads well. Recommended. 

  

Nursing Homes are restarting the ‘don’t send the MAR’ game

For a primer, from 2007, here.

Another patient, another absent MAR (if you don’t know that acronym, you didn’t read the lead in article!). Usually they send when we call, but not recently. Here’s an amalgamation of some cases:

Calls are made by the nurses at my behest. The MAR Will Not be Sent.

Per nursing, whom I work with daily and trust implicitly, here are the objections proffered:

1) It’s illegal to send our signatures
Really? No, it’s not.

2) It’s our policy not to send MAR’s
Good luck with that policy. It’s going to get you in trouble.

3) You don’t need that.
As it’s a patient who has a) gotten meds from you and b) that timing is a question and c) we don’t know what the timing is, yeah, we and the patient you sent to us need that.

4) We sent you a med list
Yes, you did. That’s a List of Meds, but we don’t know what’s scheduled, PRN, given, held, parameters, etc. That’s a dodge.

Allow me to quote me:

This is outrageous. A chronically ill patient is sent to a higher level of care for an acute problem, and without a complete information base; but not just that, information crucial to the care of the patient that’s being intentionally withheld.

It is a situation that makes me, frankly, nuts. When did intentionally withholding critical patient care information become acceptable? Seriously, have these people not learned from history? The coverup is always, always worse than the crime, and is looked upon less favorably and punished more severely that any original offense. You could ask Nixon, but he’s dead.

Send me all the info you have, and our patient will live or die based on their problem(s); withhold information I need, and it’s on you, Nursing Home nurses.

– See more at: http://gruntdoc.com/2007/06/nursing-home-mars-sent-to-the-ed-with-all-times-removed-a-new-and-horrible-trend.html#sthash.k1mXnxiK.W4zJDG1c.dpuf

And if you’re from the Texas NH Regulatory agency that emailed me after the first posting, please recontact. I’m ready to send you some facility names going forward.

How teleconferences really go

This is way too true.

 

America’s Emergency Physicians

Really good video!

VP Biden’s best speech

Joe Biden isn’t my cuppa tea.

Yet, his talk to TAPPS is the best contemporaneous speech by a Pol to military families who lost family members in combat. I now like him much more.

Happy Birthday Dad!

Thanks for not killing me all those years ago.

m&d

The NYT, Maureen Dowd, and Dr. Caplan

Behold, a very worthy rant.  Recommended.

It’s GruntDoc.com’s birthday!

The thirteenth, and as such is in that awkward non-communicative phase.

 Thanks to the seven of you for checking in from time to time!

 Yes, I intend to keep this. Should my current situation change, I suspect long form blog posts would return.

A wonderful Fisking

I’m neither terribly for nor against paramedics working as employees in the ED, but I love people ripping apart straw man arguments.

Texas ENA’s Unprofessional Attack on EMS

Author’s note: I generally avoid posting non-tech matters on my blog, but this unprofessional, unsubstantiated, fear-mongering attack of EMS in Texas has me boiling. I present to you something that doesn’t just affect Texas EMS, but EMS in the entirety of the United States of America. This has been fought in other states, and if it isn’t stopped now, will set a precedent and spill into many more states and regions. If you want to advance, you don’t do it by holding your siblings down in mediocrity and attacking their skills and intelligence. They seem to have taken a page out of the book, “How to Get Ahead in Life by Attacking Your Colleagues.” It is uncalled for.

Go, now, and enjoy.

 

They call me ‘Doc’

For the mighty Navy Corpsmen, past, current and future.

 

Olivet Nazarene University ED Nursing graphic

Well done, and some good information:

nursegraphic2

 

via http://graduate.olivet.edu/

TELCO types, I have a question

So, I figure someone out there knows the answer to this, and I’ll share my guess, but I can’t find an answer on the internet.

My Question: Why does my cell phone ignore (or add) a “1” with a phone call, but my POTS* line phone doesn’t. Not only does it not just ignore unnecessary “1”s, it makes the annoying tri-tone and tells me it’s not necessary to dial a 1.

Well, if you know it’s not necessary, why not ignore it and put the call through?

 

My guess: the equipment being used is so old it cannot be taught new ticks, but I’d be interested in an informed answer.

*Plain Old Telephone System (I found this when getting my first DSL line).

What doesn’t kill you makes you stronger

unless it’s the tail rotor. They will straight up kill you.

Buy the t-shirt!

2015-02-09_23-23-32

I read blogs were dead the other day

And then forgot to check this one.

It’s not dead, it’s just being left fallow. You have my apologies.

It’s fallow as I’m in one of those weird career places, where I’m doing just enough interesting things that are fun but that I cannot talk about, and so rather than screw up I self-censor. Long-form blogging isn’t dead for me, but now really isn’t the time.