Dear Readers,

It has been my pleasure over the last 4 years to blog on HCC-related topics and exchange ideas with many of you. I have learned a ton from everyone.

This is my last post and I anticipate retiring the blog by the end of the month.

via HCC Blog » hccblog.

Another good blogger taps out. Too bad.

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This is not a Panda that eats bamboo, but from all appearances feasts on spleens. Angry ones.

In fact, I was once texting while standing at the nursing station and some supervisor of something-or-another told me that cell-phones were not allowed and then looked on in helpless fury as I laughed and took his pictures to text to my friend. This is a good way to make enemies and I’m sure I’m going to be the first one up against the wall when “Papa Doc” Press Gainey is installed as out Great Leader and Ruler for Life but I did not come through the irritating hell of medical school and residency to be scolded by a bureaucrat like some wayward candy striper.

via We Are All Criminals Now : PANDA BEAR, MD.

I wish I wrote that well.

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Due to many things, I will be closing my practice over the next few months and going to work for the Arkansas Disability Determination Services DDS. I only recently made the final interview and signed the contract. My first day there will be October 3rd. I don’t want to discuss the reasons, but I want you to know how difficult a decision this has been for me.

via Suture for a Living: Changes.

We’re lucky she shares what she does with us, and I hope someday she can tell us what happened, if only to give courage to other docs looking at a career transition.

Best of Luck, Dr. Bates!

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How I Missed A Large Tumor and How You Will Too

He had severe right chest and shoulder pain.

His doctor had said it was the tunneled dialysis catheter. “If the pain gets worse go to the ED to get it removed.”

via Beyond the Clinical | Learning To Be A Better Physician Leader.

When you have a minute, go have a look, and bookmark it. Recommended.

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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!

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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).

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By Dr. Helen (without a comment) and by Don Surber with a very nice comment. It’s astounding to me how commenters everywhere are on board with suppression of speech. And sad.

Nice to be noticed, though.

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We were invincible. Packed into Jon’s pale yellow Olds Cutlass, the car I’d always wanted, careening down the road between our high school and its “sister” all-girls school, we’d sing along with whatever was playing on the oversized speakers garishly mounted in the back. More exactly, we’d usually be screaming along with the music, which was loud enough to rouse more than a few nearby drivers from their afternoon daydreams.

We were on our way to……take a typing class.

via Aggravated DocSurg: Waiting & watching for Jon..

It goes sideways after that.

Excellent post.

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A beautifully done blog post. Recommended.

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Here are my thoughts on why I don’t blog much anymore:

Technology changes. I Twitter more now than I blog. (@gruntdoc if you’re interested). What I twitter is occasionally snarky and completely useless and nonmemorable, so it’s not blogging, it’s just (sorta)-social media in action. Facebook is where people keep track of each other, and I’m engaging there, somewhat. I still prefer blogs.

My role in my Emergency Medicine group has changed. I’m now one of three ‘officers’ (I’m the Secretary, and no I don’t file or take dictation), but with a little more responsibility comes the awareness that people higher up than me are interested in what I think, and vice-versa. I’d hate for anyone to believe my blog is representative of my thinking (it’s not, the blog is better). Low expectations are better than high, in some circles.

I’ve said it. Frankly I’ve written 20 blog posts that I get halfway through and realize “I’ve said this before”, and that’s that. I’ll only rant about the same thing (excluding parasites) about three times, then it’s Done. Repetition isn’t fun to read on blogs, and I’ve spared you. Welcome. (Many bloggers have had this realization and had the decency to quit. Color me indecent).

I’m established. Yeah: stale, but present. There’s one continuous medblog I know of older than mine, and with that comes a sense of being, of not having to write to get attention. To be fair, stale isn’t what I aim for, but it’s what you get when you don’t push, and I’m not pushing. No argument. Also, not an excuse.

Parasites. There are ever-changing ways to screw docs, they’ll find them, and I’m less and less interested in handing them a blog post they can use against me. And, as I hate them, not worth the effort to rail at them. Doing so diminishes me, and certainly doesn’t elevate them. So, heck with that.

Commenting on the work of others is probably my best input/output option. Yeah, it’s sometimes lazy, but I think sometimes i have an interesting take on the blog/news of the moment. (YMMV).

A ton of my blog-peers, and blog-children, have packed it in. Nobody’s claimed blog-grandchild, and I understand that. It’s the blog version of an old-folks home sometimes, with the whipper-snappers causing problems and getting on the porch. No offense, but I haven’t added a blog to the blog-roll in probably a year. I don’t think blogging is dead, but it’s entirely possible it’s passed me by. Time will tell.

Shifting hobbies. I like projectile-oriented things, spend a lot of time (and the same dollars) on this hobby, and fearit’s not something people on this blog really dig. I don’t want to go all-shooting, but it’d be hard to stop if I started. So, restraint. For now.

Snootiness. Yes, me. I feel I’m setting a disapproving example in not blogging when others blog. About politics,  especially. Political hackery turns the seemingly most-eloquent, genius med blogger into a raving idiot, and not in a good way (either way). The disconnect between politics and the gentle practice of medicine is vast, and I choose to lead by Not Playing. True, I’ve lead in a direction nobody is interested in following, but I feel that it’s still worth the lack of effort. Someday my genius will be recognized. I hope.

Aging. As I become more mature I’m letting things go I didn’t before. The realization that some things are temporary, and those that aren’t don’t usually matter have made me (a little) more tolerant of folderol and foolishness. And get off my lawn.

Why I don’t plan to stop:

I’m a blogger. Yeah, not an auspicious beginning, but an actual description of an organism. (Or, to be fair in describing a blogger, an onansim, but I digress). That likes to blog.

I’m too lazy to quit. I’ve goofed on this before, but really, why quit (more than) now?  The world will miss me when I’m gone (I mutter this to myself continuously).

Blind squirrels, etc. Nuts are my especitalty…

I like all eleven of you.

Thanks for coming around now and again. I promise you…nothing, but when the Spirit moves, I shall keep blogging.

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