Texas DPS Prescription Access Texas (PAT): https://pat.dps.texas.gov/Login.aspx

Here’s your power tip: have your Texas DL in hand, as it’s not just your DL# they want, but that long, goofy number that’s aligned vertically alongside your photo. (Which you’ll need every time you log in).

Yes. Texas has caught up with West Virginia. Come for the info, stay for the snark.

Related posts:

1. Texas DPS and physician narcotic licenses, 2011 In one of those things I don’t really get*, Texas...
2. Guest Column: Better Care, Thanks to Tort Reform — Health Reform and Texas | The Texas Tribune Wait, I was told this would Never Work. Thanks to...
3. Interactive: Who Are the Uninsured in Texas? Nearly a quarter of the Texas population lacked health insurance...

Related posts brought to you by Yet Another Related Posts Plugin.

Not only does “satisfaction [have] little or no correlation with Health Plan Employer Data and Information Set quality metrics,” but, according to the results of this study, hospitals that push to have the highest satisfaction scores may be harming or even killing their patients.

via A Death Knell for Press Ganey? | WhiteCoat’s Call Room.

I’m not ever going to get tired of this.

Related posts:

1. The Case of the Crazy Rabid Squirrel | WhiteCoat’s Call Room Read the rest, and wonder. Others practice risk-avoidance to the...
2. Dr. Perfect | WhiteCoat’s Call Room …Actually, statements like that do serve one purpose. They make...
3. Skeptical Scalpel: Patient satisfaction and reality You. Don’t. Say. Christmas came early for us skeptics this...

Related posts brought to you by Yet Another Related Posts Plugin.

Christmas came early for us skeptics this year. In a landmark study, certainly one of the most interesting and thought-provoking of the year-to-date, researchers from the University of California-Davis found that the more satisfied patients were with their physicians, the higher their hospital admission rates, prescription costs and total costs were. And patients with the highest level of satisfaction with their doctors had higher mortality rates compared to those patients least satisfied with their doctors.

via Skeptical Scalpel: Patient satisfaction and reality.

Anecdotally, I think that the push for higher patient satisfaction has led directly to underperforming docs doing things they wouldn’t normally do. This isn’t good medicine, it’s playing a very dangerous game.

Related posts:

1. Doctors and dentists tell patients, “all your review are belong to us” We (especially doctors themselves) like to think docs are smart....
2. Mayo Clinic drops Medicare- in 2010 Update: this happened 2 years ago. So, I wrote this...
3. In Fort Worth, MedStar’s Community Health Program cutting costs, improving patients’ well-being … Kudos to MedStar (our Fort Worth EMS provider) for their...

Related posts brought to you by Yet Another Related Posts Plugin.

To those who submitted posts, I say thanks. I appreciate that you did. Medical Grand Rounds keeps going because of you, the medical blogger. Your voice, your impressions, your passions and your human stories make our field such a great canvas.

via Grand Rounds: February 14th, 2012–Valentine’s Day version.

I actually submitted this time around.

Anyone know the ongoing volume/edition number?

Related posts:

1. Official 2012 Honda CR-V Game Day Commercial – “Matthew’s Day Off” Extended Version – YouTube Laugh, and enjoy!   Official 2012 Honda CR-V Game Day...
2. MedBlog Grand Rounds: Year 8! I’m slow to the draw on this announcement, but you...

Related posts brought to you by Yet Another Related Posts Plugin.

…

1. For those students applying to medical school with average GPAs (3.40 to 3.59) and average MCAT scores (27-29), black applicants were almost three times more likely to be admitted than their Asian counterparts (85.9% vs. 30%), and 2.4 times more likely than their white counterparts (85.9% vs. 35.9%). Likewise, Hispanic students…

via CARPE DIEM: Do Medical School Acceptance Rates Reflect Preferences for Preferred Minority Groups?.

Related posts:

1. Is the UT System Preparing for a New Medical School? — Higher Education | The Texas Tribune The headline is disingenuous: yes, there’s a Med School headed...
2. amednews: Law enforcement can access data bank without doctors’ knowledge :: Dec. 13, 2011 … American Medical News Well, this is good news. Remember that we were assured...
3. Libertarians, Medical Malpractice and Contract | Cato @ Liberty Interesting think piece on pre-arranged medmal arrangements, and why they...

Related posts brought to you by Yet Another Related Posts Plugin.

I’m good at intubating (the procedure by which a tube is passed through the vocal cords into the trachea to assist ventilation). I’m not the world’s expert, and I haven’t written a book about it, but I know what I’m about. I was trained by people who knew what they were doing, and I (and my patients) owe them a debt of gratitude. (Lotta I’s there, sorry).

Very occasionally, I get to help out my partners in Emergency Medicine practice when they’re in a bind with this procedure, and I do.  It’s always fun, and a little gratifying, to ‘get the tube’ when a colleague (and their patient) is in trouble.

As Ron White says, “I told you that story so I could tell you this one…”

Pride goeth before the fall.

I have come to learn that one of the worst sins of a physician is Pride. This is strictly different and separable from confidence, in that confidence is a normal and rational belief in ones self and abilities whereas Pride is based in ego, irrespective of confidence. Or logic, for that matter.

The worm turns, and I’m the one who cannot get the tube in the trachea. I’ve preoxygenated, sedated, RSI’d, and taken 3 tries. I’ve changed tubes, blades (the laryngoscope has differently sized and shaped blades), and patient positioning which are among the things that should be adjusted in the event of intubating failure. The good news? This patient can be oxygenated and ventilated easily with the bag valve mask. The bad? I’m now no closer to getting the airway secured with a cuffed tube than I was when I started.

This is where not having Pride came in: I asked for help. The Prideful EM doc (or the one in solo practice, and I respect the heck out of all of you) will keep trying, and will eventually help the patient and assuage their ego (or their situation) by getting The Tube. This can come at a cost to the patient in airway trauma or worse, and it’s desirable to avoid that.

My colleague physician came in, smiled, and helped my patient and me out of a bind. Colleague made it look ridiculously easy, with a first attempt intubation. Just like I’ve done before…

He was amazingly humble, and didn’t rub my nose in my failure to intubate. I truly hope I’ve been as nice to my colleagues in the same situation. Really, he was as nice as a human could have been while pulling chestnuts from a fire. Mine, to wit.

And I surprised myself by asking for help with a procedure I’m normally good at. No Pride, no Ego, just what’s good for the patient. I’m getting this Doc thing.

No related posts.

Related posts brought to you by Yet Another Related Posts Plugin.

Nearly a quarter of the Texas population lacked health insurance in 2010, according to the most recent data released by the American Community Survey, which the U.S. Census Bureau conducted. That’s more than 5.7 million Texans.It’s likely that someone you know — and probably one you wouldn’t have guessed — doesn’t have health insurance. More than half of the uninsured are employed. More than a third have an annual household income above $50,000. And more than 1 million have college experience or post-secondary degrees.

via Interactive: Who Are the Uninsured in Texas?.

Very nicely done.

If I get a lesson from this, it’s “Stay in School. kids!” (If you live that long).

Related posts:

1. Guest Column: Better Care, Thanks to Tort Reform — Health Reform and Texas | The Texas Tribune Wait, I was told this would Never Work. Thanks to...
2. Is the UT System Preparing for a New Medical School? — Higher Education | The Texas Tribune The headline is disingenuous: yes, there’s a Med School headed...
3. Texas Lege honors a spoof – Sleepless in Midland Way too funny! Did you wonder what kept the members...

Related posts brought to you by Yet Another Related Posts Plugin.

Permanent repeal of the flawed Medicare payment formula known as the Sustainable Growth Rate just got a lot more expensive….

via Doc Fix Just Got More Expensive – Margot Sanger-Katz – NationalJournal.com.

Related posts:

1. With explanatory graphics! The Sources of the SGR “Hole” — NEJM This article and its graph (from the NEJM), and its...

Related posts brought to you by Yet Another Related Posts Plugin.

So: the 2011 winner of the worst quackery award is: battlefield acupuncture. This bizarre practice, invented just 10 years ago, offers a trifecta of ills:

It offers no medical benefit and carries a real risk of harm for some patients.

The U.S. government is wasting tens of millions of dollars per year on it, and plans to increase its spending next year.

The patients are wounded combat veterans who have no choice about where to get treatment.

In battlefield acupuncture, the “doctor” (no competent doctor would do this) sticks needles into the patient’s ear to relieve pain.

via The Worst Quackery of 2011: Battlefield Acupuncture – Forbes.

Incredible. And infuriating.

(Found on Twitter, but I cannot recall who tweeted it).

Related posts:

1. Announcing Guess-a-Nobel 2011 MedGadget has an interesting contest going on: Six days from...
2. Charles Prize: Winners of the 2011 Charles Prize for Poetry It is with great pleasure that I announce the winners...
3. A Calling for Entries in the 2011 Charles Prize for Poetry Contest Announcing the second annual Poetry Contest! An award will be...

Related posts brought to you by Yet Another Related Posts Plugin.

…peddling the same tired phenomenon of magical thinking regarding the diagnostic miracle of highly sensitive troponins…

via Emergency Medicine Literature of Note: Yet Another Highly Sensitive Troponin – In JAMA.

Nice! Go and read.

via @nickgenes on that Twitter thing…

Related posts:

1. HHS Audits the 1% … and the Rest: First HIPAA Privacy and Security Audits Begin – Davis Wright Tremaine As the original twitterer ( @NickGenes ) said, “…because there...
2. The best bumper sticker evah! « My Strong Medicine The best bumper sticker evah! « My Strong Medicine.  ...
3. Trying out embedding a Tweet 165mph winds in Scotland. http://t.co/2qzwHX49 See that link for picture...

Related posts brought to you by Yet Another Related Posts Plugin.