One reason blogging’s been light

Is my DSL connection.

This is the PingPlotter visual (red = no connection)

You can see the problem (that’s about 48 hours there in the picture).  My connection time is spent doing things I have to get done.

We’ve had the DSL techs out twice.  The first one pronounced us to have ‘too much line noise’, disconnected some things, and that didn’t fix it.  Tech 2 cut the speeds in half and replaced the modem, which didn’t help, either.

We noticed a few days ago that phone calls would just drop in mid-word, and a call to the ‘voice’ people resulted in a different test, which apparently says there’s a problem with the wires outside the house, and in typical AT&T fashion someone would be out in the next 72 hours.  No idea when, just in the next 3 days.

My guess is an intermittent short or a wire breakage that moves in the wind, so it acts normally sometimes but not others (like in medicine, intermittent things can be very hard to diagnose).

Hopefully, this’ll get fixed soon.  In the meantime, talk amongst yourselves.

Los Angeles Times: Doctors talk shop on medical blogs

Yrs. Trly, KevinMD, OBGynKenobi and Notes from Dr RW are all mentioned.  I’ll disagree mildly (I think it’s more complicated than that) with the last sentence, but the reast is pretty good.

Los Angeles Times: Doctors talk shop on medical blogs

Web posts offer insight into the profession, but also raise patient privacy issues.
By Melissa Healy
Los Angeles Times Staff Writer

August 4, 2008

For physicians of a certain age, the weekly teaching session known as grand rounds is a ritual steeped in formality and tradition. Presided over by the profession’s graybeards, grand rounds are attended with white coats on and clinical details in hand.

Here, young physicians learn to accept their elders’ old-school admonishments with reverence and humility.

Grand rounds on the Internet, however, is another thing altogether. A weekly compilation of the Internet’s best medical blog postings, it is part classroom, part locker room, part group therapy session and part office party — a free-wheeling collection of rants, shop talk, case studies and learned commentary along with the occasional recipe, movie review or vacation slide show…

I’m always interested that I sound a little smarter in interviews than I do in actuality.  That’s a good thing.

Medicare Saver

I got an email last week asking me to have a look at, and maybe blog about, the following:

Hi, I am part of the team of local independent medical and technology
professionals that have just created an online Medicare Part D tool to help
even the playing field for seniors and independent physicians and
pharmacists.  Having created this baby we realized we have no idea how to
let people know about it.  So I was wondering if you might write a review
of us in your blog.The concept is simple.  The client simply enters their
location and drugs and we search for lower cost medications and list the
plans available to them with detailed pricing and restriction information.
It is free, confidential, and takes about 5-10 minutes.  The site is

I’m all for things that help people make better decisions, so I’ve had a somewhat quick look around, and I generally like it (my gripe’s at the end).

It’s a very professionally done site, navigation couldn’t be easier.  It starts by asking your Zip code, and explains that “Medicare calculates your coverage by your location”, which drives the rest of the decisions inherent in the program.

When you get to step two, entering the medications, there’s the inherent problem with medication name entering: multiple non-sensical names for medications.  For instance, type in ‘metoprolol’ and the following appears:


I’m a doctor and I had to study the choices to make the choice I wanted.  This isn’t a slam on the Medicare saver people, it’s just one example of how this isn’t super-simple (and I don’t know how to make it more simple).

Where I think this site is very useful is the graphical presentation of Part D plans in your area, recommending the least expensive at the top:


And, I can compare all 56 plans, should I want to.  It’ll then ask some questions to check your eligibility, and spit out an answer (I’m not eligible).

This is a good site for a lot of Medicare-covered people, and I’d recommend it as a starting place for discussions about medications with their doctors, and to shop Part D plans.

The MedicareSaver people want to tailor this product for physician practices and pharmacies (they need income too), so if you’re one of those, have a look.

My gripe: the professionally done, entirely understandable talking head at the top of every page cannot be shut off.  It’s not optional.  I really hate audio that plays automatically when I open any web page, and think if you’re going to do that you have to put in a mechanism to turn it off.  I emailed the site builder and mentioned this, and was told this is a deliberate decision based on some Seniors having relatively diminished sight.  Okay, but it still needs a way to shut it off.

That’s not enough to have me pan the whole product: it’s good, and I’d recommend it for the Medicare eligible.

(I have no financial or other entanglement in this product, I just think it’d be useful).

Change of Shift: Volume Three, No. 1 // Emergiblog

Change of Shift: Volume Three, No. 1 // Emergiblog
This edition of Change of Shift marks the beginning of its third year.

In celebration, I asked nurse bloggers to send in their first posts and tell us a bit about why they started blogging.

I was surprised at how long some of my colleagues have been writing about their nursing adventures, sharing their lives and opinions.

Many thanks to all the bloggers, nursing and otherwise, who have supported CoS over the last two years and to all who have hosted the carnival.

Let’s get started!

And many happy returns!

Epocrates: Go Mobile

Some love for Epocrates.

I used Epocrates on Palms for a few years, then was an early adopter of Epocrates on the Backberry platform, and it had a glitch; they fixed it within a week, and it’s been smooth sailing/computing since (see here).

For those who aren’t using it yet, here’s a starting point: Epocrates: Go Mobile Their site will even help you pick which PDA/Mobile phone is best for you.

I use their free product, so this is essentialy a free endorsement, but here goes:

In this day and age of new drugs, continuously changing warnings, and patients on multiple drugs needing interaction checking, some resource is needed, and Epocrates is an excellent product.  It’s (relatively) easy to install, it will update automatically, and it works.  There are things I’d change if it were my product (like this: look up a drug name that’s been discontinued, you get ‘drug discontinued in the US’, but no link to the generic; I now have to back out, and re-search with the generic name: Dumb.) but for a handy, functional drug reference it’s hard to beat.

I use it, and if you don’t have a drug reference in a PDA, this is one you should look at.

My wife got a dental implant t…

My wife got a dental implant today. Frankly, I always thought if I were to spend a lot of money on implants, they wouldn’t be dental.

18 admitted patients sitting i…

18 admitted patients sitting in the ED, waiting on a bed. 18 beds that cannot be used by ED patients to be seen.

Tim Russert dies suddenly afte…

Tim Russert dies suddenly after a trip to Italy. PE?

Imagine the fun

Imagine the fun
Of the deaf patient and utterly no ASL interpreter available.

Now give the patient you’re trying very hard to communicate difficulty writing, difficulty with vision, and more than three chief complaints.


I have had to be a morning per…

I have had to be a morning person for 5 days in a row now. Its not for me.

At work I’m lucky that I can give away my mornings to others …

It’s another beautiful day. A…

It’s another beautiful day. Another day spent indoors.

Funny I don’t gripe about my indoor job in January.

Jm Mckay died. I’ll never thi…

Jm Mckay died. I’ll never think of him without thinking of the Munich massacre. Not fair to him, but life’s not fair.

There’s a doc walking around w…

There’s a doc walking around with a “vote for Reagan” lapel pin.

I’m told people are commenting…

I’m told people are commenting to my twits (these posts) on Facebook. Hmm, now I need to recheck my facebook.

Going back to work after a vac…

Going back to work after a vacation really seems to defeat the purpose of the vacation.