Sunday, November 22, 2009

1000 Awesome Things. #996: Weekend Call

Your clean wardrobe is all used up for the week, and you have to be in the hospital in an hour. It's an impossible situation until you realize it's Saturday, and you are on weekend call.

Wear those torn jeans and t-shirt to work, sneak into the locker-room to get the hospital-issued scrubs from the machine, and enjoy the bliss of working during the day at the hospital in pajamas.

AWESOME!


Inspired by "1000 Awesome Things".
(Image from SarahMcD via Flickr)

Breast Cancer and Healthcare Rationing

Breast cancer is a devastating disease, and women in the United States expect to be screened from the disease when they are at risk.

Understandably individual women were shocked when they learned that an authoritative panel is dictating that they should no longer get what they previously expected to prevent them from dying a premature death due to cancer.

This panel is the same panel which has been authorized by Obama's healthcare legislation to give official recommendations for government-approved healthcare plans. The same panel suggestions which will serve the basis for who gets what kind of treatment. A soft death panel, in Dr. Rich's words.

If the government does not approve the cost, the government will not allow it to be covered.

This is exactly how the government will work to deny healthcare coverage to millions of vulnerable Americans. Expect only more of it with Obamacare.

The nightmare of government control is alive in our open eyes.


(Image from euthman via Flickr)

Saturday, November 14, 2009

"If you can find your doctor, you can keep him"

Monday, November 9, 2009

Economic Medication: Adverse Effects

What do you call it when a medication actually makes the patient worse?

Lego MRI Machine

Lego MRI Machine from volume render of axial CT scan:
"Some time ago, I built a Lego MRI system as a giveaway for a pediatric radiologist and had it CT scanned later."
The original model on plain color image:
From Flickr user Voxel123.

Sunday, November 8, 2009

We Come in Peace (with universal healthcare)

As Glenn Garvin puts it:
Imagine this. At a time of political turmoil, a charismatic, telegenic new leader arrives virtually out of nowhere. He offers a message of hope and reconciliation based on compromise and promises to marshal technology for a better future that will include universal health care.

The news media swoons in admiration — one simpering anchorman even shouts at a reporter who asks a tough question: "Why don't you show some respect?!" The public is likewise smitten, except for a few nut cases who circulate batty rumors on the Internet about the leader's origins and intentions. The leader, undismayed, offers assurances that are soothing, if also just a tiny bit condescending: "Embracing change is never easy."
How can these aliens bring universal healthcare without resorting to a 2000-page piece of legislation? Congress is missing the mark somewhere.

Thursday, October 29, 2009

The Woman Who Swallowed the Canteen

Margaret Daalman came to hospital complaining of stomach ache - and one glance at her X-ray shows why.

Surgeons in Rotterdam in the Netherlands were flabbergasted when X-rays showed 78 different items of cutlery in the 52-year-old woman's stomach.

They rushed her to surgery in a desperate attempt to remove the dozens of forks and spoons trapped inside her body one by one.
From the Daily Mail.

Wednesday, October 21, 2009

Obama: Cap All Physician Pay at $100k per year

WASHINGTON - In a historic move, President Obama signaled Wednesday that physician salaries will be capped at $100,000 per year.

"For too long in this great country, greed has been the cornerstone of American medicine," Obama said on the south lawn. "Doctors care less about patients' well-being than their own pocketbook."

The plan calls for sweeping reform of payment to all physicians who have ever received money from the federal government, from subsidized education loans and residency stipends to Medicare service reimbursements.

"The federal government helped these people out by lending tuition or paying for their specialty training in residency. They ought to give something back to society."

When asked by the press about the specific limit of $100,000 in yearly income, the President responded, "So these 'poor' doctors can't afford a new luxury car every year. That's not hardship." He also stated, "And besides, mom and pop in Omaha, Nebraska with their 3 kids are able to survive just fine on less than $100,000. Doctors should too."

This latest announcement is on the heels of a new White House plan to curb executive pay by as much as 90% at major banking institutions receiving federal aid, capping total compensation at $200,000.

"Greed can exist in many places, but the most critical areas today are with physicians and bankers. That is where we need to start reining it in. They are the problem, the scourge, in today's society."

Thursday, October 15, 2009

1000 Awesome Things. #997: Covered Walkways

There's a hurricane passing through the area, flooding the hospital campus. At that moment you get paged about a patient in the building across the street. You need to see the patient immediately, but you can't wait for the storm to pass.

You decide to take the windowed over-street passageway, which offers a view of the few brave souls at street-level getting soaked. Yours was the path more travelled, and it made all the difference. Not a single rain drop hit your head, sparing you from a damp white coat for the rest of the day.

AWESOME!


Inspired by "1000 Awesome Things".
(Image from Arty Smokes via Flickr)

1000 Awesome Things. #998: Call-Free Weekend

Q4 call. You survived the torment of the evil weekend: Saturday overnight call, Sunday post-call. Then another full week of work starting Monday.

But you can hold your head high, because you know that sometime in your near future, you will have a Saturday and a Sunday free from your hospital responsibilities. The Golden Weekend.

Turn off that pager. Get out that to-do list. Now you have time to take care of your neglected loved ones.

AWESOME!


Inspired by "1000 Awesome Things".
(Image from Dossy via Flickr)

1000 Awesome Things. #999: Optimal Patient Load

With too many patients, you feel powerless to do everything for any of your patients. With too few, you feel powerless to do anything for everyone else who might be sick in the world.

But when you hit that sweet spot, you can take care of all of your patients, serving each and every one to the best of your capability, making a difference in the world. You are happy, the patient is happy.

AWESOME!



Inspired by "1000 Awesome Things".
(Image from benuski via Flickr)

Monday, October 12, 2009

1000 Awesome Things. #1000: Assessment

You discuss the history. You perform the physical exam. Now it comes to the juicy part. All that hard work gets put together, and a few sentences can say it all.

Without it, there is no conclusion and there can be no plan.

With it, medicine works like magic.

AWESOME!

Inspired by "1000 Awesome Things".
(Image from kurtz via Flickr)

Wednesday, October 7, 2009

Obama: Health Care Plan Would Give Seniors Right To Choose How They Are Killed

"Let me dispel these ridiculous rumors once and for all and set the record straight: Under my plan, seniors are going to be killed the way they want to be killed, end of story," said the president, who acknowledged that "wiping out" the nation's elderly population has always been his No. 1 priority. "If your grandmother would rather be euthanized in the privacy of her own home than be gutted and hanged on a high school soccer field, she is entitled to that right."
Humor is best served with a sprinkle of truth.

From The Onion.

Tuesday, October 6, 2009

When 0.05% equals 99.95%

And with state-sponsored white-coat giveaways, you know these physicians speak with authority on behalf of the whole.

Saturday, September 26, 2009

Obama and Car Insurance Mandates

Some people, including Obama, claim that car insurance mandates are the same as health insurance mandates.

The big issue with that is that the mandates for car insurance are only for 3rd party damages, i.e. only for damages to the other driver's car. Car insurance for your own car is optional and not mandated.

If Obama continues to use the car insurance mandate comparison, he should propose mandates for health liability insurance in the event of causing sickness to 3rd parties.

Of course, that is nonsense.

Monday, September 21, 2009

Chicago Cop Arrests Nurse

From Chicago:
Lisa Hofstra was the nurse in charge of the emergency room at Illinois Masonic about 4 a.m. on Aug. 1 when she said an officer named Rodriguez asked her to take blood samples from a man to determine his blood-alcohol level, according to a lawsuit filed in federal court. Hofstra allegedly told the officer the man had to become a patient first and she wanted to consult with her supervisor. The officer cuffed her and placed her in the back of a squad car, according to the lawsuit.

Thursday, September 17, 2009

Surgical Videos from the 1930s

Cesarean Section:


Prefrontal tuberculoma:


Ovariotomy:


Fractured clavicle:


Aseptic technique:


Tonsillectomy:


Indirect inguinal hernia repair:


Friday, September 11, 2009

No American Should Have to Choose Between Health Insurance and Alcohol

Thursday, September 10, 2009

Obama selects Trial Lawyer to head Tort Reform

There are credible estimates that serious tort reform could save the country between $100 and $200 billion annually in wasteful spending, as doctors practice defensive medicine to preempt lawsuits. … Now Obama says he’s going to study the issue. “I am directing my Secretary of Health and Human Services to move forward on this initiative today,” he said.

That would be Secretary of Health and Human Services, Kathleen Sebelius, whose resume includes eight years as director of the Kansas Trial Lawyers Association.

So Obama has chosen a former industry lobbyist to run tort reform.

Why are people cynical about health care reform?


From the Weekly Standard.

Obama's Speech, and the Facts

Quote: "And every day, 14,000 Americans lose their coverage. In other words, it can happen to anyone."

Fact: The major coverage expansions in all the legislation being considered would not begin until January 2013-so according to the President's own methodology, Democrat bills will allow more than 15 million additional Americans to become uninsured.


Quote: "And it's why those of us with health insurance are also paying a hidden and growing tax for those without it-about $1000 per year that pays for somebody else's emergency room and charitable care."

Fact: An even larger tax-of nearly $1,800 per year-is paid by individuals with private coverage who are forced to subsidize lower payments made by government-run health plans like Medicare and Medicaid, according to a study conducted by independent actuaries at the consulting firm Milliman.


Quote: "Nothing in this plan will require you or your employer to change the coverage or the doctor you have. Let me repeat this: nothing in our plan requires you to change what you have."

Fact: Independent experts all agree that the legislation proposed would result in millions of Americans losing the coverage they have-the Congressional Budget Office believes several million, the Urban Institute 47 million, and the Lewin Group as many as 114 million.


Quote: "Under my plan, individuals will be required to carry basic health insurance - just as most states require you to carry auto insurance."

Fact: Senior Obama Administration official Sherry Glied has previously written that a mandate "is in many respects analogous to a tax"-and furthermore has the potential to be a "very regressive tax, penalizing uninsured people who genuinely cannot afford to buy coverage." Thus this policy stance breaks the signal promise of the Obama campaign: "I can make a firm pledge. Under my plan, no family making less than $250,000 a year will see any form of tax increase. Not your income tax, not your payroll tax, not your capital gains taxes, not any of your taxes."


Quote: "There are also those who claim that our reform effort will insure illegal immigrants. This, too, is false-the reforms I'm proposing would not apply to those who are here illegally."

Fact: Nothing in any of the Democrat bills would require individuals to verify their citizenship or identity prior to receiving taxpayer-subsidized benefits-making the President's promise one that the legislation itself does not keep.


Quote: "And one more misunderstanding I want to clear up-under our plan, no federal dollars will be used to fund abortions, and federal conscience laws will remain in place."

Fact: The National Right to Life Committee, among other independent pro-life groups, have confirmed that the legislation will result in federal funds being used to pay for abortions-both through the government-run health plan, and through federal subsidies provided through the Exchange, despite various accounting gimmicks created in an Energy and Commerce Committee "compromise."


Quote: "I will not sign a plan that adds one dime to our deficits-either now or in the future. Period."

Fact: The non-partisan Congressional Budget Office has found that H.R. 3200 would increase deficits by $239 billion over ten years-and "would probably generate substantial increases in federal budget deficits" thereafter. The Peter G. Peterson Foundation released a study today which found that in its second decade, H.R. 3200 would increase federal deficits by more than $1 trillion.


Quote: "Not a dollar of the Medicare trust fund will be used to pay for this plan."

Fact: Among more than $500 billion in proposed savings from Medicare, the Democrat bills also propose re-directing $23 billion from the Medicare Improvement Fund to fund new health care entitlements. According to current law, the Medicare Improvement Fund is designated specifically "to make improvements under the original Medicare fee-for-service program."


Quote: "Reducing the waste and inefficiency in Medicare and Medicaid will pay for most of this plan. Much of the rest would be paid for with revenues from the very same drug and insurance companies that stand to benefit from tens of millions of new customers."

Fact
: The Congressional Budget Office has previously found that the cuts to Medicare Advantage plans included in the Democrat legislation would result in millions of seniors losing their current plan-a direct contradiction of the President's assertion that "nothing in this plan requires you to change what you have."


Quote: "This reform will charge insurance companies a fee for their most expensive policies, which will encourage them to provide greater value for the money - an idea which has the support of Democratic and Republican experts. And according to these same experts, this modest change could help hold down the cost of health care for all of us in the long-run."

Fact: While some Republicans support addressing the current employee exclusion for health insurance in the context of overall tax reform, the President's proposal would raise "fees" in order to finance new federal spending-a tax increase of hundreds of billions of dollars, and one that many Republicans may not support.


Quote: "Add it all up, and the plan I'm proposing will cost around $900 billion over ten years."

Fact: The Congressional Budget Office, in its score of H.R. 3200 as introduced, found that the legislation would spend approximately $1.6 trillion over ten years-nearly double the President's estimate.


Quote: "I will continue to seek common ground in the weeks ahead. If you come to me with a serious set of proposals, I will be there to listen. My door is always open."

Fact: On May 13, House Republican leaders all wrote the President a letter reading in part: "We write to you today to express our sincere desire to work with you and find common ground on the issue of health care reform....We respectfully request a meeting with you to discuss areas for potential common ground on health care reform." Nearly four months later, that meeting has yet to take place.



From here.