Why aren't more people talking about this!!!!
The Obama Administration announced Thursday a plan to start billing private insurance companies for war and service related injuries of their subscribers who are veterans.
http://www.bio-medicine.org/medicine-news-1/VFW-Against-VA-Collection-Increase-Proposal-38578-1/
That's great. The economy is bad enough as it is. Veterans have a high enough unemployment rate. Who is going to want to hire them if their insurance premiums are going to be more expensive for employers? Are they going to be in a higher risk pool? If they have to pay for their premiums how are they going to afford it? This is totally unacceptable!
These men and woman sacrificed for their country, the mission of the VA as envisioned by Abraham Lincoln was to provide for those that "bore the brunt of battle"
Tuesday, March 17, 2009
Monday, March 9, 2009
The Other Guy Started It......
In The Happy Hospitalists blog is an entry about a dentist who is less than thrilled about paying more in taxes if she breaks a certain income threshhold.
http://thehappyhospitalist.blogspot.com/2009/03/when-you-tax-something-anything-you-get.html
To her it appears to be a "tipping point" ,as described by Nurse K, where the effort is no longer worth it. Anyway, what really torqued my lugnuts was a remark by David MD: "Any dentist earning more than $250,000 per year is not doing enough to see the poor that can't afford dental care. "
Weeeeeeeeellllll David , me bucko! Since when did good works and morality get tied to income? Dentists have been smart enough not to get sucked into the managed care mess that afflicts most health care today. A Wall Street Journal article several years ago showed that the average general dentist made about 170K per year. And ya know what Davy? We give a lot of it back to the community. We don't need the government or a bunch of Birkenstock wearing, latte sipping, 10 year old Volvo driving, knee jerk, boo-hoo liberals telling us how to provide for the poor. I have spent the past two decades providing health care in some of the worst hell holes on this planet . I can't wait to retire and start making as much money as I can so I can go back to some of those places and do some more. The less the government takes from me the more I will be able to do good works with!
http://thehappyhospitalist.blogspot.com/2009/03/when-you-tax-something-anything-you-get.html
To her it appears to be a "tipping point" ,as described by Nurse K, where the effort is no longer worth it. Anyway, what really torqued my lugnuts was a remark by David MD: "Any dentist earning more than $250,000 per year is not doing enough to see the poor that can't afford dental care. "
Weeeeeeeeellllll David , me bucko! Since when did good works and morality get tied to income? Dentists have been smart enough not to get sucked into the managed care mess that afflicts most health care today. A Wall Street Journal article several years ago showed that the average general dentist made about 170K per year. And ya know what Davy? We give a lot of it back to the community. We don't need the government or a bunch of Birkenstock wearing, latte sipping, 10 year old Volvo driving, knee jerk, boo-hoo liberals telling us how to provide for the poor. I have spent the past two decades providing health care in some of the worst hell holes on this planet . I can't wait to retire and start making as much money as I can so I can go back to some of those places and do some more. The less the government takes from me the more I will be able to do good works with!
Sunday, March 1, 2009
Lettin' the Fox Guard the Chicken House
Kansas Governor Kathleen Sebelius has accepted President’s Obama’s offer to be his HHS nominee according to news sources including The New York Times.
Mmmmmmmm... She was also once the president of the American Trial Lawyers Association. And guess what? She has never treated a patient in her life. Sounds like a win/win to me!
Mmmmmmmm... She was also once the president of the American Trial Lawyers Association. And guess what? She has never treated a patient in her life. Sounds like a win/win to me!
Saturday, February 14, 2009
PA's and NP's in my world
This has been on my mind and Happy Hospitalist's post http://thehappyhospitalist.blogspot.com/2009/02/dr-nurse-pa-perspective-and-your.html got me thinking about the whole thing.
I am board certified in my field and I completed a 2 year hospital based residency, but nothing that compares to physician residencies. Because of my training and my interests I see a fair number of medically compromised patients. There are times I need to consult with my patient's primary care physician before embarking on a proposed treatment plan. When I consult with a physician it is not to ask permission to treat the patient, but to see if there are any potential landmines with my choice of meds or procedures. There have been a few times as of late that I have gotten a reply from a PA. I'm sorry, but I will not accept those consult replies.
My treatment plan will be based on my judgement and the input of the patient's physician not a mid level provider. When the patient is in my office, I am wholly responsible for their care and the outcome of any treatment. I could not defend any decision made by one of my colleagues based on input by anyone other than an MD or DO and I don't think it would be defensible in court.
I am board certified in my field and I completed a 2 year hospital based residency, but nothing that compares to physician residencies. Because of my training and my interests I see a fair number of medically compromised patients. There are times I need to consult with my patient's primary care physician before embarking on a proposed treatment plan. When I consult with a physician it is not to ask permission to treat the patient, but to see if there are any potential landmines with my choice of meds or procedures. There have been a few times as of late that I have gotten a reply from a PA. I'm sorry, but I will not accept those consult replies.
My treatment plan will be based on my judgement and the input of the patient's physician not a mid level provider. When the patient is in my office, I am wholly responsible for their care and the outcome of any treatment. I could not defend any decision made by one of my colleagues based on input by anyone other than an MD or DO and I don't think it would be defensible in court.
Saturday, January 31, 2009
Tattoo:Tooth ratio
Why is it the tattoo to tooth ratio directly proportional to ETOH intake and inversely proportional to good sense?
Like I really believe that your mandibular condyle fracture and through&through lip lac was cause by a slip and fall. Especially when your shipmate is two cubicles down with a boxer's fracture.
Arrrrrrrgh!
Like I really believe that your mandibular condyle fracture and through&through lip lac was cause by a slip and fall. Especially when your shipmate is two cubicles down with a boxer's fracture.
Arrrrrrrgh!
Sunday, January 25, 2009
Back in the day...
As you know I was once a Medic. In fact, my start in EMS was in the days of Ambulance drivers, attendants, and funeral home rigs. When I started all you needed was a Red Cross Advanced First Aid and CPR card.
The events I talked about yesterday and a post in Too Old to Work, Too Young to Retire's "Tales from the 'Blance http://tooldtowork.blogspot.com/2009/01/tales-from-blance.htmlcaused me to take a trip down memory lane to one of my favorite "rookie" stories.
It was a nice summer Saturday afternoon. The kind of day to be sitting on a blanket at the lake watching the volleyball games, seeing and being seen. At the time I was a young "attendant" with Eternal Rest Mortuary and Ambulance Service. We were dispatched to a possible OD in one of the nicer parts of town. On arrival at a pleasant suburban ranch house, we were met by an angry father and a distraught mother. It seems the eldest daughter was made to babysit her siblings whilst Mom and Dad went to the club for a game of tennis.
Little Miss was apparently in a snit because she missed out on her day at the lake and decided to punish M & D by downing whatever she could find in the medicine chest and washing it down with some of Dad's 18 year old single malt. We followed them into the living room where a very beautiful, but obviously angst ridden 16 year old girl was sprawled on the coach with a large glass of water. She was alert and oriented, but very sullen and non communicative. I introduced myself and told her we were going to take her to St. Joe's (Hospital) so the doctor's could check her out and make sure everything was okay. With out a word, she finished the glass of water, got up and sat her self on the cot.
As we rolled her out the front door, her mother, who was going with us in the rig, mentioned that she had called their pediatrician who had advised her to give Little Miss ipecac syrup and a big glass of water...the water she had just finished...but nothing had happened yet. "No problem", I said, "I'll give her a basin if she needs it. She'll be just fine". We put her in the back of the Caddy and I climbed in with her while Mike A. got Mom situated up front.
I raised the head of the cot as much as I could, draped a big bath towel over her like a bib and gave Little Miss a surgical basin as Mike pulled away from the curb."Okay Honey. Do you feel like you need to throw up?" She just shook her head, no. Since her head was up I was sitting on the attendant chair that faced her with my back to the rear door (The old low top Cadillacs had two chairs that faced each other and folded into the floor).
In a few minutes she started that peculiar half hiccup/ half spasm that signals imminent evacuation of the stomach contents. I put a damp washcloth on her forehead and said "It's okay sweetheart. It's just the Ipecac. Go ahead and throw up in the bowl. You'll feel better." She just looked at me. The spasms increased in frequency and she was obviously about to spew.
I leaned forward to help her with the bowl when she turned, leaned over, and puked right in my lap!As soon as her stomach was empty she wiped her lips with the back of her hand, looked me right in the eyes, and with the sweetest smile you can imagine said, "F*&k you, a#$hole!"
The events I talked about yesterday and a post in Too Old to Work, Too Young to Retire's "Tales from the 'Blance http://tooldtowork.blogspot.com/2009/01/tales-from-blance.htmlcaused me to take a trip down memory lane to one of my favorite "rookie" stories.
It was a nice summer Saturday afternoon. The kind of day to be sitting on a blanket at the lake watching the volleyball games, seeing and being seen. At the time I was a young "attendant" with Eternal Rest Mortuary and Ambulance Service. We were dispatched to a possible OD in one of the nicer parts of town. On arrival at a pleasant suburban ranch house, we were met by an angry father and a distraught mother. It seems the eldest daughter was made to babysit her siblings whilst Mom and Dad went to the club for a game of tennis.
Little Miss was apparently in a snit because she missed out on her day at the lake and decided to punish M & D by downing whatever she could find in the medicine chest and washing it down with some of Dad's 18 year old single malt. We followed them into the living room where a very beautiful, but obviously angst ridden 16 year old girl was sprawled on the coach with a large glass of water. She was alert and oriented, but very sullen and non communicative. I introduced myself and told her we were going to take her to St. Joe's (Hospital) so the doctor's could check her out and make sure everything was okay. With out a word, she finished the glass of water, got up and sat her self on the cot.
As we rolled her out the front door, her mother, who was going with us in the rig, mentioned that she had called their pediatrician who had advised her to give Little Miss ipecac syrup and a big glass of water...the water she had just finished...but nothing had happened yet. "No problem", I said, "I'll give her a basin if she needs it. She'll be just fine". We put her in the back of the Caddy and I climbed in with her while Mike A. got Mom situated up front.
I raised the head of the cot as much as I could, draped a big bath towel over her like a bib and gave Little Miss a surgical basin as Mike pulled away from the curb."Okay Honey. Do you feel like you need to throw up?" She just shook her head, no. Since her head was up I was sitting on the attendant chair that faced her with my back to the rear door (The old low top Cadillacs had two chairs that faced each other and folded into the floor).
In a few minutes she started that peculiar half hiccup/ half spasm that signals imminent evacuation of the stomach contents. I put a damp washcloth on her forehead and said "It's okay sweetheart. It's just the Ipecac. Go ahead and throw up in the bowl. You'll feel better." She just looked at me. The spasms increased in frequency and she was obviously about to spew.
I leaned forward to help her with the bowl when she turned, leaned over, and puked right in my lap!As soon as her stomach was empty she wiped her lips with the back of her hand, looked me right in the eyes, and with the sweetest smile you can imagine said, "F*&k you, a#$hole!"
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