Balancing Between Hubris and Despair
Dr. Robert Centor has an important post about hubris. It’s not a long post, if you want to click through and quickly read it. It’s about the danger of overweening pride and overconfidence that can come from blindly believing the praise that is often heaped upon us by those in our care. Essentially Dr. Bob is saying that we must avoid believing all the wonderful things our patients say to us.
One the one hand, I agree completely. Pride indeed goeth before a fall, and in our line of work, the pain of our falls is literally felt by others. The line between the confidence we need in order to do what we have to do, ...
Source: Musings of a Dinosaur - December 24, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
They’re Onto Us
Some folks have been talking about replacing doctors with machines of various kinds. Note that no one who actually has anything to do with taking care of real life patients is talking about this. It’s mainly venture capitalists and other people who think they can make lots of money selling machines to replace doctors who are talking about machines taking the place of doctors.
However, I’ve just discovered that the developers of Watson, the Jeopardy championship computer, have nailed it (via xkcd): (Source: Musings of a Dinosaur)
Source: Musings of a Dinosaur - December 22, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
Eighth Night of Hanukkah
Ivory elephants. I love elephants, so Menorasaurus Rex will just have to wait another year.
That’s it for this year. A very happy Hanukkah, and a peaceful and loving Holiday Season to all. (Source: Musings of a Dinosaur)
Source: Musings of a Dinosaur - December 13, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Family/Personal Source Type: blogs
Seventh Night of Hanukkah
The second gift from my contractor friend. Made of brass, clearly handmade, though no idea when or by whom. Here’s the story:
This guy is an inveterate yard sale denizen. He’s found all kinds of amazing things that he’s picked up for a song (all the brass hardware from a defunct bar for $100, which is why the bar in our new basement is so magnificent.)
He was browsing one day and saw this atop a box of detritus, and, thanks to his Jewish education from me, he recognized what it was. He was also pretty sure that the garage sale guy who was selling it did not. So he asked.
“Do you know what that is?&...
Source: Musings of a Dinosaur - December 12, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Family/Personal Source Type: blogs
Sixth Night of Hanukkah
An adorable ceramic shtetl village menorah. (Source: Musings of a Dinosaur)
Source: Musings of a Dinosaur - December 11, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Family/Personal Source Type: blogs
Fifth Night of Hanukkah
This was a gift from the wonderful contractor who worked on both my houses and my office. He’s a curious guy (not Jewish) and he made me tell him all about the Hanukkah and menorahs. He got this one for me one year at Bed, Bath & Beyond. But the following year, he brought me another, with a really cool story behind it. You’ll just have to wait two more nights to see (and hear) it.
(Source: Musings of a Dinosaur)
Source: Musings of a Dinosaur - December 10, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Family/Personal Source Type: blogs
Fourth Night of Hanukkah
I can’t even remember where or when I got this one. But it’s very nice, isn’t it. (Source: Musings of a Dinosaur)
Source: Musings of a Dinosaur - December 9, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Family/Personal Source Type: blogs
Third Night of Hanukkah
I actually picked up this beauty at Bed, Bath & Beyond last year. It’s the word “Hanukkah” in Hebrew with holes on top for the candles. The shamash (the one lit first, which is then used to light the others) is all the way to the left, atop the final hey, which as you can see rises up a bit. (Source: Musings of a Dinosaur)
Source: Musings of a Dinosaur - December 8, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Family/Personal Source Type: blogs
Second Night of Hanukkah
The baby brother of 2012’s Eight Night magnificence, another Rosenthal woven brass piece of art. (Source: Musings of a Dinosaur)
Source: Musings of a Dinosaur - December 7, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Family/Personal Source Type: blogs
First Night of Hanukkah
I bought myself two new menorahs this year, and here is one of them:
The candle cups are mounted on a chain, which means that even though it’s stretched out in this picture to look fairly classic, it can be bent and bunched up into all kinds of cool configurations. (Source: Musings of a Dinosaur)
Source: Musings of a Dinosaur - December 6, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Family/Personal Source Type: blogs
Hanukkah 2015
If you will forgive a little post-dated blogging, it’s time once again to return to an old Dino-staple this time of year. Not every year, actually. In fact, I’ve only done it three times before in nine years of blogging. That’s right: it’s Hanukkah, which means I get to post more of my menorah collection, including not just one, but two new ones I got this year.
Starting later today and then daily for the next week, I’ll be posting a picture from my collection.
Here’s a recap from previous years:
2007:
First night
Second night
Third night
Fourth night
Fifth night
Sixth night
Seventh nig...
Source: Musings of a Dinosaur - December 6, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
How Many Patients Do You Have? Who cares!
How many patients do you have?
I’m not sure what you mean. How many patients do I see on average each day? About twelve.
No. How many patients do you have?
Let’s see: Last week I saw about sixty patients altogether. Five of them were new patients.
No, no. How many patients do you have on your panel?
My panel? I don’t know what you mean by that. I don’t work as an employer in a fully prepaid system where patients are specifically assigned to me. I’m down to only two capitated HMOs, insurance plans that pay me a certain amount (not much) each month for each patient on my list. Some people on the...
Source: Musings of a Dinosaur - November 22, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
Birthdays
I still work because I don’t think I could keep up with all the activities in my new Active Adult Community. It’s a development whose initials spell out “RAP” and recently, when my Dearest Darling Spouse had a birthday commemorating six and a half decades on the planet, every single person who heard he was turning 65 said exactly the same thing. So I put it onto the cake I baked (from scratch!) for him:
Happy Birthday, DDS. Many, many more. (Source: Musings of a Dinosaur)
Source: Musings of a Dinosaur - November 10, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Family/Personal Source Type: blogs
New Codes for End-of-Life Counseling; Heaven Help Us
Poor bored Government. So much time on their hands; so little real work that needs to get done, all they can do is micromanage poor physicians like me to death. Well, they can try.
For its first forty-five years, Medicare was (in)famous for the very narrow limits on things it covered. It would pay for medical care when you were sick or injured, and that was basically it. No preventive care. No shots. Counseling, coming under the rubric of Psychiatric care, was paid at 65% of the “medical” rate. On the flip side, all you had to do to get paid was bill for it. Somehow way back then, physicians were considered pro...
Source: Musings of a Dinosaur - November 1, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
How Pennsylvania is Screwing Radiologists
Here’s something new and different: Dino defending Radiologists. Oh, I’ve lit into them from time to time over the years, but we are colleagues. And a recent ruling by the Pennsylvania Governor’s office mandating that 3D mammograms, also known as tomosynthesis, be treated exactly the same as previous technology for payment purposes (ie “Free” to patients) is patently unfair to radiologists.
Some background: The current technological standard for breast cancer mammography screening consists of taking plain low-dose xray images of compressed (ouch!) breast tissue, either with film or digital tec...
Source: Musings of a Dinosaur - October 21, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
