Healthcare insurance but no healthcare access
California doesn’t have enough doctors to provide healthcare to newly “insured” patients under the UnAffordable Care Act.
California state senator Ed Hernandez asks “”What good is it if they [state citizens] are going to have a health insurance card but no access to doctors?”
Wait. Health care insurance doesn’t mean that patients will have access to health care? Where have I heard that being said for more than 3 years?
The government is going to give patients their medical “insurance,” but access to physicians is limited by government policies, payment cuts, and administrative red tape &#...
Source: WhiteCoat's Call Room - February 14, 2013 Category: Emergency Medicine Doctors Authors: WhiteCoat Tags: Access to Care Policy Source Type: blogs
Healthcare Update — 02-11-2013
Patients gone wild. Also, a perfect example of why doctors shouldn’t play security guard. Iowa man attempts to leave emergency department, doctor doesn’t allow him to do so. Patient then slams doctor against wall and puts doctor into a choke hold before being pulled off and restrained.
Who gets paid to study this stuff? “Researchers” find that number of ED visits for pubic hair grooming injuries is on the rise. I had a couple of snarky comments, but I’ll have to leave those to you all.
Possible hope in battling drug-resistant superbugs? Scientists discover how to manipulate genes in bacteria to prevent bacteria f...
Source: WhiteCoat's Call Room - February 11, 2013 Category: Emergency Medicine Doctors Authors: WhiteCoat Tags: Healthcare Update Source Type: blogs
Spaghetti and Impaction
Stool impactions probably aren’t what most people would consider an “emergency” … until they actually have a stool impaction. Personally, I wouldn’t wish a stool impaction on someone. In chronic constipation, more and more stool collects in the colon until size of the ball of stool is too big to pass through the opening to the outside world. The major function of the colon is to absorb water from the stool, so the longer the stool sits in the colon, the larger the amount of water that gets absorbed, and the harder the blob of stool gets. By the way – the whole water absorbing function of...
Source: WhiteCoat's Call Room - February 9, 2013 Category: Emergency Medicine Doctors Authors: WhiteCoat Tags: Funny Patient Encounters Source Type: blogs
Dear Diary
Well, I thought we escaped it, but we didn’t. The past week has been full of emesis, diarrhea, and disinfectant spray. Just when we think that things are on the mend, someone else in the family starts having a stomach ache. The vomiting is the worst. When it starts out, it sounds like a loud belch … until you hear the progression of the sounds. Yeah. Too much information. But on a good note, I have seen that my kids are immune to boredom. They were able to watch the same episodes of Disney sit-coms a half dozen times and still got mad when I turned off the television.
I’ve cut back on my work hours a litt...
Source: WhiteCoat's Call Room - February 8, 2013 Category: Emergency Medicine Doctors Authors: WhiteCoat Tags: Random Thoughts Source Type: blogs
Social Media Fair Play
JustADoc commented about a Yahoo News story concerning an obstetrician who posted a mini-rant on Facebook about one of her patients always being late. The obstetrician’s post said
“I have a patient who has chosen to either no-show or be late (sometimes hours) for all of her prenatal visits, ultrasounds, and NSTs. She is now 3 hours late for her induction. May I show up late to her delivery?”
After the post became widely distributed, some people called for the doctor to be fired. Others defended her as a good physician.
The hospital assured all their concerned patients that the hospital would “reinfo...
Source: WhiteCoat's Call Room - February 6, 2013 Category: Emergency Medicine Doctors Authors: WhiteCoat Tags: Policy Source Type: blogs
Healthcare Update — 02-04-2013
Chinese man runs out of money to pay for dialysis. Government “insurance” only pays half the costs of treatment (keep that in mind, Affordable Care Act supporters). Then human ingenuity kicks in.
The man builds himself a dialysis machine out of used and discarded medical equipment, mixes his own dialysis fluid, and has been dialyzing himself … and it has been keeping him alive for 13 years.
Doctors hearing about his unorthodox methods warned him about the risk of serious infection and “long-term complications” because he wasn’t using sterile water to make his dialysis fluid. Something tells me that if the compl...
Source: WhiteCoat's Call Room - February 4, 2013 Category: Emergency Medicine Doctors Authors: WhiteCoat Tags: Healthcare Update Source Type: blogs
Open Mic Weekend
Just in case anyone was wondering what happened to Open Mic Weekends …
If you’re bored with the Super Bowl, you can post any medically-related comments, questions, or observations in the comments section. I’ll try to answer any questions on Monday or Tuesday.
As usual, the only rules for comments are that there are no personal attacks and that the comments/questions have to be medically-related. (Source: WhiteCoat's Call Room)
Source: WhiteCoat's Call Room - February 2, 2013 Category: Emergency Medicine Doctors Authors: WhiteCoat Tags: Random Thoughts Source Type: blogs
Paybacks
One of our registration clerks thinks she’s pretty slick.
We play little practical jokes on each other every once in a while. One day she’ll unplug the keyboard to my computer when I’m in a room with a patient. I’ll come out to try to enter orders and start pounding the keyboard. Another day I’ll squirt a syringe of saline onto her chair so her butt gets wet when she sits down. And on and on and on.
Recently, she tried to scare me. My desk sits across the station from hers and my back is to her. She thinks I can’t see her, but I can see everything that goes on behind me by the reflection...
Source: WhiteCoat's Call Room - February 1, 2013 Category: Emergency Medicine Doctors Authors: WhiteCoat Tags: Funny Source Type: blogs
Post Online, Get Investigated By State Medical Board
Earlier this month, a survey of state medical boards published in the Annals of Internal Medicine showed that many state medical boards were willing to investigate physicians for lack of online “professionalism.”
The authors of this study created 10 vignettes regarding online physician behavior and then queried state medical boards regarding their likelihood of “investigating” physicians based upon the scenarios. Percentages of state medical boards that were “likely” or “very likely” to investigate a physicians for behaviors were as follows:
Citing misleading information abou...
Source: WhiteCoat's Call Room - January 29, 2013 Category: Emergency Medicine Doctors Authors: WhiteCoat Tags: Medical-Legal Source Type: blogs
Healthcare Update — 01-28-2013
You can keep your doctor and your insurance … if you can afford it. Some insurance brokers expect health insurance premiums to triple in the fall prior to full implementation of Obamacare. Oh, and if you can’t afford that insurance, plan to pay a punitive tax.
But don’t worry, Mississippi Gov. Phil Bryant thinks that everything is fine now. Everyone in America has health care. All they have to do is go to the emergency room.
Once no one can afford private insurance due to premium hikes, then government funding cuts can affect essential hospital services – like what is happening in Australia.
Should smokers and ...
Source: WhiteCoat's Call Room - January 28, 2013 Category: Emergency Medicine Doctors Authors: WhiteCoat Tags: Healthcare Update Source Type: blogs
Art Kellermann Rand Rant
One of the posts in my Twitter feed was a re-tweet of something asserted by Dr. Art Kellermann (@ArtKellermannMD). Dr. Kellermann is a distinguished physician. He is the Director and VP of Rand Health. At one point he was a professor at Emory University, but apparently does not practice emergency medicine any more.
Dr. Kellermann’s tweet said the following:
Dr. Kellermann’s tweet references an editorial article that he wrote in the Annals of Emergency Medicine titled “Waiting Room Medicine: Has It Really Come to This? The article was from 2010, so I’m not sure what prompted him to tweet about it in...
Source: WhiteCoat's Call Room - January 26, 2013 Category: Emergency Medicine Doctors Authors: WhiteCoat Tags: News Commentary Policy Source Type: blogs
Art Kellerman Rand Rant
One of the posts in my Twitter feed was a re-tweet of something asserted by Dr. Art Kellerman (@ArtKellermanMD). Dr. Kellerman is a distinguished physician. He is the Director and VP of Rand Health. At one point he was a professor at Emory University, but apparently does not practice emergency medicine any more.
Dr. Kellerman’s tweet said the following:
Dr. Kellerman’s tweet references an editorial article that he wrote in the Annals of Emergency Medicine titled “Waiting Room Medicine: Has It Really Come to This? The article was from 2010, so I’m not sure what prompted him to tweet about it in 2013...
Source: WhiteCoat's Call Room - January 26, 2013 Category: Emergency Medicine Doctors Authors: WhiteCoat Tags: News Commentary Policy Source Type: blogs
What’s the Diagnosis #16 — Mmmmm, Eggs
This is an interesting case for a number of reasons.
First, it shows how a little testing can turn into a lot of testing to “rule out” diseases in the emergency department.
Second, it hopefully provides some good teaching points.
Third, the comment from the attending physician gave me the giggles. That will explain the title. But you have to read through the case to understand the comment.
I’m not going to discuss all the minute details of the case, only the major findings that contribute to the flow of the case.
A patient got sent in from the nursing home because her gastrostomy tube was leaking blood an...
Source: WhiteCoat's Call Room - January 25, 2013 Category: Emergency Medicine Doctors Authors: WhiteCoat Tags: Medical Topics Patient Encounters Source Type: blogs
More Joys of Electronic Medical Records
Go up to your favorite emergency department staff member and ask them what they think of “twofers.”
Depending on that person’s mood, chances are that you’ll get anything from a scowl to a punch in the gut in response. Two patients from the same family both needing emergent medical care at the exact same time? It still happens … car accidents, fires, maybe a stomach bug. But it can be frustrating. There’s a saying in emergency medicine that the likelihood of a true emergency is inversely proportional to the number of patients in the family registering to be seen.
That being said, a “...
Source: WhiteCoat's Call Room - January 22, 2013 Category: Emergency Medicine Doctors Authors: WhiteCoat Tags: CMS Medical-Legal Medicare Source Type: blogs
Comic Relief
Another cartoon courtesy of Mednificent Comics.
The answer to the question at the end … “absolutely” (Source: WhiteCoat's Call Room)
Source: WhiteCoat's Call Room - January 22, 2013 Category: Emergency Medicine Doctors Authors: WhiteCoat Tags: Comics Guest Posts Source Type: blogs
