tag:blogger.com,1999:blog-24021163.post2620256456536542453..comments2024-02-18T01:56:38.508-06:00Comments on M.D.O.D.: Reasons I'm Leaving Emergency Medicine (number 2)911DOChttp://www.blogger.com/profile/06466669111561150174noreply@blogger.comBlogger52125tag:blogger.com,1999:blog-24021163.post-34965782685657060262008-09-07T22:31:00.000-05:002008-09-07T22:31:00.000-05:00OMG. I thought it was a donut.OMG. I thought it was a donut.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-22939504123407180172008-09-03T12:37:00.000-05:002008-09-03T12:37:00.000-05:00Political activists propose solutions with the sam...Political activists propose solutions with the same general theme:<BR/><BR/>() They have a solution that will work if we would only stop arguing and agree with them.<BR/><BR/>() They may need to omit some information about the new arrangements and what these will cost. They observe that ordinary people do not think well enough to make decisions in their own long-term best interest. Dissenters are either uninformed or selfish. <BR/><BR/>() There is no need to argue about the specific meanings of words. The good of the society justifies telling some lies, if it comes to that.<BR/><BR/>() They do not limit themselves to offering another possibility. They reorganize everything into a comprehensive new system, breaking the existing relationships between people and defining a new set of relationships described by charts, graphs, committees, and regulations. It is an awesome task that keeps many of them at work in the bureaucracy.<BR/><BR/>() If there are not enough resources to pay people for their work according to the solution, then those people with the appropriate knowledge and experience (eg. doctors) will contribute some of their effort for free. Whatever it takes for success.<BR/><BR/><A HREF="http://easyopinions.blogspot.com/2008/08/leading-people.html" REL="nofollow"><BR/>(Continued at EasyOpinions - Leading the People)</A>Andrew_M_Garlandhttps://www.blogger.com/profile/02855052302054611917noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-38979613643314375332008-09-02T22:24:00.000-05:002008-09-02T22:24:00.000-05:00Can you possibly please post -quickly- about 2 mor...Can you possibly please post <B>-quickly-</B> about 2 more posts, so this picture disappears into the next page? <BR/><BR/>Thanks. :-)Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-41123030619579183552008-08-31T10:29:00.000-05:002008-08-31T10:29:00.000-05:00Oh, and I just LURVE you guys, MDOD.Oh, and I just LURVE you guys, MDOD.Lynn Pricehttps://www.blogger.com/profile/02958402288888144904noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-52200377834196693152008-08-31T10:28:00.000-05:002008-08-31T10:28:00.000-05:00Lynn Price: Do you ever have anything to add besid...<B>Lynn Price: Do you ever have anything to add besides sucking up to the blogmaster? You remind me of a brown-nosing college freshman </B><BR/>Um, let's see...(thinking)...(thinking)...nope, I guess I just brown nose. Really, thanks so much for catching my best talents. You rock.<BR/><BR/>But you know, I think this brave anon has a problem with me on a personal level. Gosh, if I knew who you were, I could brown nose to you as well. Help me out, oh brave anon...Lynn Pricehttps://www.blogger.com/profile/02958402288888144904noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-56034427808225981712008-08-30T17:21:00.000-05:002008-08-30T17:21:00.000-05:00Anonymous: Remind me--what have you added? --Devor...<I>Anonymous: Remind me--what have you added?</I> --Devorrah<BR/><BR/>Snort.Hey, Youhttps://www.blogger.com/profile/16677869087980832387noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-66433180151023051352008-08-30T15:46:00.000-05:002008-08-30T15:46:00.000-05:00Anonymous: Remind me--what have you added?Anonymous: Remind me--what have you added?Devorrahhttps://www.blogger.com/profile/14542045173559671539noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-46002375653705608202008-08-30T09:06:00.000-05:002008-08-30T09:06:00.000-05:00Break out the knee pads lynn. Slurp...slurp...slur...Break out the knee pads lynn. Slurp...slurp...slurp.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-18222635324881995282008-08-30T08:58:00.000-05:002008-08-30T08:58:00.000-05:00dear anonymous, here's a simple solution. turn the...dear anonymous, <BR/><BR/>here's a simple solution. turn the channel, tune us out, go elsewhere. but no. that's fine. we will give you the forum in which you may continue to prove yourself a fool. <BR/><BR/>lynn, we do appreciate your 'sucking up'... it's what we live for in our otherwise boring and unimportant lives.911DOChttps://www.blogger.com/profile/06466669111561150174noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-62061099781661555102008-08-30T08:28:00.000-05:002008-08-30T08:28:00.000-05:00One more to go 911, Thank God.Lynn Price: Do you e...One more to go 911, Thank God.<BR/><BR/>Lynn Price: Do you ever have anything to add besides sucking up to the blogmaster? You remind me of a brown-nosing college freshmanAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-16067115474279481232008-08-29T15:30:00.000-05:002008-08-29T15:30:00.000-05:00Nothing of interest to add other than that poo poo...Nothing of interest to add other than that poo poo makes me want to yak my lunch. 911, you're the jam in my jelly doughnut and I want you to be where you're happy. What scares me is what will we all do when the good guys have all left the ER? I know what my reply will be to the meatwagon as they load me up; "Screw the hospital, take me to the Ritz!"Lynn Pricehttps://www.blogger.com/profile/02958402288888144904noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-3015766013186988752008-08-29T14:47:00.000-05:002008-08-29T14:47:00.000-05:00Well, I'll do for free, after I take a nap. Teach...Well, I'll do for free, after I take a nap. Teaching kindergartners is way harder than practicing law.Devorrahhttps://www.blogger.com/profile/14542045173559671539noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-5877473724344704482008-08-29T13:58:00.000-05:002008-08-29T13:58:00.000-05:00"and all you attorneys out there... here's a quest..."and all you attorneys out there... here's a question for you." <BR/><BR/>Dear 911Doc,<BR/><BR/>I will be glad to answer your question. Please call my secretary and make an appointment. She will tell you how much money you need to bring with you just to get in the door to see me. I will provide you with a half-ass answer to your question, and then tell you that in order to fully answer your question, I will need to do some research. Of course, that will require a larger retainer. <BR/><BR/>After I flog your file for a few weeks, I will send you a one paragraph letter with my answer, along with a bill for fees and expenses in excess of the retainer. <BR/><BR/>Love and kisses, <BR/><BR/>me<BR/><BR/>PS Can you give Eto a message for me? Tell him I will bring the Peppermint Scope if he brings the balls.<BR/><BR/>(Hell, yeah, this is an anonymous comment. I don't think your crazy fans will realize I'm just playin' with ya.)Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-69019843602568199662008-08-28T23:03:00.000-05:002008-08-28T23:03:00.000-05:00Teresa: Sorry. Horrified by the very thought of h...Teresa: Sorry. Horrified by the very thought of having babies without drugs.<BR/><BR/>Amy: Nah--I went to the vet and got fixed when I was just a sex kitten (-:Devorrahhttps://www.blogger.com/profile/14542045173559671539noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-54385556763377510002008-08-28T23:00:00.000-05:002008-08-28T23:00:00.000-05:00Dev, you totally missed the point. But I'm giving...Dev, you totally missed the point. But I'm giving up on trying to explain it.Hey, Youhttps://www.blogger.com/profile/16677869087980832387noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-58107798865951992892008-08-28T22:55:00.000-05:002008-08-28T22:55:00.000-05:00Hey Dev, you're not trying to tell us something ar...Hey Dev, you're not trying to tell us something are you?<BR/><BR/>What with your whole newlywed/ultrabiker thing you've got going on. I'm just saying...I KNOW there's been some unpure thoughts at your house. *snort*Amelia Ameshttps://www.blogger.com/profile/17296224743117560163noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-91270354866404381642008-08-28T21:06:00.000-05:002008-08-28T21:06:00.000-05:00Teresa: I'm guessing you've never been pregnant. ...Teresa: I'm guessing you've never been pregnant. Fully half of the pregnancies in this country occur by accident, and some women, including myself, get pregnant just by thinking impure thoughts. <BR/> It would increase the abortion rate to withhold anaesthesia from women in labor. and women would obviously be the ones penalized, though they didn't get pregnant by themselves. I did, but they didn't.<BR/><BR/>911: Let's give the other attorneys a shot--if they bag out I'll chime in. Love those old common law writs.Devorrahhttps://www.blogger.com/profile/14542045173559671539noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-49040008701183876582008-08-28T20:12:00.000-05:002008-08-28T20:12:00.000-05:00Thank you for the answers Etotheipi. Very informat...Thank you for the answers Etotheipi. <BR/><BR/>Very informative, and, wow! <BR/><BR/>Now I know why I’m billed apart from the hospital whenever I am admitted. And I wonder why the hospital is charging me so much! It seems like my doctor should be getting the bulk of the fees, but apparently he’s not. I kind of feel sorry for him now. What is it? 13...16 years of school!<BR/> <BR/>Good God!<BR/><BR/>And 911 doc, thank you too.<BR/><BR/>So, you’re sort of commission based? But you don’t really know your commission? That is totally nuts and really, really hard to believe. How is that possible?<BR/> <BR/>Um, nevermind. :) <BR/><BR/>And you’re right about my doc. He’s a gem. When we were uninsured (and still paying our hospital bills ($7,000 worth, just in case you were wondering)), he charged me a about a hundred bucks for 3 days in the hospital. He is so awesome. I pray that he never, EVER moves away. <BR/><BR/>I really love that guy.<BR/><BR/>I loved your tiny rant about health care, billing, insurance, bureaucracy and all their woes. I understand what you’re saying and realize the problem. And I hope, for my sake and all other non-freeloading Americans, that something gives soon. <BR/><BR/>Starting with NO-OBAMA!<BR/><BR/>Keep writing. I love it.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-9749636989185304842008-08-28T19:45:00.000-05:002008-08-28T19:45:00.000-05:00Dear Objecters to my proposal,I'm more of a big pi...Dear Objecters to my proposal,<BR/><BR/>I'm more of a big picture person rather than the specifics, (Myers-Briggs N not S, if that helps), and I see that my comment was pretty poorly stated. Let me just say I agree with most of your specific objections. I meant to say in there that the ridiculous example I gave should apply only to people who could afford insurance but decided not to buy it. And it wasn't meant to be taken literally. It was more of a stake in the ground to get people thinking. Obviously, it failed.<BR/><BR/>I do want to address one specific objection. Let me just point out that people who cannot afford to pay for an epidural SHOULD NOT BE HAVING CHILDREN in the first place, because if they can't afford an epidural, they sure can't afford to raise that child. Oh, and the yeah-but-they-were-millionaires-when-she-got-pregnant-but-were-bankrupted-by-a-financial-disaster-over-which-they-had-no-control exceptions fully granted. No need to respond with exceptions like that, I gotcha.Hey, Youhttps://www.blogger.com/profile/16677869087980832387noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-23652598978755543362008-08-28T18:28:00.000-05:002008-08-28T18:28:00.000-05:00hmmm, too many questions to answer completely. dea...hmmm, <BR/><BR/>too many questions to answer completely. <BR/><BR/>dear small town lady, you do, in fact, have a 'rare breed' doctor. hold on to him! <BR/><BR/>staff physicians are paid in various ways. the biling and coding bureaucracy that has developed to shuffle money around is too complex to understand unless you are knee deep in it and the rules change every week. <BR/><BR/>here's how i get paid. i am a 'staff physician' and i am paid more if i see more patients. i am paid more based on the complexity of the care i deliver, but i have absolutely no clue, with any particular patient, how much their bill will be. here's why...<BR/><BR/>and all you attorneys out there... here's a question for you. do we have a potential 'qui tam' action here? hospital bills are closely guarded secrets. it is my belief, and one that i am currently trying to prove, that your bill will be based on your ability to pay. <BR/><BR/>example. with 'elective procedures' take a boob-job for example, almost no insurance will cover it (unless you are in the military and then you can get one for free... yes, one to make them smaller or bigger... you choose), so you pay cash or finance it. click on my sidebar 'the best plastic surgeon in america' (and he really is) and you will see that on his site he offers medical financing. <BR/><BR/>let's say you don't want to pay his fee and will be satisfied with a 'pretty good' boob job rather than the best... okay, you can go to the guy who advertises in the yellow pages and you will get what you pay for. <BR/><BR/>however, let's say you are a retired railroad employee (whether it's true or not the railroads for a long time have had the reputation of having the best medical insurance) and you need a cardiac bypass (open heart surgery). <BR/><BR/>one of my family members had this procedure recently and we saw the bill from the whiz-bang academic institution. his charge for a single EKG? $300... it's a piece of paper. the machine itself can be purchased on ebay for about $2000. a single tablet of percocet? $40. <BR/><BR/>let's say you are the same patient but have no money and no insurance. you still get the procedure but your bill vanishes into the ether. sure the hospital will try to retroactively get you medicare or medicaid and will try to collect something from either you or 'the government' but your bill vanishes. <BR/><BR/>it also works the same if you are in prison (bill to 'the government') or are in the country illegally (bill vanishes). <BR/><BR/>it is my belief that those with insurance or money are funding the best health care in the world for anyone who happens to stumble into the country. it is also my belief that the extent to which this happens would raise a huge outcry if it were known. this is why you will never be able to get a straight answer from a hospital if you call them and ask what they charge for, say, an EKG or an appendectomy. the charges are different for everyone. <BR/><BR/>here's a bit of advice for any of you out there 'waiting for your insurance to kick in' prior to getting your stress test or your cath our your cholecystectomy. you may die waiting. call your favorite surgeon or cardiologist and ask them how much it is IF YOU PAY UP FRONT. the answer might surprise you. <BR/><BR/>for instance, an ENT friend of mine will do a tonsillectomy for $900. add in the OR time and anesthesia and you are probably looking at $2500. <BR/>same bill from going in house with insurance? about $10000. <BR/><BR/>so, lawyers, do we have a 'qui tam' action here? if so i want in. <BR/><BR/>finally, as to how staff physicians get paid let's talk about me. i see patients and administer treatments etc... i write up the chart. it vanishes and goes to a billing and coding service. some months later payment is received from insurance, the patients, or, more likely, YOU. equations are used, paper is shuffled, the billing and coding people get paid, the hospital gets paid, and whatever remains comes to my pocket where it is taxed and goes to my wallet. that is, literally, as much as i know about how my paycheck is figured. <BR/><BR/>realize that with this system, which has grown to the size of rosie o'donnels thighs, is a. byzantine b. unfair c. unnecessary if not for EMTALA and d. incredibly inefficient. all of it adds up to taxpayers footing the bill, once again, for free care for, very often, folks who have smoked, drank, or drugged themselves into their emergency. <BR/><BR/>the responsible are punished, the irresponsible are rewarded. madness.911DOChttps://www.blogger.com/profile/06466669111561150174noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-40358551409803102532008-08-28T15:49:00.000-05:002008-08-28T15:49:00.000-05:00Ummm...Paul me thinks you're just a bit late. Not...Ummm...Paul me thinks you're just a bit late. Nothing we do is going to change that decision now. The speeches have been written...Amelia Ameshttps://www.blogger.com/profile/17296224743117560163noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-84374673555141386032008-08-28T12:45:00.000-05:002008-08-28T12:45:00.000-05:00With all due respect... I don't agree with penaliz...With all due respect... I don't agree with penalizing the poor by letting them be in excruciating pain (or withholding any other necessary service) because they don't have insurance. Not all poor people are bleeding the system or want to be. There are sometimes hard working, productive people that through job loss, divorce, catastrophic illness whatever...that can find themselves uninsured and unable to pay a bill up front. It would be inhumane to take that approach. There are a lot of people who work hard but are poverty level. They are the people who fall in between the cracks because they work, make too much money for public assistance and yet don't have the money for extras or paying for medical... but they make payments.<BR/><BR/>Not every poor or uninsured person is a mindless, abusing system sucking dirt bag. There are good people in that mix.<BR/><BR/> I would think that pain meds are just the tiniest tip of the iceberg financial woes in medicine. It's the expensive tests and unfortunately..anything through the ER that is expensive..or hospital stays.SeaSprayhttps://www.blogger.com/profile/07906503090688697222noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-64886479116347833022008-08-28T12:43:00.000-05:002008-08-28T12:43:00.000-05:00Please, please, PLEASE don't just blog but call th...Please, please, PLEASE don't just blog but call the McCain office RIGHT NOW and implore them to pick Palin. <BR/><BR/>See my blog. Get all your friends and family to do it. <BR/><BR/>Tell them to delay making the announcement if they have to, it's worth it.<BR/><BR/>Tell them to LISTEN TO THE PEOPLE/VOTERS.<BR/><BR/>THANKS IN ADVANCE!!Health And Fitness Geekhttps://www.blogger.com/profile/09223654615329241693noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-32488091650454206842008-08-28T12:07:00.000-05:002008-08-28T12:07:00.000-05:00Yeah but Tresa that's not exactly right either. W...Yeah but Tresa that's not exactly right either. <BR/><BR/>What about kids with cleft lip and palate? You can very certainly survive with a hare lip. Your psyche may be destroyed and you might have a wee bit of trouble functioning in society, but hey, if your parents are douchebags and can't pay, too bad kid. <BR/><BR/>And as far as limiting pain meds for childbirth to exclusively those who can pay would make us a brutal society. What about forceps deliveries and vacuum extractions? 4th degree tear? Sorry ma'am your ass is ripped to hell. Please hold still while I stitch your muscles back together. You don't need pain meds because you can't pay. We've got a free stick for you to bite.<BR/><BR/>I'm not advocating that the government remedy the inability for the poor to pay. There are charitable organizations who could help with this. Back in the day there were charity hospitals for the indigent. Our country is the most generous in the world. Surely we could come up with a non-governmental solution to help the poor among us.Amelia Ameshttps://www.blogger.com/profile/17296224743117560163noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-76214163487379775992008-08-28T10:28:00.000-05:002008-08-28T10:28:00.000-05:00Everyone in the country should pay for their own m...<I>Everyone in the country should pay for their own medical care even if only for a small portion of it. Buy insurance or not, your choice. Get catastrophic coverage only and establish an HSA. Finance your care.</I><BR/><BR/>Dear Dr. 911dDOC,<BR/><BR/>That was really a good start on the solution, but you've left out a critical piece, which is required in order for the above to work.<BR/><BR/>STOP ALLOWING EMPLOYERS to deduct the cost of providing health insurance to their employees. Better yet, stop allowing employers to provide health insurance at all. <BR/><BR/>HSA is good, but it doesn't really level the playing field between employers and those providing their own insurance.<BR/><BR/><BR/>My own idea to extend your thoughts would be that for anyone walking into a hospital or clinic without insurance and who couldn't pay cash, the care would be a tad different. For example, you don't really need pain medication for childbirth, unless you have a C-section. So you don't get that unless you can pay for it upfront. The purpose of this kind of rule would be to "encourage" young people to buy insurance. They often don't, and the more people who buy insurance, the better the system will function.Hey, Youhttps://www.blogger.com/profile/16677869087980832387noreply@blogger.com