Sunday, December 25, 2016

Whistleblower Wishes Readers Merry Christmas!

A close acquaintance of mine voiced objection to the lighting of the National Christmas tree, which occurred on the first day of this month.  Red, white and blue LED lights were illuminated.  I find no offense in this practice, which for me is a secularized event, even though I acknowledge its connection to the Christmas season.   Kids who visited Santa, as I did decades ago, do so in the days and weeks before Christmas.  Neither Santa nor his elves visit us during Arbor Day, the Fourth of July or Veterans Day.  He is connected with Christmas, although like the tree, his purpose is far removed from the true religious meaning of December 25th

A Christmas tree is not quite the nativity scene.  Readers who have more knowledge of the New Testament than I can inform us if a Christmas tree with a star on top and wrapped gifts underneath is mentioned in the Gospels.  Perhaps, Santa truly is a religious figure, since like the three wise men, he comes bearing gifts.

Religious icon?  
Santa and saint are separated by only 1 letter.  Hmm...

I am sure that many children have contemplated the mystery of how Santa was able to appear in so many department stores simultaneously.  Any thoughts here?   I assumed that his reindeer simply transported him at supersonic speed, although, perhaps, there is another explanation.

Similarly, I do not fine our national motto ‘in God we trust’ offensive or a violation of the separation of church and state.  It has taken on, in my view, a secular meaning.

Fear of offense has led many individuals and organization to sanitize their Christmas greetings using phrases that contain all the mirth and meaning of a recorded phone menu message from airline companies.  Doesn’t Seasons Greetings really nail it?  How about Happy Holidays?

At 4 p.m. today the National Menorah will be kindled on the White House grounds.  The menorah, arguably more of a religious symbol than a tree, is generally not the object of public protest. Both the menorah and the tree are illuminated.   Who would object to bringing a little more light into the world?

Sunday, December 18, 2016

Whistleblower Holiday Cheer 2016!

Jingle bells, jingle bells,
Romney’s at the door,
Standing there with cup in hand,
“Please sir, may I have some more?”

Who will be the chief at State?
Mitt or Dave or Rudy?
How ‘bout tough guy JR Bolton?
Isn’t he a beauty?

Kellyanne, she’s our man!
Smiling like a shark,
Oh what fun it is to see
Her ever present snark.

Hillary, gets shellacked!
Trump has doused her flame,
Except for Comey, racists, assorted haters, Fox News, deplorables, poor messaging, Russians and Wiki leaks,
She freely accepts the blame.

How did he win? How did she lose?
Did she have disdain
For forgotten heartland’s pleas,
While he felt their pain?

Will we ever see the wall?
Mexico pays the bill?
Or was that just campaign red meat.
A huckster’s ‘sugar pill’?

The game is done. We must move on
And think of lessons learned.
Demonizing couldn’t halt
Millions who’ve been spurned. 

I challenge you to reach inside
And summon your good sense
Is President Trump scarier than
President Mike Pence?

Joy and Peace!

Sunday, December 11, 2016

Hospital Consent Forms and Other Stories

Even though I am over 40 – by a long shot – I am familiar with the abbreviation TMI.  We are inundated with so much noise, chatter and static.  I feel that we are bombarded with information that we must sift through and ultimately delete.  The news cycle is 24 hours and hits us from so many electronic sources simultaneously.  I am deluged each day with so many unwanted and unsolicited e-mails from organizations that I have never heard of.  One of my favorite words on their e-mails can be found when I scroll to the end.  UNSUBSCRIBE!

Another genre of information assault is the panoply of warnings and disclaimers that we confront.  Of course, we are all numb to them since we have been so supersaturated.  I’ll prove it to you.  The next time you are about to take off on an airplane, the flight attendant will review safety information in the event that a catastrophe occurs.  While one might think that folks would be attentive to information that might be useful if the plane loses altitude or is headed for a ‘water landing’; no one is paying any attention at all.  Most of us are browsing through the Skymall catalogue which showcases amazing gadgets, such as a device that can dispense feedings to your cat during a week of your absence.  For the cat’s sake, I hope there won’t be a power failure.  Moreover, the flight attendants who are issuing the briefings seem more bored than the passengers. 

How often do we hear the nonsensical phrase, this product is not intended to diagnose, treat, cure or prevent any disease?  In other words, we admit our product does nothing, but please buy it to for your ailing bones and prostate glands.

How often do we hit the I Agree icon, which follows pages of lawyerly small print, just to get to the next page? 

We have been over-warned, over-disclosed and over-disclaimed. 

While rounding at the hospital, I saw the following sign posted on a coffee machine.

Newsflash!  Hot Coffee is Hot!

Look what fear of litigation has done for us.  Prior to ligitomania, we might not have realized that hot coffee is actually hot and might injure of us if we spilled its steaming contents onto us.  Now, we are all much safer knowing that hot beverages, which we desire to be hot, are hot.

Of course, these protections extend beyond steaming beverages.  If I were in charge, I’d issue rules and regs that would mandate the following warnings.
  • Caution: these steak knives are sharp and not intended to remove feet callouses
  • This chain saw is for industrial use by trained lumberjacks.  It is not intended as a toy for children under the age of 7.
  • This lighter fluid is dangerous and should not be stored in a child’s crib.
The medical profession is a part of this game also.  Every day, I have informed consent discussions with patients regarding procedures that I have advised them to undergo.  These are informal conversations when I try to give patients sufficient information so that they can make informed decisions.  This is reasonable and a fundamental part of the doctor-patient relationship.

The hospital, however, is not satisfied with my efforts and requires that patients sign lengthy consent forms, which most patients sign blindly without reading them.  For any readers here who have had the pleasure of having enjoyed hospital life, I’m sure that you can attest how many different forms you have signed from the moment you arrived at the hospital door to your discharge.  Most patients and physicians regard these signings to be mere formalities, which are intended to protect hospitals, and not patients.  If patients actually took the time to read through all of these legal CYA forms, it might grind the hospital to halt.  There's not enough time for patients to read and understand all this drivel.

Caution readers!  This blog is not intended to inform, enlighten, provoke, challenge or amuse readers.  Readers accept all responsibility for any resultant angst or mental torment and hold blogger harmless for any and all perceived damages until the end of time.  Click I AGREE.

Sunday, December 4, 2016

Why We Can't Control Medical Costs.

Most of us are skeptical that insurance companies are devoted to our health.  Answer the following question.  Do you think your insurance company is more interested in your health or in controlling costs?  Pretty tough question, huh?

There is a tension between medical quality and medical costs.  If we had a system that offered perfect quality, it would be unaffordable.  If we imposed rigid cost controls, then medical quality would be compromised.  Where do we draw the line?

 It is clear to most of us that the medical industrial complex is riddled with waste.  Keep in mind that one man’s medical waste is another man’s income.  For example, physicians define waste as excessive charges by hospitals.  Government officials define waste as excessively high drug prices.  Patients define waste as high co-pays and deductibles.  Drug companies define waste as outrageous legal expenses to get drugs to market and to defend against frivolous lawsuits.  Primary care doctors define waste as unreasonably high reimbursement that medical specialists receive.  Keep in mind that most folks don’t feel they are overpaid, but are quick to point to others whom they accuse of being overcompensated.  For example, when a politician floats a proposal to tax the rich, we hope that the definition of rich is anyone richer than we are.

Steak is cheap when someone else is paying for it.

Get the idea?  In summary, medical waste is easily defined.  It is money that someone else earns. 

This is why excising medical waste from the health care system is so difficult.  Who would you trust to decide which waste should be wasted?  The government?  Physicians?  Pharmaceutical companies?  I don’t have an easy answer here.   Part of the solution, in my view, is when patients have a little more skin in the game.  Here’s how this works.

A physician advises an MRI of the back on two different patients.  Patient A has full coverage for the study and would face no out-of-pocket costs.  Patient B has a $5,000 deductible and would have to write the radiologist a big check.

Patient A: “Thank you, doctor. My back has been hurting for over a week.  I’d like to get it done as soon as possible.”

Patient B: “$940!  Can I try those exercises you recommended instead?”

It’s always easier to spend someone else’s money.  Do you find that you order differently in a restaurant when it’s on someone else’s dime?