Hi everyone -
I have just enough time, to write a short little bit about something that happened at work this week. I haven't really been able to get it out of mind for a couple of days.
I was having this wonderful day the other day - I was totally in love with my job and all my patients for the day - which isn't always the case. No one could seem to get on my nerves.
I had this cute little 5 year old girl who was such a joy. She never made a peep when I poked her for her IV. And she even told me, it didn't hurt at all. I could not believe it. How can some people just scream and cry and carry on - and this little girl, who really wasn't sick, not make a peep. Amazing.
I also had this nice guy whose wife worked somewhere in the hospital. He was just a crackup with a sick sexual sense of humor.
Then, there was this really nice lady with this amazingly nice family. We joked around all day long and talked about a lot of personal things - mostly gardening and some hot peppers that I had been growing and sharing with my co-workers. Thanks to Duane, we were having a good laugh - especially with his translation from Spanish to English for habanero.
Anyway, I knew this lady had a new diagnosis and probably a weakened heart. But at 80+, she'd been doing pilates, yoga and some aerobic exercises less than 2 weeks later. She was feeling a little short of breath and weak - but her troponins were negative. We thought she'd just spend the night, get an echo of her heart and go home with some new medications and a few more good years. I left that day without saying good bye to her or her family.
A couple hours later, she coded - not once, not twice - but probably 8 - 10 times before finally moving on to some place else - hopefully very peaceful and joyful.
I guess that just really does prove when it's your time, it's your time. When you're in the hospital and on the monitor and you go into VFib - get shocked and shocked and shocked - keep coming back - and you still don't make it. Sometimes, it's just so bizarre to me.
I'm guessing I wished at this point, I had gone back in the room before I left, to say what I usually do - I'm leaving. I hope you get better and get to go home quickly. It's been fun spending the day with you. I hope I run into you at Walmart or McDonalds sometime.
Wednesday, October 28, 2009
Tuesday, October 13, 2009
The Public Option Broken Down
Hi all -
Good news today - well at least fair news on the health care reform front - the Senate Finance Committee got a bill through their committee. Although it's a really watered down bill, at least it's a start - and it's progress. Now on to meshing them all together. I need to get back to reading now that they've actually gotten somewhere.
And with the report out yesterday from Pricewaterhouse Coopers, there's no time like the present to talk about the Public Option.
First, let me review their report with you. I have to say, I think it's a bit funny and sad at the same time. It seems like the insurance companies, which may have been feigning their support all along, holding out for the last minute to drop a bomb or two, got caught up in the circus over the last couple of days.
It seems that the insurance companies had an "independent" review board conduct some kind of a study after reviewing just part of the Senate Finance Committee bill - the part they paid them to review. Surprise, surprise. They predict that insurance rates will increase by 111% over the next 10 years. Let's put that in more tangible figures - By 2019:
Single people will see their premiums increase $1,500.00 per year. Families will pay $4,000.00 more per year.
A further breakdown shows that single people now pay approximately $4,600.00 yearly. With the current system, these rates will increase to $8,200.00 yearly. Under the Baucus plan, these rates will increase to $9,700.00 yearly.
Families pay approximately $12,300.00 yearly. With the current system, projected rates would increase to $21,900.00 yearly. Under the Baucus plan, these rates would be $25,900.00 yearly.
Now keep in mind, under the current system we have, they are still projecting a 79% inflation rate.
Now, that's just ridiculous - especially since wage growth only averages 3 - 4 % annually.
And even more ridiculous - the insurance industry just shot themselves in the foot by releasing that report. Maybe they thought they could scare the people or the congress by talking about how high premiums would continue to rise. I guess no one stopped to think, well, if they can't control their own growth in their own premiums - maybe, just maybe we should have a public option.
Let's talk about what a Public Option is and how it could benefit or hinder health care reform.
Let's hit the basics first - what is a Public Option when we're talking about health care?
Basically, all it is is another company, the government, competing for business in the health insurance industry.
Right now there are a lot of different insurance companies -Aetna, Blue Cross/Blue Shield, Cigna, Kaiser, etc.... Technically speaking, because there are so many different insurance companies, they should be able to keep each other in check - to help keep prices competitive and affordable. Unfortunately, in most of the country, more than 70% of the market is controlled by one insurance company. This is bad for the market, as there is no competition from other companies to help keep premiums affordable. Plus, there is no way that providers, doctors or hospitals, can negotiate for better prices for services. And as the companies get bigger, they just keep buying each other out. In the last 10 years, there have been more than 400 health care related mergers.
With the Public Option, congress is hoping it would keep the insurance companies under control. Because the government has fewer overhead expenses, they can run their "business" a little cheaper. They can also negotiate cheaper fees for services provided, and this would force the insurance companies to be more competitive with their prices, to offer superior plans and to give excellent service.
Let's review some of systems that have a government agency in force already, ones that compete with the private sector.
First up - the obvious choice to discuss is the US Postal Service. Now granted, private companies like UPS, DHL and FedEx came about partly because of this agency's inefficiency and poor service. But let's be honest, someone would have eventually figured out they could make money off of something that most of us need daily in our lives - sending stuff from one place to another.
So let's take a look at these companies. They all seem to compete on a fairly even level. They all ship packages for about the same prices. They each have their own little niche they fill.
DHL, who tried to compete in the US, finally turned their domestic shipping over to UPS, I think. Guess why - they weren't making any money here. They still are excellent and competitive with international shipping services.
FedEx is relatively more expensive but they're known for their excellent service and speedy deliveries. They also provide some of their shipping materials for free. They have the best online package tracking system of them all.
UPS's fortes are their speed of service and their 100.00 worth of insurance for free. They also have cheaper shipping rates for larger packages.
The US Postal Service is still the cheapest form of shipping for many things. None of the other companies can ship - or do they try to ship - a letter for $.44. Guess why - they can't compete. Plus in comparison, a small priority mail package can be shipped by them for $4.95. The other three carriers can't compete with that. Their cheapest packages ship for over $10.00. The USPS also offers some of their shipping materials for free. They do have a 70 lb limit on packages though and their online tracking system isn't very efficient.
Funny, I think the private companies have made the Public Option pick up it's game. I have to say it's been a long time since the USPS has lost something I've sent. I think they've learned to become more efficient and concentrate more on their customer service.
So when making your choices on who you give your business to, it's on a very personal level - what kind of package are you sending, what kind of expectations do you have, what will the cost be. These are all things you consider and I don't think you really say, "Well, I'm not going to pick the Public Option because they don't compete fairly with the private sector." Maybe I'm wrong, do you?
Now, let's move on to our Education System. There are plenty of public and private schools - in primary, secondary and collegiate level education. Public schools are subsidized by our tax dollars; private schools are owned and run by private companies for a profit and charter schools are somewhere in between. Charter schools are subsidized by our tax dollars, but run by private companies for a profit. 75% of schools are public, 25% private.
Interesting enough, private schools have been good for the Public Option. They've made the public schools pick up their game. And public schools are good for private schools as well. Private schools now have to offer something special - something worth paying more for.
In comparison - public/state school tuition is generally less than $10,000.00 a year; private school tuition is anywhere from $30,000.00 - $120,000.00 a year. On the other hand, there are more grants and scholarships available for private schools.
There are a lot of regulations for public schools, where as next to none for private schools. The private schools pretty much make up their own rules. Some private schools don't even require their teachers to have college degrees or state licensure. Public schools have to follow all the anti-discrimination laws as well - private schools, not so much. And believe it or not, recent studies show that public school scores are as high and even higher in some areas.
Now, again, when making a decision about where you or your family goes to school, a lot of personal choice comes to mind. I think it's nice to be able to choose. I think we choose what works best for our family, our children - I'm guessing we decide with a lot of factors in mind - what the school has to offer, curriculum, location, costs, etc. I'm sure there's also some perceived thought that if we're paying more, we must be getting more for our dollar. I'm not sure that's always the case. Again, I'm not sure we think, well, we aren't going to even look at that school as it's a Public School.
Let's move on to another Public Option in the insurance industry. This one should make you chuckle a little bit - especially if you read my earlier blog about how the government programs take the biggest hit on the sickest and poorest people - while the insurance companies make billions off of us.
Have you ever heard of the National Flood Insurance Program? I know, in the past, I almost bought a house that was in a flood zone - not knowing of course, how much it would cost me to insure the place and it's contents.
Well after some of the horrible hurricanes over the past few years, most insurance companies started to drop their clients and they refused to pay a great deal of flood claims, through loopholes in their policies. After Hurricanes Rita and Katrina they denied numerous claims saying that the water destroyed the properties before the wind could. The private insurers decided there wasn't any money to be made. Well, guess who stepped in - the government. The private insurance companies still run these programs, but it's 100% backed by the government with our tax dollars of course. And this insurance is MANDATORY.
Funny, some of the senators that have been so nasty about the Public Option in Health Care - like Grassley, Enzi, Snowe and some other 44 Republicans - voted for this flood insurance program. And even funnier, the more conservative states have used the most money from the program - North Carolina, Mississippi, Wisconsin, Florida, Illinois, Missouri, Indiana, Iowa, Louisiana - and ........ wait for it ....... Texas. Texas has benefited the most. They've taken 1.5 billion dollars in claims. 682,000 people have turned in claims under this program.
So, I say what's the harm in having a Public Option? Come on people, weigh in.
I know, some people are going to say that the government competes unfairly in business against the private sector - they may put the private companies out of business. On the other hand, a lot of us choose to spend a little bit more money going to the UPS or Fed Ex store to ship our packages because we want to, because it's an option, because we can. I say bring it on, I'll choose it if I think it's just what I'm looking for, what's right for me and my family, for a price I can afford - because I can if I want - it's my choice.
I also say the insurance companies should say the same, bring it on. If they think they have a great product, give excellent service, are as efficient as they can be and their clientele are satisfied, then it should be a non-issue for them as well. My question to them, do they actually have a product or service to offer me that is worth paying more for????
And in closing, I must say, that the Public Option in itself will not solve the inflationary problems we have with the health care system. Competition can only help control costs so much. I'm guessing that's why Pres. Obama said it was only a small part of the whole picture.
From 1970 - 2000, Health Care spending increased by 11% in the private sector and 9.5% in the Medicare system. From 2000 - 2004, it increased by 9.5% in the private sector and 6.7% in the Medicare system. So although, you can say the government program is inefficient, just by price comparisons alone, you can see that the government program still does a little better than the private insurance industry. But sadly, the increases on either side are just too much.
What we really need more than anything is health care reform. A strong Public Option and Health Care Reform has to happen and has to happen now. We need to control costs, reduce waste and fraud. We need to restructure the payment system to pay for performance programs - quality of care, not quantity. We need to have a national information technology system - all computers, all providers talking to each other, sharing their tests and results - prevent duplication of services. We need transparency in the health care delivery system - we need to know who is charging how much for what and what their outcomes in care are. We need to form a committee that studies and implements best clinical practices for all patients. And last but not least, we have to find ways to increase access to all Americans. I can not say it enough ACCESS, ACCESS, ACCESS. We need more community health centers, more primary doctors and staff. We need to start now.
Let's do some brainstorming together to see where we can cut costs - what we can do to turn this machine around. Tell me your ideas.
More later. Off this thing for now.
Good news today - well at least fair news on the health care reform front - the Senate Finance Committee got a bill through their committee. Although it's a really watered down bill, at least it's a start - and it's progress. Now on to meshing them all together. I need to get back to reading now that they've actually gotten somewhere.
And with the report out yesterday from Pricewaterhouse Coopers, there's no time like the present to talk about the Public Option.
First, let me review their report with you. I have to say, I think it's a bit funny and sad at the same time. It seems like the insurance companies, which may have been feigning their support all along, holding out for the last minute to drop a bomb or two, got caught up in the circus over the last couple of days.
It seems that the insurance companies had an "independent" review board conduct some kind of a study after reviewing just part of the Senate Finance Committee bill - the part they paid them to review. Surprise, surprise. They predict that insurance rates will increase by 111% over the next 10 years. Let's put that in more tangible figures - By 2019:
Single people will see their premiums increase $1,500.00 per year. Families will pay $4,000.00 more per year.
A further breakdown shows that single people now pay approximately $4,600.00 yearly. With the current system, these rates will increase to $8,200.00 yearly. Under the Baucus plan, these rates will increase to $9,700.00 yearly.
Families pay approximately $12,300.00 yearly. With the current system, projected rates would increase to $21,900.00 yearly. Under the Baucus plan, these rates would be $25,900.00 yearly.
Now keep in mind, under the current system we have, they are still projecting a 79% inflation rate.
Now, that's just ridiculous - especially since wage growth only averages 3 - 4 % annually.
And even more ridiculous - the insurance industry just shot themselves in the foot by releasing that report. Maybe they thought they could scare the people or the congress by talking about how high premiums would continue to rise. I guess no one stopped to think, well, if they can't control their own growth in their own premiums - maybe, just maybe we should have a public option.
Let's talk about what a Public Option is and how it could benefit or hinder health care reform.
Let's hit the basics first - what is a Public Option when we're talking about health care?
Basically, all it is is another company, the government, competing for business in the health insurance industry.
Right now there are a lot of different insurance companies -Aetna, Blue Cross/Blue Shield, Cigna, Kaiser, etc.... Technically speaking, because there are so many different insurance companies, they should be able to keep each other in check - to help keep prices competitive and affordable. Unfortunately, in most of the country, more than 70% of the market is controlled by one insurance company. This is bad for the market, as there is no competition from other companies to help keep premiums affordable. Plus, there is no way that providers, doctors or hospitals, can negotiate for better prices for services. And as the companies get bigger, they just keep buying each other out. In the last 10 years, there have been more than 400 health care related mergers.
With the Public Option, congress is hoping it would keep the insurance companies under control. Because the government has fewer overhead expenses, they can run their "business" a little cheaper. They can also negotiate cheaper fees for services provided, and this would force the insurance companies to be more competitive with their prices, to offer superior plans and to give excellent service.
Let's review some of systems that have a government agency in force already, ones that compete with the private sector.
First up - the obvious choice to discuss is the US Postal Service. Now granted, private companies like UPS, DHL and FedEx came about partly because of this agency's inefficiency and poor service. But let's be honest, someone would have eventually figured out they could make money off of something that most of us need daily in our lives - sending stuff from one place to another.
So let's take a look at these companies. They all seem to compete on a fairly even level. They all ship packages for about the same prices. They each have their own little niche they fill.
DHL, who tried to compete in the US, finally turned their domestic shipping over to UPS, I think. Guess why - they weren't making any money here. They still are excellent and competitive with international shipping services.
FedEx is relatively more expensive but they're known for their excellent service and speedy deliveries. They also provide some of their shipping materials for free. They have the best online package tracking system of them all.
UPS's fortes are their speed of service and their 100.00 worth of insurance for free. They also have cheaper shipping rates for larger packages.
The US Postal Service is still the cheapest form of shipping for many things. None of the other companies can ship - or do they try to ship - a letter for $.44. Guess why - they can't compete. Plus in comparison, a small priority mail package can be shipped by them for $4.95. The other three carriers can't compete with that. Their cheapest packages ship for over $10.00. The USPS also offers some of their shipping materials for free. They do have a 70 lb limit on packages though and their online tracking system isn't very efficient.
Funny, I think the private companies have made the Public Option pick up it's game. I have to say it's been a long time since the USPS has lost something I've sent. I think they've learned to become more efficient and concentrate more on their customer service.
So when making your choices on who you give your business to, it's on a very personal level - what kind of package are you sending, what kind of expectations do you have, what will the cost be. These are all things you consider and I don't think you really say, "Well, I'm not going to pick the Public Option because they don't compete fairly with the private sector." Maybe I'm wrong, do you?
Now, let's move on to our Education System. There are plenty of public and private schools - in primary, secondary and collegiate level education. Public schools are subsidized by our tax dollars; private schools are owned and run by private companies for a profit and charter schools are somewhere in between. Charter schools are subsidized by our tax dollars, but run by private companies for a profit. 75% of schools are public, 25% private.
Interesting enough, private schools have been good for the Public Option. They've made the public schools pick up their game. And public schools are good for private schools as well. Private schools now have to offer something special - something worth paying more for.
In comparison - public/state school tuition is generally less than $10,000.00 a year; private school tuition is anywhere from $30,000.00 - $120,000.00 a year. On the other hand, there are more grants and scholarships available for private schools.
There are a lot of regulations for public schools, where as next to none for private schools. The private schools pretty much make up their own rules. Some private schools don't even require their teachers to have college degrees or state licensure. Public schools have to follow all the anti-discrimination laws as well - private schools, not so much. And believe it or not, recent studies show that public school scores are as high and even higher in some areas.
Now, again, when making a decision about where you or your family goes to school, a lot of personal choice comes to mind. I think it's nice to be able to choose. I think we choose what works best for our family, our children - I'm guessing we decide with a lot of factors in mind - what the school has to offer, curriculum, location, costs, etc. I'm sure there's also some perceived thought that if we're paying more, we must be getting more for our dollar. I'm not sure that's always the case. Again, I'm not sure we think, well, we aren't going to even look at that school as it's a Public School.
Let's move on to another Public Option in the insurance industry. This one should make you chuckle a little bit - especially if you read my earlier blog about how the government programs take the biggest hit on the sickest and poorest people - while the insurance companies make billions off of us.
Have you ever heard of the National Flood Insurance Program? I know, in the past, I almost bought a house that was in a flood zone - not knowing of course, how much it would cost me to insure the place and it's contents.
Well after some of the horrible hurricanes over the past few years, most insurance companies started to drop their clients and they refused to pay a great deal of flood claims, through loopholes in their policies. After Hurricanes Rita and Katrina they denied numerous claims saying that the water destroyed the properties before the wind could. The private insurers decided there wasn't any money to be made. Well, guess who stepped in - the government. The private insurance companies still run these programs, but it's 100% backed by the government with our tax dollars of course. And this insurance is MANDATORY.
Funny, some of the senators that have been so nasty about the Public Option in Health Care - like Grassley, Enzi, Snowe and some other 44 Republicans - voted for this flood insurance program. And even funnier, the more conservative states have used the most money from the program - North Carolina, Mississippi, Wisconsin, Florida, Illinois, Missouri, Indiana, Iowa, Louisiana - and ........ wait for it ....... Texas. Texas has benefited the most. They've taken 1.5 billion dollars in claims. 682,000 people have turned in claims under this program.
So, I say what's the harm in having a Public Option? Come on people, weigh in.
I know, some people are going to say that the government competes unfairly in business against the private sector - they may put the private companies out of business. On the other hand, a lot of us choose to spend a little bit more money going to the UPS or Fed Ex store to ship our packages because we want to, because it's an option, because we can. I say bring it on, I'll choose it if I think it's just what I'm looking for, what's right for me and my family, for a price I can afford - because I can if I want - it's my choice.
I also say the insurance companies should say the same, bring it on. If they think they have a great product, give excellent service, are as efficient as they can be and their clientele are satisfied, then it should be a non-issue for them as well. My question to them, do they actually have a product or service to offer me that is worth paying more for????
And in closing, I must say, that the Public Option in itself will not solve the inflationary problems we have with the health care system. Competition can only help control costs so much. I'm guessing that's why Pres. Obama said it was only a small part of the whole picture.
From 1970 - 2000, Health Care spending increased by 11% in the private sector and 9.5% in the Medicare system. From 2000 - 2004, it increased by 9.5% in the private sector and 6.7% in the Medicare system. So although, you can say the government program is inefficient, just by price comparisons alone, you can see that the government program still does a little better than the private insurance industry. But sadly, the increases on either side are just too much.
What we really need more than anything is health care reform. A strong Public Option and Health Care Reform has to happen and has to happen now. We need to control costs, reduce waste and fraud. We need to restructure the payment system to pay for performance programs - quality of care, not quantity. We need to have a national information technology system - all computers, all providers talking to each other, sharing their tests and results - prevent duplication of services. We need transparency in the health care delivery system - we need to know who is charging how much for what and what their outcomes in care are. We need to form a committee that studies and implements best clinical practices for all patients. And last but not least, we have to find ways to increase access to all Americans. I can not say it enough ACCESS, ACCESS, ACCESS. We need more community health centers, more primary doctors and staff. We need to start now.
Let's do some brainstorming together to see where we can cut costs - what we can do to turn this machine around. Tell me your ideas.
More later. Off this thing for now.
Monday, October 12, 2009
My Latest You Tube Video - Country in Crisis
Hi there -
Well here's my 3rd you tube video. Let me just say this one was not easy. It took me like 20 hours to finally get it all together and then get the editing software to actually do it's thing. I would not be defeated though and finally beat it.
This is not for the faint at heart. The message is clear - we better get it together as a country - all the fighting has never really worked out well for us. Time to play nice and take care of things that need to be taken care of.
Let's muscle through the rest of the health care reform stuff so we can move on to the wars and the energy situation. Once we start talking about green energy, more jobs can be created and we can start to be on the road to some sort of financial recovery.
Have a great day everyone. More on health care and the public option next.
Well here's my 3rd you tube video. Let me just say this one was not easy. It took me like 20 hours to finally get it all together and then get the editing software to actually do it's thing. I would not be defeated though and finally beat it.
This is not for the faint at heart. The message is clear - we better get it together as a country - all the fighting has never really worked out well for us. Time to play nice and take care of things that need to be taken care of.
Let's muscle through the rest of the health care reform stuff so we can move on to the wars and the energy situation. Once we start talking about green energy, more jobs can be created and we can start to be on the road to some sort of financial recovery.
Have a great day everyone. More on health care and the public option next.
Saturday, October 10, 2009
Weekly Medical Show Critique
Hi everyone -
Well, today I thought I'd start out on a lighter note - it came to me last night while watching tv that it might be fun to write about some of the medical writing errors of today's tv shows.
Last night I watched the pilot of Three Rivers - which I have to say, I kind of enjoyed. I think it was a bit of a new idea for a medical show - set in a transplant hospital - with the hot Alex O'Loughlin from the undead Moonlight. I have to admit that I only watched it because I wanted to see O'Loughlin again. I was pleasantly surprised at the direction of the show, I enjoyed a lot of the subtle things about the medical field - sense of humor, use of our need for food all the time. lol. Then I caught the writers with their pants down a couple of times - at least 3. 2 may be forgivable - but one I just can't let go.
Mistake #1 was at the bedside of a dying patient - the doctor taking care of the patient brought up the whole donor aspect with the distraught wife. This just doesn't happen anymore. The medical professionals taking care of the patient are not supposed to be involved in the harvesting conversation. Here in CA, we're to call Legacy One and their representative is to come out and discuss this with the family to assure that there aren't any conflicts of interest. But, on my scale, forgivable sin - because this opened up the conversation later in the show to actually talk about the process and the conflicts involved.
Mistake #2 near the end of the show - showing the circle of life. It was a wonderful scene - the saved new mother with a new heart getting to see her brand new newborn on video. The electronic records and information technology aspects of the show are amazing. They have computer screens everywhere on the walls and windows. Anyway, just not realistic to think someone who just woke up from her heart transplant would already be extubated with a little nasal cannula on - and that her beautiful 28 weeker would be held by her husband in the nursery looking like a 6 month old. Again, forgivable for tv delivery. Cute moment for closing.
Mistake #3 - never ever forgivable. They were so on cue during the code in the beginning of the show. I was impressed. Then, when the pregnant girl codes again later, they defibrillate asystole. Oh noooooooooo. During CPR, there's only two heart rhythms that you can defibrillate safely and they are ventricular fibrillation/vfib and pulseless ventricular tachycardia/vtach. Not forgivable - who on earth was the medical adviser on this scene?
Anyway, overall an enjoyable fresh new show with a good pretty cast. We'll see how long it lasts.
Anyone else out there catch this show and see anymore medical mistakes? Let me know.
And then on a personal note, it was kind of funny watching the show because they were talking about cardiomyopathy and 10% ejection fractions and it just so happens that my favorite KP patient was in the ER yesterday. I always enjoy this man, he's just a joy for someone who is so chronically ill. He's been my patient many times over the last 9 years and even when he's not my patient, I actively seek him out to say Hi and see how he's doing.
I'd like to give a kudos to KP here and applaud a look into the future of health care reform. This is a man that normally would have died years ago. His heart is just a weak, weak muscle. He's got multiple chronic conditions - COPD, Diabetes, CHF, Cardiomyopathy just to name a few. He made himself a DNR years ago with a lot of discussion with his family and medical professionals. Yesterday he told me that he may be taken off Hospice/Palliative care now as he's doing so well. The Chronic Condition Department has been working with him and his family now very diligently, trying to keep him healthy and out of the hospital - which is one of the big goals of health care reform - cutting down on costs be preventing readmissions for the same diagnoses.
Apparently it works. So wow, if we're going to start paying for preventative services and better outcomes - to me, it looks like it just might work on several levels - the patients do better and we can cut costs and save money. Kudos.
Take care. More later on the public option.
Well, today I thought I'd start out on a lighter note - it came to me last night while watching tv that it might be fun to write about some of the medical writing errors of today's tv shows.
Last night I watched the pilot of Three Rivers - which I have to say, I kind of enjoyed. I think it was a bit of a new idea for a medical show - set in a transplant hospital - with the hot Alex O'Loughlin from the undead Moonlight. I have to admit that I only watched it because I wanted to see O'Loughlin again. I was pleasantly surprised at the direction of the show, I enjoyed a lot of the subtle things about the medical field - sense of humor, use of our need for food all the time. lol. Then I caught the writers with their pants down a couple of times - at least 3. 2 may be forgivable - but one I just can't let go.
Mistake #1 was at the bedside of a dying patient - the doctor taking care of the patient brought up the whole donor aspect with the distraught wife. This just doesn't happen anymore. The medical professionals taking care of the patient are not supposed to be involved in the harvesting conversation. Here in CA, we're to call Legacy One and their representative is to come out and discuss this with the family to assure that there aren't any conflicts of interest. But, on my scale, forgivable sin - because this opened up the conversation later in the show to actually talk about the process and the conflicts involved.
Mistake #2 near the end of the show - showing the circle of life. It was a wonderful scene - the saved new mother with a new heart getting to see her brand new newborn on video. The electronic records and information technology aspects of the show are amazing. They have computer screens everywhere on the walls and windows. Anyway, just not realistic to think someone who just woke up from her heart transplant would already be extubated with a little nasal cannula on - and that her beautiful 28 weeker would be held by her husband in the nursery looking like a 6 month old. Again, forgivable for tv delivery. Cute moment for closing.
Mistake #3 - never ever forgivable. They were so on cue during the code in the beginning of the show. I was impressed. Then, when the pregnant girl codes again later, they defibrillate asystole. Oh noooooooooo. During CPR, there's only two heart rhythms that you can defibrillate safely and they are ventricular fibrillation/vfib and pulseless ventricular tachycardia/vtach. Not forgivable - who on earth was the medical adviser on this scene?
Anyway, overall an enjoyable fresh new show with a good pretty cast. We'll see how long it lasts.
Anyone else out there catch this show and see anymore medical mistakes? Let me know.
And then on a personal note, it was kind of funny watching the show because they were talking about cardiomyopathy and 10% ejection fractions and it just so happens that my favorite KP patient was in the ER yesterday. I always enjoy this man, he's just a joy for someone who is so chronically ill. He's been my patient many times over the last 9 years and even when he's not my patient, I actively seek him out to say Hi and see how he's doing.
I'd like to give a kudos to KP here and applaud a look into the future of health care reform. This is a man that normally would have died years ago. His heart is just a weak, weak muscle. He's got multiple chronic conditions - COPD, Diabetes, CHF, Cardiomyopathy just to name a few. He made himself a DNR years ago with a lot of discussion with his family and medical professionals. Yesterday he told me that he may be taken off Hospice/Palliative care now as he's doing so well. The Chronic Condition Department has been working with him and his family now very diligently, trying to keep him healthy and out of the hospital - which is one of the big goals of health care reform - cutting down on costs be preventing readmissions for the same diagnoses.
Apparently it works. So wow, if we're going to start paying for preventative services and better outcomes - to me, it looks like it just might work on several levels - the patients do better and we can cut costs and save money. Kudos.
Take care. More later on the public option.
Wednesday, October 7, 2009
A Special Commentary - A Must See Video
Hi everyone -
Since the health care debate started, I've heard and seen a lot of stuff that's irritated me, angered me, inspired me - made me laugh, made me cry and made me cuss. Today, while I was at my desk getting caught up on some emails and paperwork, I had MSNBC on in the background. I do like to watch a few of their shows on occasion - but was ultimately surprised at what I heard today.
I always thought of Keith Olbermann as a little over the top - he does report the news - but was a little over the top in the delivery. I've listened to him many times over the last several months - and I was sure that he was the greenest of the commentators on health care issues. He never really seemed to grasp the policies or bills. He was quick with the rhetoric - but didn't seem to hone in on the details like some of the others did.
Well tonight was a lot different. If you have time, watch the video to listen to his own personal family story about health care and his personal views on the need for health care reform.
These are the stories we all need to hear while all this fighting and lying is going on - personal stories of real life health care in crisis and people being genuinely emotional and impassioned.
Hang in there - sometimes he's ranting and raving, sometimes he's angry - but he's truly moved by the illnesses that have occurred recently to his own mom and dad. He's near tears many times - and Kevin and I were in tears several times just listening.
I especially appreciated his challenge at the end. He asks free clinics to set up a day in each of the cities of Senate Finance Committee members that are against some of the reform. It's a challenge I'd certainly like to see.
Enjoy:
I promise - this weekend back to blogging on my own.
Take care.
Since the health care debate started, I've heard and seen a lot of stuff that's irritated me, angered me, inspired me - made me laugh, made me cry and made me cuss. Today, while I was at my desk getting caught up on some emails and paperwork, I had MSNBC on in the background. I do like to watch a few of their shows on occasion - but was ultimately surprised at what I heard today.
I always thought of Keith Olbermann as a little over the top - he does report the news - but was a little over the top in the delivery. I've listened to him many times over the last several months - and I was sure that he was the greenest of the commentators on health care issues. He never really seemed to grasp the policies or bills. He was quick with the rhetoric - but didn't seem to hone in on the details like some of the others did.
Well tonight was a lot different. If you have time, watch the video to listen to his own personal family story about health care and his personal views on the need for health care reform.
These are the stories we all need to hear while all this fighting and lying is going on - personal stories of real life health care in crisis and people being genuinely emotional and impassioned.
Hang in there - sometimes he's ranting and raving, sometimes he's angry - but he's truly moved by the illnesses that have occurred recently to his own mom and dad. He's near tears many times - and Kevin and I were in tears several times just listening.
I especially appreciated his challenge at the end. He asks free clinics to set up a day in each of the cities of Senate Finance Committee members that are against some of the reform. It's a challenge I'd certainly like to see.
Enjoy:
Visit msnbc.com for Breaking News, World News, and News about the Economy
I promise - this weekend back to blogging on my own.
Take care.
Friday, October 2, 2009
Health Care Reform You Tube Video #2
Hi everyone -
Here's my second You Tube Video. This one is for some TV ad competition. It could only be 30 seconds. That was by far much harder than I imagined - Getting a message out in 30 seconds or less.
Click here.
I'll be back blogging in no time flat - next up - the public option .......
Here's my second You Tube Video. This one is for some TV ad competition. It could only be 30 seconds. That was by far much harder than I imagined - Getting a message out in 30 seconds or less.
Click here.
I'll be back blogging in no time flat - next up - the public option .......
Subscribe to:
Posts (Atom)
