May 24th, 2011 by Linda Burke-Galloway, M.D. in Health Policy, Opinion
Tags: Babies, Birth, C-Section, Dr. Linda Burke-Galloway, Handcuffs, healthcare, Healthcare reform, Labor And Delivery, Patient Care, Politics, Pregnancy, Pregnant Women, Prisoners, Shackles
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“But for the grace of God go I.” My late aunt drilled that value into my six-year old head and it has never left. An article regarding a New York politician recently caught my attention. When New York State enacted a bill to ban the shackling of pregnant prisoners, a New York State Assemblywoman objected. The article goes on to discuss the case of Jeanna M. Graves, who, in 2002 was arrested on a drug charge and began a three year sentence. Graves was pregnant with twins and while in labor, was handcuffed during her entire C. Section. How utterly ridiculous.
Before a C. Section begins, a patient is usually given either an epidural or spinal anesthesia. On rare occasions, she is put to sleep with general anesthesia if the baby must be delivered emergently. On all accounts, the patient’s legs will either be numb from anesthesia or she will be sleeping. Why then does she need shackles? She’s certainly not in a position to run. Although I addressed this issue last August, it needs to be revisited again. Read more »
*This blog post was originally published at Dr. Linda Burke-Galloway*
May 24th, 2011 by DrWes in Opinion
Tags: Check Boxes, Health Insurance, P4P, Pay For Performance, quality healthcare, Quality Measures, Rant, Wellpoint
1 Comment »

With the news that Wellpoint, one of the largest insurance companies in America, will cut off annual 8% payment increases to about 1,500 hospitals if they fail to “test” high enough on 51 quality measures, they have officially defined “quality” health care as checkboxes.
Yep, checkboxes.
You see how do insurers know if we offer each of our patient’s nutritional guidance or exercise counseling?
Well, they check to see of doctors have clicked on a yellow warning box advising we do this. If we have, then not only is that doctor a fine, “quality” doctor, but the hospitals (and it’s computer system and scores of administrative staff that compile and submit this data) are real, fine, “quality” hospitals.
That’s all there is to it.
Never mind if we don’t have time to actually perform the counseling.
* click * * check * * click *
Simple as pie. Efficient, too.
Beautiful bureaucratic quality.
Good luck with that.
*This blog post was originally published at Dr. Wes*
May 23rd, 2011 by DavedeBronkart in Health Policy, Opinion
Tags: Back Up Systems, Cloud Computing, Dangers, EMR, healthcare, Losing Data, Medical Records
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*Editor’s note: Dave would like readers to check out the comments section in the original post for his full views.*
A lot of people are intrigued with using “cloud” applications and storage for personal health data. This week we’re seeing what I think is the final nail in the coffin of “cloud only” for anything important. You gotta have offline backups: two huge cloud vendors – Amazon and now Google – have demonstrated that even they can go down, leaving their users absolutely powerless.

Cloud computing (Wikipedia) is hugely attractive to software developers and businesses. As shown in this diagram from Wikipedia, the idea is that you do your computing using storage or tools that are on some computer somewhere out there “in the cloud.” You don’t know or care where, because somebody out there takes care of things. As your business or database grows, “they” take care of it.
And it’s real – it works.
But when “they” screw up, you could be screwed.
Last month Amazon Web Services went down for a couple of days. PC Magazine posted a good summary, and many of us learned that well known companies like Hootsuite and Foursquare don’t actually own the computers that deliver their product: they rent services from Amazon Web Services (AWS). So when AWS went down, there was nothing they could do to help their customers. Read more »
*This blog post was originally published at e-Patients.net*
May 23rd, 2011 by John Mandrola, M.D. in Opinion
Tags: Cyclist, OCD, Perfectionism, Physician, Psychiatry, Psychology, Self-Reflection
1 Comment »

“Perfectionism is the voice of the oppressor, the enemy of the people. It will keep you cramped and insane your whole life…
…I think perfectionism is based on the obsessive belief that if you run carefully enough, hitting each stepping stone just right, you won’t have to die. The truth is that you will die anyway and that a lot of people who aren’t even looking at their feet are going to do a whole lot better than you, and have a lot more fun while they’re doing it.”
—Anne Lamott, Bird by Bird
Wow.
This paragraph hit me between the eyes. I’ve now read it about ten times in the past 24 hours. Ms Lamott was talking about the first draft of a manuscript. Just get it down on paper, willy-nilly, free lance, she said. Let loose and enjoy yourself she goes on to advise.
But these words spoke to me about so many other things in life. Read more »
*This blog post was originally published at Dr John M*
May 22nd, 2011 by Bryan Vartabedian, M.D. in Opinion
Tags: Blogs, Facebook, Physicians, Psychomanipulation, Semil Shah, Social Media, Social Networks, Techcrunch, Twitter, Who You Are
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This Techcrunch post, The Illusion of Social Networks, is worth thinking about. The author Semil Shah suggests that we have a tendency to use social networks to create illusions for our audiences. And over time these illusions compound to create something that may not reflect real life. It’s a type of socical psychomanipulation.
But I wonder if Shah overstates the shady side of human social conduct. I’m more optimistic about the promise of human connectedness. The crowd is smarter than we think. And while we can create any story possible, it’s ultimately the responsibility of the listening masses to decide what’s real. It’s our job to ask the hard questions. Be it television, the web, or our own homes, we’re individually responsible for who we let into our world. Read more »
*This blog post was originally published at 33 Charts*