May 27th, 2011 by Edwin Leap, M.D. in Humor, True Stories
Tags: Drug Screen, Emergency Medicine, Medical Education, Non-emergencies, Public Health, Strange Requests, Testing, Virginity Testing
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As the country wrestles with the cost of health-care, and as various media outlets address the role of emergency departments, I thought this little guide-might be helpful! I pulled it out of my archives from several years ago. Enjoy!
All too often, I discharge a patient and think to myself, What instructions can I give for this? Sometimes there are problems and questions that don’t have obvious solutions or answers. And in these situations, coming up with something useful for the patient to read at home is, to say the least, difficult. I’ve come up with a few based on some of the enigmas I see at Oconee Memorial Hospital.
Virginity evaluation: The emergency physician has not determined the status of your daughter’s virginity. In fact, the emergency physician does not wish to know the status of your daughter’s virginity. Furthermore, this doesn’t constitute an emergency. Unfortunately, no one has so far developed any simple home kits for making this determination. If you do, please notify the emergency department so that we can refer other families to your product. If you wish to know more about your daughter’s sexuality, try talking to her. If you found her naked in bed with a boy, you don’t need us.
Drug use evaluation: The emergency physician has not performed a random drug test on your teenage son. He has no complaints, is not suicidal, and has no apparent medical problem. This is not a family counseling center. If you want to know if he is using drugs, talk to him. Admittedly, he is a surly, unpleasant, disheveled, and foul-mouthed young man, whose multiple piercings make him look like a Stone Age erector set. But finding out if he is using drugs simply doesn’t constitute what we like to call an emergency. If he isn’t using drugs, be certain that repeated trips to the emergency department accompanied by screaming parents will certainly give him good reason to start.
Whole body numbness: It simply isn’t possible to be awake, walking, talking, and functioning and be entirely numb from head to toe. Admittedly, your ability to overcome the sensation of sharp needles and other painful stimuli is impressive, and may herald a future career with the CIA. For now, however, our physician has determined that the one thing likely to be numb on your person is your skull. Read more »
*This blog post was originally published at edwinleap.com*
May 23rd, 2011 by RyanDuBosar in Humor, Quackery Exposed, True Stories
Tags: Alternative Medicine, Evidence Based Medicine, Jeff Gardere, Natural Frequency Technology, Philip Stein, Press Release, Psychology, Watch
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Every once in a while, a press release comes along that’s worth mocking publically. Here’s one of them.
In honor of National Mental Health Month, one PR flack pitched Philip Stein watches. In the flack’s words: “The highlighted element of the watch is the brand’s exclusive wellness technology that helps wearers improve sleep and reduce stress. The watch is embedded with a metal disk that emits natural frequencies into the body wearer and in turn, affects the wearer’s energy field. It’s called ‘Natural Frequency Technology’ and is a new patented technology studies suggest help to improve sleep quality and reduces stress.”
Really. That’s what the flack said. Right off the bat, he’s gone from mental health issues to sleepless nights from stress. Not content with confounding the two issues, he continues: “Dr. Jeff Gardere, America’s well-known psychologist, is Chief Medical Executive for Philip Stein Watches and had been running a practice for over 20 years. He recognized during that time that there was a huge need to educate the public on the possible severities of stress and everyday lifestyle changes that everyday people can make without a prescription. Dr. Gardere found a natural way to reduce stress and prescribed his patients with a high-end accessory Philip Stein Watch.”
The psychologist “prescribed” a watch. I wonder if my insurance company would pay for that scrip? Read more »
*This blog post was originally published at ACP Internist*
May 23rd, 2011 by Michael Kirsch, M.D. in True Stories
Tags: Gastroenterology, ICU, Medical Error, Near Miss, Never Events, PEG tube
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Photo Credit
I barely escaped from an embarrassing situation recently in the hospital. I was consulted to place a feeding tube, called a PEG, in an ICU patient. We gastroenterologists are rarely consulted for our opinion on whether these tubes make sense, which they often don’t. We are recruited to these patients simply to perform the technical function of inserting the tubes, so that Granny, or Great-Granny, or Great-Great… , won’t starve. Multiple medical studies have demonstrated that providing this nutrition to individuals with advanced dementia doesn’t benefit them. In addition, while it may seem intuitive that artificial feeding provides comfort, this may not be the case. It may provide more comfort to the physicians and family than it does to the patient. Read more »
*This blog post was originally published at MD Whistleblower*
May 19th, 2011 by KerriSparling in Health Tips, Humor, True Stories
Tags: Diabetes, Endocrinology, Glucose, Insulin Pump, Internal Medicine, Type 1 Diabetes, Wedding Dress, Women's Health
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Yesterday I wrote about my wedding, focusing on the parts that meant the most to me: the man I love, our families and friends, the church service, saying “I do,” and dancing ourselves silly at the reception.
But diabetes was a part of my wedding day. We did our best to keep it quiet and unnoticed, though, using several tricky methods. I’m like a diabetes wedding magician … sort of.
First things first: the dress. Wearing an insulin pump is the easiest and least intrusive way for me to take my insulin, and I wasn’t about to go off the pump just for the sake of fashion. My solution? Design a pocket to hold my insulin pump, hidden in my wedding dress. I spoke with the seamstress at Ye Olde Bridal Shoppe and she and I designed something that left the pump accessible, yet hidden.
Even if you were looking for it, the pump pocket was almost impossible to find. Hidden along the seam of my wedding gown, it was held shut with a small piece of velcro. Read more »
*This blog post was originally published at Six Until Me.*
May 16th, 2011 by Lucy Hornstein, M.D. in Health Policy, True Stories
Tags: Codes, CPT Codes, Health Insurance, Illegal, Medical, Modifiers, Payment Avoidance, Semantics
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Insurance companies are supposed to pay for health care, although they do everything they can think of to avoid doing so. One company in particular (a small player here though a much bigger gorilla in other markets) does so by playing with words, even when another behemoth lost a lawsuit over the same issue.
The topic involves paying for preventive services while a patient is in the office for care of an acute illness or management of a chronic condition. The way we communicate with insurance companies about what we do in the office is by way of codes; CPT codes, to be precise. There are separate codes to differentiate between preventive services and the so-called Evaluation and Management (E/M) services. The latter are your basic office visit codes covering all the “cognitive” services I offer — as opposed to procedural codes, where I actually do something to you other than talk with and examine you. Read more »
*This blog post was originally published at Musings of a Dinosaur*
