September 13th, 2009 by Happy Hospitalist in Better Health Network, Opinion
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How expected. The CEO of whole foods says that government is not the solution to out of control health care expenditures. He says we are. The American people are responsible for out of control health care expenditures. He preaches a life of personal responsibility, of personal choice and actions that lead to health. And what does he get for it?
Pragmatists on all sides of the health care question (and probably every political question) believe that, on the whole, human nature does not change, and we’ve got to fight or not fight the health care war with the citizenry we’ve got, not the one we wish we had. Utopians like Mackey, on the other hand, believe that public-policy debates are only a middle step in the real solution to our problems, which is to change human nature. The solution to our health care woes, Mackey seems to believe, is for all of us to become like him—hyper-rational in evaluating our options, hyper-responsible in following through on them, and devoted to healthy living (that plant-based diet!).
Yes, that is actually the solution, to become more hyper-rational in evaluating our options, hyper-responsible in following through on them, and devoted to healthy living. The fact that this commentator makes a mockery of personal responsibility, instead choosing to support couch potato, Chetoo eating, Oprah watching smokers with for all their health care needs because, well, that’s just what humans do, is pathetic.
If you want someone else to pay for your health care, be prepared to play by their rules. And the rules have to change. Or there won’t be any money for anyone.
Ninety-nine trillion dollars says so. Making humans entitled to the side effects of bad habits because that’s just what humans do is a race to the bottom mentality. It’s at the core of the finance
quandary. Encourage bad habits by paying for them, and you get bad habits. Nobody can sustain that model of third party financing.
Would you insure a house who’s participants stated up front they would burn it down? Would you insure a car from a driver who said he would intentionally drive it into a brick wall? If not, why would you buy insurance for people who intentionally did things we know destroys them?
The CEO of Whole Foods should be hoisted onto the podium next to Obama for all the world to applaud. Obama should declare a God given right to live healthy (and he should quit smoking for good) and a God given right to pay more for your insurance if you don’t. It’s about personal responsibility. It’s not about handing you a plate of free insurance and saying go smoke ’em if you got ’em.
*This blog post was originally published at A Happy Hospitalist*
September 13th, 2009 by MotherJonesRN in Better Health Network, Opinion, True Stories
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Nurse Andrea Bartlett is literally having a meltdown. She is in the midst of her midlife crisis. Nurses like her are easy to spot. She’s having a hot flash, note the hand to her forehead and the look on her face that says, “Crap, I’m going to pass out,” and she’s reliving her hippy Peace Corps days by working as a Congo nurse. I bet she is kicking herself for leaving home, especially at her age. After all, who in their right mind would give up their Mac computer and iPhone.
It’s official. I’m having my midlife crisis. I knew I had hit crisis mode the day one of my patients tried eloping from the unit. I saw the patient racing down the hallway towards the door, and my brain said, “Run, catch the patient,” and, after a few strides, my joints started screaming, “Brain, we hurt. Go to hell.” Fortunately, the techs and a few nurses, all of whom are youngsters, ran right pass me like little gazelles and effortlessly caught the patient before he bolted off the unit. I felt like a relic. I wanted to cry all day long.
If anyone over the age of 55 tells you that they aren’t going through their midlife crisis, they are in denial, or they are lying through their teeth. I started making some changes at home after that fateful day at work. I can’t afford a facelift, a tummy tuck, or a red sports car, so I started redecorating my living room, a la Peter Max. I said goodbye to my Martha Stewart country living room by replacing everything that was made from gingham and lace with burgundy silk pillows, hand blown glass bottles, and Bakhtiari carpets. I even scored this 1960s leather chair, matching footstool, and hoop lamp from one of my best friends. Yeah, they’re groovy. I can’t wait for my husband to finish off my bookshelves. Maybe I’ll start a new hookah collection when he’s done.
Having a midlife crisis isn’t just about getting gray hair, saggy boobs, and a wider girth. It’s about getting to know who you really are as you hit the midpoint of your life. This midlife journey is especially bewildering and fear provoking for nurses. Everyone is in a big hurry to get an advanced nursing degree before “it’s too late.” Too late for what? I see nurses frantically checking out school websites, and exchanging information about online classes. Some nurses want to expand their knowledge base so they won’t have to work as bedside nurses anymore, while others want to go back to school because of a mandate put out by the ANA. The ANA doesn’t recognize anyone without a nursing degree as a professional nurse. The ANA can kiss my ass. I’m not going back to school, and I refuse to burst one brain cell over a class assignment that has no relevance in my life.
God willing, I have at least twenty-five years before I check out of the world and I plan to have some fun before I head for the Pearly Gates. My short-term goal is to buy the new Beatles Boxed set in stereo and to finish redecorating my house. I’m going to light up some incense, play my tunes, and party on. My long-term goal is to make love, not war, get on the peace train, and to follow the sun.
Can you dig it?
*This blog post was originally published at Nurse Ratched's Place*
September 12th, 2009 by Kenneth Trofatter, M.D., Ph.D. in Better Health Network, Health Tips
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Probably one of the most popular series I have written over the past few years is the one on recurrent early pregnancy loss. There is not a week that goes by that I still don’t get inquiries related to that subject, most accompanied by the pain, frustration, sense of loss, and feelings of hopelessness for future fertility. There are several points I always remind readers and patients about whenever I have the opportunity to discuss their concerns: 1) In most cases, the tincture of time alone offers the answer to their prayers; 2) If specific reasons for their losses are found or suspected, these can often be addressed medically and/or surgically; 3) If specific reasons cannot be identified, there are reasonable approaches to ‘empiric therapy’; and, 4) If these approaches fail, the science of assisted reproductive technology (ART) has advanced to the point that it can often overcome most obstacles that stand in the way of fertility.
The other points I always mention in response to the questions of “Why did this happen to me?”, “What did I do wrong to cause this?”, “What can I do to assure that it never happens to me again?, particularly to couples who have had their first or second miscarriage, or a sporadic miscarriage after successful pregnancies, are the following: 1) Miscarriages occur in 15-20% of all conceptions; 2) The MOST COMMON cause of early pregnancy losses are chromosomal abnormalities that occur by chance (except in the case of parental chromosomal rearrangements) and are not under any controllable influences; 3) It is unlikely that anything was “done” to cause the loss, although if there are such potential factors identified, the loss may provide an incentive to modify lifestyle prior to another pregnancy attempt to minimize their risks.
Recently, I received the query below from a woman who has had early pregnancy losses related to documented chromosomal abnormalities. Despite the other problems that have been identified which might contribute to reduced fertility in her case, these probably had no influence on her babies’ chromosomal abnormalities. But, they do give us the opportunity to briefly discuss the well-known observations that certain seemingly “unusual” chromosomal abnormalities (“unusual” in that they rarely or never result in a live born baby) actually contribute to a relatively high percentage of early pregnancy losses. Read more »
This post, Genetic Causes Of Early Pregnancy Loss, was originally published on
Healthine.com by Kenneth Trofatter, M.D., Ph.D..
September 11th, 2009 by GruntDoc in Better Health Network, True Stories
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From an old HS buddy (also a Navy Man) now in healthcare:
Texas law makes almost any item with a doctors prescription exempt from
sales tax.
(most details at : RULE §3.284 Drugs, Medicines, Medical Equipment, and
Devices (Tax Code §151.313) Item 11 is the sort of catch all.
What is most odd item you have been asked for a prescription for purely for
tax-free purposes?
Sellers of the Select Comfort beds, and hot tub/spa dealers are very aware
of this law. Presciption needed for bed, letter and presciption needed for
hot tub/spa.
Oddest request received at clinic where I work: one for in ground pool,
heated and deep enough for water aerobics.
While I don’t notice it on that list, food for helper animals is exempt
from sales tax.
Interesting also, repair parts for devices are exempt, but not
*improvements*. If you replace like for like wheel on a walker, it is tax
free. Replace with improved wheel-taxable.
I’ve never been asked to write a prescription for anything like that in the ED, but I’d be willing to bet my office-based colleagues have. Care to share?
*This blog post was originally published at GruntDoc*
September 11th, 2009 by Emergiblog in Better Health Network, Opinion
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I’ve received some emails from nurses who would like to start a blog. Some are a bit nervous about starting, others are not sure how to begin. There are a million sites out there on how to start a blog; in fact, I wrote a post specifically on how to be a “nurse blogtitioner”.
But their emails got me thinking about the blogosphere in general and the most important considerations in starting/maintaining a blog.
1. The blogsosphere can never be saturated.
Think you have nothing to add to the dialog? Think that everything about your topic has been said? Think again. If you aren’t blogging there is still a voice that needs to be heard. What exactly do you bring to the discussion? You! No one has had your experiences or can express your opinions. More importantly, no one else can bring your voice. And unlike a meeting or an email, there are no time limits or physical boundaries to the blogosphere. There is room for everybody, and that means you!
2. The heart of the blogosphere is interactivity.
If you read blogs, you probably leave comments. Comments are the soul of the blogosphere. With them, the blogosphere is a conversation. Without them, the blogosphere is simply a virtual collection of “articles”. By starting a blog, you bring the dialog to your “home turf”, so-to-speak. You are the host/hostess of a virtual “salon”, providing information on your sphere of expertise, initiating the debate and most importantly, learning from those who comment on your posts.
3. The blogosphere is the great equalizer.
There is no hierarchy of blogs. Don’t confuse size with importance. Some blogs may have a million readers a day and some may have ten, but in the blogosphere, no one is “better” than anyone else. Your blog, with that first post, is just as important and just as relevant as anything you see on “Instapundit” or the “Huffington Post”. It’s unique and cannot be replicated, because it is based on your outlook and experiences.
Here are some things to keep in mind as you start your blog:
1. Content is King
Maybe you look at the blogs with the sidebars and the graphics and the ads and the widgets and think, “Man, I don’t know how to do all that!”. You don’t have to do all that! All you have to do is start posting. One post. Later, if you want, you can add a blogroll or a few widgets. But the way to start is to begin writing, and keep writing. People will come for your content. Everything else takes a back seat to that.
2. Promotion, Ur Doin’ it Right
You’ve just put up your first post. A few folks might stumble on your site by accident, but you need to get out the word that you’re on the web. This is where you start promoting your blog. The best way to do this is find a carnival for your niche and submit a post. For those of us in the medblogging community, examples would be Grand Rounds, Change of Shift, Patients for a Moment and The Handover. Make your url part of every email signature and blog comment you send. Write it, and they will come…but they need to know you’re there.
3. Prolific Perfection…Not
Blogging can be addicting, and in a good way. It can be challenging, therapeutic, frustrating, and energizing – all in one post! But…you do not have to be the “perfect” writer. Just find your style and run with it. And while consistent posting makes it easier for readers to find your blog, you control your posting schedule. “Prolific” is what you say it is, be it once a week or once a day. But know this: the more you write, the easier it becomes to write; the more you are interacting with the blogosphere, the more inspiration you will find and the more you will want to write. It’s the blogosphere “circle of life”!
So…if you ask me, should I blog?
I’ll say YES!!!!
Been there, still doing that, and if I can do it, you can do it.
It will clarify your outlook.
It will recharge your batteries.
It will change your life.
Really, the bottom line?
You’ll never know unless you write…
That first post.
*This blog post was originally published at Emergiblog*
