August 7th, 2008 by Dr. Val Jones in Uncategorized
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My personal physician, Dr. Alan Dappen, will be interviewed tonight at the Doctor Anonymous show. The topic? A new model of medical practice – something I like to call “concierge medicine for the masses” because most people can afford it and they get first-rate treatment.
Sound too good to be true? Then ask him how he does it! The show starts at 10pm EDT tonight, August 7th. Hope to see you in the chat room…
Many thanks to Maggie Mahar who covered my recent interview with Alan here. I hope she’ll join the call!
Click here to listen to the podcast.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
August 4th, 2008 by Dr. Val Jones in Announcements, News
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I was welcomed as a new member of Washington, DC’s 100-year-old National Press Club (NPC) today. My credentials for membership? I’m a blogger.
The Internet has revolutionized information sharing and news reporting. Not only has it democratized the process, but it has harnessed the power of the common man and woman to bring a new depth and breadth of insight to the news. Just as medicine is becoming “personalized,” one could say that blogging is making journalism “personalized.”
Mainstream media outlets like the Los Angeles Times, the New York Times, and the Wall Street Journal have recognized blogging as a legitimate platform for information sharing. Bloggers like me, KevinMD, Gene Ostrovsky, Dr. Rob Lamberts, and many others are openly recommended sources for further reading. In the span of 5 years, medical blogging has become a respected part of the new media landscape.
When I told my parents that I was becoming a member of the National Press Club, my dad asked if they were going to give me a press credentialling card for my fedora (hat). For him, the NPC clearly conjured up images of 1920s news reporters crowded into small, smoke filled rooms to interview foreign dignitaries.
There was a hint of truth to my dad’s vision – the NPC retains a relatively austere interior, with large flags and club seals prominently displayed in regal blue conference rooms. But beyond the C-SPAN aesthetic, the club is undergoing substantial modernization. The restrooms feature Dyson airblades, the old library’s bookshelves are being torn down to expose bay window views of DC, and the fourth floor studios are constructed with glass and clean-line architecture.
The NPC’s new member luncheon was hosted by two staff and an NPC member who joined the club in 1971. I was astonished to learn that my new membership entitled me to a free daily breakfast and unlimited access to: their librarian for my fact-checking needs, a gym with a full-time personal trainer, meeting rooms that I could book in advance for my convenience, and a Friday night taco bar. Who knew?
Near our table was a portrait of Will Rogers who, among other things, was a nationally syndicated columnist featured in over 4000 different newspapers. Our member-host pointed at the portrait and said, “Back in Will’s day – everyone wanted to know what he thought of current events, so they’d purchase their daily newspaper to find out.”
As I considered Will Rogers’ smiling face, it suddenly struck me that blogs offer today’s readers a filter through which to view current events. And thanks to the abundance of blogs, there is an ever expanding array of personal editorial. Finding a good blog is like finding a voice you can relate to – a living commentator on events. No longer is there one voice like Will Rogers who dominates the national consciousness.
But citizen journalism has its downside, as does Karaoke. Karaoke offers everyone a microphone, but not everyone is a talented singer. In the same way, blog quality varies considerably, and so now more than ever we must cling to the old news addage, “consider the source.” The danger of blogs is that readers may ascribe more authority to their authors than they deserve. When it comes to medicine – and your health is hanging in the balance – it’s important to get the facts straight. So I believe that professional medical bloggers should work extra hard to uphold the ideals of medicine, and respect patient privacy.
Just as the NPC is welcoming bloggers like me into their midst, I hope that new media gurus will welcome what the NPC has to offer them: a rich history of journalistic integrity. I think that a fusion of old and new media might actually produce a hybrid product that will bring us the best of both worlds – a broad array of trusted voices in online journalism.
With this blog I add my “voice of reason” to the choir and look forward to all that the NPC can teach me. At the very least, I’ll enjoy Friday night taco fests with my peers in Washington.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
August 4th, 2008 by Dr. Val Jones in Uncategorized
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I’m not sure if you’ve heard the news from north of the border, but my parents recently called me to tell me about it. Apparently, a 22 year old man was attacked on a bus en route to Winnipeg. A Chinese male passenger with a hunting knife had some sort of psychotic break and began stabbing his seat mate. The bus driver pulled over and the terrified passengers exited the bus as the assailant decapitated, gutted, and partially ate his victim in front of the onlookers.
The Royal Canadian Mounted Police (RCMP) subdued the man and have taken him into their custody.
This is probably the most disgusting, heinous crime ever committed in Canada. We are all in shock.
I’m sure that more information about the murderer will become available as the investigation continues.
**
Addendum: a Twitter friend of mine pointed out that this beheading was actually the third in a series of bizarre and unrelated decapitation murders world-wide. There was also one in Greece and one in the UK. Tragic.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
August 2nd, 2008 by Dr. Val Jones in True Stories
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I posted this true story on my blog previously, but I think it bears repeating (especially with the recent news of increased violence against physicians and threats at gunpoint). Details of the story were altered to ensure privacy of all involved.
***
The son of a business tycoon experienced some diarrhea. He went to his local emergency room immediately, explaining to the staff who his father was, and that he required immediate treatment.
Because of his father’s influence, the man was indeed seen immediately. The physicians soon realized, however, that there was nothing emergent about this man’s complaints. After several blood tests and a stool sample were taken, he was administered some oral fluids and monitored for several hours, they chose to release him to recover from his gastroenteritis (stomach flu) at home.
The man complained bitterly and said that he wanted to be admitted to the hospital. The physicians, with respect, explained that he didn’t show any signs of dehydration, that he had no fever, his diarrhea was indeed fairly mild (he had only gone to the restroom once during the hours of his ED visit – and that was when he was asked to produce a stool sample). The man’s pulse was in the 70’s and he had no acute abdominal tenderness.
The man left in a huff, and called his father to rain down sulfur on the ED that wouldn’t admit him.
And his father did just that.
Soon every physician in the chain of command, from the attending who treated him in the ED right up to the hospital’s medical chief of staff had received an ear full. Idle threats of litigation were thrown about, and vague references to cutting key financial support to the hospital made its way to the ear of the hospital CEO.
The hospital CEO appeared in the ED in person, all red and huffing, quite convinced that the physicians were “unreasonable” and showed “poor judgment.” Arguments to the contrary were not acceptable, and the physicians were told that they would admit this man immediately.
The triumphant young man returned to the ED for his admission. Since the admitting diagnosis was supposedly dehydration, a nurse was asked to place an IV line. The man was speaking so animatedly on his cell phone, boasting to a friend about how the doctors wouldn’t admit him to the hospital so his dad had to make them see the light, that he moved his other arm just at the point when the nurse was inserting the IV needle. Of course, the poor woman missed his vein.
And so the man flew into a rage, calling her incompetent, cursing the hospital, and refusing to allow her to try again.
At this point, the ED physicians just wanted him out of the emergency room – so they admitted him to medicine’s service with the following pieces of information on his chart:
Admit for bowel rest. Patient complaining of diarrhea. Blood pressure 120/80, pulse 72, temperature 98.5, no abdominal tenderness, no white count, patient refusing IV hydration.
Now, this is code for: this admission is total BS. Any doctor reading these facts knows that the patient is perfectly fine and is being admitted for non-health related reasons. With normal vital signs, and no evidence of dehydration or infection, this hardly qualifies as a legitimate reason to take up space in a hospital bed. And when the patient is refusing the only treatment that might plausibly treat him, you know you’re in for trouble.
The man was discharged the next day, after undergoing (at his insistence) an abdominal CAT scan, a GI consult, an ultrasound of his gallbladder, and a blood culture. His total hospital fee was about $8,000.
Do you think he paid out of pocket for this? No. He submitted the claim for payment to his insurance company. Their medical director, of course, reviewed the hospital chart and realized that the man had no indication for admission, and refused medical care to boot, so he denied the claim.
So the son appealed to his father, who then rained down sulfur on the insurance company, threatening to pull his entire business (with its thousands of workers insured by them) from the company if they didn’t pay his son’s claim.
The medical director at the insurance company dug in his heels on principle, assuming that if he continued to deny the claim, the hospital would (eventually) agree to “eat the cost.”
In the end, the insurance company did not pay the claim. The CEO of the insurance company called the hospital CEO, explaining that it was really the doctor’s fault for admitting a man who didn’t meet admission requirements. The hospital CEO agreed to discipline the physician (yes, you read that corretly) and eat the cost to maintain a good relationship with the insurance company that generally pays the hospital in a timely manner for a large number of patient services.
Welcome to the complicated world of cost shifting in healthcare.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
August 2nd, 2008 by Dr. Val Jones in Uncategorized
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I’m planning to attend a ScienceBlogger event next weekend. Hope you can join me and Gene Ostrovsky from
Medgadget.com… Here is the email invite I received:
So far, we’re expecting about 50 readers and a dozen ScienceBloggers.
We’ll be meeting at 2:00 pm on Saturday, August 9, at the Arthur Ross Terrace at the American Museum of Natural History. Once there, please head to the cafe tables and chairs set by the trees on the upper terrace, facing the Rose Center. The terrace is accessible from the Theodore Roosevelt Park at 81st Street and Columbus Avenue.
Here’s more information about the site:
This is an outdoor location with tables and shade, which we thought was best for the large numbers we’re expecting. After we’re all assembled in this spot, if smaller groups are interested in grabbing a coffee or sitting in air conditioning, then we’d be happy to point them to one of several nice cafes nearby.
Please pass this on to anyone who might be interested. We’re all very excited to interact with readers in RealSpace!
Cheers,
Ginny
Addendum: due to overwhelming interest, the venue has changed (Ginny’s new email):
Hey guys,
So due to our increasing numbers and the chance of rain, we’ve decided to change the location of Saturday’s Reader Meetup. The new spot will be at a bar on the west side called Social. We’ve reserved a room in the back, and it’s three floors in case we need even more room. We’ll buy the first round of pitchers (alcs and non-alcs).
Details:
2pm-4pm on Saturday, August 9
Social
795 8th Ave (close to 48th St.)
New York, NY 10019
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
