tag:blogger.com,1999:blog-3358291Thu, 24 Jan 2008 02:17:04 +0000http://www.rangelmd.com/Chris RangelBlogger1394125tag:blogger.com,1999:blog-3358291.post-1905980402060608857Sun, 30 Dec 2007 17:06:00 +00002007-12-30T12:30:33.322-07:00What I've Been Doing on My Winter Vacation. Thinking about changing to WordPress as my blogging platform (getting tired of waiting for Blogger to load).Trying out an amazing Electronic Medical Record (EMR) system for the office. SynapseDirect is great in that's it's FREE and continually updated!Working. Duh.Being totally disgusted by almost every single Presidential candidate sans Ron Paul and http://www.rangelmd.com/2007/12/what-ive-been-doing.htmChris Rangeltag:blogger.com,1999:blog-3358291.post-1459342864153597365Thu, 11 Oct 2007 03:34:00 +00002007-10-11T08:05:38.281-06:00Doctors are not bartenders - In response to my last post about the prevailing CYA (Cover Your Ass) attitude of many docs in the medical profession, "Disabled" wrote, "The best defense is a good offense, so accept that CYA is part of the job and do your job . . If you do your job correctly then you have nothing to worry about, right? Did you know that in some states a bartender (whose income is http://www.rangelmd.com/2007/09/are-docs-like-bartenders.htmChris Rangeltag:blogger.com,1999:blog-3358291.post-99597709717028572Wed, 10 Oct 2007 03:39:00 +00002007-10-10T11:17:20.943-06:00Q: When do you enforce HIPAA? A: When the patient is a celebrity. - The Health Insurance Portability and Accountability Act of 1996 (HIPAA) codified measures taken to protect patient privacy. Most people working in health care know and love to hate HIPAA for taking what was previously common sense and mucking it up with all kinds of overly bureaucratic obstacles for a problem that was largely http://www.rangelmd.com/2007/10/what-hipaa-is-good-for.htmChris Rangeltag:blogger.com,1999:blog-3358291.post-6787571003378322160Thu, 27 Sep 2007 21:52:00 +00002007-09-27T19:22:48.310-06:00How Defensive Medicine Changes the Practice of Medicine. Emergency physicians are well known in the medical profession to be paranoid about litigation. And well they should be. Emergency medicine docs are among such litigation high risk specialties as obstetricians and neurosurgeons. There is every reason to believe (and some evidence) that this paranoia alters how these physicians practice http://www.rangelmd.com/2007/09/er-physician-logic.htmChris Rangeltag:blogger.com,1999:blog-3358291.post-1041855219136920897Thu, 20 Sep 2007 18:59:00 +00002007-09-21T11:42:05.865-06:00 Medical Ethics: You can't force a patient to stay alive. The patient is in his 50s and is suffering from a neurological disorder that has impaired his ability to breathe and swallow. He is dependent upon a feeding tube inserted into his stomach for nutrition and a ventilator inserted through a tracheostomy to breathe. He faces the prospect of being like this for the rest of his life. The http://www.rangelmd.com/2007/09/please-dont-assault-my-patient.htmChris Rangeltag:blogger.com,1999:blog-3358291.post-8774846561416782989Tue, 18 Sep 2007 15:53:00 +00002007-09-18T10:51:05.485-06:00Canada Has Success with Privatization of Government Services - Over a decade ago Canada privatized a critical government service which lead to improved capital investment and modernization, and improved efficiency without any negative impact on safety. Unfortunately this service was not health care. No, in 1996 Canada privatized their air traffic control system. "Since 1996, planes in Canada havehttp://www.rangelmd.com/2007/09/canada-privatizes.htmChris Rangeltag:blogger.com,1999:blog-3358291.post-3060205281193882032Mon, 17 Sep 2007 16:45:00 +00002007-09-17T15:12:26.181-06:00Hilary Clinton Backs Away from Health Care Reform - In a stunning move, potential Vice Presidential candidate Hilary Clinton performed a politically tricky 180 degree maneuver when she announced today that she now opposes her previous plans for universal health care coverage. Despite the fact that up to 18,000 Americans are estimated to die each year for lack of health care coverage, Senator http://www.rangelmd.com/2007/09/clinton-says-no-to-health-care-reform.htmChris Rangeltag:blogger.com,1999:blog-3358291.post-9139146760601515993Mon, 17 Sep 2007 13:01:00 +00002007-09-17T08:24:03.340-06:00Hospital Rounds: A woman in her 70s with shortness of breath and a pleural effusion. This previously healthy patient had originally presented to her primary care physician complaining of swelling and pain in the lower neck. An ultrasound was done which showed a large thyroid mass. A fine needle aspiration (FNA) of this mass showed a hurthle cell tumor. Subsequently the patient was found to havehttp://www.rangelmd.com/2007/09/hospital-rounds-woman-in-her-70s-with.htmChris Rangeltag:blogger.com,1999:blog-3358291.post-2827019104922679849Tue, 11 Sep 2007 13:48:00 +00002007-09-15T08:35:09.643-06:00Six Years Later - I found a great (free) archive of uncut news footage from 9/11/01. Watch the world change in a span of minutes.http://www.rangelmd.com/2007/09/never-forget.htmChris Rangeltag:blogger.com,1999:blog-3358291.post-8517116364675512678Fri, 31 Aug 2007 03:39:00 +00002007-08-30T23:25:16.863-06:00Toxic Mold Makes People Depressed - An American Journal of Public Health study looked at World Health Organization data from almost 6,000 adults in Europe. The WHO data showed that those living in damp buildings with mold problems were more likely to report that they suffer from depressive symptoms such as decreased appetite low self-esteem and sleep disturbances. Lead study author Edmond http://www.rangelmd.com/2007/08/test.htmChris Rangeltag:blogger.com,1999:blog-3358291.post-3967020011852008170Wed, 29 Aug 2007 19:50:00 +00002007-08-29T15:02:54.518-06:00 Wait Times Much Shorter for Botox Appointment Than Mole Check - A UC medical school study found that the usual wait time for patients to get in to see a dermatologist to evaluate a suspicious mole is 26 days vs. only 8 days to get an appointment for a Botox treatment. The study was just a telephone sample survey and so did not look into the reasons for the difference though it should be http://www.rangelmd.com/2007/08/botox-trumps-mole-check.htmChris Rangeltag:blogger.com,1999:blog-3358291.post-1992417871465043319Mon, 27 Aug 2007 04:20:00 +00002007-08-26T23:16:40.257-06:00Medical School Application Step #12: Clean Up Your Online Persona - The essay on your medical school application may be eloquent and use several big words of Greek or Latin origin but your MySpace page may contain way too much detail about certain aspects of your life that you would rather not discuss during an interview. There is nothing to prevent members of admissions committees from Googlinghttp://www.rangelmd.com/2007/08/before-you-apply-to-med-school.htmChris Rangeltag:blogger.com,1999:blog-3358291.post-5361759103116619347Sat, 25 Aug 2007 23:22:00 +00002007-08-26T01:54:02.307-06:00The WHO's World Health Care System Rankings - In the mockumentary 'Sicko', Michael Moore points out that despite spending the most on health care of any nation ($7,400 per capita), the US ranks near the bottom among industrialized countries and only two spots above Cuba (that spends $251 per capita). What rankings? In 2000 the World Health Organization came up with rankings for the health care http://www.rangelmd.com/2007/08/us-health-care-system-is-almost-as-bad.htmChris Rangeltag:blogger.com,1999:blog-3358291.post-243570791745500947Fri, 24 Aug 2007 03:57:00 +00002007-08-23T23:18:50.436-06:00Hospital Rounds: A 59 year old with fever and a headache. About 3-4 days prior to admission this patient developed fever and a generalized headache. She saw her PCP who prescribed ciprofloxacin antibiotic of which the patient took about 3-4 doses. The symptoms worsened and she had two bouts of vomiting. She has a history of diabetes type II and hypertension. She denied any photophobia, neck http://www.rangelmd.com/2007/08/hospital-rounds-59-year-old-with-fever.htmChris Rangeltag:blogger.com,1999:blog-3358291.post-5819201531163930271Wed, 22 Aug 2007 04:33:00 +00002007-08-22T00:00:54.362-06:00Less Access to Health Care in Canada? - What I like about Canada; hockey! What I don't like about Canada; socialized medicine. Robert Goldberg, while criticizing those who advocate for a Canadian style socialist health care system here in the US, points out that 17% of Canadians don't have a regular family doctor. According to the College of Family Physicians of Canada; Approximately 5 million http://www.rangelmd.com/2007/08/lack-of-access-to-care-in-canada.htmChris Rangeltag:blogger.com,1999:blog-3358291.post-6633107349657452405Tue, 21 Aug 2007 04:36:00 +00002007-08-20T23:20:46.892-06:00Med Bloggers React to New Medicare Rules - There was quite a lot of reaction among med bloggers to this week's announcement by CMS that the Federal Government will no longer pay for certain complications it considers to be preventable. The obvious problem is that many of these complications are not 100% preventable even with the best of care. The obvious question is whether or not hospitals will http://www.rangelmd.com/2007/08/new-medicare-rules-steam-med-bloggers.htmChris Rangeltag:blogger.com,1999:blog-3358291.post-6086893298103233880Mon, 20 Aug 2007 01:17:00 +00002007-08-20T08:26:57.254-06:00Medicare Won't Pay for These Medical Complications! When you take your car in to the mechanic to have the engine worked on and they screw up your transmission, you don't expect to have to pay for their mistake. This is the logic that the Federal government is using in its new regulations for hospital reimbursement. CMS will no longer reimburse hospitals for the costs of treating eight http://www.rangelmd.com/2007/08/if-we-screw-up-then-you-dont-pay.htmChris Rangeltag:blogger.com,1999:blog-3358291.post-6961651261327649492Fri, 17 Aug 2007 03:32:00 +00002007-08-17T00:07:32.501-06:00Public Hospitals act Like Private Hospitals - In the US most large population centers have public county or city hospitals to help serve the needs of the local uninsured and under insured population. They can bill Medicare, Medicaid, and private insurance but unlike most private hospitals they are eligible to receive local, state, and Federal public funding (often on the order of tens to hundredshttp://www.rangelmd.com/2007/08/i-hate-county-hospital.htmChris Rangeltag:blogger.com,1999:blog-3358291.post-2743354644381473699Tue, 14 Aug 2007 22:55:00 +00002007-08-14T23:05:42.244-06:00Doctor successfully defends self against fraud charges, still loses over $700,000 - They call this a rare success story. In 2002 the US Department of "Justice" charged Dr. Capener, an otolaryngologist, with fraud from billing insurers for endoscopic sinus surgeries they claim were either unnecessary or never performed. The government’s case was largely circumstantial i.e. the number of http://www.rangelmd.com/2007/08/when-federal-prosecutors-attack.htmChris Rangeltag:blogger.com,1999:blog-3358291.post-4221129706237567398Mon, 13 Aug 2007 22:41:00 +00002007-08-13T20:11:37.052-06:00The problem with surveys - The "observer effect" is what happens when the very act of measuring something changes the properties of what is being measured. This is common in physics as well as sociology where people tend to change their behavior if they are aware that they are being observed (much like the waving idiots in the background of any given local TV broadcast). Yet it's surprising how http://www.rangelmd.com/2007/08/when-surveys-fail.htmChris Rangeltag:blogger.com,1999:blog-3358291.post-5319451317396181321Sun, 12 Aug 2007 15:23:00 +00002007-08-12T19:04:49.064-06:00Excessive Wait Times in Socialized Medicine (a follow up to Part I) - A 22 year old English woman died from a rare (but treatable) brain tumor after waiting almost 13 weeks for an MRI of the head. Dr. Luba had the following to say; "The NHS used to be a much better system. The Tories cut funding greatly when they were in control in the 80s. It still hasn't quite recovered. . If she had been a http://www.rangelmd.com/2007/08/socialized-medicine-less-advanced-care.htmChris Rangeltag:blogger.com,1999:blog-3358291.post-1593881161640510816Fri, 10 Aug 2007 23:44:00 +00002007-08-10T17:53:03.348-06:00Make sure your Living Will is not too Ambiguous! Last night, my wife and I were sitting in the living room and I said to her, "I never want to live in a vegetative state, dependent on some machine and fluids from a bottle. If that ever happens, just pull the plug." She got up, unplugged the TV and then threw out my beer.http://www.rangelmd.com/2007/08/clarity-in-living-wills.htmChris Rangeltag:blogger.com,1999:blog-3358291.post-2065149282624414026Fri, 10 Aug 2007 03:36:00 +00002007-08-09T23:46:32.067-06:00Socialized health care kills patient with excessive wait times for MRI. A 22 year old English woman collapsed and died from a rare brain tumor after having severe headaches for over a year and after no less than 5 visits to her physician. Her headaches were diagnosed as "stress related" and she received 6 physical therapy sessions for head and neck pain. Only after she became so sick that she http://www.rangelmd.com/2007/08/nhs-kills-young-woman.htmChris Rangeltag:blogger.com,1999:blog-3358291.post-4967594426182323533Wed, 08 Aug 2007 04:28:00 +00002007-08-08T00:20:26.907-06:00The Publix Pharmacy Marketing Ploy - The Rx chain anounced that it will be filling prescriptions for certain antibiotics for free. While this alone is not necessarily new (other pharmacies are already doing something similar) it is unusual in that this announcement made national news. ABC Evening News alluded to this as a "marketing tactic" but left out all the details. The reality is that these http://www.rangelmd.com/2007/08/dirt-cheap-antibiotics-now-given-away.htmChris Rangeltag:blogger.com,1999:blog-3358291.post-6339857368310059212Mon, 06 Aug 2007 23:05:00 +00002007-08-06T18:34:06.568-06:00Socialized Medicine = Workfare. - It's like welfare which is getting something for nothing but instead, workfare is the requirement that the recipient do some type of work or training in order to get benefits. To this definition I add jobs where it's almost impossible to be fired as long as you do the bare minimum of work. What employer would have such a ridiculous retention policy? Why, the http://www.rangelmd.com/2007/08/single-paier-health-care-is-workfare.htmChris Rangel