Skip to main content

Posts

Physician Fee Schedule 2014 Uses Frequent Flier Model

Whistleblower readers know that I have spewed some vitriol toward the airline industry, where customer service goes to die.  Indeed, in a prior post I contrasted their routine harassment of frequent fliers with the individualized stroking that Apple customers routinely receive.   For sarcastic scriveners like me, the airlines are the gift that keeps on giving.  The target is so large that one can hit it from miles away with a blindfold on at night. Fun, fun, fun... Some, but now all, sources of customer angst include: The convenience and rationality of the TSA process (“Out with those dentures, Granny!”) The sumptuous meals served aboard. (“Exact change for the pretzels is appreciated.”) The plush and spacious seats which easily accommodate those with BMIs < 18 On-time performance (Do we really know what time is?) Truthfulness with regard to the occasional flight delay  (Pinocchio would nasally impale customers if he worked as a gate agent.) The simplicity and p

Disaster Obamacare Rollout Rolling Over A Cliff

I can’t add much meaningful commentary to the Obamacare roll out disaster.  There has been a deserved tsunami of criticism and derision across the political spectrum.  Democrats are sprinting for the exits.  Many of them in their last campaign repeated the sound bite of 2013, “If you want to keep your doctor…”.  Of course, without the miracle of video tape, these obfuscators would simply deny their own words.  The disaster rollout is a travesty on so many levels.   We should not forgive any institution that produces an abject failure after 3 years of preparation and nearly $600 million when they have been crowing for months about the October 1 st start date.  It did start something, but not what the government wanted.   More incredible is that the government was told by experts prior to the launch that the website was not even half baked, and yet they rolled it out anyway.  Is there any reader who can explain this decision to me?   If we knew that a plane had mechanical defects,

Thanksgiving, Pausing to Say Thanks...

To everything, there is a season, and a time to every purpose under heaven. Ecclesiastes It’s time to pause and offer gratitude for the blessings that have been bestowed upon us. Roman Goddess with Cornucopia We are thankful that our insurance coverage has not yet been cancelled. We are appreciative for websites that work as promised. We are grateful when our personal approval rating is above 50%. We acclaim the president for his interim deal with the Iranians, a government that supports Bashar Al Assad, funds Hezbollah and refers to Israel as a rabid dog. We offer Hosannas to Democrats Dianne Feinstein, Harry Reid, Barbara Boxer, Joe Biden and Barack Obama who were all vehemently against dismantling the Senate’s filibuster rule until they were for it. Diverging from sardonicism, I hope that all enjoyed a Thanksgiving holiday filled with mirth and laughter in the presence of loved ones.  To those who find themselves in one of life’s valleys, I hope that brigh

Should Doctors Apologize to Patients?

I had thought that apologizing was a straightforward act, but I now realize that it is a nuanced art form.  We’ve all heard the ‘mistakes were made’ version, usually issued by politicians who attempt to insert a layer of passive voice insulation between themselves and their screw ups.  There is also the ever present conditional apology which by definition falls short of complete responsibility acceptance.  The template here is: “I’m sorry for my oversight which wouldn’t have happened if….” The Gettysburg Address - Silly Remarks? There have been several apologies in the news recently.  First President Obama offered a faux mea culpa with regard to his indisputable and repeated ‘misrepresentations’ on his broken promise that we could all keep our own doctors and health insurance plans.  Here’s what he said on November 7 th . “I am sorry that they are finding themselves in this situation based on assurance they got from me.” Finding themselves ?  Really?  I grade this as

Medical Overtreatment: Why Doctors Like to Slay Dragons

Saint George slaying the dragon. Bernat Mortorell, 15th century I’m sending a patient downtown to see a pancreatic expert.   He’s a young man who didn’t fully appreciate the health risks of a former alcohol addiction.  He’s been sober for well over a year, but alcohol toxicity can be unforgiving and permanent.   We don’t fully understand why some alcoholics develop cirrhosis and other complications while others seem to skate by without a scratch.  While I want folks who have the strength to conquer addictions to regain lost health and opportunities, many life choices lead to irreversible consequences.   Life is often an unfair mystery.  We witness this in medicine often.  Some smokers live well into their 80s, while others become tethered to oxygen tanks or contract cancer.   Trim athletes who eat seaweed salads seasoned with probiotics keel over while obese Whopper-swallowers wallow their way into old age.  My guy has chronic pancreatitis, a known consequence of alcohol ab

Why Won't President Obama Tell us the Truth about Keeping our Doctors?

Morality, truthfulness and personal integrity do not command the currency that they should or used to.  Truman’s phrase, ‘the buck stops here’ is of historical interest only.  Consider authors and journalists who admit to plagiarizing and then go on to resume their careers.  Resourceful students use modern technology to cheat on standardized tests.  Our government refuses to classify a military replacement of a government in Egypt as a coup d’etat.  Teachers strike for more money claiming that their only interest is their precious students.  Politicians deny that campaign contributions will confer any special influence by the donors. A parade of overachieving athletes over the years denies they have ingested any banned substances.  Our intelligence services are not spying on Americans.  Physicians order diagnostic tests claiming they are only for medical reasons. Sometimes, the dishonesty is stealth while on other occasions it is transparent.  I suggest that the phrase ‘it h

Has Your Health Insurance Policy Been Cancelled? Who Knew?

I feel bad for Jay Carney, the president’s spokesman.  Each day, he faces the Washington Press Corps -piranhas on the hunt – and he must dodge and obfuscate.  I am surprised that the velocity of his spinning hasn't resulted in him drilling himself a mile below the earth’s crust.  He is a human spinning tornado. Presumably, this role must be challenging for Carney, who formerly practiced as an actual journalist who was charged with ferreting out the truth.  Now, he is under orders to avoid the truth.  While I do not suggest that he openly prevaricates, withholding the truth qualifies as dishonesty, as I see it. Tornado or Jay Carney? Carney and all politicians leapfrog over the specific questions being asked.  Their non-responsive responses are exasperating to the questioner and to the public.  There are many rhetorical techniques that these professional double talkers use to change the subject.  Let me illustrate with a hypothetical interview. Interviewer:  “If the v