ZiyadMD
Some people just haven’t seen enough evidence that President Barack Obama does not deserve re-election. And if the following 55 reasons don’t convince you that Obama should be shown the door, nothing will. Here’s a list of what Obama has done for healthcare while in office. With Obama, health care has been made unaffordable, less effective, and in shorter supply..
Halloween. The word conjures up wonderful memories for most people, and children often rate it as one of their favorite days of the year. However, it is also one of the 4 most likely days of the year that children will make trips to the emergency department. Injuries in both adults and children can run the gamut from trips and falls, as a consequence of ill-fitting costumes, to motor vehicle accidents resulting from excessive alcohol use. What are the factors that lead to the increase in risk? And what are the specific injuries and events seen in both adults and children on this often very frightening night?
“Good, it’s about time that these greedy doctors get smacked down for being the financial rapists that they are. Medicine in this country is the biggest, most destructive SCAM going on today. Doctors think they are entitled to RIDICULOUS amounts of money for simple routine procedures.” ~ Johnathan Blaze
It is generally agreed upon that the more one values a good or service, the more he or she is willing to pay for it. Most will agree that shoes are important. They keep your feet from bleeding and hurting when you walk on the street. People seem happy to pay anywhere between $20 to $150 for them. Some will clamor to pay without complaint as much as $315 for sneakers that mimic those of their favorite basketball hero, or $865 for designer Manolo Blahnik “BB” Snakeskin Pumps. Many place great value on a youthful physical appearance and sex appeal and will gladly pay up to $15,000 cash for a new pair of breasts with little if any sense of resentment for the doctor providing the service and metering the charge. Having a car, most of us will agree is very important, and therefore paying around $30,000 is pretty average. Though it seems that many are outraged at a Plastic Surgeon charging $12,000 to repair a fingertip, most people consider their limbs and appendages important, and being able to use them of significant value. Therefore, it follows that a total cost of approximately $40,000 for a hip replacement tends be generally well accepted and frequently paid by insurance companies along with the physician portion of $1,505 (CMS CPT 27130.)
So how much is your life worth to you? Clearly it is worth more than a pair of shoes. Are we still in agreement? Certainly you would be more than happy to pay $20 to $150 to have it saved, if you or your insurance company had the finances. Is a human being’s life in total worth more than the $15,000 pair of augmented breasts on the human being? I’m sure most would agree it is. I’m sure as a society we must pay more than this for a human life saved, correct? I’m sure we all similarly agree that the entire value of a human life saved is greater than the value of a “spare replacement part” such as a $40,000 hip. We must certainly and gladly pay those who save our lives at least as much as we pay for sneakers, designer shoes, our cars or a spare hip, correct?
No. We don’t. It’s not even close!
The life of a physician can be full of stress and aggravation. In a recent discussion on Medscape Physician Connect, an all-physician discussion group, doctors shared some of the ways they unwind after a trying day.
“What do you do to relax? Are you physical or contemplative? Do you prefer to be alone or with friends? Do you allow yourself enough time to destress after a trying day?” a general practitioner queried.
“But the idea of cutting $716 billion from Medicare to be able to balance the additional cost of Obamacare is, in my opinion, a mistake.” — Romney
Mitt Romney and Paul Ryan have both used the figure $716 billion in their debates. That’s the amount that the Congressional Budget Office (CBO) estimates will be cut from Medicare to pay for some of the costs associated with the ACA. In fact, Romney and Ryan brought up that number a combined 13 times during the first 3 debates this month. The CBO, in a report prepared for House Speaker John Boehner, concluded that repealing the ACA would increase spending for Medicare from 2013 to 2022 by $716 billion, reducing the amount cut or saved.
What Romney and Ryan have not made clear is that the cuts to Medicare will come from reducing payments to insurance companies operating Medicare Advantage plans, hospitals, and other providers (except for physicians), and not from reducing benefits for seniors. For example, reimbursements to hospitals will be cut by $260 billion. However, there is uncertainty as to whether these cuts hurt access to care. In other words, will hospitals and other providers stop accepting new Medicare payments once reimbursements are cut? The Obama administration says that increased enrollment in Medicare, Medicaid, and private health insurance, spurred on by the ACA, is expected to bring in revenue and balance out the cuts.
Ryan’s healthcare plan similarly includes $700 billion in savings from Medicare, but that was not mentioned by the candidate.
Short answer: Romney’s statement is true but vague, and possibly was meant to worry seniors into thinking that their Medicare services will be cut, although these cost-savings in the program may not affect them.
A 76-year-old man presents to the emergency department with sudden-onset abdominal pain of 4 hours duration. The pain is present in the upper abdomen, centered in the epigastrium, and described as deep and burning. The patient has a medical history of coronary artery disease and hypertension. He also reports having “indigestion,” which has caused pain similar to today’s episode in his upper abdomen. In the past, food did not relieve this symptom.
On physical examination, the patient is pale and in obvious discomfort. His heart rate is 122 beats/min and his blood pressure is 110/65 mm Hg. The cardiovascular and respiratory findings are unremarkable, but he has tenderness in the epigastric region of his abdomen. His stool is brown and guaiac positive. Hyperactive bowel sounds are heard on auscultation. Laboratory investigations show a mild anemia, with a hemoglobin concentration of 127 g/L (12.7 g/dL) and BUN and creatinine values of 17.1 mmol/L (48 mg/dL) and 106 µmol/L (1.2 mg/dL), respectively.
What is the diagnosis? How would you approach this patient’s treatment?
Our thanks are extended to Gautam Dehadrai, MD, for providing the details of this case. Check back here in about two weeks when I post the diagnosis and follow-up for this patient.
New research today from the Department of Oh My God Why Does This Study Have To Exist — turns out, vaccinating teenage girls against HPV won’t cause them to go from innocent children drawing pictures of flowers with crayons to unstoppable sexzillas. Sort of like how wearing seatbelts doesn’t cause car accidents, or how wearing sunscreen doesn’t cause skin cancer. But will the study convince reticent parents to abandon their ass-backwards logic and actually acknowledge that their daughters’ sexuality will someday exist?
The study, published today in the journal Pediatrics, showed that there was no evidence that girls who are given the Gardasil vaccine against HPV respond by going out and hopping on the nearest guy. Instead, girls who receive the vaccine have similar sexual trajectories to their unvaccinated peers — except the girls who are vaccinated get the bonus of being protected from a deadly and preventable form of cancer when they do have sex.
Redditor johnboy9210 retrieved a football from a stagnant koi pond one day and contracted necrotizing fasciitis, the infamous flesh-eating disease. Fortunately, we don’t have to experience the tissue-chomping bacteria first-hand, and can instead witness his photographic account from the early signs of infection through his multiple surgeries.
Just 36 hours after the bacteria first entered his body, johnboy9210 took a photo of his swollen, throbbing pinky finger. When his pinky started turning black, he rushed to the ER. At first, the doctors planned to culture the bacteria from his finger, but it soon became clear that he needed immediate surgery to remove the infected tissue. It wasn’t until after his first surgery that he received his diagnosis, and learned exactly which bug it was: Streptococcus pyogenes. And that proved just the beginning of his medical adventure.
The question of how much money physicians should make has long been a provocative topic. Even about 250 years ago, pioneering economist Adam Smith summarized the prevailing tone when he wrote, “We trust our health to the physician… Such confidence could not safely be reposed in people of a very mean or low condition. Their reward must be such, therefore, as may give them that rank in the society which so important a trust requires.” (An Inquiry Into the Nature and Causes of the Wealth of Nations; 1776)
With today’s focus on the need to control US healthcare costs and boost the number of primary care physicians, physician payment again is in the limelight.
Physicians are clearly fighting to maintain the incomes they — often justifiably — feel they deserve and for which they have paid their dues. But it’s obvious that just about no one else in society is weeping over any potential decline in physician salaries.
Few experts think that US physicians overall are paid too little, especially compared with most American workers. Some say that US physician fees, income, and services overall are excessive, contributing to US medical spending that’s by far the highest per capita in the world. Others argue that certain types of specialists, such as radiologists and orthopedic surgeons, are paid too much, while others, such as family practice physicians, pediatricians, and geriatricians, are paid too little.
A growing number of experts argue that the prices that physicians and other providers charge need to be curbed, along with wasteful and inappropriate care. That could lead to reduced physician incomes — though no one wants to see the draconian Medicare sustainable growth rate cuts take effect.
However, many consider high physician incomes to be perfectly justified.
Another view is that the US free market more or less accurately determines how much money it takes to attract and keep talented people in medicine. In a country where the top 1% have an average pretax income of $380,000, not counting capital gains, while the median household income is about $50,000, these observers say that it takes the promise of high and secure earnings to convince the brightest young people to choose a career in medicine rather than the potentially more lucrative fields of finance, management, law, and lobbying.
In my Emergency Department we see our fair share of strange and obscure things, but nothing quite like this..
A man sought emergency treatment at hospital in Auckland this week with an eel stuck up his bottom.
The unnamed individual presented himself at the A&E department at Auckland City Hospital to explain his embarrassing problem. It is believed the patient was sent for X-rays and a scan, which showed there was an eel lodged inside him.
“The eel was about the size of a decent sprig of asparagus and the incident is the talk of the place,” a hospital source said. “Doctors and nurses have come across people with strange objects that have got stuck where they shouldn’t be before, but an eel has to be a first.”
Read more at: NZ Herald
