Tag Archives: medical

Two Words Can Change the World

26 Apr

Last week, I went in for my drug test, because it’s one more step closer to my new job. Because I’m particularly boring in real life, I wasn’t worried about passing it, just finding the stupid place. This could have been solved with writing two words.

Since I used to be a consultant, I used to have to go through this process every six months when I got a new contract. Normally what happens is that you go to a testing clinic, where very bored, very poorly paid technicians make you sit for 15 minutes (or more, if you picked a bad time to arrive) then take you back to a bathroom, where you pee in a cup and hand it back. Despite the name “lab” on the door, there is no actual lab there, they have to mail it off to… wherever people have autoclaves and the proper chemicals.

So when I got the request for “additional background information,” I wasn’t terribly worried, just confused. First off, my new employer doesn’t bother to say “drug test.” Every employee in America in the last 30 years understands the term “drug test.” I just went through a background check; every employee understands that, too. When I first see “additional background information,” I’m thinking, “What’s wrong? I’ve gone through fifteen background checks in the last ten years. What could they have possibly found?!”

But no… it’s just a drug test by another name. So they give me a two hour window to show up at this medical facility, which I thought, “That’s odd,” but okay. I drive out to this industrial area (again, weird place for an outpatient facility), park, and look for Suite 110. There is only one suite listed above the multiple doors and it’s Suite 100. So after trying a couple doors (locked), I finally ask a secretary, and she says, “Yeah, you want the urgent care.”

Those were the magic words: “urgent care.” When I go to a building, my first thought is NOT to go into the very busy urgent care (busy? in an industrial park?), wait in line for five minutes, to be told where to go for the drug test. Instead, I wasted ten minutes checking doors and making sure I was in the right building. I know this is not the first time these secretaries have had to answer these questions (from their response), so the second easiest thing you could do is put up a sign that says “Drug tests go through Urgent Care.” Six words. Solves a LOT of problems.

So I go through the urgent care, fill out a lot of paperwork (which probably would be a lot less if it were a normal lab and not a @#$&*$ urgent care!), and wait…. and wait. There are more people in the lobby than chairs. I’m certain half the folks are there for drug tests as well, but having worked in urgent cares, I know that test only folks are the lowest priority. They’re more concerned with folks with a broken leg, burns, etc. That’s when I realize that this is a first stop for injuries on the job and screening workers’ compensation. So I wait a #*$&@$ hour for me to go through the process to pee in a cup and get the freak out of there.

It’s a simple thing to ask — just add two words to the sheet! This has to annoy the heck out of the other secretaries, you’d think they’d want a solution. But a sign never occurred to them? It’s the little things that can change the world. What do you think? Am I overreacting? Let me know in the comments below! Then you can read some more words of mine and check out one of my books. However, if $1.99 is too expensive for some words, go ahead and download one of my stories for free.

Avoiding the Doctor’s Office

26 Dec

I don’t have a fear of the doctor–after all, I worked in hospitals for 11 years–but I have no great desire to go see one, even when I’m sick. Is it being cheap, annoyed at taking the time, just stubborn, or do I understand the limitations of what the doctor can do for me?

The answer is all four–sorry to give it away right at the beginning–but there’s no one reason. I certainly have a great respect for what modern medicine can do for me, but having worked primarily in emergency departments, I also know what is routine and doctor’s really can’t do anything about. These are known as Triage/Acutity 5 patients, and they take up so much time, that bigger ED’s actually have separate sections (“fast track” areas) to quickly deal with those patients, so they can leave space for the real cases.

Let me address my issues one at a time–yes, I’m cheap. Even if I had better insurance, it would still cost a significant amount of money to go into the doctor’s office. Thankfully, there are plenty of urgent cares, which do deal with the low acuity patients that ED’s would rather not see, but won’t wait to see a family practitioner. So even if I wait to see the local doc, I still have to pay $35 up front on top of whatever else he wants me to buy. I’ve actually gone to alternative medicine clinics more often because it’s far cheaper.

I also get annoyed at the waste of time. Average visit to the urgent care/ED still run between 2-4 hours, depending on the capacity. I understand why that is the case–the patient can’t, because they don’t see the other patients, or the amount of paperwork that has to be done for every intake, but it doesn’t make it any easier. Especially when you’ve been waiting an hour and the doctor comes in for two minutes, takes a look, and then says, “Oh, yeah, you’ve got X. I’ll write a prescription.” Unless you’re looking for a antibiotic, it’s usually not worth the wait.

There’s also a limit to what doctors can do. A majority of doctors tend to die at home, because if you know what’s killing you, you also know what can be done to stop it. And if there’s nothing–or the price is too high–why bother going somewhere else to die? I’m not saying you shouldn’t go in for testing or a physical every so often, but there’s no point going in for a sniffles.

So there’s the stubborn issue–my mother actually died from it. She was deathly afraid of doctors, and even though the ovarian cyst she had was perfectly and routinely treatable (and probably hurt like hell before hand), she didn’t want to go in. So when it burst–poof, she died of blood loss. (This was thirty years ago, so don’t feel too bad for me; man proposes and God disposes.) However, I have that stubborn streak, and if my kids cut their hand, my first thought is not, “My God, get them to the hospital!” It’s usually, “Okay, let’s get a bandage.” I’m worse with myself; I’m more willing to go for my family members.

What do you think? Do you have trouble going into the doctor’s office? Do you have the opposite problem? What’s your line for wanting to be seen by a medical professional? Tell me in the comments below!

Just a Spoon Full of Sugar

22 Oct

Modern medicine provides miracles, but the sad truth is that medicine only provides miracles because there’s money behind it. So should we expect miracles in our health care? How much are we willing to pay for it?

There’s an easy answer that most people (usually my wife) give: “then we need public health care funded by our taxes! Make it free for all!” First of all, it’s not free – at present, Medicare/Medicaid/CHIP (America’s version of free health care) already covers 25% of Americans and takes up a huge amount of the existing budgets at the federal and state level. Here in Arizona it was 30% of the state budget five years ago; at the federal level, it costs $555 billion/year in matching funds to states. All of that amount goes UP when you add the other 75%. And Americans complain about taxes now.

Second, money drives people. Any family practice doctor will tell you that Medicare pays terribly compared to regular insurance; in fact, many family practice stop seeing Medicare patients for precisely that reason. (Well, most family practice is pointless in my opinion anyway.) “Well, if it’s all public health care, they won’t have a choice. They’ll have to see patients.” Really? To be a surgeon requires 20 years of schooling, 3 years of residency, and 2 (or more) years of fellowship before you’re considered qualified. Sure, they love cutting into people, but the reason they put up with the extra crap involved is because they get paid two to three times the amount of an emergency room doctor.

Now take money out of the equation – doctors get paid like teachers – based on length of education and time in grade. You might say that’s a false argument – specialists would still get paid more for their work… but if you look at Medicare rates, it would still be a lot less. If you’re a new doctor, you might say, “hell with surgery, I’ll be a urologist.” Why? There’s almost never an emergency in urology, so you’re never called in, and you don’t have to work weekends. (That was what my neighbor, the urologist, told me when I asked why he picked his specialty.)

Don’t believe me? Here’s my story – I was trained as a history teacher; I really like teaching history. I worked as an instructional designer (corporate teacher) in hospitals because it pays twice as much. It’s not because I had a great love of medical software – I needed a job and it paid great. After five years, I became a travelling consultant and travelled the country, working in hospitals because (wait for it), it paid twice as much as being an instructional designer. It wasn’t because I had a great love of flying to Allentown, Pennsylvania; I do like flying, but I went to these not-tourist destinations (or tourist destinations in the off-season) because that’s where the job was. If I got the same pay for medical software versus history, hell, I’ll teach history. I get to come home every night and I don’t have to deal with doctors. So you’ll have to wait on that medical software training.

And we can see that in Canada, in the UK, in any place with public health care… you have to wait. Six months for a routine appointment, years before surgeries, and many patients die because there’s no bumping the queue just because you need it more urgently. If you’ve got the money, you fly to somewhere else to get the surgery done faster. There’s a whole industry in Thailand dedicated to cheap surgery for western patients; their hospitals look like frickin’ palaces.

My wife likes to say, “People are willing to pay higher taxes if they see the benefit they get from it.” I agree – in Finland, you’re willing to pay 80% taxes if you get free and quality health care, education, infrastructure… sure, it’s great! My experience with any level of government in the United States tells me you might get free, but you will not get quality. And Americans won’t accept raising their taxes sky-high for not much benefit.

But I could be wrong – what did I miss? What oversimplification did I make? Let me know in the comments below!

Should We Expect Miracles?

21 Oct

It’s a clever slogan – “expect miracles” – but by its very definition, you can’t expect a miracle. And yet, we hear about miracles everyday and wonder, “Why shouldn’t I expect one? It happened to him, why not me?” The reason? Miracles aren’t cheap.

The slogan was about a medical charity for children – what’s more noble than that? We can and do deliver miracles daily in modern medicine. A disease that would have killed someone five years ago is treatable today. Surgeries that would have required two weeks of inpatient recovery are now outpatient procedures.

But here’s the sad truth – medical miracles are expensive. I was talking with Tom, a former potentate of the Shriners, which operate a chain of children’s hospitals that specialize in many diseases and offer their services free to kids who are suffering from them. He told me that their daily money requirement to keep their services operational is $2.3 million US. Daily. Here in Arizona, they don’t have a Shriners hospital, so they spend $22,000 (weekly?) just transporting the 800 kids here to their locations in Los Angeles, Galveston, and Salt Lake City.

At the same time, their own membership is decreasing. Here in Phoenix, they went from 6000 members thirty years ago to a present number of 1100. They’re trying to downsize from their large halls to more reasonable facilities; and due to escalating rents, those are often not there. Since they don’t need inpatient facilities anymore they’re trying to get rid of their specialty hospitals in favor of specialty clinics which already work with children’s hospitals to give kids the free help they need.

Miracles costs money. Since this post is running too long, let me answer the obvious answer to this question tomorrow. Otherwise, what do you think? Should we expect medical miracles? What are we willing to pay for them? Put your answers in the comments below!

I Got a Bubble in my Ear

1 Oct

All this has happened before – and it will all happen again. For the second time in my life, I got a bubble in my earlobe. Really annoying. I know it will go away, but just like an itch, you can’t help but play with it. How the #*$& did it get there?!

After yesterday’s line crossing into controversial, I figured I’d stay on this side of the love today. Also, NOTE: Apologies if I gross you out on this post – I’m trying to use benign terms, but since I’ve worked in multiple Emergency Departments… well, let’s just say Your Mileage May Vary.

The medical term is called an “earlobe cyst,” and although that sounds serious, it’s really not. Apparently the cause is just a malfunctioning system in the skin. Dead skin cells that are supposed to shed for some reason don’t, and just like any foreign body, your skin develops a shell to isolate the skin cells and forms the “bubble.” Then the dead skin cells breakdown and form keratin (yes, the stuff that’s good for your nails), but it’s really pus, and when it releases, it’s rather stinky but not harmful. Eventually it will either be absorbed or released (“popped”), but unless it’s huge (and it’s not), it’s not a noticeable or even slight problem.

But darn, is it weird! On the positive side, it gives my fingers something to fiddle with that won’t cause any harm. Thankfully, I’ve grown out of my excessive teenage skin oil phase, so I don’t have pimples to pop (or at least, not very often, and usually on my nose). Plus, I got rid of that ingrown hair on my chin, so I can’t fiddle with that. So in some ways, it’s a blessing, because I have something to touch that it’s bad for me.

The negative side is I’ve basically got a pimple on my earlobe that I can’t get rid of. If I wanted to get rid of it, I suppose I could heat a pin and jab it, but as much as I consider myself pretty tough when it comes to pain, I don’t seek it out either. So I just have to wait it out.

For a blog post, this is not the most exciting thing I could be typing about, but it does give you an insight into my random thoughts. However, I know I’m not alone. How many people out there have had that very same problem? Have you had a similar but equally annoying problem? Let me know in the comments below! Don’t worry about grossing me out – like I said, I’ve worked in multiple ED’s (as tech support, not as a medical professional), so I can handle it!

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