Rounds Online

I have a good friend who is truly a McDonald’s eating, Marlboro smoking couch potato with high blood pressure, high cholesterol, enough vitamin deficiencies to spell most words in the dictionary and very few teeth that have not been through some form of reconstruction.  He is a great guy that has a thinly veiled death wish. But it has not always been so.  For a brief period early last year he was a paragon of virtue

He assured me that he was brushing his teeth three times a day (and flossing).  He joined a local gym, stopped super-sizing his lunches when we went out, and actually sported a Nicotine patch on his arm.  What brought on the epiphany?  He became a statistic.  He got down sized.  Actually he got out sized.  His company eliminated his position and over night he became one of the 46 million Americans without health insurance.  He no longer had access to affordable pills and treatments designed primarily to offset his irresponsibility.

So he did what any desperate soul would do.  He began addressing his mortality.  And to my surprise I began to notice changes.  When we encountered the occasional flight of stairs, he no longer experienced oxygen deprivation at the first landing.  He seemed to carry a smaller chip on his shoulder in the hours before noon.  I think his eye sight might actually have improved.  Even his girl friend’s kisses (at least in my presence) seemed to last longer (let’s hear it for dental hygiene).

And all because he could no longer count on an affordable if not free trip to the doctor’s office.  Of course being the talented guy that he is, his term on the unemployment roles was relatively brief and he once again became the proud recipient of employer paid health insurance. The resulting slide was both predictable and precipitous. 

As we recently sat watching the NCAA championship game on his wide screen TV, sipping aluminum containers of alcoholic malt beverages, munching on salty snacks and awaiting the arrival of the pizza delivery guy, I found myself wondering if universal health care is going to usher in a new era of fit, healthy Americans.  Pass the Picante Sauce.

“Yes, we have the freedom to do what we please, but it only works because we don’t do everything we might please - we should exercise some degree of personal responsibility.” Tammy Bruce

One of the things that makes the job of Snake Charmer less attractive is the fact that the snakes you are charming have poison tipped fangs.  If you could find me a couple of nasty looking snakes that didn’t bite and weren’t poisonous and paid me a decent salary (with benefits of course) I might give it a try.  A compelling argument could be made that the job of ER physician has many of the drawbacks of Snake Charmer. 

Many primary care physicians who are otherwise qualified will not accept shifts in the ER.  Fewer medical students are selecting Emergency Medicine as a career track.  The reason most often cited…the fear of litigation…and by a wide margin. 

Making life and death decision in a pressure cooker environment can sometimes lead to poor outcomes.  I can’t think of another profession where the standard of performance upon which professionals are judged is perfection!  The doctors I talk to tell me that they refuse to put their lives, their careers and their financial future at risk by being second guessed by attorneys who, with the luxury of hind site, and with all the time in the world to review, evaluate and speculate, judge decisions made by those on the front line of medicine.

And that is a shame because one of the most challenging, exciting, rewarding and fulfilling medical positions out there is that of Emergency Room physician.  Each day ER doctors are faced with true life and death decisions.  They have access to the best technology that medicine has to offer.  They are performers on the most demanding stage imaginable. 

A good place to start healthcare reform might involve pulling some of the fangs from the legal profession…a charming if somewhat unrealistic expectation. 

A recent gallup poll showed that 73% of  Americans would trust physicians to recomend the right thing for reforming the U.S. Healthcare System.  On the other hand, 66% wouldn’t trust the Republicans and 58% wouldn’t trust the Democrats.  Even the president only registered 58%  on the Trust O Meter.

On Healthcare, Americans Trust Physicians Over Politicians

by Lydia Saad               

PRINCETON, NJ — Nearly three-quarters of Americans (73%) say they are confident in doctors to recommend the right thing for reforming the U.S. healthcare system. That is significantly higher than the public confidence extended to President Barack Obama, as well as to six other entities that will be weighing in during the emerging healthcare reform debate. Full Story Here

NO SHORTAGE OF PATIENTS IN THIS CLINIC

Staring at my double bypass burger, I felt a bit like a coward as I glanced over to my left and saw an older man downing 4 ½ lb patties, 4 pieces of cheese, and a bun glazed in lard. I then glanced across the room and saw a 9 year old begin to work on a triple. But I had a 3 hour plane ride home that day and couldn’t risk the battle that would ensue inside me had I attempted either of those behemoths. I’ll admit though, I wish I had taken on the challenge; a burger at HAG is absolutely amazing.

Heart Attack Grill® (visit) is a restaurant out of Chandler, Arizona that makes no apologies for who and what they are. There are only 4 items on the menu: the single, double, triple, and quadruple bypass burgers. They offer an endless supply of fries, deep fried in lard (which are quite delicious). To top that all off, if you weight over 350lbs, you eat free, something I witnessed during my visit. (continue reading…)

Texas governor Rick Perry signed a bill today providing medical education debt relief for doctors who are willing to move to medically underserved rural counties in the state.  The question of course is can other states facing serious fiscal problems follow the Texas lead.

Rural areas to benefit from bill Perry signed help lure doctors

By Enrique Rangel | AVALANCHE-JOURNAL

AUSTIN, TX - Dozens of rural counties in West Texas suffering a doctor shortage - especially 27 that do not even have one physician - got some welcome news Wednesday.  As expected, Gov. Rick Perry governor signed into law House Bill 2154, which will help 114 medically underserved counties in the state lure as many as 900 new doctors, mainly recent medical school graduates.  Full Story Here

With an average of 25,000 cases of E-coli annually, most emergency medicine physicians find themselves treating patients throughout the year in isolated incidents. It’s only so often that something happens that jeopardizes the entire nation. Get ready doc, that time has come.

SOLON, Ohio, June 19 (UPI) — A food poisoning scare has prompted Nestle to recall all varieties of its Toll House refrigerated cookie dough, the company’s USA Baking Divison said Friday.

The voluntary recall was prompted by recent reports of people falling ill after eating raw Toll House cookie dough, the company said in a release from its Solon, Ohio, offices.  Full Story