tag:blogger.com,1999:blog-8206677169397293052.post1422184557538277554..comments2023-09-10T08:35:25.739-07:00Comments on Street Rat Crazy Saloon: How many times do we have to go throught this!!!!!Dinkhttp://www.blogger.com/profile/10907199567928816652noreply@blogger.comBlogger9125tag:blogger.com,1999:blog-8206677169397293052.post-76032054746692836352010-05-19T07:50:25.079-07:002010-05-19T07:50:25.079-07:00When they were in it was all about having Drs sign...When they were in it was all about having Drs sign an order within 48hrs. Everyone had to do this or there would be big fines. If it is a seclusion order it is 24 hrs or we will pay. How does that improve the well being of the pt? Maybe it improves the well being of the chart and the well being of JCAHO. <br /><br />You are right. If they stop finding things they will be out a job.Dr Johnhttps://www.blogger.com/profile/07453949255704523726noreply@blogger.comtag:blogger.com,1999:blog-8206677169397293052.post-32398932607610167782010-05-19T07:14:59.331-07:002010-05-19T07:14:59.331-07:00I think they think "80% improvement from curr...I think they think "80% improvement from current standard, that's a lot"<br /><br />I think they genuinely want people better.<br /><br />I think they do not want to be sued.<br /><br />I think they don't think about spending someone else's money.<br /><br />I think they think they serve the patient in front of them and no one else.<br /><br />I think they don't realize that OTHER PEOPLE'S resources are finite<br /><br />I think they think they'll loose their job if they don't think this way.<br /><br />I think it is in JCAHO's interest that others continue to think this way.<br /><br />... I once watched JCAHO fine a hospital for not having EXIT signs on its roof.<br /><br />JCAHO is like any well paid physician in a fee for service model: they always fine something. They are not dummies. ;-)Thaihttps://www.blogger.com/profile/00700253024420397221noreply@blogger.comtag:blogger.com,1999:blog-8206677169397293052.post-78638953189336414112010-05-19T06:46:23.632-07:002010-05-19T06:46:23.632-07:00I have vowed I would die at home with a jug of mor...I have vowed I would die at home with a jug of morphine and a straw. Maybe I will get cold feet. I hope my wife does not as I have made my wishes clear to her since internship. <br /><br />Do the Drs you work with really believe in putting forth those kinds of resources in such a case or are we all just on a train going to fast to get off?<br /><br />We just had JACHO through. The recommendations they made have nothing to do with improving pt care just ensuring they will be back for another visit.Dr Johnhttps://www.blogger.com/profile/07453949255704523726noreply@blogger.comtag:blogger.com,1999:blog-8206677169397293052.post-44041366422420447002010-05-19T06:03:50.191-07:002010-05-19T06:03:50.191-07:00And no I haven't but I do agree.
Of course, i...And no I haven't but I do agree.<br /><br />Of course, if we can't say we see an 80% improvement in mortality by treating septic shock in a 90 year old with dementia and metastatic cancer in the ICU vs. the floor so we can use all these central lines, telemetry monitors, consultants, etc... all at a cost of $300,000, then we have a problem.<br /><br />80% improvement sounds so good.<br /><br />Of course this just might mean the absolute benefit went from 0.1% probability of survival to 0.18%.<br /><br />And I'm making these numbers up by the way to simply make my point.<br /><br />But someone does needs to pay for the physician's/nurse's/administrator's/JCAHO's/Regulator's new cars.<br /><br />Point stuff like this out very often however and you're likely to discover you need a new job.<br /><br />Besides, its not like the 90 year old needed the money. And if (s)he decides the spending is low value and wants to give it to his/her kids/grand-kids so the kids get a better chance in life, someone else would just tax the money anyway thereby preventing him/her from giving it to their heirs anyway. The old man likes his neighbors but not that much. So what difference does it make to the patient/family?<br /><br />Do everything!<br /><br />... What a mess we've made.<br /><br /><br />I wonder if instead you pointed out to people that you could live a little less time on this planet (say 3-5 months) but have an extra week of vacations every single year of your life whether they would really do what they do.<br /><br />Of course the 3-5 months you lost are not exactly the highest quality time you will ever spend on this planet.<br /><br />The vacations on the other hand might just be.<br /><br />Even when it comes to death, we have become so "specialized" we simply fail to look up and see the big picture.Thaihttps://www.blogger.com/profile/00700253024420397221noreply@blogger.comtag:blogger.com,1999:blog-8206677169397293052.post-67089353674985402702010-05-19T05:42:55.689-07:002010-05-19T05:42:55.689-07:00If they didn't then they would not be getting ...If they didn't then they would not be getting 5s on those patient satisfaction surveys by Press Ganey and we all know it is all about customer experience. ;-)Thaihttps://www.blogger.com/profile/00700253024420397221noreply@blogger.comtag:blogger.com,1999:blog-8206677169397293052.post-26219776489596979022010-05-19T04:02:39.060-07:002010-05-19T04:02:39.060-07:00By the way Thai, I know this is supposed to be fir...By the way Thai, I know this is supposed to be first year medical school but I don't think most doctors really know how to or care to tease apart a research study. If they did they would not be giving most of the meds they are handing out.Dr Johnhttps://www.blogger.com/profile/07453949255704523726noreply@blogger.comtag:blogger.com,1999:blog-8206677169397293052.post-41140424589708611812010-05-19T03:59:35.319-07:002010-05-19T03:59:35.319-07:00Funny post Thai. I worked with a psychiatrist who ...Funny post Thai. I worked with a psychiatrist who was obsessed by the idea that Aspartame was poison. He actually managed to get some study published that followed 6 pts who used it one who had a retinal bleed that he reported may have been related to their use of the sugar substitute. The fact that millions of people were using it millions of times a day without obvious effect was of no importance to him.<br /><br />His paper was actually sighted in an issue of Skeptic on what constitutes bad medical research. <br /><br />Have you read <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1182327/" rel="nofollow">this</a>?Dr Johnhttps://www.blogger.com/profile/07453949255704523726noreply@blogger.comtag:blogger.com,1999:blog-8206677169397293052.post-354552466669989072010-05-18T23:29:56.999-07:002010-05-18T23:29:56.999-07:00This Gibson book (with the bad ending) had a few i...This Gibson book (with the bad ending) had a few interesting things to say about "viral" spread of information. Its breathtakingly fast, but it can extinguish pretty fast as well. The information may remain as a hazy memory, but its no longer "active".<br /><br />I guess what I'm trying to say is that the rumor spread fast, the fact that it was disproved spread fast, and this study is just trying to get some attention based on the hazy memory. It will fail to get attention long.<br /><br />About your Iron Man 2 experiences:<br /><br />They best not screw up the Tron sequel! Ah, what am I talking about. Lots of great movies had terrible sequels that have been lost in time without harming the original (Blues Brothers, Caddyshack, Matrix, Jurassic Park). I take Tron personally, though. I'll go lie on the floor and breath into a paper bag now.Dinknoreply@blogger.comtag:blogger.com,1999:blog-8206677169397293052.post-43027238181289191672010-05-18T21:12:59.767-07:002010-05-18T21:12:59.767-07:00For commentsFor commentsThaihttps://www.blogger.com/profile/00700253024420397221noreply@blogger.com