Civil servants

An NPI, for those of you unfamiliar with medical billing, is a government-issued magic number that registers doctors and practices with health insurers.

Occasionally my billing agency has to make a change in payment settings, which requires me to call Medicare to authorize it because only the actual NPI holder can do that. Fortunately, it's only every few years I have to deal with such because it usually involves long hold times. In fact, I plan it for when I have a lot of reading or writing to do, so I can work while listening to endless repeats of "your call is very important to us, please continue to hold" mixed with generic synth-pop music.

Last week was one of those times, so after being on hold for a while...

Music: "bee-bop-shooby-do" CLICK

Fred: "Thank you for calling Medicare. This is Fred. How can I help you?"

Dr. Grumpy: "Hi, this is Ibee Grumpy, I'm calling to verify my NPI for case number 8675309."

Fred: "What is your NPI number, please?"

Dr. Grumpy: "6EQUJ5."

Fred: "Thank you, one moment please... That number isn't in our system, can you repeat it?"

Dr. Grumpy: "6EQUJ5."

Fred: "Thank you... I'm still not able to find it. What state are you calling from?"

Dr. Grumpy: "I'm in Ohio."

Fred: "I'm sorry, you've called the wrong number. Ohio is in the Midwest region, and you've called the number for the Southeast region."

Dr. Grumpy: "Oh, are you able to transfer me?"

Fred: "No. You'll need to call 1-800-MID-WEST for Ohio practices."

Dr. Grumpy (sighs): "Okay, thank you."

Fred: "Thank you  for calling Medicare, have a nice day."


I get another Diet Coke to brace myself for more hold time, which this time was a surprisingly short 15 minutes.

Music: "bee-bop-shooby-do" CLICK

Fred: "Thank you for calling Medicare. This is Fred. How can I help you?"

Dr. Grumpy: "Hi, this is Ibee Grumpy, I'm calling to verify my NPI for case number 8675309."

Fred: "What is your NPI number, please?"

Dr. Grumpy: "Um, didn't I just talk to you about 15 minutes ago?"

Fred: "Yes. I'm answering phones for both Midwest and Southeast regions today."

Dr. Grumpy: "Then why didn't you check my number in the Midwest system when I called earlier?"

Fred: "Because you called in on the wrong line."

Thank you, I'll be here all week

Dr. Grumpy: "Have you had any problems walking?"

Mrs. Brady: "Well, a few months ago I felt like my feet were sticking to the floor, but that's better now."

Dr.  Grumpy: "Did it get better after you started Sinemet?"

Mrs. Brady: "No, it got better after I cleaned the floor."

Seen in a chart

 

Stupid mistakes are nothing new. But they've really increased in the world of EHR. It's funny... But at the same time it's not.

Random pictures

Okay, time to hit the mailbag for stuff you guys have sent in.

 

First, from the "Those are definitely changing looks, Billie" department we have this headline-photo mismatch:

 

Next, in the "this way, suckers" category we have a pool product that claims to - I swear - make water moister.

 

For novel methods of self-defense we have this brass knuckles - iPhone case combo.

 

 

From the "No wonder the bison was mad" file:

 

Here's the mysterious, yet oddly prevalent, use of quotation marks to make you wonder what's REALLY going to be served.

 

Of course, sometimes even without the quotation marks you know there's something wrong.

At other times you Just. Don't. Want. To. Know.

 

 

Sixteen Tons

Hi, this is Craig.

So, while Frank has been bagging groceries for the summer, I've been working for Tiffin Deliveries, picking up food from various restaurants and dropping it off at a variety of houses, businesses, apartments, and the occasional parked car (really!).

Basically, I'm the messenger. So I get blamed when things go wrong. Restaurant burned your food? Hey, I didn't cook it. You didn't get enough ketchup? Again, that's not me. During this viral summer restaurants are stapling delivery bags closed and leaving them on a table outside, so I can't eat your stuff, sneeze in it, or toss in the extra 3 packets of pickle relish you wanted - especially since many of you seem to think of the extra mustard needed AFTER I've left the restaurant.

To get this job I had to go through an extensive background check, which consisted of me emailing my name to a guy on the other side of the planet. He responded within 30 seconds that I'd been cleared, so I'm pretty sure all he did was type "Craig Grumpy mass murderer" into Google to see if it returned any hits.

Of course, this job has its highlights, which explains why Dad told me I should put it on his blog.

The best part of the company's app is for special instructions, where people get to type in pretty much whatever. This has included requests for me to pick up laundry while I'm getting your lunch, asking if I happen to know a good roofing service, and if Local Grocery has hand sanitizer in stock (I texted Frank for that one).

I think my favorite set of instructions so far was this:

Orders like that make me wonder if I'm on Candid Camera. Then I have to go to the place's counter and put in the order, knowing how ridiculous I'll look, since this specific dive won't accept them from the app. I felt like Jack Nicholson ordering toast.



Another great order was this one:

Fortunately, that order was pretty easy to fill, though I have to wonder where this lady previously got her tacos from.


I also got an order from a guy who lives across the street (literally) from a McDonald's to get him a Big Mac and fries (simple, huh?). BUT he wanted it from a specific McDonald's that was a 20 minute drive from his apartment.


Lastly, I got an order to run to Blazing Ketchup. They got the order right, and I made it to this guy's office within 10 minutes of picking it up. So I'd like to thank him for recognizing my effort:

Diary of an ER doctor

I have no idea who wrote this. I wish I could take credit for it, but I can't. But, since it's awesome, I'm sharing it. Thank you, Webhill, for sending it to me.


So guys, this is what my typical day at the hospital looks like now:

6am - Wake up. Roll off of my pile of money that Big Pharma gave me. Softly weep as it doesn’t put a dent in my medical school loans.

6:30am - Make breakfast, using only foods from the diet that gives me everlasting life by avoiding all fats, sugars, carbs, and proteins. For details buy my book and check out my shop.

7am - Get to work, load up my syringes with coronavirus before rounds.

8am - See my patients for the day. Administer the medications that the government tells me to. Covertly rub essential oils on the ones I want to get better. Flush down the toilet all the hydroxychloroquine tablets patients were to receive for the day. 

9:30am - Call Bill Gates to check how 5G tower construction is going, hoping for more coronavirus soon. He tells me they’re delayed due to repairs on the towers used to spread the Black Plague. Curse the fact that this is the most efficient way to spread infectious diseases.

10am - One patient tells me he knows “the truth” about coronavirus. I give him a Tdap booster. He becomes autistic in front of my eyes. He’ll never conspire against me again.

11am - Tend to the secret hospital garden of St. John’s wort and ginkgo leaves that we save for rich patients and donors. 

12:30pm - Pick up my briefcase of money from payroll, my gift from Pfizer for the incomprehensible profits we make off of the free influenza vaccine given every year. 

1pm - Conference call with Dr. Fauci and the lab in Wuhan responsible for manufacturing viruses. Tell them my idea about how an apocalypse-style zombie virus would be a cool one to try for the next batch.

2pm - A patient starts asking me about getting rid of toxins. I ask her if she has a liver and kidneys. She tells me she knows “the truth” about Big Anatomy and that the only way to detoxify herself is to eat nothing but lemon wedges and mayonnaise for weeks. I give her a Tdap booster.

2:45pm - Help the FBI, CIA, and CDC silence the masses. Lament the fact that I can only infringe on one or two of their rights. Oh well, there’s always tomorrow.

4pm - One of my rich patients begins to crash. I laugh as I realize I’ve mismatched her spirit animal and zodiac moon sign. I switch out the Purple Amethyst above her bed for a Tiger’s Eye geode. She stabilizes. I throw some ginkgo leaves on her for good measure.

6pm - Go onto YouTube and see coronavirus conspiracy videos everywhere. Curse my all-powerful government for how inept they are at keeping people from spreading “the truth”

6:10pm - Go onto Amazon and see that a book about “the truth” is the #1 seller this week. Question the power of my all powerful government. Make a reminder to myself to get more Tdap boosters from the Surgeon General next time we talk. 

7pm - Time to go home. Before I leave, sacrifice a goat to Dr. Fauci and say three Hippocratic Oaths.

9pm - Take a contented sigh as I snuggle under the covers made of the tinfoil hats of my enemies, realizing that my 4 years of medical school and 3 years of residency training have been put to good use today.

Seen in a chart

"I feel SO relaxed right now."

Social distancing

Mary: "Dr. Grumpy's office, this is Mary."

Mr. Zoom: "Hi, this is Mr. Zoom. My wife is a patient of Dr. Grumpy's. She's having all kinds of new neurological issues and needs a video appointment ASAP."

Mary: "Let me see... Your wife hasn't been here in over 3 years... You said she's having new problems?"

Mr. Zoom: "Yes! They just started a few days ago and..."

Mary: "I'm sorry, but after 3 years, and especially with her having new symptoms, she'll need to be seen in person."

Mr. Zoom: "Uh, there's a pandemic going on! It's not safe for us to leave our house!"

Mary puts him on hold, checks with me, I absolutely agree with her.

Mary: "I just double-checked with Dr. Grumpy. Because she's having new issues this really isn't something he's comfortable handling over the phone or on camera. He needs to be able to examine her in person, check reflexes, and all that other stuff he does, to get an idea of what's going on and what should be done. He wears a mask, and takes lots of precautions to minimize..."

Mr. Zoom: "This is criminal. It's unethical. Dr. Grumpy is needlessly endangering our lives by making us come to see him. We're both in our 80's and are a high risk group. He should be able to do this sort of thing over the phone. Can't he just order a bunch of tests and see what he finds?"

Mary: "He doesn't work that way, sir. You can certainly try to find another doctor to see her, or go to ER, or..."

Mr. Zoom: "No other doctor will be able to get her in before the weekend. She needs to be seen and have all the tests done before then."

Mary: "Why is this so urgent?"

Mr. Zoom: "We're flying to Miami on Friday night for a big family reunion."

Bliss

Dr. Grumpy: "Your MRI was entirely normal, which is very reassuring, so the next step..."

Mrs. Scan: "Oh, thank heavens. I was so worried I had a brain tumor."

Mr. Scan: "That is reassuring."

Mrs. Scan: "Isn't that wonderful news, Phil?"

Mr. Scan: "Yes."

Mrs. Scan: "What? You don't think it's good news?"

Mr. Scan: "I said I did. I said it was reassuring."

Mrs. Scan: "You could try to look a little more enthusiastic. Or happy. Or something."

Mr. Scan: "I am, what should I be doing?"

Mrs. Scan: "Why can't you ever be happy for me?"

Mr. Scan: "Why does this have to be a production?"

Mrs. Scan: "Dr. Grumpy, don't you think he should look happier about the news?"

Mr. Scan: "Dr. Grumpy, do you..."

Dr. Grumpy: "I'm staying out of this."

That narrows it down

I'd like to thank my E-prescribing service for this helpful message to let me know which patient's script didn't go through.

Don't remind me

Dr. Grumpy: "What color is my hair?"

Mr. Curmudgeon: "There's not enough left to tell."

Seen in a chart

Weekend on call

Dr. Grumpy: "Hi, I'm Dr. Grumpy. What's going on that landed you here?"

Mr. Paganica: "Well, Doc, me and the boys were playing golf. On the 6th hole I noticed my left leg was weak, and by the 8th hole my left arm wasn't working, either. It got better for a bit, but came back on the 12th hole, and on the 14th hole my buddy said my speech was slurred, too. It hadn't gotten better by the end of the 18th hole, so we decided to skip the drinks and they brought me to the hospital to get it checked out."

Clinical conundrum

Dr. Grumpy: "Wow, you look great for 94! Well, what can I do for you?"

Mrs. Methuselah: "Thank you! My daughter asked me to come see you, she was concerned I had a neck injury.

Dr. Grumpy: "What's going on?"

Mrs. Methuselah: "Well, I moved into a new place over the winter. Now that it's summer the air conditioner turns on, and if it blows on the back of my neck it gets cold there and I get a chill down my spine."


Pause. I'm waiting, figuring there has to be more than that.


Dr. Grumpy: "Is there, uh, more than that?"

Mrs. Methuselah: "Nope. That's it. My daughter insisted I come in because she thinks I need an MRI of my neck. I think she's nuts."

Dr. Grumpy: "Does, uh, does anything make this better?"

Mrs. Methuselah: "Yeah, I don't sit near vents. If I have to, like in my reading chair, I wear a scarf.

Dr. Grumpy: "Does that work?"

Mrs. Methuselah: "It works fine. I told you. I think my daughter is nuts."

Dr. Grumpy (sets down pen): "I think you can tell your daughter that I said you're fine."