Thursday, January 31, 2019


Seen in a veterinary orthopedic course brochure:

Thank you, Webhill!

Monday, January 28, 2019


I recently was at a hospital staff meeting where one of the administrative clowns got up to speak. He was trying to show us how grateful the hospital is to have all of us, and mentioned that the food in the doctor's lounge costs the hospital $350,000 a year, so we should be thankful.

I know this sort of thing varies between hospitals, but here's what mine supplies to doctors for that $350K:

Morning: bagels and donuts. Boxes of cereal and instant oatmeal. Granola bars. Little milk cartons in the fridge.

Lunch: Tray of deli meats and cheeses in the fridge. Irritatingly small cans of soda. A tray of cookies.

Dinner: Not supplied. Whatever is left over from breakfast and lunch.

Always available: coffee, tea, sliced bread, English muffins, little packets of peanut butter, jelly, butter, and honey.

So, I guess that's what $350,000 a year gets you. I'm sure you also have to figure in there the salary of the person who restocks & cleans it each day, frequent repairs to the heavily-used coffee machine, and a few other items. Plus, they probably fudge in how much money they're losing by not giving us the finger and turning the lounge into another endoscopy suite.

That's not a huge sum of money in the modern healthcare world, but since hearing that figure, I keep wondering how it might be better spent. Maybe a few more nurses in the rotation. Or respiratory techs. Or physical therapists.

I'm sure some doctors would whine, but realistically I think most would be happy with coffee and a bagel in the morning, since that's when most round, and the hospitalists buy their own stuff for lunch anyway.

There are certainly bigger wastes of money in modern healthcare: CEO bonuses (at my hospital his was around $7 million last year) and paying Press-Gainey to do surveys, to name two of them. And the people involved in those things don't care about patients, anyway (regardless of what their PR staff tell you).

But I do care about patients, and would be more than happy to give up a deli tray, cookies, or even a bagel, to improve their care.

That's provided the money actually went to that use. Realistically, it would probably just go to some administrator's year-end bonus for the money he saved by cutting coffee and bagels out of the doctors lounge.

Thursday, January 24, 2019

Survey says

Dr. Grumpy: "So, I last saw you a week ago, when you were in the hospital for Transient Global Amnesia. How have you been doing?"

Mr. Percheron: "Fine, I guess, everything seems back to normal. I've returned to work."

Mrs. Percheron: "He's back to himself."

Dr. Grumpy: "Good."

Mr. Percheron: "I have a question, though."

Dr. Grumpy: "Go ahead."

Mr. Percheron: "What am I supposed to do with the survey the hospital sent me? It has all these questions about my stay, but I don't remember any of it."

Monday, January 21, 2019

Overheard on rounds

Nurse: "Have you had any previous heart issues?"

Patient: "I have a porcelain heart valve."

Nurse: "You mean porcine heart valve?"

Patient: "Whatever."

Saturday, January 19, 2019

And now, music

Thursday, January 17, 2019

Seen in a chart

This isn't the first time I've put up stuff like this, and it won't be the last.

But you know what? Crap like this is no longer the exception. It's the rule. I'd say at least 50%-60% of charts I read from hospitals and practices that use computer charting systems (which is pretty much all of them) have errors of this kind.

And these are what the world is pushing us to use more and more of.

I'm not saying computer chart systems are bad things. They have a lot of advantages. But they also encourage the slacker inherent in all of us. It's easier and faster to check boxes, cut & paste, and use templates than it is to actually type out what's correct. Especially if you skip the critical step of proofreading what you've just done. Most do.

The majority of these errors are just amusing. This one is just stupid, but likely won't cause a serious patient outcome.

But if it can make an error about smoking, it can also make them about your allergies. Your current medications. What conditions you have. Your past surgeries.

And one "minor" error in any of those could lead to a disaster in the right setting.

Monday, January 14, 2019

Cole slaw

I'm in the emergency room, talking to a patient's wife:

Dr. Grumpy: "When did this all start?"

Mrs. Concern: "Last night. He fell down in the bathroom, and said he couldn't move that side."

Dr. Grumpy: "Then what happened?"

Mrs. Concern: "I figured he was just angry at me, and trying to get attention. We'd had this big argument over cole slaw at lunch, because..."

Dr. Grumpy: "Okay, but last night..."

Mrs. Concern: "Oh yeah, anyway, so I watched some TV in bed - there's that new detective show I like - until I fell asleep. When I woke up this morning he was still on the bathroom floor, and boy, was he angry. So that was when I called paramedics."

Tuesday, January 1, 2019

New year's day

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