Thursday, February 4, 2021

Vaccination Update


The vaccination programs are picking up speed and are better organized than before January 20th.

We are not to a good place yet, but the programs are picking up speed.

Johnson and Johnson has asked for approval of its one dose vaccine, so may be 3 or 4 weeks.

Do not be passive, use the phone and Internet to find and register at vaccination sites. Some states are already moving into the 65 - 74 year old cohort.

There is light at the end of the tunnel, but it is a ways off.

Friday, January 22, 2021

Aggressive Action


The Biden administration has come out of the gate with a number of agressive measures to combat the Covid-19 pandemic.

Will these meaures be effective? Are we too late?

Time will tell.

Wednesday, January 20, 2021

Deferred Care


The pandemic is causing a second crisis - deferred care.

Patients are hesitant to go to medical facilities and some facilities are limiting care, especially elective surgeries.

Not the providers' fault, not the patients' fault, but there will be a reckoning.

We need to begin addressing this soon.

Thursday, January 14, 2021

Vaccination Follies

Getting enough doses to the states is going ok, but not great.

Finding enough people and places to get people registered and have someone push the plunger is moving very slowly.

This will get done, but not as fast as we would like.

For those of you coming nearer the top of the list, check every possible option within your range of easy travel.

Wednesday, January 13, 2021

Long Form Writing

 As the blog is restarted I will also be writing long form pieces;


Many of the pieces will involve health care operations and policy.

Wednesday, October 28, 2020

Deferred Health Care Pandemic Edition


Due to the pandemic many Americans, and especially many seniors, are delaying and deferring diagnostic and preventative health care.

There is natural concern about walking into a health care setting.

There is very little indication that using routine health care services is a risk for contracting Coronavirus.

Physicians should be proactive about follow up and informing patients of the safety versus risk of routine health care services.

cross posted:


Thursday, April 2, 2020

Zantac Recall

The popular antacid Zantac (and generics) have been recalled because a chemical element can be a carcinogen.

Might cause cancer is of of course not the same as will call cancer.

Safe disposal:

Thursday, March 26, 2020

Lean Supply Chains

Modern supply chains have allowed providers and facilities to go to a near just-in-time inventory system, conserving cash and limiting storage space.

Pick up the phone, log on to a website, and the next day a delivery truck rolls in with supplies.

No more.

The on-going pandemic has taught us a brutal lesson about failed supply chains, especially when the chain starts overseas, and really especially when the start of the supply chain is compromised by the same pandemic.

We have also learned lessons about depending on the federal government and strategic reserves.

Someday when we are out of the current crisis we must rethink out inventory and supply chain systems, and in particular critical items. Governments must also rethink their plans and capabilities. 

Tuesday, March 24, 2020

Corona Scams

Thursday, October 31, 2019

Cheap Insurance is .... Cheap .....Insurance

The Trump administration is working to empower short term easy-to-buy insurance plans.

These are sometimes known as "association health plans."

Problem is you get what you pay for.

Lousy insurance is only marginally better than no insurance at all. Or maybe worse.

The Affordable Care Act marketplace has better products and some at decent (but not cheap) prices.

Buyer beware.

Wednesday, October 30, 2019

Ambush Billing

Most people think of a hospital as a large building with lots of departments managed by a central group of executives.

Maybe not.

Increasingly a hospital is a large building full of contractors and subcontractors hired by a central administration.

Problem is, not all of the contractors are necessarily contracted with major insurance companies. This is called OoN or Out of Network.

This is especially prevalent with emergency department contractors.

Sometimes this failure to contract is very intentional... and the resulting billings can be massive as compared to in-network providers.

Both state and federal governments are talking about a fix, and the contractors are directing a fierce lobbying campaign toward protecting ambush billing.

Sunday, May 19, 2019

Miracle Cures (?)

Advertisements abound for miracle cures for seniors.

Stem cells:

Stem cell clinics are popping up everywhere promising cures and possibly a fountain of youth.

There is scant valid evidence that stem cells cure much of anything in seniors, especially aging. They will make your wallet skinny.

Cheap surgery:

Several Florida plastic surgery clinics are losing licenses due to killing and mutilating patients.

The lure was cheap plastic surgery. Cheap and surgery are not really compatible.

Some of the clinics were owned by felons with no medical background. Oops.

Medical Tourism:

Travel to Mexico or India and get surgery for less money.

Sometimes this works very well, sometimes it is a disaster.

Buyer beware.


Saturday, August 4, 2018

How Did Larry Nassar and Richard Strauss Avoid Discovery? Three Cultural Factors

How did these physicians, who practiced very much in the open atmosphere of sports medicine team doctors, avoid discovery?

There are at least three cultural factors that enabled Nassar and Strauss to continue their terror for about two decades each.

Sports – winning is the only thing!
Whether pre-teen gymnasts or young adult college athletes, the pressure to win, perform and conform were and are intense.
We see now that sports and academic administrators will deny reality in order to protect the program, to protect the brand.

Patients  - do not question your physician!
Physicians are highly educated miracle workers who simply should never be questioned about their examinations, diagnosis, prognosis or treatments.

Phooey. Physicians must do everything they do within “informed consent” parameters, and patients (and surrogates) have rights to be fully informed at a lay person standard. Those who supervise physicians have a duty to enforce informed consent practices and procedures.

Physicians Will Not Rat On Physicians – the Lab Coat Line
Only in extreme cases will physicians rat out other physicians for misconduct or poor quality practice. Mediocrity is just ignored.
Medicine is a statistical aberration, every physician is above average!
But physicians know better, nurses really know better, and executives and administrators know better but will rarely admit as much.