I love being a Doctor. I love being an Anesthesiologist and I love taking care of patients. I am aware of the costs. The current debate continues to emphasize cost and I understand the preoccupation. However, I’d like for us all to look more deeply into the system. Don’t be distracted by the money debate. The question is and should always be; is my patient getting the best care? The corollary to that question is; am I providing the best value to this patient.
The care provided should always be evidenced based to the best of our knowledge and cost has to be factored into the discussion. If there is no medical need for a test or procedure it should not be done. As Physicians we need to stand up and do our part. We need to do only what is medically necessary and not what will cover our butts. At the same time there must be protection from litigation so physicians feel free to practice.
With freedom comes responsibilities and we must hold each other to high standards. We must be prepared to help our fellow Physicians provide appropriate and timely care.
Health care is a team sport and we must all play nicely together. These are my proposals to improve our system.
1. all hospital employees should have 30 minutes of protected nap time
2. patients should be guaranteed a single bill for all services provided
3. all care should be directed through a single coordinator.
These suggestion are a starting point.
The Affordable Care Act is the law of the land and will not be repealed by the next President. In spite of this the people with their heads up their dark places are still trying to circumvent it. What is your alternative? Without a clearly defined alternative the only option seems to be that we stick with the current system.
The system as currently constituted seems to work well. However with close objective examination it does not. The rate of cost growth is faster than inflation and is ultimately unsustainable. The quality of the system seems great only if it is not compared with a similar system. I must admit that for some it is truly the best. However for most it is a mediocre system.
For those with chronic disease the system is poor at best. If you are an African-American no matter your economic status you know that the system is very poor. The worse part of the current and next system is that quality is not a meaningful part of the discussion. The whole discussion is about cost. I contend that the discussion should be about quality first. My postulate is, if quality evidence based care is provided cost will be manageable and sustainable. What constitutes quality care is not the question. The only question is, can we align the system to pay for the delivery of quality care not quantity of care.
For the first time I truly understand why people of other belief systems are offended and sue when their kids are subjected to prayer in school. Recently I took my 3-year-old to daycare and she told me, “we don’t say happy holidays”. Without thinking and with the teacher looking on I said, “Honey its okay, say whatever you want because it doesn’t matter”. From the look on the faces around it was as if I had called for the killing of Christ. If you know me personally you will understand my views on Christmas.
Since I am not afraid to say what’s on my mind I nearly did, but I had to restrain myself. For the kid’s sake. I am already having a hard time de-programming the bovine defecation that is sold as holiday cheer. Santa? Why are you teaching my kid a myth. To round the day off the school sends home a note saying that Santa will be visiting the school and we should provide a gift but not tell the kids. Give me a break. Stop preparing our kids to be easy marks for the predators.
Alas I will send the gift but I will let them know that daddy and mommy sent the gifts. I will not be party to the deception of our kids. Every chance I get I speak the unvarnished truth. The truth hurts sometimes, but in the long run we are better for it. Like the proverb says, “tell the truth, tell it even, cost it what it will”, I’d like to follow that advice.
Myths have taken over American society. Our political class is intellectually dishonest and the people are following blindly. Teach your kids to be honest and they will succeed. God bless America.
Worker and workplace safety has improved significantly over the last century. Today most workplaces are very safe or perceived to be. However, what is safety? If we are evaluating the rate of workplace injury then we have truly and substantially improved. If the emotional well-being and out of workplace injuries are evaluated things are a little different from the talking points. The question is, when money is god, who cares about the safety or comfort of the worker? Does the emotional well-being of the employee matter?
The wall street mantra of greed is good as taken over the world. The latest talking point is that of developing a culture of safety. The platitudes are plentiful and melodic but what does it mean? I suggest that very few people actually understand what that means. The problem is that the people who know better have decided that profit is more important than employee well-being. We have become slaves to profits, while the creators of profit, the worker, is reduced to an item on the ledger. She is a liability and treated as such. The boss only requires she completes her tasks while using as few resources as possible. So, what does a culture of safety look and feel like?
I propose that employee satisfaction and workplace safety should be co-equal goals. However the current system is concerned more with reducing expense to the organization without concern for the individual. In such a system the employee who accomplishes her tasks without complaint is valued above all others. The safety measures adopted are usually those that increase her load and decrease the cost to the employer. In order for the system to be maximally safe she needs to be considered to be more than a fixture in the system. Her ability to work in comfort and with minimal distraction improves both safety and productivity.
I further suggest that neither can be achieved without the other. We can achieve a culture of safety and maximize productivity by empowering her to report safety concerns without risk to her employment. Her concerns should be objectively evaluated. She should be well rested and in a comfortable environment. Some methods to attain those goals are universal and include daily nap-time, secure childcare, incentives for improved lifestyle choices, access to quality health care and recreation. The typical response is that, that kind of system will be too expensive to create and will be abused. That argument is only valid if her well-being is of no concern.
The current excess of labor allows the employee to be treated as a commodity without intrinsic value. Employers who treat their employees with respect and consideration will retain loyal hardworking productive employees. Treating employees like sentient beings provides excellent rewards. The value of productive and loyal employees should not be underestimated.
After a long and mutually beneficial relationship Nokia and Symbian OS have come to the end of the road. The Board of Nokia after much pressure from outsiders decided to put Symbian out to pasture. On February 11, 2011 the new management relieved her of her duties and showed her the retirement path. As many of you know I was very disappointed and I am still in mourning. I mourn because the combination of Symbian and Nokia allowed me to pursue my loves. My name is Enzro Greenidge and I am a camera phone addict.
The merger of cellphone and camera has been one of the most innovative areas of recent consumer technology. Some may disagree with my assertion, but I stand firmly behind it. Do you own a DSLR? I own one, a canon 60D which I love and use often. However, the convenience of carrying your camera in your pocket is priceless. However, the truth is that this convenience is only of interest to you if you love taking pictures and I love taking pictures. The combination of top class photography and excellent cellphone technology is what I crave.
Since 2007 all my cellphones have been excellent cameras as well and my brand of choice is Nokia and the Symbian OS in particular. Symbian is old and clunky for some but to me she is like a great red wine, improving with age. In spite of her obvious deficiencies she still supports the best photography technology. I will likely be using a Symbian based camera phone until she expires.
I continue to be amazed by what can be done with a modern camera phone and have no patience for the runners-up. My killer app is the camera. Thanks Nokia, I’ll miss you when you are gone.