Report: Cool OB/GYNs Perform Pelvics with Head Mirrors

Report: Cool OB/GYNs Perform Pelvics with Head Mirrors

WASHINGTON, D.C. – How can you tell if your OB/GYN is cool? Well, the coolest OB/GYNs perform pelvic examinations with the use of head mirrors, this according to an official report from the American College of Obstetricians and Gynecologists (ACOG).

Other than the stethoscope, the head mirror is the medical instrument most often affiliated with doctors, particularly in cartoons and caricatures, though its use in modern medicine has steadily declined, at least among general practitioners.

“It takes considerable skill to perform an appropriate pelvic exam and it takes considerable skill to master the head mirror,” explained gynecologist Dr. Sharin Wagner, who makes it a point to teach others how to use a head mirror with female patients in stirrups. “We tell our medical students and residents that if they can do both, then there isn’t anything they can’t handle. We even push them to the extreme by asking them to put a penlight in their mouth and use that to illuminate the vagina.”

The head mirror is traditionally associated with otolaryngologists, as the device was used primarily to better indirectly illuminate the ears, nose, and throat. The concave mirror has a central hole through which the physician can see. A headband means it is easy to wear. And unlike fiberoptic headlights, a head mirror is portable and stylish. As a result, in the past few years OB/GYNs have asked the question, why can’t head mirrors be used to illuminate other human cavities like the vagina?

“When I see my OB/GYN using a regular light or even their smart phone to light up my vagina, I think, ‘Not cool,’” said patient Veronica Faulkner, who admits she has a pelvis. “But when I see my OB/GYN use a head mirror, I think, ‘Wow, so awesome, what a true badass, go ahead and do your business!’”

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POTS – Postural Tachycardia Syndrome

The postural tachycardia syndrome (POTS) is a disorder of young people and usually becomes manifests between ages 14-45. It is characterized by an abnormal increase in heart rate without a significant change in blood pressure upon standing. It is estimated that at least 500 thousand Americans suffer from the disorder (1). Of this total, 25% … Read more

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One-Dimensional Chiropractic Anatomist Only Dissects Vertebral Arteries

One-Dimensional Chiropractic Anatomist Only Dissects Vertebral Arteries

Norfolk, NE– Kim Strokemaker was only 3 months into her chiropractic training when she performed her first vertebral artery dissection. “As soon as I cracked his neck, the customer’s entire body relaxed. It was clear I had alleviated all of his pain as well as most of his motor and sensory function.”

“I wanted to do nothing but vertebral artery dissections, I was in love with that specific anatomic region and wanted to dissect vertebral arteries full time!”

“Then I can dissect this artery… maybe its a nerve, but I could probably dissect it too.”

Later that day she did some thorough internet research and make a shocking discovery, “Google couldn’t find a single chiropractic anatomist, I knew right then that I could be the first!”

She set her mind to that goal and worked at it for the entire remaining 27 months of her chiropractic training. 

While thousands of chiropractors perform vertebral artery dissections across the country every year, very few lack specific expertise in that area like Strokemaker has. 

“Any chiropractor can dissect a vertebral artery and many do every day.” Strokemaker explained, “but I’m an expert in the field. After I dissect a patient’s vertebral artery, they feel like they’ve died and gone to heaven. Some actually have!”

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New Concierge Pediatrics Office Won’t Turn Away Any Kids with Money

New Concierge Pediatrics Office Won’t Turn Away Any Kids with Money

GREENWICH, CT—Piggybacking off the successful concierge medicine practices that have sprung up over the last two decades, a local pediatrician, Dr. Willis Cornwallis, has founded a concierge pediatrics practice. Named PedsVIP, the business model is similar to its adult medicine counterpart in that patients pay a large annual retainer fee in return for more attention from the pediatrician.

The response from this affluent community has been overwhelmingly positive. “It’s about time a clinic that focuses only on the health of wealthy kids opened,” said Greenwich socialite, Ellie Tist, who rapidly enrolled her 3 children the minute PedsVIP opened its doors. “You wouldn’t believe the riff-raff that would come to their old pediatrician’s office, from what our nanny tells me at least. I, of course, never set foot in that god-forsaken place. There are kids who go to public school in that practice—can you imagine? Thankfully at PedsVIP, my kids won’t have to associate with those peasants anymore.”

That’s only one perk of this exciting, new practice. Most would say that being able to contact the pediatrician 24 hours a day on his personal cell phone is the best part. Dr. Cornwallis says he doesn’t mind the constant flurry of texts and calls in the wee hours of the night. “At 3am last night, a panicked dad whose wife was out of town called me because his baby had an up-the-back poopy explosion. I went over there, and yeah, I wiped that baby’s butt and gave him a bath. Did I mind? Of course not—that family pays me $5 million a year! I’d wipe the dad’s butt too if he asked!”

Dr. Cornwallis indicated that there has been very high demand from upper-class families to join his practice. “Although we prefer to limit our practice to between 75-100 patients,” said Dr. Cornwallis, “we would obviously never turn away any ailing child who comes from money. We’re not monsters!”

Critics, however, argue that providing medical care only for the wealthy is highly unethical, but Dr. Cornwallis dismisses these complaints as hogwash. “What about all those inner-city clinics that cater only to the poor?” he asked. “Are they unethical too?!”

With the early success of PedsVIP, Dr. Cornwallis has high hopes for the future. Next month, he plans to roll out his PedsVIP limousine service to chauffeur patients to and from his office. Of course, automobile travel is less than ideal for his clientele, so he is aiming to offer a private jet service as well, just as soon as he converts the adjacent soup kitchen he purchased into a mini-airport.

Long-term, his dream is to open similar franchises in snobby towns all across America and build a multi-billion dollar PedsVIP Hospital that, while shuttered most of the time, immediately springs into action when a well-off kid becomes unwell.

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New Helmet for Spleen Allows Mononucleosis Patients to Play Contact Sports

New Helmet for Spleen Allows Mononucleosis Patients to Play Contact Sports

EAST RUTHERFORD, NJ—Athletes afflicted with infectious mononucleosis, a disease caused by the Epstein-Barr virus and sometimes marked by splenomegaly, will soon be able to participate in contact sports throughout the course of their illness. Long counseled to avoid physical activity due to the threat of a life-threatening splenic rupture, these patients will no longer be sidelined thanks to a technologically-advanced sports-medicine innovation: the splenic helmet—a hard, plastic helmet that fits snugly around the spleen.

The inventors of this ingenious, life-saving product were inspired by the success of the head helmet, which has virtually eliminated concussions and chronic traumatic encephalopathy in football players [Ed. Note: Reminder to self—gotta fact-check this claim prior to publication]. With two simple intraabdominal surgical procedures—one for sizing/fitting of the spleen and one for installation of the splenic helmet (plus one more later on for removal of the helmet after resolution of the infection)—the athlete can safely return to the field. As he is pounded in the abdomen by a 300-pound lineman, he will be comforted by the fact that a hard helmet is encased around his spleen, protecting it from rupture.

“Not many people know this,” said Sam Darnold, quarterback of the New York Jets football squad, who missed 3 games in the fall of 2019 after being diagnosed with mononucleosis, “but I was the first person ever to have the splenic helmet inserted.” Darnold added that they planned to implant a special helmet painted Gotham green and emblazoned with the Jets logo, but he ultimately opted for a pink bicycle helmet covered in unicorns, thinking that would give him better luck.

Darnold had the splenic helmet installed within days of the mono diagnosis and would not have missed any games but for some unforeseen circumstances: his spleen ruptured! So much for the lucky unicorns! It turns out his spleen was not done enlarging, and with a fixed helmet surrounding it, the expanding organ had no room to grow, leading to its eventual bursting. Whoops!

Despite that small, utterly unpredictable setback, physicians and athletes are thrilled about the game-changing splenic helmet. Next up, designers of this product plan on inventing a brain helmet. “Even with the resounding success of the football helmet,” said the splenic helmet inventor, “we think we can do even better if we surgically place a helmet directly around the brain.”

“A helmet around the brain, huh? Why didn’t I think of that?” thought God, up in Heaven, as He tapped His skull.

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God Postpones Miracle Due to Slightly High INR of 1.6

God Postpones Miracle Due to Slightly High INR of 1.6

HEAVEN ABOVE – God, Creator of the Universe, has decided to postpone His plans for a miracle today after morning labs revealed an elevated INR of 1.6, Gomerblog reports.

“He can eat,” God reluctantly told nursing staff as He canceled the NPO order. “We’ll recheck an INR the morning and if it’s still high we might have to give some vitamin K and FFP. Ideally I’d like to see that INR less than 1.3.”

God’s decision reflects a growing trend among health care professionals to delay a procedure unless the INR is even lower than the traditional cutoff of 1.5. Interventional radiology has been the most stalwart in this respect, demanding an INR of less than 0.

“Miracles are not without their slate of potential complications and that includes bleeding,” God explained as He washes His Almighty hands with Holy Foam. “How embarrassing would it be to perform this life-saving miracle only to have this person exsanguinate because his INR was a tad bit high? Even I won’t take that chance.”

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FDA Streamlines Drug Approvals by Eliminating Cumbersome Process of Reviewing Evidence

FDA Streamlines Drug Approvals by Eliminating Cumbersome Process of Reviewing Evidence

WASHINGTON, D.C. – A new report published in JAMA (Journal Against Medical Advice) found the Food and Drug Administration’s plan to streamline the process of approving drugs has been made possible by removing the cumbersome step of reviewing any and all pertinent evidence.

“When we stepped back and asked what was the biggest hurdle in the FDA’s process of approving of new drugs for the market we found that reviewing clinical trials and their evidence as the major rate-limiting step,” explained FDA spokesperson Ira Brisk. “Over the past few decades, we have made good progress rolling out novel drugs based on weaker evidence. It’s time to take the next step forward. Evidence shmevidence.”

Without the time-consuming process of thoughtfully, carefully and cautiously analyzing the nitty-gritty details of clinical trials, the FDA expects to see the number of same-day drug approvals skyrocket. If it sounds good, it must be good, said one senior FDA official.

If this is indeed the case, the FDA will try to make a strong case for banning the use of evidence as early as 2021.

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To Hide Identity from Crazed Patients, Psychiatrists Urged to Use Porn Star Names Professionally

To Hide Identity from Crazed Patients, Psychiatrists Urged to Use Porn Star Names Professionally

WASHINGTON, DC—Studies indicate that of all medical specialists, psychiatrists are the most likely to be physically harmed by their patients. In response, the American Psychiatric Association (APA) recently strongly encouraged all mental health professionals to hide their true identities from their potentially dangerous patients by using their porn star names professionally. As everyone surely knows, one’s legal porn star name is easily derived from the Official Porn Name Formula: Porn name = name of one’s 1st pet + street name where one grew up.

The unconventional recommendation was announced at last month’s APA convention by a highly distinguished panel that included APA President Dr. Ginger Sugar Bottom; Harvard psych professors, Drs. Bullet Banger and Whiskers Waterfall; world-renowned psychiatry researchers, Drs. Sloppy Second and Smoky Sunset; National Institute of Mental Health executives, Drs. Lucky Longwood and Cuddles Caramel; and of course, beloved adult film star, Jane Smith.

Reaction has largely been positive. “I think it’s a fantastic, titillating idea! It shows the APA really cares about our safety,” said the newly coined Dr. Bubbles Chestnut. “My patients are psycho! I don’t want any of those loonies using my real name to track down my residence, my family, or (God forbid) my social media accounts.”

Dr. Chestnut added that everyone has gotten so used to her porno moniker that even her friends and family—including her 3-year-old son and his preschool buddies—are calling her “Bubbles Chestnut” now. As for her real name, she refused to reveal it to GomerBlog despite repeated requests, though she noted that it wasn’t out of concern for her safety but rather that her real name is so plain, she doesn’t even remember it anymore.

Not everyone is as gung-ho about the porn aliases as Dr. Chestnut, though. “I just wouldn’t be comfortable going around with a sexy, promiscuous name,” said Dr. Foxxy Peaches, who surprisingly has yet to change her name.

Dr. Peaches aside, most have embraced their porn star alter egos, including Drs. Epiphany Dragon, Misty Lovers, Vegas Destiny, Shady Beaver and Chappy Weiner. HIPAA has even taken notice and is experimenting with the idea of having patients use porn star names too, which is why last week there was an office rendezvous between a patient named Horny Willie and Dr. Steamy Bush.

Despite the obscene names, patients so far say the quality of their patient care has not suffered and may even have improved. “I was feeling anxious all week,” said Mr. Toby Dawson, “until I made an appointment with Dr. Bubbles Chestnut. She’s amazing—one hour alone with Bubbles and wow, let’s just say all my stress was gone.”

Mental health professionals are also less stressed, no longer having to worry about violent patients like local psychopath, Buddy, who was recently overheard complaining that he couldn’t find Dr. Fuzzy Kitty’s info anywhere online. “If I find out she’s been using a fake name with me,” said Buddy, “I swear I’m gonna kill her!”

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On a Hot Streak, Palliative Care Makes 35th Straight Patient DNR

On a Hot Streak, Palliative Care Makes 35th Straight Patient DNR

LOS ANGELES, CA – Displaying once again why they are the most dominant subspecialty at Los Angeles Medical Center (LAMC) right now, Palliative Care has just extended their amazing streak again by making their 35th straight patient DNR.

“You’ve got to ride the hot hand and right now it’s the team of Dr. Mattie Tuttle & nurse practitioner Ralph Roach on Palliative Care,” said LAMC hospitalist Jeff Barrels, who currently has zero patients that are full code. “They’re like the Mariano Rivera of inpatient care. When it’s late and things are looking dicey, call Tuttle & Roach to get your patient out.”

Tuttle & Roach admit that they’re streaky when it comes to family meetings. Their longest DNR streak was 22 consecutive patients back in 2017. However, prior to this incredible run, the duo went to 18 straight family meetings without establishing a single DNR.

“We were frustrated. We went back to drawing board when we were in that DNR slump,” explained Tuttle, who admits they feel unstoppable at the moment. “We broke down our approach, really simplified things and went back to the basics of goals of care discussions. Once we got that first DNR, we locked in and it’s all about momentum now.”

LAMC personnel knew they were witnessing something special when Palliative Care converted back-to-back-to-back DNRs before lunchtime on December 25, 2019, one of whom was a healthy newborn baby without any reason to be DNR so soon.

“We’re taking it one code status at a time,” Roach told Gomerblog, who is well aware the world-record for consecutive DNRs is within reach at 44. “It’s not about breaking records, but I’d be lying if I told you we weren’t thinking about it.”

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Black Cloud Begs On-Call Meteorologist for Help

Black Cloud Begs On-Call Meteorologist for Help

NEW HAVEN, CT – Finding herself underdressed & underprepared for this torrential downpour of admissions and cross-cover calls, third-year medicine resident and self-diagnosed black cloud Nirali Patel is now begging the on-call meteorologist for help.

“This isn’t even a black cloud, this is a black hurricane!” screamed Patel, trying not to drown amidst admission storm surges of 12 patients an hour. Patel doesn’t know how to swim. “I can barely see in front of me, the pace of things is so blinding. No one is safe, everyone is trying to stay above water. Is evacuation an option?!”

Many health care professionals are unaware that hospitals have 24/7 coverage from a meteorologist. For issues regarding temperature, humidity, and pollen levels, the on-call meteorologist can field questions over the phone though they will likely not drop an official consult note until the next day. But for those suffering with a true emergency like Patel, an on-call meteorologist is always available in house to best attend to a black cloud’s needs.

“Thank you for coming, you’re my hero, can you help?” Patel said to third-year meteorologist Javan Jones. “Pardon my French, but it is a total sh*t show.”

“Not really, I can’t help,” Jones responded. “I can’t change your black cloud status. I can only tell you there’s a 90% chance you will remain a black cloud until 8 AM tomorrow, with conditions improving only until your next shift when a new storm front appears and, boy, is it a doozy. Good luck! I’ll drop a note later tonight. Good night!”

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Intermittent Fasting and Health – The Scientific Evidence

Intermittent fasting has recently gained popularity as a means of reducing body weight and improving metabolic health. Animal studies also suggest that intermittent fasting may promote healthy aging and increase longevity. Throughout the ages, humans may have benefitted from limiting food intake for specific time periods, either for religious reasons or when food was scarce. … Read more

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Pharmacists Reassure Worried Public They’ll Never Run Out of GoLytely

Pharmacists Reassure Worried Public They’ll Never Run Out of GoLytely

BRAINTREE, MA—From antibiotics to analgesics and anesthetics to ACLS drugs, there is an underreported epidemic of drug shortages in America. With over 140 vital drugs currently in short supply, the health of patients is being adversely affected. While acknowledging this issue is real and serious, pharmacists today reassured a worried public that there’s one pharmaceutical product they’ll never run out of: GoLytely, everyone’s favorite bowel cleanser.

GoLytely, a polyethylene glycol solution that completely cleanses the colon of stool, is well

known for its, ahem, special smell and taste, and patients guzzle it several liters at a time. Most agree they’d have a strong reaction if GoLytely suddenly disappeared off of store shelves.

“Please don’t worry!” said Bradley Tice, President of the American Pharmacists Association. “While it’s true your doctor soon won’t be able to treat your infection, restart your heart or anesthetize you before surgery due to severe drug shortages, I can confidently tell you that you’ll always be able to prep for your colonoscopy.

“I know many of you were probably concerned you’d have to delay—or God forbid, cancel—the colonoscopy procedure you’ve eagerly been anticipating, but I can’t stress enough that there’s nothing to worry about. We have enough GoLytely solution to fill all of Earth’s oceans ten times over.”

Braintree Laboratories Inc, the maker of GoLytely, reiterated the same message. In a brief press release, the company stated: “There’s enough GoLytely for the entire world population—all 7.7 billion of us—to undergo colonoscopies every day for the rest of our lives. Rest assured, the planet will run out of water and oxygen before it runs out of GoLytely. One day soon, we hope, you may even have running GoLytely come out of your faucets at home!”

In fact, there is such a surplus of GoLytely that many believe the US Preventive Services Task Force’s (USPSTF) 2002 recommendation that everyone over the age of 50 get a screening colonoscopy was not based on any scientific evidence but rather that health officials “just didn’t know what the hell else to do with all this damn GoLytely.”

Regarding the concerning shortages of other essential medications, health officials stress that they are working on addressing the issue, though it may take some time. “It’s very possible,” said Surgeon General Jerome Adams, “we’ll have to delay treating your sepsis or life-threatening cardiac arrhythmia, but while you’re waiting, why not rule out colon cancer a few dozen times?”

So, don’t lose any sleep worrying about the availability of GoLytely; lose sleep because you just drank 2 liters of the solution and are spending all night getting to know the toilet. And don’t be surprised if the next USPSTF guidelines for colon cancer screening advise weekly colonoscopies for everyone aged 18 and older.

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Breaking: Standardized Patient Leaves AMA

Breaking: Standardized Patient Leaves AMA

TALLAHASSEE, FL – Standardized patient Lily Huron has left against medical advice (AMA) once she game to grips that none of these medical students would cave in and give her IV Dilaudid, Gomerblog reports.

The incident took place at the Clinical Learning Center (CLC) at Florida State University’s (FSU) College of Medicine.

“The standardized patients were asked to portray a classic case of acute cholecystitis, with fevers and right upper quadrant pain,” explained CLC director Cody Glands, who is admittedly a bit frazzled. “It quickly became clear to all of us watching this standardized patient was drug-seeking.”

Third-year FSU medical student Amanda Shore relays her experience.

“I knocked on the door and entered the standardized patient’s room,” Shore told Gomerblog, “and before I could even say hello, the standardized patient said ‘Are you my doctor who is managing my pain regimen? Because this Tylenol isn’t cutting it.’ Immediately I knew this was a red flag.”

The four medical students who followed Shore had similar encounters with the standardized patient. Huron refused to answer any questions and refused to be examined. None of the FSU medical students were comfortable giving IV Dilaudid.

“Ms. Huron became very belligerent, screaming course words at the students, demanding to see their attending and even the CEO,” explained Glands. “Even when the students explained this was all a simulated experience and that no medications were actually available at the Clinical Learning Center, she continued to beg for narcotics.”

The standardized patient finally left the simulation AMA when the students refused to give her IV Benadryl. She left the CLC still dressed in her hospital gown.

“On her way out,” Shore continued, “she gave us the finger and told us she was going straight to another simulation center to get pain meds. Well, good luck we told her. Good luck.”

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Clutch: Resident Places A-Line Into Circle of Willis

Clutch: Resident Places A-Line Into Circle of Willis

ATLANTA, GA – In the same way patients can be progressively difficult sticks from the venous standpoint, the same holds true for their arteries. Thankfully one determined ICU resident didn’t let this stop her as she was able to emergently and successfully place an arterial line into the circle of Willis.

“Only one word can describe this performance and that’s clutch,” said pulmonary critical care attending Dr. Max Mathiason, praising third-year medicine resident Gina Richter. He points towards the patient’s monitor. “Excellent waves forms, we’ve been able to get crucial ABGs and routine labs to help with management. Again, clutch.”

The patient was brought in by EMS after being found down, and initial work was concerning for septic shock. In the emergency room, patient had a central line successfully placed. However, the radial arterial line clotted off.

“I attempted a few more arterial lines, but couldn’t get them,” Richter told Gomerblog. “The patient was cool and clammy and the blood pressure cuff reading was unreliable. We needed that A line. I knew what I had to do.” In one try, Richter successfully placed the catheter into the patient’s circle of Willis. Not bad for a first try.

The patient is currently in stable condition.

“The good thing is that an arterial line is a safe procedure, granted that’s when dealing arteries outside the brain,” explained Mathiason. “Talk about threading the needle. But she did it. The patient has evidence of complications: no infection, meningitis, stroke, aneurysm, intracranial hemorrhage. Even our neurosurgeons that they couldn’t have done a better job. If that’s not a compliment, I don’t know what is.”

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Perverted Urologist Keeps Looking at Patients’ Genitals

Perverted Urologist Keeps Looking at Patients’ Genitals

BOSTON, MA – Now this is just sickening: Gomerblog has received multiple reports that Dr. Mason Cho, a urologist at Massachusetts Specific Hospital (MSH), keeps looking at his patients’ genitals, both men and women. What a damn sicko!

“This is a complete breach of professional conduct, it violates patient privacy, and we absolutely do not condone this type of behavior, especially from a medical professional,” wrote MSH administration in a statement released today. “He must be held accountable.”

Cho has been placed on indefinite suspension without pay.

According to hundreds of accounts from patients and medical staff, Cho has made it a career repeating a predictable but disturbing pattern: greeting his patients either in the office or in the hospital, listening to their complaints as if he cared, and then immediately examining their genitals, male and female, on physical exam.

“He even did this in the presence of nurses, techs, and medical students,” exclaimed nurse Evelyn Tuttle. “In fact, he even asked us to please come into the room so we could watch. Ugh. He would always ask permission from the patient to do the exam, although we know it was just an act. Come on, talk about a huge pervert. This guy should not be practicing medicine. He’s a urologist, for Pete’s sake.”

Gomerblog was able to access several of Cho’s patient charts, and what we found was even more disturbing: he described the patient’s genitals in incredible detail – down to the urethra even! – and then would occasionally describe future plans to manipulate them even more, in some instances asking the help of anesthesiologists to help sedate the patients so that they weren’t awake when it happened. WTF!!

In late breaking news, Gomerblog also reports that gastroenterologists and OB-GYNs across the country are now under investigation for similar offenses relating to patients’ rectums and vaginas. What heathens! What has become of modern medicine?!

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Red Sharps Containers Replaced by Magic Sword Boxes

Red Sharps Containers Replaced by Magic Sword Boxes

MAGIC CITY, ID—If you’ve been at Magic City Medical Center recently, you may have noticed that those iconic red sharps containers that used to hang on the walls have been replaced by magic sword boxes, complete with an assistant sitting inside of it. Marketers of these new sharps containers claim that these sword boxes are a much safer way to dispose of needles, scalpels and other sharp instruments.

“Think about it,” said hospital CEO Harry Blaine, “no one ever gets hurt in these contraptions. Magicians plunge dozens of swords into these things and the person never, ever gets hurt. We don’t know how it’s done, but it’s clearly effective. Meanwhile, with the old red containers, we would have dozens of needlestick injuries every year. It was time to try something different.”

So far, it’s been working magically. Typically, a lowly medical student or nursing student is chosen to sit in the sword box for their entire shift. Whenever medical staff has to dispose of a needle, they just jab it right into the box. That’s it—so simple. Most just walk away afterwards, though a few protective nurses ask for confirmation that the student inside is ok, at which point the student sticks his thumb out of the box and points it up or down to signal his condition.

For those wondering if the students get any special training prior to being placed inside the magic sword box, the answer is shockingly no. “Nope!” said Blaine. “We asked a few top magicians if they would train our students, but none of them wanted to give up their secrets. So, we figured we’d just let our students learn on the job.”

“We’re not really worried about it, though,” noted Blaine, adding that if there’s a mishap with a sharp instrument, then that’ll finally give the trauma surgeons something to do. (It’s apparently very quiet for the trauma department here in Idaho.)

And while the sword box has clearly been a huge hit, another magical innovation in the hospital has not. Vascular surgeons have been very vocal about their frustration over the unusual operating tables—which look an awful lot like magic “Saw-A-Woman-In-Half” tables—installed by David Copperfield Medical Supplies. “It’s crazy. Every time I use a saw to amputate a leg,” said vascular surgeon, Emmitt Wolf, “the patient somehow walks away from the operation with both legs still attached!”

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Anti-Vaxxers Uncertain How to Feel About NewAutism Vaccine

San Francisco, CA – Jenny McCarthy has been an idiot and an anti-vaxxer for most of her adult life. Going so far as to blame the autism that her son doesn’t have on vaccines.

When asked if she would consider an intervention to prevent any future children from developing autism, McCarthy immediately said she would in a heartbeat… until she learned it was in the form of a vaccination.

“This so called autism vaccine probably contains live autism that is even more autisticy than normal vaccines!”

“There is no way I would give my kid a vaccine to prevent autism! Thats how my first kid didn’t get autism in the first place!” McCarthy ranted. McCarthy’s son has Landau-Kleffner Syndrome, not autism, a fact that has failed to dissuade the former playmate turned MTV host turned ranting idiot from her ongoing war to bring back polio, measles, pertussis and several other once eliminated causes of childhood death.

“If there is a vaccine that big pharma claims will prevent autism, its probably a super double secret way to give even more kids autism so they can sell more medications to treat autism because they’re all a part of big autism! I’d much rather raise my kid’s naturally and unvaccinated so they can live to a natural death at 35 like nature intended!”

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ENT Changes Focus to Elbows, Nipples & Testicles

ENT Changes Focus to Elbows, Nipples & Testicles

ALEXANDRIA, VA – Saying 2020 is finally going to be the year where they really change things up, the nation’s ENTs will be fully abandoning their traditional territories of expertise and instead focusing on patients’ elbows, nipples & testicles.

“For decades, we’ve been typecast into examining the same head organs: ears, noses, and throats. Boring,” exclaimed Erica Flap, M.D. and spokesperson for the American Academy of Otolaryngology-Head and Neck Surgery. “You’d be surprised what other organ systems we know and are truly excited about. The change was necessary.”

Many were predicting a dramatic change was afoot, particularly after the news was announced that ENT was dropping care for the nose back in September 2019. It was only a matter of time before ears & throats would be abandoned as well.

Similar to a high schooler leaving their hometown for college in another city and state, ENT doctors really wanted to leave the head and neck. Though total consensus was impossible, a compromise was reached: elbows placated the ENT specialists in favor of limbs, nipples pacified the ENT folks who favored the thorax, while testicles quietly calmed the ENTs in favor of the abdomen and genitals.

“There was initial excitement over focusing on ears, knees & toes, thus giving us access to the opposite end of the body, the legs, but we were saddened when we realized that knees start with the letter K although it sounds like it starts with an N,” continued Flap with a sullen tone. “I’m still upset about that.”

American ears, noses & throats are taking the news hard. “It’s not you, it’s us,” Flap told them collectively, trying to soften the blow. “Hopefully we can still be friends.”

In the interim, Gomerblog has not received word of anyone stepping up to take ownership of patients’ ears, noses & throats, so for those patients presenting with symptoms related to any of these organs they will unfortunately will be sh*t out of luck.

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Skilled Phlebotomist Draws Blood from Aorta

Skilled Phlebotomist Draws Blood from Aorta

NASHVILLE, TN – Warned ahead of time that the patient was a notoriously difficult stick, madly-skilled phlebotomist Mattie Stevenson pulled off a neat little trick and successfully drew blood from the patient’s ascending aorta.

“I trust the nurses and my peers and if they say he’s a hard stick, I believe them,” Stevenson told Gomerblog. She pointed to the patient’s numerous bruises over his hands and arms, evidence of multiple prior failed attempts. “As they say, necessity is the mother of invention. Watch and learn.”

Cool as a cucumber, Stevenson grabbed two extra-large tourniquets and wrapped one around the patient’s neck, the other around the lower abdomen. Quickly and precisely, she inserted a jumbo butterfly needle with an overhand stabbing motion into the patient’s sternum and quickly got blood return. In just under a minute’s time, she had obtained a critically-needed set of labs including CBC, CMP, and troponin. She undid the tourniquet. She held gauze over the sternum for 30 seconds before placing a Band-Aid and further securing it with tape. So impressive and professional was Stevenson that the patient had fallen back asleep during the aortic stick.

As she backed away from the bedside and turned to leave the room, she winked at both our Gomerblog team and the nursing staff watching from the doorway. She jammed the needle into the sharps container. “Not my first time.”

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Tom Brady Suffers Congestive Arm Failure

Tom Brady Suffers Congestive Arm Failure

Foxborough, MA – In a shocking development that could spell the end of his storied football career, Tom Brady developed acute congestive arm failure (CAF) in the first quarter of the New England Patriots loss to the Tennessee Titans.

Brady has occasionally struggled to hit even his legendary 2-yard check-down passes throughout this season. Through it all, his screen passes and the occasional 5-10 yard pass have been relatively accurate until Saturday night.

“Peyton Manning managed to win a Super Bowl with arm failure so severe he couldn’t even throw the ball to the original line of scrimmage from the shotgun. Tom could have years of check downs left, or he may not.”

“We knew his arm was in a precarious state going into the game with a triceps ejection fraction hovering around 35% of normal for an NFL QB” Patriots Team Physician Dr. Mark Price explained. “On the 1st offensive series when Tom under threw N’Keal Harry and James White on back-to-back plays I knew what was happening even without the echomusculogram.”

“Like Brett Favre, Peyton Manning, and Tony Romo before him, Tom had developed full on congestive arm failure” Dr. Price explained. “I knew the only way he was throwing a touchdown in that game was if the Titans picked off one of his ducks and took it back the other way.”

Dr. Price’s premonition came to fruition in the game’s closing seconds when Brady’s eephus in the general direction of Mohamed Sanu Sr was intercepted by Titans cornerback and former Patriot Logan Ryan who promptly returned the pick for a Titans touchdown.

Football purists may argue that Ryan would have done more for his team’s chances if he had kneeled down allowing Ryan Tannehill to kneel out the clock but Ryan doesn’t see it that way. “Tom Brady is one of the all-time greats. If that was his last throw, he deserves to have it returned for a touchdown!”

When asked about the prognosis of Brady’s arm failure going forward, Dr. Price was coy, “Peyton Manning managed to win a Super Bowl with arm failure so severe he couldn’t even throw the ball to the original line of scrimmage from the shotgun. Tom could have years of check downs left, or he may not.”

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Electronic Prescriptions Now Available in Illegible Doctors’ Font

Electronic Prescriptions Now Available in Illegible Doctors’ Font

WASHINGTON, DC—Pharmacists beware! The newest Electronic Health Record/e-Prescribing systems are being programmed to send out prescriptions written in an illegible “doctors’ handwriting” font. Called Hell-vetica (or Hell-to-read-vetica), the new font is officially described as “squiggly, scribbly, gobbledygook bearing zero resemblance to any real letters of any real alphabet—or any fake alphabet too, for that matter.”

Believe it or not, the request for this change was made by none other than the American Pharmacists Association (APhA) after its leaders observed that pharmacists have had it too easy lately. “Pharmacists used to spend 90% of the day trying to decipher the chicken scratch scrawled onto prescription slips,” said APhA President Bradley Tice. “Now with everything computerized, prescriptions take less than a second to read. This means they now have nine-tenths of their day completely free, and they just haven’t a clue what to do with themselves anymore.”

Leading pharmacy chains also fully support the plan to give pharmacists impossible-to-read prescriptions again, noting that they “have to justify paying these people for 8-hour workdays somehow.”

Programmers carefully developed the illegible typeface over the course of many years after scouring the world for physicians with the absolute worst penmanship. The final product is an aggregate of the 50 most horrifying samples they could find. However, before officially launching it, they compared it to a font made from the handwriting samples of 3-year-old kids. When they concluded that the toddler-based font was far more legible, they knew they had a winner.

Pharmacists who have already dealt with the Hell-vetica prescriptions say they are simply impossible to decode. “Usually after an hour or so,” said local pharmacist, Kent Reeditte, “I just give up, close my eyes and randomly point at a shelf. Whichever drug I find myself pointing at is what I end up filling for the customer.”

Mr. Reeditte justified this practice by claiming that most drugs work due to the placebo effect anyway. “It doesn’t really matter what I give them,” he said. “As long as my customers think they’re getting the right medicine, their symptoms will probably go away!”

Despite not being able to read the electronic prescriptions anymore, pharmacists are not at all frustrated. “These are a godsend,” said Mr. Reeditte. “It helps the day go by so much faster!”

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That’s So Mean: Hospital Kitchen Sends NPO Patients Empty Tray

That’s So Mean: Hospital Kitchen Sends NPO Patients Empty Tray

North Portland, Oregon—The defiance of an NPO order, whether intentional or accidental, may have profound consequences, including worsening of symptoms and delay of surgical procedures. In many of theses cases, the patients simply had forgotten their diet status. So to help remind them, administrators at North Portland Hospital have instituted a new policy whereby every hospitalized patient gets a tray for each meal no matter their diet order. In the case of NPO patients, their trays will simply be empty.

“What the f@&# is this?” asked a bewildered Murray Thurman, upon receiving his bare tray. “Is this some kind of sick joke? You send me a tray with an empty plate, an empty bowl, an empty cup, an empty carton of milk and a pile of napkins? You even sent an empty sugar packet?! Was that really necessary? But, oh sure, this time you remembered the moist towelette! What the hell do I need that for now?”

Another patient, Harriet Chase, was similarly furious as she gazed upon her bare tray. “Those evil bastards even had the audacity to force me to make selections from a menu. There were so many delicious-sounding options, but for each section, the instructions were: Please choose none!”

Although unhappy, the NPO patients have quickly learned it’s better not to make a fuss about it. Chefs at this hospital apparently do not take criticism of their food well—even when the “food” is an empty tray. Take Mr. Thurman, for example, who unwisely complained and sent his “meal” back to the kitchen. Later, the head chef paid him a visit to apologize and deliver him a bag from a local fast food joint. Taking in the glorious smell of eggs and bacon, Mr. Thurman pounced on the bag, reached in and pulled out…an empty, crumpled-up wrapper and a lame toy. The chef just shrugged his shoulders, rubbed his belly, let out a thunderous belch and sauntered out.

There was, however, at least one patient who was pleased with getting an empty tray. “My family always says,” said Sal Ricci, “that I’m a terrible eater. Today, they came right after breakfast, saw the empty tray and thought I ate everything! They’ve never been more proud of me!”

Despite the mixed reactions from patients, the empty tray program has already been deemed a resounding success. Amazingly, no NPO patient—not a single one—has accidentally eaten since the new policy went into effect! Hopefully, lunch will go as smoothly as breakfast did.

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Exhausted RN to Go Home with Home Health Services

Exhausted RN to Go Home with Home Health Services

FORT MYERS, FL – Deconditioned, weak, and perpetually hypoglycemic from such a prolonged hospital shift, exhausted RN Catherine Weal will be sent home with home health services.

“It was her sixth straight 12-hour shift, and we all know that 12 hours is a best-case scenario especially around the holidays,” explained sympathetic social worker Jason Grimes, who helped with Weal’s home health arrangements. “Her patient load was unbearable, and they were all really sick. That stage 3 sacral decubitus ulcer from charting all day looks bad. Her feet are all swollen from running around all day. She was barely able to walk by the end of her last shift.”

Nurse Weal was evaluated by both PT and OT, who recommended subacute rehabilitation, but Weal respectfully declined and stated her preference to go home. Grimes helped Weal get set up with home health nursing, physical therapy (PT), occupational therapy (OT), an aide, and wound care. A rolling walker, 3-in-1 commode, and hospital bed have already been delivered.

“I understand that I could make a faster recovery at rehab, but it’s just not the same as being at home, I just really want to go home,” revealed Weal, who has spent her 15-minute break lying prostrate on the floor. She misses seeing the sun, but misses her bed even more. “If I could just get a little help at home, I think I might be alright.”

Weal did meet with Palliative Care. Palliative Care did not feel she met criteria for inpatient hospice just yet. Even if she did, Weal wasn’t ready to throw in the towel.

“I’m so tired, I don’t have the strength to lift a towel let alone throw one,” explained Weal, her fellow nurses helping turn her onto her back. She is still lying on the ground. All the lifting, shifting, and repositioning of patients has drained her; the fuel tank is empty. “I may not be going to hospice, but if anyone asks, I am a DNR.”

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40 years of ward attending

January 1, 1980 I walked onto the 7th floor of the old North Hospital at the Medical College of Virginia to make rounds as the attending physician. I had spent much time there as an intern and resident, but now I had a new role.

As I reflect on 40 years and probably between 12 and 15 years of total time making rounds, I first feel fortunate that I quickly discovered that my vocation was also my avocation. Now while I have retired from administrative responsibilities, I still devote 3.5 months each year to rounding with students, interns and residents. And each rotation still brings out the same excitement of going to the bedside and trying to help patients, of exposing students to the wonder of internal medicine, of helping interns through that difficult year and of helping residents in the final year of their internal medicine journey.

When I started, I thought that I really knew what I was doing. On reflection, I had some excellent instincts, adequate knowledge and yet much to learn about leading a ward team. The job has changed dramatically over these 40 years, and hopefully so have I.

In 1990, I had the wonderful opportunity to spend a month at Stanford, learning about teaching from Dr. Kelley Skeff. To this day, he remains one of my heroes and important colleagues. He taught us how to evaluate our own teaching. He provided a structure of the attributes for successful teachers:

  1. Creating a Positive Learning Climate
  2. Organizing Control of the Teaching Session
  3. Communication of Educational Goals
  4. Promoting Understanding and Retention
  5. Evaluation of the Learner
  6. Providing Feedback
  7. Fostering Self-Directed Learning

To read more from Dr. Skeff

His insights and videos allowed us self-reflection. Under his guidance, we learned to strive for improvement and to critically evaluate our own teaching. I borrowed much from Kelley.

He transformed my teaching in many ways. The most important in reflection was that I began seeking ways to assess my own teaching through student, intern and resident feedback. I learned that experimentation was desirable for teachers – as long as one could adequately evaluate the experiment. Over the years my teaching has matured thanks to the patients, students and housestaff who have given me either direct or indirect feedback.

Teaching attending responsibilities have changed dramatically over the years. When I started we never wrote notes. Then we transitioned to brief notes for billing.

It took many years to developed my unique ward rounds teaching style. I am happy to argue that there is no correct teaching style, rather each attending physician needs to develop a style that works for patients, students and housestaff.

Medicine has changed dramatically over the past 40 years. We treated heart failure with digoxin and furosemide when I started. We had no HIV reported, no MRSA, nascent CT scanning and MRI, many fewer drug classes, and no billing requirements. Our understanding of pathophysiology has grown. Our ability to diagnose prior to autopsy is much greater, yet we likely make as many diagnostic errors now as we did then.

The research into what makes successful ward attending rounds – Using cognitive mapping to define key domains for successful attending rounds – further helped me understand what to emphasize and what to de-emphasize.

At the beginning I aspired to become a great clinician-educator although no one used that term. In the 70s and 80s (and for some today) most deans and chairs assumed that any good physician could teach clinical medicine. Today we are more clearly defining the value of great clinician-educators and hopefully insisting on quality (although this might be an aspirational hope).

So what do I know now that I did not know then. First, I have a much better personal understanding of my limitations. I know when to ask for help. Second, I have developed my best style. I allows start in the team room, discussing each patient, having the team tell me their plans. We often have a brief educational discussion of some aspect of the patient (dx, rx or something tangential). Once we all understand the general plan for the day, we go visit each patient. At the bedside I often am the “role model”. I repeat parts of the history when appropriate, repeat the high yield physical exam, answer patient questions, and make certain that the patient understands the day’s plan. I deliver bad news if necessary. Afterwards, we often debrief the team about bedside manner. Whenever we have images to view, we walk to the radiologists. I started doing this several years ago, and it has become extremely popular with the housestaff and students. It also helps us more quickly get to the proper diagnosis.

My advice to junior attendings:

  1. Read both linked articles
  2. Try hard not to micromanage
  3. When you disagree with the team, or when you are directing the plan – make your thought processes explicit – that is the number one wish of your learners
  4. Respect their time – always finish on time, even if you must see a few patients w/o the team
  5. Get to know the team members
  6. Ask team members what they did for fun on their off day
  7. Give feedback daily – both positive and formative – and label it as feedback
  8. Touch patients, sit down, learn who the patients are – your learners will emulate your bedside manner, so make it impeccable

I have left much out. Being an internal medicine ward attending is and has been my perfect vocation and avocation. I hope they let me reach 50 years.

Thanks to the many patients, students, interns and residents who have challenged me to be a better physician and a better educator. You have given me the great gift anyone could receive.

And on February 16th I go back on service for another 1/2 month. Looking forward to it.

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ID to Prescribe Way More Vanc & Zosyn in 2020

ID to Prescribe Way More Vanc & Zosyn in 2020

ARLINGTON, VA – Gomerblog is thrilled to report that the Infectious Diseases Society of America (IDSA) has officially revealed their New Year’s Resolution, and it is to prescribe way more vancomycin & Zosyn (piperacillin-tazobactam) in 2020.

The IDSA announcement has been the long-awaited response to feedback from non-ID health care professionals that they need to “chill out” regarding antibiotic use.

“We’re stingy, really stingy with antibiotics, in particular broad-spectrum antibiotics, to the point we were stressing out over it and driving our blood pressures to the roof,” explained IDSA spokesperson Merrill Pelham. “This is the year, 2020 is the year we loosen up and have a little fun with it. A little vanc & Zosyn isn’t going to hurt anyone. So seriously, go nuts, we’re totally cool with it.”

According to the newly-updated IDSA website, all patients should be started on empiric broad-spectrum antibiotics irrespective of diagnosis, and if cultures are negative after 48 hours, just “f**k it, keep them going indefinitely.” In fact, Pelham encouraged all health care professionals to add on both acyclovir and micafungin for, what infectious disease specialists are now calling, “sh*ts and giggles.”

Tomorrow morning the IDSA plans to reinforce their 2020 New Year’s Resolution by publicly denouncing antibiotic deescalation and recommending antibiotic courses of at least 6 weeks duration no matter what.

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Untreated ENT Patients Ring In Another New Year with Tinnitus

Untreated ENT Patients Ring In Another New Year with Tinnitus

NEW YORK, NY – Contented to spend the end of 2019 on the couch with all the television coverage of the Times Square ball drop on mute, the nation’s untreated ENT patients are not looking forward to ringing in yet another New Year’s with incapacitating tinnitus.

Collectively they are not on any medications that could cause this most resolute of symptoms, and all have been reassured by ENTs throughout the year it is likely viral and will pass even though it’s been going on for some months or years by now.

As you count down 10, 9, 8… and wonder where your friend or loved one is, they’re just covering their ears with their hands and ear muffs, trying to suppress the urge to scream and cry, which is their own way of joyously expressing “Happy New Year!”

Or should we say, “Happy New Ears!” (Silly joke FTW!)

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Shmedtronic Release New ICD-Pacemacer-WiFi Hotspot

Shmedtronic Release New ICD-Pacemacer-WiFi Hotspot

ST. PAUL, MN – In response to patient feedback on how to make their medical devices even better, Shmedtronic is slated to release a new combined implantable cardioverter-defibrillator (ICD), permanent pacemaker (PPM), and WiFi hotspot in February.

Shmedtronic told Gomerblog that the new device was specifically designed based on feedback from over several thousand patient surveys, where the number one most requested improvement was having wireless networking capabilities.

“The older ICD-PPM model probably saved my life on a couple of occasions,” wrote one anonymous patient in one of the Shmedtronic surveys. “But when I’m feeling well and not dealing with any issues related to my heart, I have to use data on my phone plan, which is a complete downer. Isn’t there any way we can fix that?”

Another patient echoes the same theme in another survey: “This device has shocked me out of dangerous rhythms several times, but while I waited for EMS I couldn’t surf the web since I was in a 4G and WiFi dead zone. What gives, Shmedtronic?”

According to interventional cardiologists, placing an ICD/PPM/WiFi device is similar to implanting previous Shmedtronic devices. The only difference is to confirm functionality they check both Facebook and last night’s scoreboard.

Study patients who have used the new combined ICD/PPM/WiFi device note significantly fewer episodes of symptomatic tachycardia now that the stress of accessing a good connection has been dramatically reduced. One cardiologist involved in the study is “confident” that most episodes of symptomatic arrhythmias are “due to the stress of finding a good WiFi connection.”

Shmedtronic states the only drawback of the new device, which “isn’t too big of a deal,” is that if you share password access to your WiFi, then others can change the settings on your pacemaker and defibrillator.

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Breaking: Rare Nurses Station Computer Has Working Keyboard & Working Mouse

Breaking: Rare Nurses Station Computer Has Working Keyboard & Working Mouse

NASHVILLE, TN – In what is certainly the best medical feel-good story since the patient who asked only for Tylenol for pain back in 2015, a computer at the nurses station has been identified that not only turns on and has a working screen but, get this, it has both a normal-functioning keyboard and mouse. What?!

“This is shocking in the best way possible as this is truly the rarest of rare findings in modern health care,” said charge nurse Catherine Bennett, who made the discovery one hour into her shift. “The screen is on. None of the buttons on the keyboard are sticky, broken, or both; in fact, they all work, even the Space bar and Enter button. Then the mouse,” she moves the mouse back and forth, “moves as it should and both left and right-click buttons work. This truly is astounding.”

Bennett’s findings have been confirmed by several other health care professionals. Even the IT department, who was initially suspicious of the report, found that these details check out. This is the first time they have encountered a health care system computer that “works just fine.”

“It’s the strangest thing,” said hospitalist Jason Bush, who is sitting at this gold standard computer. “Whenever I type or click on something, the computer actually responds the way I want it to. This computer is a unicorn. I can’t believe it!” Streams of tears started to flow from Bush’s eyes. “This computer allows me to be… productive.”

Ask any health care professional and the gold standard work station triad is a working computer, a working keyboard, and a working mouse. As of December 1, 2019, only three of these work stations exist in the entirety of the American health care system, and two of them aren’t even accessible to health care professionals; they are in the offices of hospital administrators.

Even rarer is the gold standard work station quartet: the aforementioned triad plus a chair.

“Could you imagine if we had two, even three computers like this in the nurses station?” asked Bennett. “I know, that would never happen, but one can certainly dream.”

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Family Meeting Gone Awry: Patient Makes Medical Team DNR

Family Meeting Gone Awry: Patient Makes Medical Team DNR

KNOXVILLE, TN – In a palliative care-run family meeting that has gone completely awry, a patient and family has made their multidisciplinary inpatient medical team DNR/DNI with comfort measures only.

“This is certainly not the outcome any of us were expecting,” said palliative care nurse practitioner Alison Husk, standing bedside a chaplain and both the patient’s nurse and hospitalist. “But truth be told, any time anyone can be made DNR by the end of a family meeting it really should be considered a victory. It just so happens it’s all of us.”

Though we are unable to fully disclose the details of the patient’s medical condition, the patient did have several chronic medical conditions that were unfortunately end-stage. According to palliative care, the patient had a life expectancy of 6 months or less and was eligible for hospice.

“The patient and family are very reasonable and understanding of the situation, realizing that cure was not possible and that comfort was the best course of action,” said hospitalist Sean Grimes. “That was why after a really productive 75 minutes of discussion they made our team DNR/DNI with comfort care measures only. Everyone in that room was on the same page, myself included.”

The medical and palliative care teams have already met with a hospice agency and it appears that all would be agreeable for inpatient hospice.

“The nurse, charge nurse, hospitalist, subspecialists, and everyone on Palliative Care have uncontrolled symptoms of stress and fatigue, and could benefit from being started on a Dilaudid PCA in inpatient hospice, at least to get them a little more comfortable,” said hospice liaison David Loveless. “Now let’s cross our fingers a bed opens up: our inpatient hospice unit is currently filled to the brim with burned out medical teams.”

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All Aboard! Next Stop on the Hot Mess Express: ICU City!

All Aboard! Next Stop on the Hot Mess Express: ICU City!

ER STATION – All aboard! Health care professionals, have your tickets and IDs in hand as you get ready to step aboard the Hot Mess Express! This is the Hot Mess Express #4139 at ER Station making 12 stops with final destination ICU City!

This express train makes the following stops: Altered Mental Station, Los Chest Pain, The Twin Cities of Hypoxemia & Hypercapnia, ATN Park, Shock Liver Land, Troponin Town, San Anemia, Can’t Peeville, Sepsis City, Intubation Station, Pressor City, and ICU City!

This express train DOES NOT make stops at Double Portions or Narcoticos.

Please watch your step as you board the Hot Mess Express! We apologize for all the tangled Foleys, telemetry wires, IV lines, central lines, rectal tubes, as well as the paperwork saying “Full Code.” Again, please watch your step!

This is a fast-moving express train – the Hot Mess Express doesn’t wait for anyone – so please find your seats quickly, buckle up, and hang on tight!

Do take a moment to read the safety pamphlet found in the seat pocket in front of you should this Hot Mess Express experience a train wreck.

Just a reminder that only the first four cars of this train platform at both Troponin Town and Shock Liver Land. Additionally, students and interns are allowed on this train but require 24/7 adult supervision. Finally, any members of Palliative Care can ride this express train for free, just show your conductor your ID badge!

Departing ER Station in 2 minutes, estimated arrival at ICU City in 3 minutes! ALL ABOARD!!

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Man Hospitalized for Gout Flare After Just Thinking About Steak

Man Hospitalized for Gout Flare After Just Thinking About Steak

ATLANTA, GA – A massive sign that his gout is poorly controlled, area 56-year-old Jefferson Mason was hospitalized late last night after just thinking about a steak.

“I thought it was innocent, a five-second fleeting thought about how nice a steak would taste, but man oh man was I wrong,” Mason said. He said that immediately upon having the thought his right first toe “exploded” with pain, redness, and swelling. “You’d think that excruciating pain would be enough to tell my brain to shut up. But no.”

Almost reflexively, Mason thought about a glass of Cabernet Sauvignon. Moments later, both of his ankles and knees flared up, so excruciating that he forgot about his podagra. He couldn’t walk. He called 911. He was life-flighted to Grady Memorial Hospital where he was immediately taken to metro Atlanta’s only level 1 gout center.

“Unfortunately, we see this in patients with extraordinarily difficult cases of gout,” explained on-call Grady rheumatologist Paul Trang, who purposely hasn’t thought about any purine-containing foods and beverages for over three decades. “The patient is vegetarian, exercises regularly, is on a good dose of allopurinol, and takes daily colchicine. We asked him to not think about purines, but clearly he admits to being noncompliant. He’s a frequent flier in that regard.”

Mason is feeling better after his first dose of steroids, but doctors have warned Mason that if he doesn’t immediately suppress these “gout-causing thoughts” of chicken sandwiches, rack of lamb, or bacon-wrapped trout that he could quickly progress from acute gouty polyarthritis to other end-organ involvement including acute gouty pericarditis, acute gouty nephropathy, and acute gouty meningitis. Palliative Care has already been consulted.

“There is nothing more disturbing than performing a lumbar puncture and getting back tophi,” Trang told Gomerblog. “Right now Mason is stable. But if Mason even thinks about a beer or a shrimp cocktail in the next 24 hours, he could be a goner.”

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Santa Gonna Be Up All Night Charting Children’s Visits

Santa Gonna Be Up All Night Charting Children’s Visits

NORTH POLE – Having successfully rounded on kids across the planet and delivering them gifts on Christmas Eve & Christmas Day, Santa Claus has finally returned to his office to begin his least favorite part of this otherwise joyous holiday: charting every single one of those 500 million-plus visits.

“These kids don’t realize how much I appreciate all those milk and cookies,” an exhausted Santa voiced while brewing a fresh pot of coffee. He boots up his North Pole electronic gift record. “It’s not to keep me fed during all the travel – and it is a lot of travel – it’s to keep me fueled as I hammer out all these notes.”

For Santa to be appropriately reimbursed, he has to document if each child has been naughty or nice; address at least 10 systems on his physical exam of the chimney; and detail not only every single gift he gave each child, but what wrapping paper was used, what colored bow was attached, and where exactly under the Christmas tree it was placed.

“If I don’t document the presents, then the children never received them, that’s what the Christmas elf coders tell me,” Santa explained.

Despite the long hours he has ahead (he’s most worried about any mistakes he makes since he’ll be so tired when he charts everything), Santa is in good spirits.

“I felt great traveling about this year, so that’s holly jolly news,” he said. “No chest pain, no shortness of breath, no bleeding.” For those who don’t remember, Santa suffered an acute pulmonary embolism last Christmas but has been compliant with his Coumadin and tolerating it well. “Now let’s hope the immobility from charting doesn’t cause me to throw another clot, HO HO HO!!!”

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ERs Overwhelmed by Life-Threatening, Wrapping Paper-Related Paper Cuts

ERs Overwhelmed by Life-Threatening, Wrapping Paper-Related Paper Cuts

EVERYWHERE, UNITED STATES – What should be a Christmas morning filled with celebration and cheer has turned to horror and bloodshed: life-threatening wrapping paper-related paper cuts have sent millions of Americans to emergency departments, completely overwhelming the health care system this morning.

No deaths have been reported, but at least 20 million are listed in critical condition.

“It appears that the anticipation for gifts has caused everyone to let down their guard: kids, great grandparents, and everyone in between,” explained Director of the Centers for Disease Control and Prevention Robert R. Redfield, who now reports a nationwide shortage of Band-Aids and gauze. “Americans are carelessly tearing and ripping into their gifts, and the result is the worst wrapping-paper crisis since the Great Depression.”

Emergency room personnel are seeing record-breaking cases of disfigured fingers, hands, arms, and faces, each laden with dozens even thousands of brutal paper cuts, some penetrating so deep as to lacerate brachial arteries and, in a dozen cases, the aorta. Surgeons and blood banks are desperately pleading those who haven’t been afflicted to donate blood as supplies are running dangerously low.

“Wrapping paper is not only taking out the gift recipient, it’s taking out others,” Redfield told Gomerblog, who has asked that all Christmas gifts in American households be quarantined or, at the very least, opened only after putting on the appropriate safety gear. “Once the wrapping paper is flung off the present, it is ricocheting off unsuspecting bystanders, causing secondary and tertiary trauma often worse than the ones suffered by the initial gift recipient.”

Elders with femur fractures sustained from slipping on stray wrapping paper number just shy of 2 million.

Unable to keep his composure any longer, Redfield has just issued a dire warning to Americans: “For the love of Pete, stay in your rooms and do not open any more gifts this Christmas!! Avoid that damn Christmas tree and everything underneath it!! Your life, the lives of others depend on it!!”

In additional and heartbreaking breaking news, Gomerblog reports one family in Philadelphia is trapped and possibly crushed under the weight of an over-sized red gift bow after trying to remove it from their brand-new Lexus.

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Breaking: Study Finds Efficacy of Turkey Sandwiches in Convincing ED patients to Discharge AMA Down 40%

Breaking: Study Finds Efficacy of Turkey Sandwiches in Convincing ED patients to Discharge AMA Down 40%

In what is being called a major wake-up call for the Emergency Medicine community, a groundbreaking study published in The Washington Journal of Emergency Medicine found that the efficacy of turkey sandwiches in convincing frequent fliers to discharge against medical advice is down 40% from previous studies. This phenomena of turkey sandwich resistance has ED providers across the nation nervous.

“When I was in training we were taught that turkey sandwiches were a silver bullet when it came to getting frequent fliers to AMA,” explains Thomas Randel MD, Chair of the Washington Society of Emergency Physicians.

“With the loss of this panacea we will have to resort to more classic techniques, many of which were being phased out when I was in residency.”

When asked what techniques he was referring to Randel responded, “We will be forced to use the second line treatments of offering saltine crackers with chicken broth or graham crackers and peanut butter, and if those don’t work we will have to resort to actually working up whatever vague complaint these individuals present with.”

At the time of publishing researchers from across the country were working tirelessly on techniques to combat turkey sandwich resistance. “Drawing from the knowledge that clavulanic acid has synergistic effects with amoxicillin, our group has tried adding various compounds to turkey sandwiches to improve their efficacy,” says Nicholas Jacobs PhD, a researcher from Kings Canyon University.

“We are still in the early stages of this research but our preliminary data shows that adding either pesto or sriracha to turkey sandwiches can return the effectiveness to nearly pre-resistance levels.”

Other research groups, such as the one run by Steven Larson MD at the North Cascades Medical Institute, are using different approaches. “We are developing novel, next generation treatment modalities that we hope will cause patients to AMA while avoiding this newfound resistance”. When probed about what these new modalities might look like Larson elaborated

“Thus far our group has seen huge success [at convincing patients to AMA] with roast beef and, to a lesser degree, ham sandwiches. These findings are promising as they suggest that the resistance is isolated to turkey sandwiches.”

This good news could not come soon enough according to Sam Kirkpatrick PhD, an epidemiologist from the San Francisco office of the CDC. “According to my models,” says Kirkpatrick, “if complete turkey sandwich resistance develops before these alternative treatments can come to fruition our nation’s emergency departments will be completely overrun by frequent fliers within 2-5 weeks.”

When asked to explain what this worst case scenario might mean for the average citizen Kirkpatrick elaborated, “The models predict that this resistance will strain our health care system more than the 2009 Swine Flu pandemic. If we do not get this resistance under control EDs will become so full that there will be no room for those who really need emergency care, like the person who has had lower back pain for 3 months and decided to come get it checked out at 3am on a Friday, or the chronic pain patient who needs another dilaudid refill because their pills were stolen for the 4th time this month.”

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Wearing Santa Hat Not Curative for Burnout, Career Dissatisfaction

Wearing Santa Hat Not Curative for Burnout, Career Dissatisfaction

BOSTON, MA – A new study published in a special Christmas edition of the New England Journal of Burnout has unfortunately found that wearing a Santa hat on Christmas Day is not curative of career dissatisfaction or burnout.

“I initially had a big smile on my face when I put this big, red, floppy hat on my head, I mean, it is the holidays after all,” said ER attending Dr. Stephanie Stone, who is working Christmas for the fifth year in a row. “But five seconds into my work day, it’s like it wasn’t even there. Same old sh*t all over again, just with this f**king hat on my head.”

The study looked at several secondary outcomes and the news was no better there: they found that wearing a Santa hat did little to ameliorate let alone cure sleep deprivation, depression, anxiety, medical debt, and social isolation. If anything, they all got markedly worse.

“What a cute hat, we’re twins!” said nurse Derrick Jones, who was also donning an oversized Christmas hat, as he passed by Stone. Minutes later, Jones was overheard in the restroom having a good, long cry.

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Santa Just Giving Everyone Influenza B for Christmas

Santa Just Giving Everyone Influenza B for Christmas

NORTH POLE – He himself quarantined up in the North Pole at his wife’s insistence, Santa is just bagging it in and giving every man, woman & child, good or bad, influenza B for Christmas.

“Why do we live in the f**king North Pole? It’s so g-ddamn cold,” Claus complained to his fellow Christmas elves, all of whom were wearing surgical masks just outside his isolation room, still reluctant to enter. “Turn up the heat, I don’t care if it melts all the snowmen.”

Even Santa’s reindeer have been cautious, washing their noses and hooves a little more liberally than usual.

Jolly Old St. Sick was doling out early Christmas gifts this year – the November appearance of influenza B caught everyone by surprise – which gave Santa Claus a great laugh until that laugh turned into fever, cough, sore throat, headache, and muscle aches.

Don’t worry if influenza B wasn’t what you asked for this Christmas. Mrs. Claus is making sure everyone’s stockings are stuffed with a full treatment course of Tamiflu.

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Expectant Fathers Neglected No More: Hospital Opens Much-Anticipated Paternity Ward

Expectant Fathers Neglected No More: Hospital Opens Much-Anticipated Paternity Ward

BOCA RATON, FL—“Push, push, push!” yelled the hospital staff at a patient who was intensely laboring. But surprisingly, this scene was not taking place in the Labor & Delivery ward, and even more shocking, the patient was a man. How can that be, you wonder? It turns out this man was among the first patients who checked into the brand new Paternity Ward at Boca Health Center, and he was currently parked in front of the ward’s gorgeous poker table, “laboring” over whether to follow the staff’s recommendation to “push” his chips all in.

That’s right, the hospital that previously introduced the geriatric maternity ward now has a sparkling new paternity ward, where expectant fathers can go to relax while their female partners are in labor. The days of men’s needs being neglected by hospital staff during the chaotic time of labor and delivery are finally over. After a 9-month-long, multi-billion-dollar renovation of the abandoned women’s health clinic, the paternity ward opened last month to much fanfare.

“Prior to last month,” explained hospital CEO Duncan Reeves, “new dads always complained about how hard the labor & delivery process was for them. I understand—cause I’m a dad too—how stressful it is to be with your wife for hours and hours of labor—missing work, listening to her constantly kvetch about the pain, and watching the staff give all its attention to your wife as if you’re not even there. Then the delivery itself—geez, can you give a guy a drink before making him watch that horror show? And after baby arrives, all anyone asks is ‘How are mommy & baby doing?’ Well, what about daddy…WHAT ABOUT DADDY?”

Well, the new Paternity Ward is all about daddies. Here’s an excerpt from its promotional brochure: “When wifey’s in labor, get in that car and have her drive you to the hospital pronto! After she drops you off, we’ll whisk you away to Paternity. Settle into your large private suite, and then explore the unit with the other dads there. You’ll find amazing amenities including: 5 sports bars, an award-winning steakhouse, a full casino, nightly adult entertainment, glorious massage chairs (Press the ‘Pitocin Boost’ button for a more intense massage experience) and a free pharmacy (help yourself to much-needed analgesics and anxiolytics).

“Then chill out on our C-(shaped)-sectional sofas and watch a live stream of your baby being born in the comfort of our stress-free, state-of-the-art TV lounge, surrounded by your new bros. Did we mention the TVs are 3D? (“It looks like the baby flies out right at you!” said one exhilarated and inebriated dad). You can even play Fantasy Labor & Delivery with the other guys, scoring points based on your wife’s performance (major points if she can gut it out without an epidural).”

The new unit, unsurprisingly, is getting rave reviews. “Best of all, while Maternity only gives women 48 hours, the Paternity Ward never kicks you out,” said new dad, Kevin Conway, as he puffed on a Cuban cigar and rolled a hard 8 on the craps table to the delight of the other dads, before adding that his wife and baby actually went home 3 weeks ago. “I haven’t even met the baby yet!”

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Year-End Bonuses to be Paid Entirely in Educational Experience

Year-End Bonuses to be Paid Entirely in Educational Experience

Tampa, FL – For hospital CEO John Stevens, 2018 was a great year. Profits reached an all time high, and his board members had received record breaking compensation. In an effort to show his appreciation, Mr. Stevens announced that he would be handing out bonuses to all four hundred Residents at his hospital.

The announcement was made just three days before New Year’s Day. “We couldn’t have done it without you,” he said, accompanied by Program Directors representing each specialty. “Please think of these bonuses as a small token of our appreciation for all of your hard work.” The bonuses, which were sealed in plain white envelopes, contained a revised work schedule with increased hours across all residency programs.

“You may want to cancel your New Years plans for this one,” he grinned, noting that several Residents who were previously given the day off were now scheduled to work.

“Money doesn’t buy happiness,” explained board member Terry Brooks, while stepping into his brand new Porsche. “The gift of education is invaluable and something they will cherish forever”.

The new schedule, which increased overnight and holiday shifts, was applauded by the board of directors as a way to boost morale and bring profits to the next level.

“I can’t imagine how appreciative the Residents are for this educational experience,” Mr. Stevens said. “I only wish I could see the look on their faces when they open their envelopes.”

At press time, Mr. Stevens was boarding a private jet for a three week vacation around the globe.

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Lawless Family Boldly Sits in “Well” Section of Pediatric Waiting Room Despite Kids Clearly Being Sick

Lawless Family Boldly Sits in “Well” Section of Pediatric Waiting Room Despite Kids Clearly Being Sick

CHEVY CHASE, MD—Shameless. Ballsy. Chutzpah. These are some of the words being used to describe a family that had the audacity to sit in the “Well” section of a local pediatric office’s waiting room despite clearly being sick.

As several traumatized witnesses describe it, a mother barged into a Chevy Chase-based pediatrician’s office this morning with 2 incessantly coughing and sneezing toddlers in tow. Though these kids were covered head-to-toe in green, viscous snot and phlegm, the mother quickly surveyed the even ickier state of affairs over in the “Unwell” section and then defiantly directed her contaminated children towards the glistening, aseptic chairs in the “Well” section.

The daring mother, fully aware she was committing a crime of epic proportions, hastily sat down and stared straight ahead pretending to read the “Patient Bill of Rights” poster on the wall and refusing to make eye contact with any of the other parents in the room.

Well, let’s just say the well occupants (the Wells) of the well section did not take it very well. At first, they resorted to simple tactics like evil death stares and passive-aggressive comments to make it clear to the infectious intruders that they were unwelcome.

When that didn’t work, the Wells sprang into action: One father frantically sprayed air freshener every time the sick kids coughed or sneezed. One mother slathered an entire Costco-size bottle of antibacterial gel all over her baby. Another pulled her son in close, protectively hugging him in her bosom to shield him from the germs; after all, she wouldn’t want her 12-year-old to catch anything during his annual checkup.

But still the fearless woman wouldn’t take a hint, and she and her tainted toddlers remained perched in their well seats. This meant war—a battle of wills (or “Wells”, if you will). The Wells banded together, put all their well children in Level A Hazmat suits—yes, they all carried Hazmat suits in their bags, because of course—and then they called the police.

Within minutes, dozens of cops, SWAT team members, FBI agents, Navy SEALs and CDC bioterrorism experts descended onto the scene. But despite the impressive display of force, the intrepid woman continued staring straight ahead, now seemingly engrossed in a HIPAA placard on the wall. The agents finally just shrugged their shoulders and left.

Desperate, one courageous well mother then tried something unconventional. She marched over to the woman and politely asked, “Can you please move over to the Unwell section?”

“Sure,” said the woman, “no problem at all.” She then gathered her snotty kids and together, they stepped over a line of red tape on the floor that separated the Well and Unwell sections and sat down one seat over from their old one. With a collective sigh of relief, the Wells finally relaxed, knowing they were safe at last, protected from the germs by an impenetrable line of tape.

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How to Get Dental Leads – 9 Ways to Think About Lead Gen for Dentists

how to get dental leads

Operating a dental practice is a rewarding job, but one of the most difficult aspects of it is continually generating new dental leads. Simply having an open dental practice is not enough, and dental offices must continue to find new ways to successfully find new patients.

Dental lead generation takes a lot of hard work and isn’t always easy. You may struggle to generate new dental leads by only having regular patients refer a couple of family members or friends.

dental referral banner

Luckily, there are many ways you can successfully generate new leads. As dental marketing experts with years of experience, we’re here to share with you the best ways to do so.

We suggest a multi-tiered approach which means using many different techniques to find new leads for your dental practice. A few methods that will be highlighted in this article include:

  • Use a Low-Cost Patient Referal Program
  • Encourage Word of Mouth with Current Patients
  • Participating in your community

Keep reading to find out the 9 best ways to successfully generate new dental leads.

1. Save Time and Money with Low-Cost Patient-Referral Programs

You don’t have to be a marketing expert to get lots of new patients. A variety of low-cost patient referral programs are ready to help keep your schedule full by providing you with a continuous flow of well-qualified new patient referrals. Month-after-month you’ll receive referrals that are carefully matched to your practice by dental need, location, appointment availability, and your preferred patient-payment method — including insurance.

Patient referral programs save you time, money and staffing. They reduce your advertising costs, streamline the front desk team’s workload and – at least one – offers you a 100% production guarantee that protects your investment. There’s really no smarter, easier or safer way to grow your practice.

2. Word of Mouth Still Works as Lead Gen For Dentists

As mentioned, having your regular patients refer their family members or friends to your dental office is one way to get new dental leads. This strategy works because people trust someone they know more than they trust an advertisement on the radio or in a newspaper.

How to Get Dental Leads

However, they most likely will not do this on their own volition. You need to verbally ask them to refer their loved ones and ask in the right way. We have also found that dentists have had the most success with this method when they ask their long-term patients as opposed to someone who has only been once or twice.

When your patient is about to leave, tell them you are taking new patients if they know anyone who is looking for a dentist. You can also give them a business card or two with your information and ask them to give it to anyone they know who is looking for dental services.

Be sure to stay organized when asking for referrals. Check your schedule beforehand to make sure you won’t get overbooked. This is to avoid having to turn down any potential new patients.

Even if you’re schedule is tight, it’s important to never turn down a new dental lead. Find a way to fit them in, even if you are busy. Turning someone away will give the impression that you aren’t taking new patients.

3. Reward Patients for Making Referrals

Continuing off of the first method, offer your patients a reward for making referrals and bringing in new patients. This not only will help bring in new dental leads but will also make your current patients feel special and part of your community.

Lead Gen for Dentists

When a patient refers someone, send them a thank you note with 10% off their next appointment. It’s a great way to show your gratitude towards them and let them know they are important to your business.

4. Generate Dental Leads By Elaborating More on the Services You Offer

Elaborating on more of your services is a great way for dental lead generations, but be careful not to overwhelm your patients with too much information.

Here is what we have found works well for other dentists. For example, if one of your patients requires a porcelain cap, it doesn’t hurt to mention all of the other cosmetic dentistry services you offer to see whether or not they’d be interested in another service.

Other services you may want to consider talking to your patients about are:

  • Teeth Whitening
  • Gum reshaping
  • Dental Implants

If this is something that you plan on doing, however, make sure your staff knows about it, too. They’ll more than likely be asked for more information if word gets around, so you will need to make sure that they are ready and able to answer any questions patients, especially potential patients, may have.

5. Hire a Part-Time Marketing Specialist

Marketing your practice can be a difficult thing to do, especially if you have no experience. This is why hiring a part-time marketer is a great idea to help you bring in more business in a professional way.

lead gen for dentists

They will be able to make your business more visible online through various techniques such as:

  • Search Engine Optimization
  • Online Advertising
  • Content Marketing
  • Social Media
  • Email Marketing

Having an online presence is major to a business’s success and many dental practices aren’t currently employing any marketing tactics. Even hiring one person for a minimum of 10 hours per week is more than enough to get your business bustling with new patients.

ways to get more dental leads
They will have the experience to help you write a newsletter, create and manage any of your social media pages, and give you new marketing ideas.

6. Send Out a Weekly or Monthly Newsletter

Email marketing is one of the most effective marketing channels and is definitely a method to consider when it comes to dental patient acquisition.

In our dental marketing experience, we always remind dental offices to provide a call-to-action at the end that encourages your patients to make referrals. If you hire a part-time marketing specialist, they will be able to write effective email newsletters.

It’s a great way to let your current patients know about any current deals you’re offering, such as 15% off teeth whitening, for example. Then, they can pass the information on to a friend or a family member who is looking into that service.

7. Become an Active Participant in Your Local Business Community

Becoming an active participant within your local business community is another great way to build up a referral network that drives results. It gets your name out there to other businesses and members of your community.
dental marketing

Some ways you can get more involved in your community are by:

  • Hosting and attending community events
  • Donating to important causes in your community
  • Reaching out to other businesses

Another example is offering discounted or completely free dental services for veterans. This is doing something incredibly noble for those who fought for your freedom as well as advertising your practice at the same time.

8. Offer Unbeatable Customer Service

Customer service is key to generating new dental leads time and time again. It’s what patients will remember the most about you good or bad and you’d be surprised how often patients speak to their friends and family about the customer service they receive at your dental office.

One way to have great customer service is to make it as easy as possible for patients to book appointments. Offer a variety of different ways to schedule appointments that include booking both online and in person.

Billing is also especially important. Make sure you accept many forms of payment and possibly consider implementing an online portal on your website that allows your patients to pay their dental bill online.

The best way to show you care about your patients is by making sure your entire dental team is always greeting your patients with a smile, making sure they’re well taken care of, that they feel comfortable throughout their entire appointment, etc.

Go that extra mile to cater to each individual’s needs and referrals are guaranteed to be sent back to your dental office.

new ways no get dental lead

9. Offer New Patients and Existing Something They Can’t Refuse

One of the best ways to get some new patients through your door is to offer something they can’t refuse, especially when it’s paired with something your long-term patients can take advantage of, as well. Giving new and returning customers a chance to save money is a great way to get them to come back each time.

Here’s an example that other dental offices have seen success with. You can offer long-term patients 10% off when they refer a new patient, who will receive 20% off the cost of their first appointment. Both people will receive a discount and save money.

Generating Dental Leads for Dental Practice Success

While the thought of new dental leads and growing your practice may seem overwhelming, becoming a successful operation is much easier than you think.

The 9 ideas we discussed today are the best ways to bring in new business. Through referral programs, online marketing techniques, and getting involved with your community, you will be able to find dental leads and grow your business immensely.

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Become Board Certified in Administration Medicine

Become Board Certified in Administration Medicine

Philadelphia (PA). On Monday, the ABIM presented the first group Diplomats in Administration and Management Medicine. The DAMMed, for short, graduated a residency started “out of the desire to create physician led health care systems,” in the words of Douglas Pennipintcher, who spearheaded the development.

“Traditionally we would have expected physicians with years of clinical experience go into admin,” said Pennipintcher. “This was a disadvantage. These individuals often have a sense of obligation to the patient and residual empathy. This has proven to be a problem in health care management.”

Initially the program used physicians that have dropped out of clinical practice due to burn out, but that proved difficult . “For some reason these physicians have a very negative attitude towards hospital administrators,” said Cody Biller, the programs co-chair. “We had the insight of recruiting straight out of medical school. That way physicians are untainted by patient contact that could dissuade them from their task of maximizing profits. “

The program is 2 years in length. It consist of a year long computer resilience acquisition program (CRAP), followed by 3 month rotations in coding, billing and scheduling. There is a 3 month elective as all. “We encourage trainees to seek experience outside medicine. Our collaboration with the Asian textile industry has proven very helpful in providing a skill set needed to run a hospital, “ said Biller.

The second class of DAMMed are set to graduate soon. So far, there is just one residency, run out of the headquarters of Aetna in Hartford, CT. “We decided to have a chief resident year for the highest achieving physician, called the Senior Administrative Track Award Newcomer (SATAN). It comes with a $1M compensation and a company car. Not bad for a starting salary!” added Pennipintcher.

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Natural medicine – a growing force in world healthcare

Over the next five years, the natural health sector is expected to generate $210 billion in revenue annually, making it one of the top three fastest growing commercial sectors in the world. Outside of retail, only tech and cosmetics are growing faster.

As the second decade of the millennium draws to a close, I want to take a moment to look back at how the sector has developed, to highlight why I believe natural medicine has a critical role to play in prevention and treatment in the years to come, and to look at why the clinical medical sector remains resolutely opposed to ensuring patients are properly informed about their care options.

The media explosion of the last five years means that broadly speaking people now have access to much more knowledge and information about healthcare strategies than ever before.

With that awareness comes an understanding that we all now have a range of options to choose from when it comes to deciding how we want to take care of ourselves – and the internet has put those choices squarely within our reach.

Although it’s hard to imagine a world without the world wide web, it’s not all that long ago that we relied more or less entirely on our GP to recommend the best treatment for whatever ailed us – and we trusted that they would prescribe not just the right medicines to cure or treat us, but also the best medicines.

The world has moved on a lot in the last two decades – and as the months have passed, so the resources available to us to help us make critical health decisions have multiplied.

That has brought much greater understanding that natural health treatments have an important part to play in keeping us well, just as we have also learned that some of the standard curative and preventative options we once took for granted aren’t necessarily as effective or safe as we once believed.

We now know that mammography, for example, has very specific risks and disadvantages associated with it.

There are so many arguments against mammography that some countries have either already phased it out as a routine screening tool (Switzerland) or are considering taking that step (France).

The arguments include the fact that mammography isn’t wildly effective in identifying breast cancer (it has a success rate of around 65%).

It also has a questionable track record of false positive and false negative diagnoses – in other words wrongly diagnosing a cancer that doesn’t exist or missing one that does.

From a patient point of view, it’s at best an uncomfortable process to undergo and at worst downright painful (the breasts are crushed between two heavy x-ray plates), it risks exposure to radiation, and there’s evidence that the process itself can actually trigger cell mutation that can lead to cancer.

And, of course, it’s only routinely available to women aged between 47 and 73 (breast tissue density in younger women means it’s not deemed effective or, therefore, suitable, below the age of 47. This ignores the many hundreds of women outside that age bracket who are at risk, often unknowingly.

So while 20 or so years ago mammography was accepted at face value as the best and only way to effectively screen for cancer, we now know not only that it’s a flawed process, but that non-invasive screening tools like breast thermography are both non-invasive and potentially much more effective in correctly identifying an early problem in the breast (and doing so many years before a mammogram would).

There are those who would choose to abolish the use of mammography screening, as Switzerland has already done. But regardless of one’s view on that issue, at the very least women should be made aware by their GP or healthcare provider that alternative, complementary screening options are open to them.

In menopause treatment it’s a similar story. Since the dawn of synthetic hormone replacement therapy (HRT), GPs have handed out HRT medication like M&Ms to any woman who wanted to be free of the very unpleasant side effects that menopause brings.

Not that long ago, the media was awash with claims that varied in their degree of accuracy and inaccuracy about associated health risks – cancer and heart disease were two that were widely reported – and many women elected either to stop the HRT treatment they were already on, or avoid treatment at all.

But as natural health solutions have evolved, so have the choices available to women battling with the menopause. Bioidentical (or body identical) HRT uses natural compounds to replicate the hormones produced by the body and is just as effective – if not more so – in treating the symptoms.

Yet, if you were to do even the most rudimentary survey you’d find a large proportion of women remain oblivious to the availability of this treatment as a low-risk, highly effective alternative to synthetic HRT that would see them through what could otherwise be a deeply unpleasant 5 years or more.

These are just two areas that have seen tremendous benefit from the evolution within the natural medicine sector. There are many more – including hair loss treatments and heart health screening.

The big question is: why is there not more public awareness of the natural treatments that are available to people when it comes to making decisions about their care?

Ultimately, I believe, it comes down to two things: ignorance and money.

The Government agency responsible for approving NHS treatments – NICE (the National Institute for Health and Care Excellence) – will tell you that there isn’t enough evidence that some natural treatments are effective.

This is obviously nonsense, since the efficacy of a significant proportion of all drugs currently provided by the NHS is largely unproven and many natural treatments have been determined to be, at worst, harmless.

By that measure, all the treatments discussed here should be available to NHS patients.

Which brings us to money.

Big Pharma invests hundreds of millions of pounds in drug development, and those companies make many more millions by selling them around the world. Big Pharma also contributes heavily to medical research through university hospitals.

It’s well known that they target the individuals, agencies and Government departments that buy the drugs they make for financial benefit.

In short, it’s not in the interests of those involved in developing, selling, buying and dispensing clinical medicine to open the field to the providers of natural healthcare.

This is why, despite its rapid growth, this sector will continue to rely for the time being on individuals like you to make informed choices that are aligned with their own wishes about how, where and when they want their healthcare to be delivered.

If you’d like to find out more about the treatments and services we provide at The Natural Doctor, why not get in touch with us for a confidential and informal conversation?

The post Natural medicine – a growing force in world healthcare appeared first on The Natural Doctor.

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Nurse entering thirty-sixth hour trapped in med room trying to return med to pyxis

Nurse entering thirty-sixth hour trapped in med room trying to return med to pyxis

An on-going watch continues at Northshore Memorial Hospital as Tracy Smith, RN, is stuck at the pyxis trying to return an extra dose of oxycodone she took out by accident.

Direct sources (nurses who tried to help her but then determined that they didn’t have time for this shit) reveal that Nurse Smith attempted to take out her patient’s q6hr PRN dose of 10mg but accidentally clicked on his q4hr PRN breakthrough dose of 5 mg. The pyxis fooled her into thinking she had selected the right narcotic prescription (she even got the count right on the first try!) until she slammed the door shut and realized her error was permanent. Although she has the right amount of pills to give the correct dose, the pyxis thinks she is stealing a dose, and as we all know, what the pyxis thinks is happening trumps all reality.

Thinking quickly, she obtained another nurse and they tried to return to bin, but per the fucking usual, the med was unable to scan and opened an internal miscellaneous drawer, but this was the second to last oxy left and Nurse Smith knew she would eventually need it when the patient demanded his q4hr PRN, and the likelihood of it being restocked by pharmacy in a time frame remotely helpful to the flow of patient care was slim to none.

Nurse Smith grabbed another innocent nurse who was only passing through looking for a pulse oximeter that would stay on her patient (ha! good luck!) and they tried to edit and cancel the med, which almost worked until the selected box on the screen was greyed out for no apparent reason.

Updates now reveal that the two nurses are standing there staring at the screen, then back at the oxy, then back at the screen, desperately trying to figure out how to remedy the situation without receiving a berating email from pharmacy asking what the hell they thought they were doing with that extra oxy.

Nurse Smith’s colleague is trying to make an SOS call to the charge nurse but sadly, she can’t hear the answer since her patient’s pulse ox has fallen off again and the monitor is ringing through her phone while she makes her call. Meanwhile, Nurse Smith’s patient has “basically died” from 3/10 pain.

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Baby Yoda Memes Improve Patient Compliance

Baby Yoda Memes Improve Patient Compliance

In what started as a joke by the senior emergency medicine residents at Hospital Woeisme, Baby Yoda memes posted around the ED have had an astonishing and unexpected impact on patient behavior.

Baby Yoda, the beloved 50-year young version of the Jedi Yoda from Star Wars spin-off TV show The Mandalorian, has quickly become a celebrity in his own right. Baby Yoda memes have been storming the Internet lately, inspiring the residents’ prank.

One meme shows Baby Yoda looking adorable and wise, counseling “Take your meds, you will.” Another shows Baby Yoda looking upwards with the quote, “Follow-up, you must.” And a third shows a serious Baby Yoda, eyes closed and hand reaching out, with the caption, “Return here, you mustn’t.”

The Jedi-inspired messages appear to be sinking in. The rate of bounce backs has reportedly declined 50%, medication compliance has improved by nearly 80%, and almost every patient now has a primary care doctor.

The senior residents who started the hoax were shocked to see that their posters have now been enlarged, professionally printed with a glossy finish, and hung in every patient hallway. “Our goal was just to piss off the administrators, but yeah, I guess this is a good thing. I supposed we’ll have to think of a different prank now…”

ED Chair Dr. Hans proudly reported, “We’ve seen a huge surge in patient compliance. Patients are taking their medications and they’re actually going to their follow up appointments. It’s pretty incredible. This change in behavior has yielded almost three million dollars in savings for Woeisme in just the past two months.”

Dr. Hans added thoughtfully, “People don’t like listening to doctors anymore, but they sure do love taking medical advice from a small, green fantasy character without a grasp of basic English grammar.”

Perhaps Baby Yoda really is exercising the power of The Force in the ED.

Mysterious, it is

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Weakened HIV No Longer Worthy of Own Chapter in Medical Textbook

Weakened HIV No Longer Worthy of Own Chapter in Medical Textbook

BETHESDA, MD—HIV, the AIDS-causing single-stranded RNA retrovirus that was once universally feared, has become so much easier to control over the last couple of decades that it is no longer deemed worthy of having its own chapter in medical textbooks, editors say. Instead, the now non-intimidating HIV will be considered for “maybe a paragraph or two” in a broader “Viral Illnesses” chapter.

Despondent over its demotion, HIV hasn’t felt so irrelevant since the 1970s when no one even knew of its existence. It’s really not taking it well; sources say that since the demotion, HIV hasn’t even gotten out of bed. Too depressed to infect anyone, the virus spends its days watching MTV videos and 1980s movie marathons, waxing nostalgic for the decade when it reigned supreme.

One could certainly say the famous retrovirus has gone “retro”. “Oh how I miss the glorious eighties,” HIV whined, as a barber styled its surface glycoproteins into a big, frizzy perm. “I was unstoppable back then. I graced every magazine cover, starred in movies, captured the attention of every researcher and had enormous volumes written about me. I was untouchable—literally, no one would touch a person infected by me.”

In the decades since, however, its power to induce fear has diminished substantially thanks to very effective antiretroviral drugs that keep it suppressed. It’s gotten so bad that HIV-afflicted patients don’t even have to see HIV specialists anymore as any old ID doctor can easily handle it now. Even worse, HIV fears that the day will soon come when even general practitioners will be able to fully treat HIV. Oh the horror!

“Oh the virality!” shouted the HIV particle as it watched more of its comrades get blown up by powerful “nukes” (Nucleoside RTIs), a scene that was becoming all too familiar for the embattled virus. “I don’t stand a chance. My life near-life is ruined.”

But perhaps there is slight optimism for the depressed virus. Having analyzed Back to the Future obsessively, HIV was said to be plotting to infect Marty McFly and catch a ride on the DeLorean time machine back to the 1980s, so it could relive its glory days. However, experts say that while this is a viable plan, HIV probably missed its best chance as Marty and the DeLorean have not been seen since 2015.

With that plan doomed, HIV fell back into a deep depression. Feeling suicidal, HIV flipped open its medical textbook to the chapter page paragraph line about HIV and searched for ways to kill itself. But, alas, there was nothing even written about the treatment of HIV.

“Oh well,” sighed the downtrodden virus as it lay in bed watching The Goonies, “I guess I’ll just lie here dormant for a couple decades. Go ahead, and forget all about me…I dare you.”

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Improving The Health And Appearance Of Your Skin

Even though your vital organs are important to focus on and keep healthy, we tend to forget about the largest organ of all – the skin. Looking after your skin is just as important as looking after your heart, lungs, or kidney. Here are some tips to improve the health and appearance of your skin.

Drink Plenty Of Water

Water is a great thing for your skin because our skin cells are mostly made up of water anyway. A lack of water will leave our skin feeling very dull and dry. To get more water into your body, make sure you’re always carrying a bottle of water around with you and that you’re asking for water whenever you have a drink in the day. This extra pint or two per day can really make a difference in how your skin feels and looks. Flavor your water with fruit or certain vegetables like cucumber, for example.

Keep Out Of The Sun

Although it’s nice to sit out in the sun, care should be taken to protect your skin from harmful UV rays. Sun cream should be a necessity and nothing something that’s optional. Make sure you’re applying it routinely, and if you feel any part of your body starting to burn, it’s a sign to top up on the SPF. Damage to your skin from sun rays can lead to skin cancer, and so there’s really no excuse not to use sunscreen when you’re laying out in the sun. Try to keep out of it if your skin is sensitive, and wearing hats or caps over your head, can help protect your head and more importantly, reduce the chance of you getting sunstroke. 

Have A Good Skincare Routine

A skincare routine is going to help protect your skin in the long run. It’s important to remember that your skin is aging as you get older, and it’s visible to the outside world. That means that you want to do everything you can in order to make sure it stays looking perfect. Make sure you’re taking your makeup off at the end of every day and that you’re cleansing your skin. Exfoliating is good for the skin to have every so often and keeping it moisturized is key to adding hydration and keeping the skin looking healthy. You don’t need to go to the extent of having a seven-step routine, but having an awareness of what you’re currently doing is good.

Look At What You’re Eating

You are what you eat, so when you’re thinking about your diet, you want to ensure that you are eating everything that will help out your body both internally and externally. Too many takeouts or fatty food is not only dangerous for your heart health and cholesterol but also your skin. It can dull the glow of your skin and can cause havoc with how your skin reacts.

Improving your health in this way is just as important as any other, so make the changes to look after your skin.

The post Improving The Health And Appearance Of Your Skin appeared first on Lower Cholesterol and Blood Pressure with Lisa Nelson RD.

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Elderly Man Admitted with MI Requests Pediatrics Consult

Elderly Man Admitted with MI Requests Pediatrics Consult

ORLANDO, FL—Bobby Kidman, an elderly man admitted to the hospital today with a suspected myocardial infarction bizarrely rejected a cardiology consultation and instead requested only a pediatrics one, because, really, he’s just a kid at heart.

Dr. Mallory Cartwright, the on-call pediatrician, was dumbfounded when she received what she called “the weirdest consultation I’ve ever had to do.” She said, “I’m a pediatrician! How am I supposed to treat an 82-year-old man with a heart attack? With balloons and lollipops?”

Well, yeah, something like that if Mr. Kidman gets his way.

Initially upon meeting the elderly Kidman, Dr. Cartwright offered him the best possible relevant medication in the pediatrician’s armamentarium: a “baby” aspirin. She then racked her brain, trying to recall how to treat an MI, a condition she hadn’t faced since medical school. “I think you need more antiplatelets, anticoagulants, lipid-lowering agents and a cardiac catheterization,” she hesitantly recommended.

But the “kid at heart” would have none of that. “This condition I have is the result of too much adult-type stress on my heart. It’s just a kid; all it needs is some childlike interventions, and it will be fine.”

So instead of calling cardiology, Dr. Cartwright consulted a clown. The clown brought him a few dozen Doc McStuffins stickers, a giant lollipop, an ice cream cone and a large latex animal balloon (the clown got the balloon to him in just under the 90-minute “door-to-balloon” recommendation), and Mr. Kidman quickly felt like a new man, er, boy.

But tests the next morning revealed that his heart had not yet fully recovered. So at the patient’s request, he was urgently transferred to another institution: Disney World. There, under the care of Dr. M. Mouse and his assistant Dr. D. Duck, he was prescribed a strict cardiac rehab program. This program, meant to de-stress his heart, consisted of twice-daily roller coaster rides and Tower of Terror freefall drops. Within days, Mr. Kidman’s heart was once again content.

After discharge from Disney World, all was well with Mr. Kidman until one week later when he developed a headache, one so severe that he went to the ER. But once there, he stubbornly rejected a neurology visit and instead requested only a veterinarian consult because, really, he is just so darn pig-headed.

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Hospitalist Program Offers 7-Years-On/7-Years-Off Schedule

Hospitalist Program Offers 7-Years-On/7-Years-Off Schedule

PHOENIX, AZ—Many hospitalist programs around the country follow a 7-on/7-off model where clinicians work long hours for 7 consecutive days followed by a full week off. One hospitalist program, however, has taken it a step—okay, many steps—further by offering a 7-years-on/7-years-off schedule.

Hospitalists at Phoenix General Hospital work every single day for 7 years straight followed by a 7-year-long vacation. Joe Merkel is one such hospitalist; he worked non-stop from 2010-2016 and is now in year 3 of his vacation. He recently sat down with GomerBlog to share his experience with this highly unusual program.

“It’s definitely unique, and I was hesitant to join the program at first, but the allure of a 7-year break was too much to walk away from,” Merkel said. “Those first 7 years were pretty insane though. When I began my shift, my daughter was 2 years old. Next time I saw her, she was 9, and my wife had 2 more kids with her new husband. I didn’t even know she had divorced me.”

Yes, that’s correct, the 7-year-on part of the schedule is one marathon shift. The clinicians are true hospitalists in that they do not leave the hospital for 7 years. Sounds like you have to be nuts to join such a program, but it’s totally worth it once you start your 7-year break, right?

“Not exactly,” explained Merkel. “At the end of the 7-year shift, your body basically shuts down. You spend the first 2 years of your break in a coma. I actually just woke up a few months ago. From what I hear, the middle 3 years are fine. But once year 6 begins, the overwhelming dread of the approaching 7-year-on shift begins to consume you. Plus, you quickly realize that every guideline you followed six years prior is obsolete, and so you have to read the entire latest edition of Harrison’s Principles of Internal Medicine to catch up. Then you spend the whole 7th year catching up on 7-year-old discharge summary dictations that you never did.”

So, would you consider a 7-year-on/7-year-off program? Leave a comment below, and then return next week when we delve into a hospitalist program in Reno, NV that follows a model of the opposite extreme: 7-seconds-on/7-seconds off. In the time that it’s taken you to read this article, those clinicians have already changed shifts about 10 times.

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Area hospital announces plans to no longer provide complimentary room air

Area hospital announces plans to no longer provide complimentary room air

The current trend of monitizing all aspects of human existence has spread into all corners of society, including health care. Insurance companies have required that physicians prove medical necessity for even the most basic of treatments. This includes the use of room air. Up until recently, Riverside hospital was resolute in its promise to provide room air free of charge. Unfortunately things have changed and now room air is considered a medical treatment to be coded and billed as such.

CEO Jen Nitro told reporters on Tuesday that Riverside, in spite of budget shortfalls and economic woes, had been providing complimentary room air to all visitors patients and staff as a way to show their commitment to excellence. This indiscriminate allocation of room air has put the hospital in financial arrears. Ms. Nitro told reporters that this is no longer financially feasible. Insurance reimbursement for room air has been next to nothing because doctors are required to fill out lengthy paperwork to establish medical necessity. In addition, the supply of room air has been dwindling as the natural manufacturers such as forests and vegetation, are being decimated by forest fires and commercial logging.

Traditionally, Riverside has relied solely on atmospheric room air to satisfy its increased demand. However, due to a recent increase in the amount of hyperventilation, they are now trucking it in from the North Pole. This hyperventilation is believed to be happening in the hospital due to anxiety regarding the increasing cost of room air.

Riverside is also mandating that staff decrease their respiratory rate to 5 inhalations and 2 exhalations per minute. The latter point was added to reduce Riverside’s carbon footprint. Staff that is found to consistently breach the preset allotments of atompspheric gas would be required to attend Yoga class to learn how to breath.

Gen Nitro told reporters “all options are on the table. We just have to find out what works best for our patients. We know that they are very attached to their room air. Some of them just can’t see themselves surviving without it. At the present time, we are forced to add a nominal charge to patients for room air. We also ask that the public not just breathe indiscriminately whenever they feel like it so that we can keep the room air fee low“

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APA Finally Admits It Just Too Damn Lazy to Add Treatment Section to DSM

APA Finally Admits It Just Too Damn Lazy to Add Treatment Section to DSM

WASHINGTON, DC—The American Psychiatric Association (APA) has at long last definitively answered a question that has been floating around ever since the publication of its first Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1952: Why doesn’t the DSM, the so-called “bible of psychiatry”, contain treatment recommendations for the 300+ disorders it describes? The answer comes in today’s official APA press release, in which the organization admits that it’s “just too damn lazy” to add a treatment section.

In the past, the APA has either been evasive or downright untruthful when posed the aforementioned query. Months ago, APA President Bruce Schwartz said, “Honestly, our patients aren’t really that interested in treating their mental illnesses. They really just want to know the name of their condition. Once they get that info, they’re so relieved they don’t even bother staying to hear our recommendations.” Schwartz also points out that most psychiatric patients don’t adhere to their treatment regimen anyway, so “why bother even coming up with one?”

But now, for reasons that remain murky, the APA is coming clean. “The DSM lacks a treatment section for one reason and one reason only,” confessed Schwartz, as he reclined on his office couch, seemingly relieved to finally get this long-held secret off his chest. “We’re just a bunch of lazy ass slackers.”

“Okay?” he continued. “You got us! When we worked on DSM-5, the diagnostic section took so damn long. By the time we finished cutting-and-pasting the diagnostic criteria from DSM-4 into DSM-5, we simply had no energy or motivation left to devise treatment plans for hundreds of complex disorders.”

But for the few overly ambitious clinicians out there who wish to diagnose and treat their patients, Schwartz has a few words of advice: “There are actually a number of treatment guides out there. I think the APA might even have published one. But, you know what, I can’t think of their names right now, and I’m just too lazy to look it up.”

Schwartz did offer some hope, though, explaining that he expects the DSM-6 to contain a treatment section. But sources tell us that privately, he assured his slothful colleagues that they have nothing to worry about, pointing out that everyone will forget this promise by the time they get off their asses to write the 6th edition in 30 years.

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Eco-Unfriendly Plastic Urinary Catheters Banned, Replaced by Paper Ones

Eco-Unfriendly Plastic Urinary Catheters Banned, Replaced by Paper Ones

SEATTLE, WA—Following the successful mission to replace hazardous plastic straws with paper ones, environmentalists are now targeting plastic urinary catheters, hoping to swap them

out for paper catheters. The push to ban the dangerous plastic catheters gained steam after a disturbing video depicting a poor sea turtle struggling to remove a foreign object went viral.

“I actually thought it had a plastic straw stuck in its nose,” said Lou Harrison, the man who shot the video from his boat. “But when I picked the turtle up, I discovered it was not a straw and it was not his nose that was affected. Shockingly, the hard-luck turtle had a plastic urinary catheter lodged in its genital papilla. There was even some urine in it—I don’t know if it was the turtle’s or someone else’s. Anyway, I yanked on it so hard, it finally came out, along with a river of blood. Poor little guy.”

In response to the video, activists demanded a ban on plastic catheters and argued that the main alternative—rubber catheters—was also harmful to the environment. Thus, paper catheters gained popularity. They are made from the same sturdy cellulose material as paper straws—you know, the ones that instantly begin to shred and dissolve as soon as you start slurping up liquid.

“So weird,” said Davey Rome, the first patient at Seattle General Hospital to experience the pleasure of having a paper urinary catheter inserted through his urethra into his bladder. “I could’ve sworn the nurses shoved a catheter into me last night. But when I woke up this morning, it was just gone…vanished just like that. Oddly enough, I did pee out some particles of paper today—don’t know what that was about!”

The clever design of this paper-based catheter system is such that the urine empties out into a paper collection bag. “There was a large puddle of piss on the floor at the end of the day!” said a chuckling Fred Garfield, another early paper urinary catheter user. “I don’t get why they switched to paper. Is paper really better than plastic? What…we suddenly don’t give a crap about trees anymore?!”

Not everyone experienced immediate dissolution of their paper catheter, however. “Mine held up really well,” said Maurice Johnson. Fortunately for him, it turns out his urine pH was 11.0, reflecting a very alkaline urine, and paper does not seem to dissolve in alkaline solutions. Why was his urine so basic? He had a severe bacterial urinary tract infection.

“Eureka!” said staff urologist, Dr. Larry Hayes. “That’s how we will prevent these paper catheters from dissolving. We will just introduce pathogenic, highly virulent bacteria into the patients’ bladders before inserting the new catheters.”

Problem solved! Sea turtles everywhere are so grateful

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White Coat Investor’s Wife Leaving Him for Man who took her out to Applebee’s for Dinner

White Coat Investor’s Wife Leaving Him for Man who took her out to Applebee’s for Dinner

Dr. Dahle, otherwise known as The White Coat Investor, who is well known among the medical community as the authority when it comes to personal finance among healthcare professionals, has some bad news to announce.  His wife of 19 years has decided to finally leave him for a man who took her out to Applebees.

“I couldn’t stand it anymore,” stated Jane Dahle who sounded exhilarated to be speaking to the press. “He always obsessed over saving money and how whole life insurance blows and is the worst investment ever, I couldn’t take it anymore.”

Jane had endured decades of economic discussions and spending (or lack of) from Jim throughout their 19-year marriage.  The only thing keeping her going was the thought of finally being able to spend money in her 70s, that is until Ron came along and invited her out to an Applebees.

“Ron, an acquaintance invited me out to an Applebee’s for early dinner one day and I went and I haven’t looked back since.  He allowed me to order the NY strip steak with a garden salad, a beer, and even an ice cream dessert.  I couldn’t believe it! The meal came to $18 and he said he would pay for it! I was in heaven.  I knew I had to leave my relationship immediately.”

“Shocked, that’s how I feel,” said Dr. Dahle.  “Here we have been saving every penny in low cost Vanguard index funds, buying millions in life insurance, umbrella insurance, disability insurance, and maxing out HSAs, 401ks and my favorite, backdoor Roths.  Why would she think an Applebee’s steak was worth leaving me?”

Jane was last seen walking into a Chipotle yesterday with Ron and the look on her face was “priceless”.

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Cardiac Cath Clearance: A Rant from the Renal Fellow

Cardiac Cath Clearance: A Rant from the Renal Fellow

Thank you very much for this very interesting consult for clearance for cardiac catheterization in this lovely man who is unfortunately having a myocardial infarction and needs some contrast dye. Even if his estimated GFR has been reported as > 60 ml/min, who knows what the real GFR is, right? So it was very important to get renal involved.

First of all, I have to say you guys need to come up with a better way to diagnose MIs- come on man its 2019 and you’re still using that “dye” to look at the heart- can’t you use like Co2 or something? Or just guess from the EKG where the stent should go in without actually having to put the whole 3 cc of dye in ?

The whole practice of medicine is changing towards safe practices so this is really not acceptable. Secondly, as I said before, even though the eGFR is reported > 60 ml/min, who knows what it is- it maybe 61 or 120- so do you really want to take the risk of dropping someone’s GFR from 61> 50 and tell them they now have CKD and have a higher risk of ending up on dialysis compared to general population? Think about it, whats the point of saving their life now if they will be on dialysis in 15 years from now?

So, my strong recommendation for this patient is NOT to get any dye. He is NOT cleared for cardiac cath and if you ask me this question 5 more times during the course of his stay, I’m going to say NO. Its against my work ethics, against the whole practice of nephrology and most importantly, against safe patient care. So please don’t call me again.

Yours truly
Renal Fellow.

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Saint Mary Hospital’s EMR Offers 2 New Discharge Disposition Options: Heaven or Hell

Saint Mary Hospital’s EMR Offers 2 New Discharge Disposition Options: Heaven or Hell

BETHLEHEM, PA—Following the lead of religiously-affiliated hospitals around the country, St. Mary Hospital recently updated their electronic medical record/order entry system to include two additional discharge disposition options. Normally, when a patient leaves the hospital, the clinician enters a discharge destination, e.g. home, nursing facility, another hospital or death. But many consider “death” too vague, and so it has been replaced by two discharge locations that provide far more clarity: Heaven or Hell.

“The first time I noticed these new options,” said Dr. Eleanor Bernstein, “was right after an 87-year-old patient of mine died. After an emotional encounter with her grieving children, I went to click on ‘Death’ but instead found ‘Heaven’ and ‘Hell’ as my only choices. Did I mention her kids were standing right behind me?! Obviously, I selected ‘Discharge to Heaven’.

“Well, huge mistake!” Dr. Bernstein continued. “The daughter furiously shook her head at me and, in between sobs, said, ‘No, that bitch is definitely in Hell!’” Dr. Bernstein was later reprimanded by her bosses for her rash, non-evidence-based choice of Heaven.

After that unfortunate mishap, physicians are now expected to extensively research their deceased patients’ histories before determining their appropriate final destination. By interviewing family, friends and enemies; reviewing their social media accounts; and placing STAT consults to God and Satan, they’re learning if their patients were righteous or sinful.

Armed with that essential information, physicians were then able to more confidently choose between Heaven or Hell. Deborah Cohen, a Jewish woman who diligently taught kindergarten for 40 years and volunteered for over 40 charities, tried a bite of bacon one time (Discharged to Hell). Morris Robertson, a gentle, law-abiding Christian and donor of one kidney to an ailing teenager and his other kidney to a sister (thus requiring that he be placed on dialysis), had sex with his fiancée one week before their wedding (Discharged to Hell).

All of the following upstanding members of their communities were also delivered to Satan: Kelly Borger (watched 15-second clip of porn), Henry Jones (once said “F-ck”), Alex McDougal (coveted neighbor’s wife), Vanessa McDougal (divorced cheating husband), Melissa Schwartz (turned on light on Sabbath), Kevin Jeffries (New York Jets fan***) and Lily Gordon (practiced sorcery—yes, really!).

In fact, since the introduction of these choices, “Heaven” hasn’t been selected even a single time, so administrators say they’re “just gonna get rid of Heaven as an option and discharge all dead people to Hell.”

***Sadly, it’s been reported (and confirmed) that the Jets fan was in Hell while alive too. Poor, poor soul.

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Intern honored for shortening length of stay by leaving everyone NPO

Intern honored for shortening length of stay by leaving everyone NPO

Intern Connor was given the distinguished length of stay award by prestigious academic hospital. During his acceptance speech he stated he was not surprised as this has always been “his thing.” Driven by fear of having a procedure canceled he has the policy of keeping everyone NPO.

When looking at a hungry patient with no planned procedures it can get difficult, but “I always knew I had a larger mission.” Competition is raising red flags about his length of stay stats, feeling his AMA rates padded his numbers. Others are saying it is ultimately going to come back to bite him through lower Press Ganey scores.

Connor ignores the critics saying the proof is in the pudding. This award validates my decision to keep all patients NPO, even if they may not have needed it. “As I always say if you’re going to make an omelet you gotta break some eggs.”

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Simple Solution to Medication Non-Adherence: Get Patients Addicted to Their Medicine

Simple Solution to Medication Non-Adherence: Get Patients Addicted to Their Medicine

BLUNT, SD—An innovative physician fed up with patients who don’t take their medications as prescribed has successfully lobbied Congress and pharmaceutical companies to adopt his rock-solid plan to improve adherence: Get patients addicted to their vital life-saving drugs by adding illicit substances to their pills.

“For the longest time,” said Dr. Abbott Forman, the aforementioned physician credited with the idea, “I couldn’t figure out how to get my cardiac patients to take their medicine regularly. Then after seeing a few crack and heroin addicts in my practice, it suddenly hit me. Why don’t we add cocaine, marijuana, opiates, etc to their heart medications? Pretty quickly they’ll be addicted and won’t ever miss a dose of their essential medicine!”

“I’ve never been so excited to take my medicine,” said Ed Strauss, one of Dr. Forman’s patients. “I used to always forget to take my cholesterol pill, Zocor. Then Dr. Forman switched me over to Blowcor (cocaine-simvastatin). Now I can’t wait for my daily dose. And you wanna know a dirty little secret? Sometimes I take it 4 or even 5 times a day!”

Mr. Strauss then grabbed his thigh and screamed, “Ouch! Why do my muscles ache so bad? Eh, whatever, I’ll just take a little Grasspirin (cannabis-acetylsalicylic acid); that’ll take care of the pain and protect my heart at the same time. Boy, does it make me feel good too.”

Another amazing success story is that of Rachel Monroe, a 55-year-old with a slew of medical problems, including diabetes, CHF, COPD and GERD. Notoriously non-adherent to her medication regimen, her doctor recently changed her meds. Her medicine cabinet, which used to contain boring drugs, has been upgraded and spiced up, now boasting Meth-formin (metformin-methamphetamine), DigoxiContin (digoxin-oxycodone), Marlbuterol (Marlboro cigarette-albuterol), and Xantac (alprazolam-ranitidine). “My life has been a little up and down lately,” said Monroe, “but at least I don’t have to worry about forgetting my meds anymore.”

These habit-forming combination drugs are also ideal for fighting drug addiction. Anita Parker, for example, wanted her heroin addiction treated but always forgot to appear at her methadone clinic. Yet ever since the clinic began handing out a new, highly effective formulation called Crystal Meth-adone, she hasn’t missed a dose, hasn’t abused heroin and, oddly enough, hasn’t slept a wink.

Of course, Ms. Parker’s insomnia is troubling and is thought to be related to her sleep apnea, so Dr. Forman plans on changing her CPAP machine (which she never used) to a PCPAP machine, which periodically delivers doses of PCP to the CPAP user.

Despite promising results, some misguided critics of these new drugs worry that users will become dependent on the habit-forming substances. In response, Merck has released a new ad for Blowcor, in which it asserts that taking Blowcor is considerably better than being non-compliant and taking no statin at all. It ends with the tagline: “Take a statin laced with crack. It’s better than having a heart attack.”

UPDATE: Regarding the slogan, it was pointed out that cocaine itself can cause MIs. As a result, Merck has pulled Blowcor off the shelves, which has led to stock in Pfizer going up 500% as its LiPotOr (atorvastatin-cannabis) is now set to take over the statin market. But there’s no word yet if Novartis plans to follow Merck’s lead and pull their cocaine-statin combo pill, Snowcor.

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Patients Unable to Pay Hospital Bill Can Stay and Do Scut Work Instead

Patients Unable to Pay Hospital Bill Can Stay and Do Scut Work Instead

WILMINGTON, DE—With no end in sight to the national healthcare debate, one community hospital in Wilmington, DE is experimenting with a new way for patients to pay off their debts. Patients at Wilmington General Hospital who are ready to be discharged home now have the option of staying longer and performing scut work in lieu of paying their hospital bill.

“Look,” said hospital CEO Marvin Gore, “we know that it can be hard for our patients to afford medical care. We also know that there’s a ton of tedious tasks that must be completed everyday for a hospital to run smoothly. And as a tiny community hospital, we don’t have lowly medical students and residents to foist these menial tasks upon. So we let our financially-strapped patients do them—it’s a win-win situation. They don’t have to pay us, and we don’t have to pay them!”

Early results seem to be very promising. Current scut workers include Gertrude Steinman, a frail 92-year-old woman with dementia admitted for pneumonia who indicated she lacked the funds or insurance to pay for her stay. So upon discharge one week ago, she opted to stay and do scut work. Her first task was to deliver STAT bloodwork from a coding patient to the lab. Seven days and seventy stops for directions later, she is nearly halfway to the lab.

With this new plan, there is no shortage of scut workers. Trish Berman, a 71-year-old woman admitted with giant cell arteritis complicated by sudden blindness, is now busy attempting blood draws and IV insertions. Mark Pham, a 36-year-old man hospitalized for severe cellulitis of his right arm, now has that same arm deep inside an elderly man’s rectum struggling to disimpact a lodged piece of hard stool that just won’t budge.

Then there’s Raymond Cleary, a 74-year-old man status post MI, who was seen transporting an obese patient up a ramp towards the Radiology unit. After helping lift the heavyset patient onto the CT scan table, Mr. Cleary promptly collapsed. But not to worry, Ms. Steinman is on her way to go get him and deliver him to the ER…just as soon as she drops off those test tubes.

While Mr. Gore acknowledges that patients recovering from acute illnesses may not be the ideal candidates to perform these tasks, he admits it doesn’t really bother him. “As long as it gets done and it’s not me doing it, I frankly don’t care who does,” Gore said.

“If all goes well,” the notoriously thrifty CEO added, “in a few years, these patients will be running the entire hospital themselves.”

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Is your business menopause friendly?

There has been a lot of media coverage lately about menopause in the workplace, and the consensus has been pretty unequivocal: far too many of the UK’s businesses are failing to provide enough support for their older female employees.

What that translates into is a working environment for women that has systemically failed to recognise that menopause is not a condition that can be dodged – it will affect every woman at some stage of her life.

For a lucky minority, the ‘change’ slides by without much more fanfare than perhaps an occasional hot flush. For the majority, though, the menopause – a biological process that can be glacially slow to pass (around 5 years, on average) – is a miserable cocktail of multiple debilitating symptoms.

The online health resource WebMD estimates there are as many as 34 recognised symptoms of the menopause.

Among the unenviable things with which the majority of women can expect to become acquainted, apart from relentless hot flushes, are insomnia as well as fatigue, loss of sex drive, fierce mood swings, anxiety, depression, lapses in memory, headaches, irregular periods, racing heart, loss of bladder control, aches and pains, and vaginal dryness.

Although there can be few people over the age of 20 who aren’t aware of its existence, it seems that the menopause is an unrecognised concept in many offices. Or, at best, there is little recognition that the menopause has the potential to impact on an employee’s productivity which, in turn, impacts on their employer’s profitability.

There are many possible reasons for this bewildering lack of acknowledgement. One is that many women simply choose to endure the symptoms alone.

Not all women want to take hormone replacement therapy (HRT) to combat their menopausal symptoms.

Media reports of concerns that conventional HRT is linked to cancer or heart disease have done a good job of making a lot of women think twice about taking the synthetic – or lab-grown – hormone therapy.

And for most of those women, that’s where they believe their options end. Except, conventional HRT isn’t the first and last option beyond putting up with it – and this is where businesses could be doing so much more to help educate and support their female colleagues.

Bioidentical – or body identical – HRT is a low risk alternative to conventional menopause treatment. It uses compounds that exactly replicate the hormones produced naturally by the body, making it the closest thing to a woman’s natural physiology it’s possible to get.

In a spectacular dereliction of their duty to make women aware of all their treatment options (even if they choose not to recommend it), the NHS and successive governments have simply abandoned those women who believe they have legitimate concerns about the standard treatment routinely offered by their GP.

In some more enlightened GP practices, doctors do choose to lay out all the choices available to their menopausal patients, but those clinics are few and far between, though growing in number.

BHRT effectively relieves women of all their symptoms, leaving them much better placed to live life as they did before. That means happier, healthier employees.

So, if business is failing its female employees by being either being unwilling to recognise the menopause as an issue in its workplaces or too ill-informed to understand the issue exists, what can it do to be the bridge between the misery of the menopause with its stark ‘HRT or bust’ reality, and the promised land of health and happiness?

The first step, of course, lies in breaking down the taboo and fear that stops women talking to their colleagues and managers about the menopause and the adverse effect it’s having.

If businesses can conquer that, then ensuring their female employees have access to information about all the options available to them is a good next step.

Beyond that, making access to BHRT a part of its staff benefits package should be a genuine consideration for any business that’s serious about protecting both its employees and its bottom line.

The menopause has spent too long as the punchline of a joke that has long since ceased to be funny for millions of women in the UK. It’s time business took it seriously.

The post Is your business menopause friendly? appeared first on The Natural Doctor.

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Surgeons shocked to learn anesthesiologists have actual names

Surgeons shocked to learn anesthesiologists have actual names

The plenary session of the annual American College of Surgeons meeting was brought to a standstill last Saturday when the keynote speaker, Dr. Davinci, said that he had determined “to a high degree of likelihood” that Anesthesiologists are not all legally named “Anesthesia”.

Several surgeons in the audience initially burst out laughing, sure that it was a joke. Dr. Cappodorno was overheard gaffawing and then turning to his neighbor, Dr. Poorlow, and saying “Ha! That’s a good one. Can you imagine how confusing that would be?!”

Soon, however, it became clear that Davinci was not joking. He offered, as evidence, a birth certificate of an anesthesiologist he knew. On his powerpoint slide he blew up the section titled “given name” and the audience gasped to see “Robert” listed where they all expected to see “Anesthesia”.

After the conference, this reporter spoke with several surgeons who appeared to still be in shock. Dr. Owens, veteran hepatobiliary surgeon, looked dazed. “All this time I thought they went into anesthesia because they were named Anesthesia. Now I can’t figure out why they chose that specialty.”

Dr. Shuck, prominent vascular surgeon, looking as if he’d seen a ghost, said, “I don’t know when they decided to make this change, but I’m writing to the Joint Commission immediately to ask them to change it back. Patient safety will suffer if I have to dedicate brain power to remembering individual names!”

Dr. Embray, pioneer of robotically controlled robotic surgery, was skeptical, saying, with a chuckle, “I don’t buy it. I think Davinci is trying to pull one over on us. Next thing you know he’ll say the Xray techs aren’t actually named “Fluoro!”

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