Good Health And Wellness For Life

Sympathy for doctors please

This article from the New York Times talks about how unhappy doctors are. They are overworked because they spend too much time dealing with insurance companies and patients who think they know something. Here’s a story that comes from a friend of mine (not from the article):

A patient comes in with 2 days of congestion and basically a viral common cold. I examine them and give advice on how to treat the symptoms. Patient then demands a “z-pack”. I then spend the next 10 minutes explaining and basically arguing with the patient that they don’t need a z-pack and that giving it is not indicated for a virus. Now I’ve spent 15 minutes for what should have been a quick 5 minute appt. Waiting room is backed up and everyone’s pissed including the patient I just saw.

2 days later, I get a letter from one of the local urgent care centers saying they treated this patient for a “sinus infection” with a z-pack. Now, the patient’s insurance has not only paid for my visit, but they’ve paid for the urgent care visit which is usually at a 25% higher rate because it’s “urgent”. Oh, and the patient got an antibiotic they don’t need and further helps spread antibiotic resistance in the community. It’s a friggin joke sometimes.

This story helps show some of the problems. Insurance companies are paying for unnecessary stuff (but not paying for stuff they should cover).The other problem is the time doctors spend dealing with insurance companies who, of course, have clerks arguing with doctors about medical decisions. There’s a good example of that in the article.

How to get treated faster in the emergency room

WAYS TO BE SEEN QUICKER IN THE ER (No particular order)

1- Arrive by ambulance. They can’t take a patient from an ambulance and put them in the waiting room in most states. This is also why you can wait in the waiting room forever… if a steady stream of meatwagons keep pulling up, it doesn’t matter how long you’ve been sitting, they have to come first.

2- Speak English. if your medical professionals can’t understand you, you’re less likely to receive quick treatment b/c it’s harder to prove you need quick treatment.

3- Be bloody. If there’s one thing hospital staffs hate, it’s the potential for cross contamination. The more blood, the more likely they are to get you in the back.

4- Be polite. Accusing the staff of not giving you the treatment you deserve guarantees you’re not going to get it.

5- Be attractive. Hotties get all the percs.

6- Know your stuff. If you know your medical history, know your symptoms, and have records/samples of all your medications, you’re an easy paperwork case. Medical professionals hate paperwork, that’s why they’re medical and not financial.

7- Bring a child that’s not yelling. Yelling children negate #4. Tearful children invoke sympathetic responses. “Is my mommy/daddy gonna be okay soon?” advances you to the head of the line automatically.

8- Actually need medical attention. If you can reasonably wait until morning to go to a doctor, chances are you’ll be waiting until morning anyway in the waiting room. If you have a steak-knife sticking through your hand, that gets in quicker.

9- Onset time. Ties to #8. When someone asks you “When did these symptoms first occur?” If you answer “Oh, sometime last month” there’s no REASON for them to see you now that couldn’t wait until the next guy’s shift. The informed answer is “Sometime last month, but the severity drastically changed 2 hours ago.” This way you’re not misinforming that about onset (which can be key in diagnosing non-traumatic events) but also giving them a reason you should get into the ER as soon as possible.

10- NEVER threaten to leave. This guarantees you’re not getting back. It’s the medical version of holding one’s breath until someone else does what you want them to. You’re daring the Attending Physician to call your bluff, and I promise you they will every time. Also, never order food to the waiting room, or leave the waiting room to go get food…. if you’e with it enough to eat, it’s not an emergency, and you’ll be sitting there until the next shift comes in.

Medicare to Keep Paying for Heart Scans

Medicare said Wednesday that it would continue to cover the use of an increasingly popular scanning procedure used to detect heart disease, despite the agency’s earlier misgivings over whether there was sufficient evidence to justify paying for the tests.

Reversing a proposed decision issued last December, Medicare said Wednesday that it would continue to leave payments for the scans — which can cost $600 or more — up to the local insurance carriers that the agency employs to oversee medical claims. Most of the local carriers have been covering the test.

Medicare paid for roughly 70,000 of these heart scans in 2006, according to the agency, at a cost of $40 million to $50 million. For people not yet eligible for Medicare, thousands of other such scans were paid for by commercial insurers or from patients’ own pockets, at prices sometimes close to $1,000. Firm data on the number of non-Medicare patients tested were not immediately available.

Because commercial insurers typically follow Medicare’s lead on what medical procedures they will pay for, Wednesday’s decision seemed likely to allow for continued growth in the number of scans. They are now widely advertised as a noninvasive alternative to tests like angiography — which requires the insertion of a catheter into the blood vessels.

Medicare’s initial proposal, which would have ended payment for the scans unless the patients were enrolled in studies to determine the technology’s effectiveness, had met with fierce resistance from the doctors who perform these scans and the companies that make the equipment. They strongly defended the use of these scans as an important alternative to traditional angiography.

“We found that the evidence is not black and white either way,” said Dr. Barry Straube, the chief medical officer for Medicare. Given the overwhelming criticism of the preliminary decision, the agency decided that it did not have enough reason to override the local carriers’ decision to cover the tests as medically necessary. “Before we make a significant change in policy, we need more evidence,” Dr. Straube said.

Advertising: When a Corporate Donation Raises Protests

WHEN the Columbus Children’s Hospital agreed to name a new lobby after two retail chains to thank their corporate parent for a $5 million donation, everyone was all smiles. The same was true when the Ohio hospital renamed itself Nationwide Children’s Hospital, to acknowledge a $50 million gift from Nationwide insurance, a large local company.

But a coalition of children’s advocates contends that the hospital went too far by agreeing to name a new emergency department and trauma center after another locally based retailer, Abercrombie & Fitch, in exchange for a $10 million donation.

The coalition, which includes the Campaign for a Commercial-Free Childhood, several pediatricians and Parents for Ethical Marketing, is asking the hospital to reconsider the decision made in June 2006 to accept the donation. The plea is being made now because ground is to be broken this year for the building to house the emergency and trauma facilities.

The 15 organizations and 80 individuals that compose the coalition contend that naming the new center after Abercrombie & Fitch — known for provocative advertising and revealing clothing — sends a grievously wrong message.

“It is troubling that a children’s hospital would name its emergency room after a company that routinely relies on highly sexualized marketing to target teens and preteens,” the members of the coalition wrote in a letter that was sent on Tuesday to the hospital’s office in Columbus, Ohio.

“The Abercrombie & Fitch Emergency Department and Trauma Center marries the Abercrombie brand to your reputation,” said the letter, addressed to five senior officers of the hospital. “A company with a long history of undermining children’s well-being is now linked with healing.”

The complaint is an example of negative reaction to the increasingly prevalent practice of naming public facilities after corporate sponsors, donors and supporters.

Opponents who complain about the growing commercialization of the American culture are upset that private companies are able to brand stadiums, parks, schools, school buses and hospitals.

About a dozen hospitals across the country bear corporate or sponsor names, including at least two other children’s hospitals: Mattel Children’s Hospital U.C.L.A. in Los Angeles and Hasbro Children’s Hospital, the pediatric division of Rhode Island Hospital in Providence.

Naming a facility for Abercrombie & Fitch “is more egregious,” said Susan Linn, the director of the Campaign for a Commercial-Free Childhood in Boston, because of the reputation of the retailer as “among the worst corporate predators” for “sexualizing and objectifying children.”

“Selling corporate naming rights is a slippery slope, and this is way down that slope,” said Ms. Linn, who is also the associate director at the media center at Judge Baker Children’s Center, an affiliate of the Harvard Medical School.

The sex-drenched images of toothsome young men and women that Abercrombie & Fitch has used for years to sell its own-brand apparel in ads, posters and catalogs have made the company and its chief executive, Michael S. Jeffries, billions of dollars — and countless enemies.

The opponents of the company’s campaigns, which are typically shot by the fashion photographer Bruce Weber, contend they cross the line by presenting undressed teenagers and 20-somethings in overly sexualized situations. The company describes its ads as playful and celebratory of the free spirit of today’s young Americans.

Last month, the police in Virginia Beach, Va., removed two large posters — part of the chain’s national campaign — from the windows of an Abercrombie store in a mall and charged the manager with an obscenity misdemeanor. One poster showed a woman with a breast mostly exposed and the other displayed three shirtless young men, one of whom was also revealing part of his backside.

The city of Virginia Beach subsequently decided against prosecuting the store manager.

Other times, however, the opponents of the Abercrombie approach have prevailed; in 2003, the company discontinued its popular magazine-style catalog, A.& F. Quarterly, because of mounting complaints from parents about its racy contents.

And a year later, the company, based in New Albany, Ohio, agreed to pay $50 million to settle a suit that accused it of discriminating against minority employees for promotions and cultivating a white-only image.

As for the coalition’s protests against the hospital naming, Tom Lennox, a spokesman at Abercrombie & Fitch, said on Tuesday, “We are proud of our longstanding relationship with the hospital and pleased to help secure its bright future.”

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A call from a reporter to Nationwide Children’s Hospital for a response to the letter from the coalition was returned by Jon M. Fitzgerald, the president of the Nationwide Children’s Hospital Foundation.

“I like to focus on the philanthropy of it,” Mr. Fitzgerald said, adding, “I don’t feel comfortable addressing” any of the objections raised in the letter.

“Two years ago, Abercrombie & Fitch made a very significant philanthropic gift,” Mr. Fitzgerald said. “In honor of that gift, we chose to offer recognition of their tremendous support of our organization.”

Mr. Fitzgerald took issue with a contention in the letter that the hospital agreed to “sell naming rights” to Abercrombie & Fitch in exchange for the $10 million.

“We don’t sell naming rights,” Mr. Fitzgerald said. “We as a nonprofit accept gifts to support our mission. We’re looking for philanthropic support.”

The ground-breaking for the building in which the facilities are to be housed will probably take place in late fall, he added, with completion scheduled in 2012. The new lobby, to be named after the Limited Too and Justice retail chains owned by Tween Brands, also will be in the new building.

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Abercrombie & Fitch has been a frequent target of criticism from organizations and activists like those that wrote the letter. They also include the National Institute on Media and the Family, Teachers Resisting Unhealthy Children’s Entertainment and Dr. Alvin F. Pouissant, the nationally known professor of psychiatry at the Harvard Medical School.

One school of thought holds that complaints from parents and the establishment only elevate the brand’s appeal with the target audience.

“There’s always a ‘forbidden fruit’ aspect to what adolescents do; that’s probably why they smoke,” said Dr. Victor Strasburger, professor of pediatrics at the University of New Mexico School of Medicine, who also signed the letter. A main goal of the letter is “trying to influence the decision-makers at children’s hospitals to act responsibly,” Dr. Strasburger said. “We’ve reached a point in our society where it seems there’s no such thing as bad publicity,” he added. “We have to pull back from that.”

Abundance is for Everyone

Abundance is for everyone, not just the limited few that life appears to have smiled on. We are surrounded by abundance. Nature is lavish, even wasteful in its abundance. Anyone caring to look will find an abundance of love, joy, money, and health is readily available to everyone willing to accept them. If there is any lack in our lives it's not because there is not enough, but rather, because we are limiting our intake. What we receive in life is controlled by the limits we place on our emotions, behaviors, thoughts and actions. There are many factors involved in why it is so hard for us to open the valve controlling the flow of abundance in our lives. By the time we become aware of the fact that we create our own limits, the beliefs and habits we've developed that produce these limits are so ingrained they are very difficult to change. Society also has its role to play. Since most of the world's governments have become capitalistic societies, it's in their best interest to promote conditions and belief systems that produce large numbers of have-nots. Simple economics tells us that in order for capitalism to thrive, there must be a large supply meeting a large demand and you must have people who are in debt to create a large enough demand to consume that large supply. The simple reality is that the governments of the world make their money from our poor health, debt, and our struggle to "just get by." Their abundance is dependant on our lack. But this does not mean we have to accept these limits. While it's true that most people will never take advantage of it, information about attracting wealth and prosperity is freely available to anyone caring to look. And the law of attraction says that the more you look, the more information you will attract. What fills your life is what you focus on. Learning to create abundance in your life is about much more than simply creating material wealth, it is about enriching your Self as a whole. When you begin to understand the principles and laws that govern Abundance, you begin to understand that you are not constrained by the conditions of the economy or the amount of your present income. Your ability to increase your wealth, live in abundance, and have financial freedom is all based on your understanding of the universal laws that govern the flow of energy controlling your ability to turn potential into reality. Yet there is more to creating abundance than simply placing an order and then sitting back to wait for its delivery. You have to be giving something of value, adding to the flow, in order to make this work. When this is the case people are more than willing to pay for your contribution. Wealth, money, success, love, and health are all forms of energy. Being part of the flow means that you are a participating member. Once you understand how to operate in the flow of that energy, you learn to work with the Source of energy and actively create your reality instead of simply letting random thoughts create a chaotic existence for you. Abundance is about living a healthy, vibrant life with a purpose and experiencing the joy that comes from possessing a strong sense of Self.

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