You’ve probably heard about the outbreak of swine flu in various parts of the U.S. and Mexico recently. We even received a page via the UrgiCare service that one mother believed that her daughter had swine flu today! Talk about mass panic.  Interestingly enough, the swine flu is of a similar in subtype to the flu that caused the 1918 Spanish influenza outbreak (H1N1).  Google has set up a tracker to follow all of the suspected swine cases in North America:

View H1N1 Swine Flu in a larger map

medicine humor, medicine

I laughed the first time I read this question on my risk management training exam, which I am hoping to finish in between the 90hrs I anticipate being in the hospital this week:

The blunt end of the healthcare system can be described as:

a) action by clinicians

b) latent errors

c) inaction by clinicians

Oh boy, I have quite a bit to learn…

medicine humor

I have been cycling through paperwork for my new residency over the past few days. The packet contains a mix of poorly photocopied forms, some of which is either illegible or completely cut off. The hospital also graciously included a photocopied Chase Bank flyer dated 2004, which offered $200 for opening a checking account. I called the graduate admissions office (GME) later to clarify some issues:

Me: Hi, I’m starting residency at XXX next month, and I’ve got some questions about some of the forms I received from your office.

GME guy: You need to call YYY.

Me: The forms came from your office, one of them is a verification of medical school training. I’m not…

GME guy: (cuts me off) And?

Me: I’m not in town, and I was going to fax in the form to the Registrar’s office to be stamped. Do you accept faxed signatures?

GME guy: It depends if you sign it. Up to you.

Me: It goes to your office! Ok, I’ll fax it over. I’ve another question: what time and where do I show up for the orientation in June? The forms don’t say.

GME guy: We don’t do orientation.

Me: The form says “Please show up to Occupational Health on time”, but it doesn’t say when and where.

GME guy: This is OHS. You said orientation, confusing me.

Me: (I was getting really pissed off at this point) Yea, OHS. Where do I show up?

GME guy: <paused for 10 secs> You got the green sheet? Read the top.

Me: <looking at the green sheet> It says ..ving Pavilion, and no address.

GME guy: Yup, call the number at the top for info. Irving Pavilion.

<click>

Apparently the address for Irving Pavilion was completely cut off the top of the page. If I didn’t already know where the buildings on campus were, I’d have no idea where to find it.

Ah yes. And now I am reminded why I left NYC…

medicine humor, rant

Paperwork is the bane of the U.S. health system. Hospitals hire trolls to ensure that physicians and nurses document every last detail of a patient’s bowel movement in case of legal dispute. Social workers hound us to document minutiae so that the hospitals will receive their cut of the bill. I was recently told to draw a down arrow along with “K+” to document hypokalemia so that the hospital will be able to bill for the medical condition.

I am in the process of registering to work in a new hospital system in another state. The other day, I received a huge packet of poorly photocopied paperwork to be completed before I get hired. One of them is a statement that I will not sue my employer under any circumstances. Another form states that if I choose to work at this hospital, I am forbidden to moonlight in my free time. Other forms include various tax withholding forms (W-4′s, IT-2104′s), applications for employment, background check forms, and a variety of nondescript forms with a blank to sign and date.

To think, these forms are only for residency training! How much worse is the paperwork for a real job? I would have thought that the blood and sweat ended after I matched, but I’ve come to realize it’s a lifelong journey.

Do doctors in other countries have to go through the same harrowing process simply to practice medicine? What if I moved to France or China? Would there be as much paperwork? The thought of practicing medicine outside the U.S. is intriguing….

Readers! Please share your thoughts!

medicine humor, medicine, rant

In the research arena, there is always a “conflict of interest” declaration to enumerate any reasons why the researcher may benefit from favorable results of a study. Many times, the researcher’s lab is sponsored by the very same company whose drug  is being studied. Other times, the primary investigator holds stock in the pharmaceutical. Regardless, any conflict of interest is often viewed with critical skepticism, based on the notion that research should be purely scientific.

I’ve never had any financial disclosures in research. Is that good? I’ve begun to reconsider. Would it not be a privilege to be able to state that you are a primary shareholder in a pharmaceutical company? After all, don’t you have to be an important person to be in that situation? Don’t we all want to be important?

My next goal: strive to generate as many conflicts of interest as possible. More to follow…

medicine humor, medicine