Well, at least I am hijacking my own thread. I sometimes wish I would have started a blog and been a solo pediatrician for the past 20 years. There are so many things I could have written about. But, I likely would have pissed off 300 people instead of just the 100 without it.
Don't even get me started on radiology. You give the rule out, which is not allowed to contain the same word as the diagnosis so if the diagnosis is scoliosis, you have to rule out curvature of the spine. But, then the dictation will at times talk about the film but not even mention what you asked for. But, we are now forced to add a clinical vignette, which I think can be helpful. But, what kills me is when you give the rule out and all of the clinical information, they still say, "suggest clinical correlation."
And back to pain, I have an appointment with one of my patients who is paralyzed from T12 down, and her Dilaudid and oxycodone isn't covering it. But, she is already well over the 100 MME they are allowing, so I will either have to get a prior authorization or refer her to a pain specialist. And, the PA will require PT/OT and accupunture, something that isn't going to help someone with multiple decubitus ulcers. Actually, her story should be put on 48 hours or some documentary as it is both a heartwarming and horrible story, which has just culminated with a beautiful baby.
Politics is interesting. Everyone rips our governor who is a mini-Trump but without all the biases. He is Republican but came in to cut all the money wasting. I probably should be in the anti-Lepage group, but sometimes, you just go with what someone does for you. He basically told both of the hospital conglomerates they can fend for themselves when it comes to Medicaid as well as the FQHC. Then, he turned around and DOUBLED the Medicaid reimbursement for all non-hospital and FQHC practitioners, which percentage-wise makes me the highest-paid Medicaid doctor in the state. Medicaid now pays me better than every other private insurance.
I will most likely be at the next ACUC if I can afford to get away. Still going on 10 years without a day off. and no vacation for 14 years.
Now, I don't agree with what the NFL football are players are doing when it comes to not standing for the flag, and I start a lot of sentences with "The problem with America is...." just as we start sentences with "The problem with healthcare is..." but what happened to me two weeks ago, makes me simply want to hate the U.S. government. I have debated talking about it. My attorney will probably kill me, but you know, I really don't give a f..k anymore. But, I will put it in a separate post, so I can delete it. One of the benefits of being an admin. I can delete my post after eternity where others only get four hours or so. The story is so sick and so pathetic, that if I could I would just quit medicine today. And, remember, I see more Medicaid patients per provider than any other provider in the state. The U.S. needs providers to see Medicaid patients and yet...
