Laughing Baby and Italian Greyhound Dog Face Off Over Puffs! (Cute Video)

Nine month old Zachary and Cooper, our eight year old Italian greyhound go face to face for puffs.  Zach thinks it's hilarious and can't stop laughing.  Cute video!

You can also watch all the other blog posts, videos and beautiful pictures of Zachary and his two brothers Marty and Cooper.

Laughing Baby Discovers Nature (Video)

Laughing baby Zachary discovered a little nature during his walk as you can see on this video.  As a bonus, you also get to see Cooper, our Italian greyhound, pooping.

For all associated videos, pictures and blog posts click on their respective links to Zachary and Marty and Cooper.

Ducks Gone Wild (Fighting Over Women) Video!

I took this video today of a bunch of ducks minding their own business when all of the sudden two of the males started going at it.  It appears there were six males and five females in the bunch.  I suppose one of them got mad when the other called him an odd duck and the rest is history.

Here are some other videos about ducks and geese!

• Ducks swimming at the Yacht and Beach Club Pool at Disney 
• Great American Duck Race!
• Baby geese jump into the water after lining up. 

Percent of Hospitals Using Hospitalists Has Grown To 60% (2012 AHA Hospital Statistics)

What percentage of hospitals are using hospitalists in 2012?  Today's Hospitalist is reporting  (via the American Hospital Association (AHA) 2012 Hospital Statistics edition) that 60% of hospitals now use a hospitalist program.  That's  three out of five hospitals that now have a new or mature hospitalist program, up from just 30% in 2003.

Why is that?  Why would the number of hospitals using hospitalists continue to grow at such an astonishing rate?  Why would hospitals continue to provide hospitalist subsidy and support payments of nearly $130,000 per hospitalist per year?  Why does the hospitalist salary continue to rise year over year?

It's because hospitalists provide so many benefits to hospital systems that, for many, they are in invaluable asset in so many ways.  Hospitals that spend the money on  the front end will find their stable, mature and growing hospitalist programs will return millions of dollars on the back end.  It's the 57 million dollar hospitalist advantage.

With so many landmines, known and unknown,  ready to blow a whole in the voodoo economics that is ObamaCare, having a stable hospitalist program in place to navigate that reality may be one of the only ways for many hospitals to survive. 

What about the other 40% of hospitals without hospitalist programs?  Give them time.  This is how not to run a hospital or hospitalist program.  These hospital systems will eventually understand what they are missing.  And once hospitalist penetration as hit 100%, look for hospitalist growth from within as the Baby Boomers are just beginning their war path toward bankrupting the Medicare National Bank.

Forgot To Take My Thyroid Pills. Should I Take a Double Dose? What Should I Do?

I just got done writing about the possible link between CT contrast and thryoid damage and I realized that I'm getting close to the end of my three month refill for my own thyroid medication.  It looks like it's time to  conveniently refill my prescription using my Walmart $4 drug list iPhone app.  

But, I also  noticed that I've got an additional six pills left  in the bottle, taking me well past the renewal date on my prescription.    Oops!  That can mean only one thing.    In the last three months I forgot to  take my levothyroxin (generic Synthroid) on at least six different occasions. 

That's a shame.  Heck, if I can't remember to take one pill once a day how can I expect many of my patients to take 10, 15, 20  or more pills on multiple occasions throughout their day?   How can we expect our heart failure patients to make it through to day 31 to avoid the dreaded unpaid 30 day heart failure readmission rules coming shortly from the Medicare National Bank..  Even free heart medications won't keep these folks from bouncing back.  

It's obvious to me I forgot to take my thyroid pills.  What should I do know?  Should I take a double dose daily until I'm back on schedule?  Should I just let is slide and be a bit off on my renewal schedule.?  I think I'm going to take a double dose daily for three days until I've caught up on my schedule.  I might  take two at a time or I might take my additional thyroid dose at night instead of the morning.   I haven't yet decided.  Some studies even suggest dosing once a week thyroid medication is just fine and dandy as well.

I don't know if there is any hard fast rule about what to do in these situation.  And I'm sure that's what most of the general public thinks as well.  I'm sure some folks will skip the dose.  Some will take double their dose and some folks will call their doctor, get a voice mail, leave a message for the nurse and get called back at 5:15 pm the next day with information on what to do, after they've either already doubled their dose or skipped it entirely.

This is not medical advice for you.  Do as I say, not as I do.  Doctors make the worst patients.