Friday, September 30, 2011

Best Obama Bumper Sticker Ever! It's Funny, Trust Me.

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I saw the best obama bumper sticker ever the other day while driving.  It's funny.  Really funny.  Are you ready?  I have to warn you.  It's hilarious on so many levels.  Prepare yourself.  Make sure you don't have any food in your mouth.  Make sure you don't have any clients within ear shot.  You're going to laugh your butt off.  Ok, here goes:  I present to you the  funniest Obama bumper sticker ever
Panhandlers For Change!
OK.  Get back to work or panhandling for your change.  You have taxes to pay, but only if you're rich.

Now, go here for the best Obama joke ever or the funniest homeless sign ever.  Or a couple funny midget jokes.  

Thursday, September 29, 2011

Italian Greyhound Lives Change With New Babies (Pictures of Life With Zach)

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Marty and Cooper have been our angel puppies for the last eight years.  This year we welcomed little baby Zachary to our lives. We first wondered how well do Italian greyhounds do with newborn infants? But that didn't last.  We now know that Italian greyhounds do well with new babies.   But do their lives change significantly? Do Italian greyhounds and babies fight for attention?  Do they compete in tummy time warfare?   Do Italian greyhounds act like a baby when the new baby arrives?   Do they want to have their own crib?  Do they try and clean the baby?   Do they offer their lives to goodwill?   Do they help mom and dad find time to exercise?     The answer to all these questions is yes.  They do all that.

But, how did our Italian greyhounds' lives really change with a new baby in town?  The answer is simple, because they have  simple requests in life.  Now they have many more toys to choose from.  Maybe, just maybe, I'll have some ExerSaucer pictures to take with Marty and Cooper in the near future.

Click either photo for their full size view.


They also have another warm body to snuggle up with.



Because these are the things that matter most to our Iggy angels.

For much more of Zachary, you can visit all his blog posts and videos  or catch his Faces of Zachary slideshow presentation.

For more Marty and Cooper action, you can read all their blog posts, catch them at their YouTube channel  or watch their three beautiful slide show presentations, a full color slideshow, another  full color slide show and the all black and white slide show, all available for viewing in my side bar as well.

Wednesday, September 28, 2011

We Lost Our Baby Zachary For Several Hours Yesterday While Hunting!

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We lost baby Zachary for four hours the other day while hunting online for a new big boy chair.  We looked everywhere in our home for him and we simply couldn't see him.   Thankfully, he was OK.   That's the last time we buy him a camouflage onesie

We took off his camouflage onesie and replaced it with a moose onesie with a hoodie. At first he wasn't sure what to think.


But after a few moments, he was back to his normal smiling Zachary.



And after all that happy smiling, Zachary got tired and Marty decided to snuggle him to bed.



I love Happy endings!

For other great onesies, visit
For much more of Zachary, you can visit all his blog posts and videos  or catch his Faces of Zachary slideshow presentation.

For more Marty and Cooper action, you can read all their blog posts, catch them at their YouTube channel  or watch their three beautiful slide show presentations, a full color slideshow, another  full color slide show and the all black and white slide show, all available for viewing in my side bar as well.

Tuesday, September 27, 2011

Hilarious Grand Rounds Edition

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Hospitalist ZDoggMD delivers this weeks Grand Rounds in the only way he knows, with an awesome dose of hilarious medical humor.  Go check it out.  The guy is a genius and you're sure to find a nugget or two to give you gut wrenching laughs.

Monday, September 26, 2011

Breast Cancer Virus Research Cure And Patent? Virus AAV2 May Hold The Answer, Says Penn State Researchers

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Perhaps, some day, all cancers may be cured with virus therapy.  According to Penn State researchers the adeno-associated virus type 2 (AAV2) may hold the answers to  fighting breast cancer and a whole lot of other cancers.  More interesting though is that these researchers  filed for a U.S. patent on the work.  That means if you want the eventual fruits of their labors, you're going to have to pay for it.

Yet, many people believe that doctor health care is a right and should be provided free of charge at the expense of grueling physician education, time and energy.  Heck, even California is saying if you don't accept our offer of  12 cents on the dollar, we won't pay you anything.

Perhaps the AMA on behalf of all physicians, should file for patent protection on physician education.  That way, if these researchers want the services of their physician, they'll understand, at least, that they'll have to pay for it.  Because, as they surely must know, the fruits of their labors don't come free either.

Sunday, September 25, 2011

Stock Market T-Shirt Humor: " I Didn't Lose My Ass In The Stock Market"

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I recently opened up a store called Happy's Four Humors and have started an original inventory of good humor for the holidays.  I love good humor and with world stock markets on edge,  what better way to spread a little up and coming holiday cheer than to offer up a healthy dose of funny t-shirt humor.

They are sure to be great ice breakers for good conversation and bring lots of laughs to friends and family.  Perhaps strangers  will even get a kick out of them.

It all started  with my original Future Potbelly T-shirt.  Since that day (yesterday), I've experienced phenomenal growth.  I have just  tripled my merchandise selection with the addition of a special line of his and hers funny stock market apparel.  Obama would be proud.  That's how you get America working again, with a little entrepreneurial spirit.
I-Didn't-Lose-My-Ass-In-The-Stock-Market-Funny-T-Shirt-Graphic-Humor

What you see above is the backside graphic of the article of clothing.  At Happy's Four Humors, you have a large selection to choose from.   Whether you're looking for performance, organic t-shirt or even maternity, my store has a wide  selection of colors, sizes and fabrics for all your good humor clothing needs.

What are you waiting for? With world stock markets going crazy on the heals of great uncertainty these days,  let the world know you haven't lost your ass in the stock market.  Yet.

Saturday, September 24, 2011

FUTURE POTBELLY! T-Shirt: Good Humor Waiting To Find A Home!

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Why not a FUTURE POTBELLY! T-shirt with an arrow pointing down to the stomach?  I saw a pregnant woman wearing a t-shirt the other day suggesting her unborn child was a future football star of her favorite team.  So I say,  for all the men (or women if they're from thu pahts out yonder) should get their own t-shirt equivalent, courtesy of Happy's hard work and determination to bring joy to the faces of others.  I've teamed up with an online vendor  so you too can proudly display your  FUTURE POTBELLY!  T-shirt.  Hey lady!  Two can play that game!

Here's a picture of what the front of the t-shirt shows.
They make good gifts for the family too!  Get your FUTURE POTBELLY! T-shirt today and be proud to be an American. You might even make yo' mama proud.   I've given you lots of options to choose from on the site.    There is even a baby onesie in the mix.  Now that's a mama who's proud to be an American!

Father Son Workout (Cute Picture). That Kid Is Gonna Have Some Guns.

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I've been working on my back extension exercises due to an L5-S1 disk protrusion with impingement on my neural foraminal exit that has been giving me unremitting pain for the last several months.   If you've never had sciatica, count your blessings.  It's painful, especially when it makes picking up your new infant  almost impossible at times.

I've been working diligently with a physical therapy regimen to try and strengthen my core and posture to eliminate, or at least alleviate, the pain that it causes.  

And wouldn't you know it, I have a fan club.   Shortly after catching Zachary on video rolling over with confidence,  he now wants to join me in a little father son workout retreat.  Man, that kid is gonna have some guns when he grows up.  If he's already doing push ups at five months old, I hate to see what he's going to look like by the time he turns two.

Anyway, I think it's sweet.  Even angel Marty came in to join in some fun. Click image for full size view.



Notice I'm wearing my Popeye shirt.  That's right.  Back off.  I'm not messing around. I might even add this shirt to my winter workout and gear.   I'm going to lick this disk pain if it's the last thing I do, or at least until I give up and have surgery.

For much more of Zachary, you can visit all his blog posts and videos  or catch his Faces of Zachary slideshow presentation.

For more Marty and Cooper action, you can read all their blog posts, catch them at their YouTube channel  or watch their three beautiful slide show presentations, a full color slideshow, another  full color slide show and the all black and white slide show, all available for viewing in my side bar as well.

Camouflage Dog Collar With Bow Picture (Marty Iggy Models The Goods!)

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Marty, our eight year old Italian greyhound has received his free camouflage dog collar with the pretty orange bow.  Why you ask?  Well, Marty won an  Italian greyhound collar photo contest with his awesome stare down of our four month old Zachary during a tummy time pose.  Marty is a Princess. But, after great consideration, he decided to choose the camo collar provided by crazyforcollars, instead of going pink.  

You go Marty.  Hold your head up high with confidence.  Marty is still currently being treated with prednisone for an autoimmune pemphigus skin condition he developed out of no where several months ago.  His ongoing treatment with prednisone has made him gain a significant amount of weight with a voracious appetite for food and water.  He's not the fattest dog ever and hopefully it will stay that way.

While talking to strangers the other day, they remarked that Marty was taking on the shape of a bullet, instead of the deep chest and tiny midline of the Italian greyhound family.  Don't you worry Marty.  It's not your fault.  You have a glandular problem.  

Wear your camouflage colar with pride and dignity and if anyone tries to insult you again, take out their femoral head and walk away.  Nobody's gonna mess with you and your camo collar with the pretty orange bow (arrow not included!).



For more Marty and Cooper action, you can read all their blog posts, catch them at their YouTube channel  or watch their three beautiful slide show presentations, a full color slideshow, another  full color slide show and the all black and white slide show, all available for viewing in my side bar as well.

It Wasn't Me Skunk Outfit For Baby (Zach Makes His First Picture Book!)

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We caught Zach wearing his very own it wasn't me skunk outfit the other day. It turns out, he made his very first baby picture pages book and he didn't even know it.

"Ah.  This is the life!"



"Who could ask for anything more?"




"Oh, Oh!  What was that?"



"My oh my!  Something's happening!"



"I smell something stinky!"




"OK.  It was me!"


For much more of Zachary, you can visit all his blog posts and videos  or catch his Faces of Zachary slideshow presentation.

Friday, September 23, 2011

Hospital Sanctuary Right In My Backyard (Picture)

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When you're sick and not feeling well you want you and your family to know that there is a hospital sanctuary right in your backyard. It's part of the market share building hospital concierge plan with a Medicare and Medicaid exit strategy. If you're going to be in the hospital for an extended period of time, you want to know there is a place you can go to that brings peace and tranquility. So it came as quite a surprise to me to find this little hospital sanctuary right in the middle of my parking lot, hidden in a bunch of trees and bushes.


I believe this used to be where the smokers went before the hospital smoking ban policy went into effect. It looks like they've really done a fine job of really cleaning it up.  Look how wonderful it is.  She's a beut Clark.  The peaceful green water accent that compliments the trees around it.  The quiet drops of a one foot tall fountain waiting to be discovered for its simple beauty.  It's one of those times where you just had to be there to appreciate nature at its finest. This is what a hospital sanctuary is all about.

It's a good thing the the Joint Commission hasn't (yet) decided to  set national hospital sanctuary fountain standards.  They  might force all hospitals to go big or go home.

I hope this hospital sanctuary stays like this forever.  Because it's just perfect the way it is.

EMR Comparison

Successful software implementation starts with choosing the right system. This  checklist contains over 50 of the most important features to look for when evaluating:
  • electronic medical records
  • medical billing software 
  • scheduling software
  • technology, security and certifications
    Download now and get started todayDownload Tool Other useful information is available at my EHR Resource Center.



    LINK TO E/M POCKET REFERENCE CARD POST


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    Click image for high definition view

    How To Find A Lost Cell Phone In the Hospital

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    Ok, I'm sure most hospitalists and other doctors in the hospital have done this at one time or another in their career.  They've lost their cell phone while rounding and have to back track their steps to try and find it.   The good thing about the iPhone is that it has an app that can GPS track the cell phone should anyone ever decide to walk away with it.

    But the app doesn't work well in big buildings like a hospital where the 'ping' area can only usually be pinged down to a city  block or so.   This is unlike at my home where I can follow the cell phone ping on another device and actually see the phone on an internet map moving from one room to another.

    Fascinating stuff.  But it doesn't help me if I've lost my cell phone in the hospital.  So, if you're wondering how to find a lost cell phone in the hospital, whether it's an iPhone or a flip phone, just call the number.  That's what I did recently when I misplaced my cell phone during hospital rounds.  Who answered?  Why one of my patients, of course.  I recognized the voice, hung up and retrieved my phone in less than a minute.

     In retrospect I think I've just created a new diagnostic test.  It's called Happy's honesty sign.   I believe it might come in handy when one is trying to determine if patients in pain are drug seeking or if they are honestly having pain.  If you're honest about returning a brand spankin' new iPhone, you're more likely to be telling the truth about your need for pain medication.  So leave your phone in the room of a patient whom you question their motivation and you might find the answer you seek. 

    If you're a student or a resident, it's time to tuck away Happy's Honesty Sign in your diagnostic arsenal along with these other great medical signs:
     For more posts about cell phones visit

    Thursday, September 22, 2011

    TSA Afro Pat Down Story (and Video). I'm Not Kidding. Afro Gate Is Here.

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    So the TSA is now worried about bombs in the  female afro.  She's a black hairdresser with hair she hasn't cut in forty years.  And the TSA found it necessary to perform a TSA afro pat down.  It's afro gate I tell you.  I am happy to report that no bombs or weapons were found in her afro.  They did, however, offer her a spot on the next season of America's Got Talent!!

    View more videos at: http://nbcdfw.com.


    This got me thinking.  Happy's hospital has a no firearms policy.  I'm wondering if a full hospitalist afro pat down is necessary during my history and physical examination.

    ACLS For the Critical Palliative Care Physician: The New ObamaCare Reality

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    So I'm rounding the other day when I happen to stumble across an advanced cardiac life support (ACLS) manual, that is given out by the American Heart Association, sitting aimlessly at one of the nursing stations. I just completed my ACLS recertification this month with a remarkable 84% on the test.  I say remarkable because the ACLS nurse certifiers tell me that means 84 out of 100 patients I perform CPR on will survive.

    If only I had answered intraosseous instead of intravenous as the preferred medication route of access during a code, five out of one hundred  more of my patients would survive with my CPR skills.   Apparently, 99.9999% of all hospitals performing CPR are killing their patients by not providing intraosseous access, as the answer to the test question says so.

    With that said, I was surprised to see the name of the physician on the ACLS packet hanging out at the nursing station.  It was none other than the phenomenal palliative care physician I have the honor to work with on a daily basis. 

    I thought that was a bit odd.  A palliative care doctor recertifying for ACLS?  Perhaps there was a new branch of palliative ACLS I wasn't aware off.  Maybe it was PACLS, or palliative advanced cardiace life support, where talk therapy and communication replaces  chest compressions and all that nonsense.

    Everyone knows that patients prefer talking and communication over quality and good outcomes.  That's a fact.  Having a branch of palliative advanced cardiac life support just makes sense in an ObamaCare world where cost is everything and quality is defined by patient satisfaction scores.  Perception trumps reality.   That's the world we now find ourselves practicing in.  And that perception equals money.  If you want to get paid, you're going to have to play the game the best in order to beat the rest.

    As for this up and coming branch of critical palliative care, I see her leading the charge for the new specialized subspecialty of palliative advanced cardiac life support, complete with its own set of invented billable CPT procedure codes, rammed through the RUC and the AMA with reckless abandonment. Forget everything you've learned about ACLS in the past.  It's not about   CPT® 92950 .  It's not about  Code Gold.  It's not even about  hospitalist vs palliative care in the ICU

    It's about making the patient feel good, even when they lack a beating heart.  Heck, it even gives you an opportunity to bill critical care on a dead person.  The time has come for all hospitalists to take the initiative and learn palliative advanced cardiac life support. Because our patients deserve it.  More on that soon...

    Baby Rolls Over Video Milestone (Zachary Says What's Next?)

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    Five month old baby Zachary celebrated his five month birthday by rolling over front to back and back to front. He's had a few spotty attempts with intermittent success in the last few weeks.  Now he thinks he's a pro at it.    He seems to take it all in stride and wonders what's next?  I, on the other hand, think I got confused and spoke to him like he was Marty and Cooper trying to roll over.

    That's OK though. I don't think Zachary minded one bit. 


    For much more of Zachary, you can visit all his blog posts and videos  or catch his Faces of Zachary slideshow presentation.

    Italian Greyhound Giving an Anxious Dance Hug (Cute Video)

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    Marty is our eight year old angel  Italian greyhound that gives hugs.  I swear, he was born to hug.   Here is a cute video of him giving a little anxious dance hug to a cute little puppy fella.  I think they're in love.


    For more Marty and Cooper action, you can read all their blog posts, catch them at their YouTube channel  or watch their three beautiful slide show presentations, a full color slideshow, another  full color slide show and the all black and white slide show, all available for viewing in my side bar as well.

    Wednesday, September 21, 2011

    ER Quote of the Day: You Know It's Busy When...

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    Here's the funny ER quote of the day:  You know it's a busy day in the ER when you run out of speculums.  

    OK.  Just in case I ever had any doubt, it's now official.   I'm glad I'm not an ER doctor.  As if patients faking seizures in the ER wasn't enough.  God Bless you ER docs and all that you do.  It's a thankless job most of the time.  So, I'm saying thank you.  Thank you for being masters of the speculum, among other life saving skills.

    I haven't done a pelvic exam in over eight years.  With patient satisfaction being so important these days to the bottom line, I've got the perfect out for never doing another one ever again.  I'm pretty sure most women would request someone else when I tell them I haven't performed a speculum exam in eight years. 

    Do you agree?


    EMR Comparison

    Successful software implementation starts with choosing the right system. This  checklist contains over 50 of the most important features to look for when evaluating:
    • electronic medical records
    • medical billing software 
    • scheduling software
    • technology, security and certifications
      Download now and get started todayDownload Tool Other useful information is available at my EHR Resource Center.



      LINK TO E/M POCKET REFERENCE CARD POST


      EM Pocket Reference Cards Using Marshfield Clinic Point Audit



      Click image for high definition view

      Hospitalist Medicine Is Unpredictable: Daily Census Management.

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      Hospitalist medicine is unpredictable.  How do I know that?  Because I've been doing this for over eight years and my starting daily census can often vary  from eight to eighteen patients a day. 
       
      Over the years, I've come to accept the unpredictable nature of a hospitalist based medical practice.  We are at the mercy of patient.   If they are sick, we are here to help.  We don't actively recruit our clientele. They're here so we care for them.  We can either complain about it or minimize the effect  and the number of the unpredictable times.  I believe flexibility is key.  While hospitalist medicine does offer the benefit of fixed schedules, having some flexibility can introduced a satisfying compromise during busy times.


      EMR Comparison

      Successful software implementation starts with choosing the right system. This  checklist contains over 50 of the most important features to look for when evaluating:
      • electronic medical records
      • medical billing software 
      • scheduling software
      • technology, security and certifications
        Download now and get started todayDownload Tool Other useful information is available at my EHR Resource Center.



        LINK TO E/M POCKET REFERENCE CARD POST


        EM Pocket Reference Cards Using Marshfield Clinic Point Audit



        Click image for high definition view
        If Happy's hospital succeeds in getting patients into our front doors,  Happy's hospitalist medicine service grows too. When the hospital wins, we win. Because we are hospitalists.  We care for hospitalized patients.   It's all about market share in our aging population.  Economically speaking if they win, we win.  If we win, they win.   And don't forget the patient wins too with our excellent care.

        And let me tell you, I see winning all around me the the incredible changes going.  Slowly, but surely the hospital culture is changing.  And I see it changing for the good. By leaps and bounds.  Years ago I would laugh at such a position.  Not anymore.

        Despite all the government noise and unfunded mandates we must deal with navigating the uncharted waters  and economic suicide that is ObamaCare, the members of administration I have had the honor of working with are some of best medical and nonmedical minds in hospital based care.  They get it.  Period.  It's my honor to move forward in all the initiatives playing out to make Happy's hospital the best regional medical center that patients and doctors and nurses will want to experience.

        With that said, as hospitalists, we always seems to remember the really busy days.  We tend to forget the slow ones.   Happy's hospitalist service has finally hit the summer slow down.    And  it just happens to be the first day of fall.  That's the unpredictable nature of hospitalist medicine.  I can say, without a doubt, we have become busier as a hospitalist group.  Our daily beginning census is growing.  This year, compared with last, we are seeing more patients.  We are seeing sicker patients.  We are seeing more complicated patients.

        Some hospitalist rounding efficiency can be gained with technology, such as rounding with an iPad.  Some hospitalist efficiency can come in other ways.

        What is an appropriate starting daily census and appropriate total number of encounters per day for a hospitalist group?  The generally accept point of peak efficiency occurs in the 15-17 total daily encounters per day.  Of course, I believe, that number is widely variable based on the technology platform we are given to work with.  The fewer steps I make in a day, the less often I log into a computer, the more often daily patient data is presented to me in an always on fashion with immediate access to my wide range of data (including lab, x ray and nursing information), the more patients I can see in a day.

        Does that mean I could see 25, 30, 35 patients in a day?  Possibly.  In the future.  Not now.  No way.  Not even close. But, give me the tools to manage my daily census and unpredictable will become irrelevant.  And I'll remember everyday like I only had eight patients.

        And that's WIN-WIN for everyone.

        Tuesday, September 20, 2011

        Peek-A-Boo Baby Zachary Giggling (Cute Video Fun)

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        Little four month old baby Zachary discovered the peek-a-boo game with a cute little giggle laugh.  Here he is being happy about the whole experience.



        For much more of Zachary, you can visit all his blog posts and videos  or catch his Faces of Zachary slideshow presentation.

        Ready For Teeth (Baby Holding Toothbrush Cute Picture)

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        It appears to me that Zachary is ready for teeth in this picture of him holding a toothbrush.  Now, if I could just get some of my patients to have the same enthusiasm for teeth as Baby Zachary does. 

        My favorite tooth joke to tell patients?
        Happy: Hi sir, it appears to me you've got a case of the summer teeth.
        Patient: What's that?
        Happy: Some er there and some aren't.
        For much more of Zachary, you can visit all his blog posts and videos  or catch his Faces of Zachary slideshow presentation.

        Redheaded Sperm Donors Denied By World's Largest Sperm Bank: Not Enough Demand, Except In Ireland.

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        Well, it's official.  Redheaded step sperm children get no respect.   The internets is reporting on a striking case of redheaded discrimination.  Cryos, which is reported to be the largest sperm bank in the world  is now denying sperm donations from redheaded donors.

        Cryos shelves are apparently filled to the brim with the little squiggly fellas and the redheaded sperm are just not in demand, except in Ireland, where apparently the redheaded sperm donors contributions are flying off the shelves.  Perhaps all the red beer consumption explains it.

        I smell a class action lawsuit on behalf of redheads, because, you know, redheads are a suppressed minority who need protection to spread their genes without discrimination and sperm donation is a right, not a privilege.

        Alternatively, all the redheaded sperm donors could just dye their hair and surprise a whole bunch of families who ordered brown but got red instead.

        Monday, September 19, 2011

        Napoleon Dynamite, MD (Another Hilarious ZDogg MD Masterpiece Video)

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        ZDogg MD takes Napoleon Dynamite to the next level with Napoleon Dynamite, MD. It's got hilarious one liners for the internists, the gastorenterologists, the orthopaedic surgeons and even a little groovy emergency room doctor action. It's sure to make you laugh out loud.  Bow to your attending!

        Enjoy this hilarious Napoleon Dynamite, MD video from the ZDoggMD masterpiece theater series. I heard he's got another awesome one in the production phase too.  Leave it to ZDoggMD to take funny Napoleon Dynamite and making it hilarious.


        Make sure you catch the hypertension rap at the end of the video.



        You can catch his entire library of awesome videos in my sidebar for your convenience or at his YouTube  channel too.

        Sunday, September 18, 2011

        Hayrack Ride Baby Pictures (Zach Discovers The Great Outdoors)

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        Five month old baby Zachary went on his first hayrack ride today.  As you can see in these pictures, I think he's going to be a fan of the great fall outdoors.  The only question now is what should we dress him up for on Halloween?





        For much more of Zachary, you can visit all his blog posts and videos  or catch his Faces of Zachary slideshow presentation.

        Saturday, September 17, 2011

        Concierge Hospital Plan: The Perfect Exit Strategy.

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        Ask yourself this question:  Would you pay 20-30% less in insurance premiums if it meant you were locked into one hospital system for your health care?  I would.  That's  what one hospital system in Massachusetts is offering to provide.  It is, essentially, a concierge hospital plan.   You or your employer will pay a set premium, which the hospital is offering at a 20-30% discount, and you get all your health care needs in their system, only going to a competing hospital system if they are unable to provide your necessary services.


        EMR Comparison

        Successful software implementation starts with choosing the right system. This  checklist contains over 50 of the most important features to look for when evaluating:
        • electronic medical records
        • medical billing software 
        • scheduling software
        • technology, security and certifications
          Download now and get started todayDownload Tool Other useful information is available at my EHR Resource Center.



          LINK TO E/M POCKET REFERENCE CARD POST


          EM Pocket Reference Cards Using Marshfield Clinic Point Audit



          Click image for high definition view
          What a great idea.  In fact, it's an idea I have thought about previously for Happy's hospital.  Why shouldn't Happy's hospital offer direct premiums to large and small business employers in our city in exchange for reduced pricing?  I'd sign up.  My health insurance premiums cost over $12,000 a year.  In the eight years of my practice, I've probably sent over $100,000 to health insurance companies and realized less than $10,000 in expenses.


          It's a concept who's time has come.  In fact, direct concierge hospital plans also offer patients  and their employers the opportunity for tiered pricing for special amenities  (flat screen television service, pet therapy dog service, dialysis spa, designer ostomy covers, wine vending machines, free soda machines, gourmet cookies, closer parking,  door-to-door service, and 24 hour special access to their physicians and nursing staff).  

          No more worries about not getting paid for heart failure 30 day readmissions. Nobody's keeping track with concierge hospital plans unless the employers demand it.  That is  who these hospitals are accountable to because they are the ones paying the bills.   

          You are an employer and you  want your employees to have more amenities during their hospital stays?  You can purchase the premium amenity plan for a few dollars more.  You want the doctor to come back and talk to you and your family a second time in the same day?  No problem.  You've signed up for the all access hospital pass.  Your doctor gets paid more for the service they are providing and you and your family get the extra service you're paying for.

          The vast majority of one's health care in major cities can be provided in full service hospitals that have all the medical technology your illness  could desire.  Instead of sending your $20,000 a year in family premiums to  an insurance company for you and your family's  healthy lifestyles, send it all to your local hospital and let them use it to improve their amenities and customer service should you ever need to get admitted.  If your hospital is non profit they might even send you a partial refund at the end of the year as a way of saying thank you for staying healthy. 
           
          Let's take it one step further.  The time has come to use this concierge hospital plan model and its higher operating margins to exit the bankrupt Medicare and Medicaid National Banks and with that all their ridiculous unfunded mandates and unproven quality initiatives.  No more EMTALA.  Sorry patient faking a seizure in ER.  You're going to have to go to a hospital that takes your Medicaid.    Imagine the reduction in administrative costs that would be realized by exiting government health care.  Sorry Medicare.  Sorry Medicaid.  You folks are going to have to find another hospital to get admitted to.  Cut your daily census by 85% and increase your income at the same time.  Now that's a smart business solution.

          Instead of having the government force quality onto hospitals, hospitals should have to compete with each other for direct concierge hospital plan dollars and force quality on to themselves through transparency.    Medicare and Medicaid are demanding hospitals do more with less.  I say it's time for hospitals to do more with more competition and it's not CMS dollars they should be competing for.  Those concepts are dead. They cannot survive.  Hospitals should be competing for  private money from employers looking for the best quality health care dollar.  It's WIN-WIN for the hospital and it's WIN-WIN for the employers and it's WIN-WIN for the patient. 

          The only loser is the Medicare and Medicaid patient.  For those patients, I recommend they contact their Congressman and complain that nobody will take their insurance anymore. Hint.  It's because they pay less than the cost of doing business.  And when that happens, every business will eventually go bankrupt unless they change their business model.  That's exactly what these concierge hospital plans offer.  The perfect exit strategy.

          Bouncing Baby Zachary Has Fun on Daddy's Knee (Video)

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          Four month old Zachary enjoys a bit of fun and excitement bouncing on the bum bum knee with daddy. 



          Ah, what I wouldn't give to be four months old again.  Those were the days.  For much more of Zachary, you can visit all his blog posts and videos  or catch his Faces of Zachary slideshow presentation.

          Thursday, September 15, 2011

          Statistics of Poor Americans: A Shocking Look At the Facts.

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          Poor in America is not poor to the rest of the world. 

          Here are the surprising statistics and  facts about being poor in America.   46 milion Americans live in poverty surrounded only by hopelessness and despair;  And cable TV, the internet, a computer, video games and a flat screen television.  


          I agree with these findings.  Why?  Because in my ten years as a hospitalist I have never admitted a single person with starvation due to lack of food.   The poorest Americans are some of the wealthiest folks in this world.  

          Shocking, but not surprising.  Not one bit.  

          Laughing My Diaper Off (LMDO) Onesie Picture. LMAO.

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          Wednesday, September 14, 2011

          Best Nursery Rhyme Ever. Hands Down!

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          Mrs Happy and I went Zachary shopping today at a local consignment event.  It was one of those deals where folks try and sell all their gently used baby stuff and the organizer of the event takes a cut.  This place was packed full of everything a new family could ever need, except food stamps.

          It even had  books about nursery rhymes.  We had been looking for a nursery rhyme book for quite some time.    Nobody seems to sell them anymore.  And then we came upon a big giant hardback book titled Read to me Grandma for three bucks.  Not bad.  It contained nearly two hundred pages of timeless classics  such as Little Jack Horner, Pop Goes the Weasel and Twinkle, Twinkle Little Star.

          After flipping through the pages for a few minutes, one nursery rhyme gave me a double take.  I looked again.  And I saw it again.  I thought to myself, what kind of nursery rhyme book is this?  It was the the mother of all nursery rhymes that put all other nursery rhymes to shame.  

          The first thing I thought of was Andrew Dice Clay's interpretation of Little Boy Blue. 
          He needed the money.
          But this nursery rhyme.  Man oh man.  If only the Dice Man had gotten ahold of this one.  I would say, It might even be the best nursery rhyme ever, although probably a tad bit uncomfortable for a grandmother to be reading to her grandson.

          What is this best nursery rhyme ever?  I present to you page 66 of this nursery rhyme book:

          I Love Little Pussy.

          I can't figure out why I've never read the story about Little Pussy and I can't recall my grandmother ever sitting me down for a goodnight story with me about Little Pussy.  How does this nursery rhyme go?  From page 66 of Read to me Grandma

          I love little pussy,
          her coat is so warm,
          And if I don't hurt her
          she'll do me no harm.
          So I'll not pull her tail,
          nor drive her away,
          but Pussy and I very
          gently will play.

          Wikipedia says there are additional lines that aren't contained in this book.

           I'll sit by the fire,
          and give her some food
          And Pussy will love me
          because I am good.  

          Somebody pinch me and tell me I'm not dreaming.  This has to be the best and funniest nursery rhyme ever made, on so many levels.   Or, it might even be the biggest nursery rhyme FAIL ever. 


          So, for all of you grandmothers out there, remember to read to your grandson often. I know you're looking for those special times with Grandma.  But please, what ever you do, try and stay away from page 66.  As his father, I'm not sure I want Grandma talking with Zachary about Little Pussy.

          That is, of course, a job best left for the public school system.

          Best Doctor and Worst Doctor Ever, In The Same Day! That Takes Talent!

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          How many other doctors out there can say they've had one patient say they were the best doctor they ever had and another patient call them the biggest asshole ever.

          In the same day.

          Please step forward. We could start our own support group.