Walmart Rounds Helping Train Nation's Young Doctors.

Little Rock, AK - Doctors at the University of Arkansas Medical Center celebrated the three year anniversary of Walmart Rounds on Friday, a one-of-a-kind initiative exposing student doctors to a wide variety of conditions rarely seen anywhere else in the world.

Attending physicians, residents, interns and medical students  from most specialities have donned their white coats and headed to their favorite local Walmart isle for the last three years to observe the stunning pathology of Walmartians in their natural environment.

Walmart helping train young doctors.
"During Walmart rounds, we try and tell our students to be as discrete as possible whenever they discover a horse or a zebra, but sometimes their excitement overcomes them," said attending Neurologist Dr. Krzesimir Bednarczyk.

"Just last week one of my gunners in isle three started yelling back to the team 'Here comes a hemochromatosis with a lupus rash, even though it was clearly just an old lady with a bad tan.'"

When the Rheumatologists heard about a possible case of lupus heading their way,  they laughed and chuckled arrogantly.  "I teach all my fellows that nobody has lupus unless we say they do," said Dr. George Bostinza, the Rheumatologist known best for his shirt 'Why the Hell did you order a sed rate anyway?'

"We also had to put up a sign that says 'If  you're here for fibromyalgia, STOP!  Turn around and go back.  Fibromyalgia is a primary care disease.'"

But FP would have no part of it.  By punting every shopper to another service, attending physicians used Walmart rounds to educate student doctors on the financial aspects of medicine.   "We always thought our young Medicaid clinic patients rolling up in their fancy rims and newest iPhone were a bit on the entitled side, but we were shocked to learn how belligerent they became when the cashier wouldn't accept their Medicaid card as payment in full," said Dr. Alan Fenwick.

ER doctors hanging out in deli hated Walmart rounds because of the never ending stream of shoppers sent over by other teams telling them to go see ER without even a courtesy call overhead.  "Just last week some old guy showed up with Dizziness of No Possible Cause to get a stat MRI and wondered why the neurosurgeon wasn't waiting for his immediate arrival," said Dr. Brenda Dresser, an Emergency Medicine doctor who has since authored a case series in the NEJM titled  Turkey Sandwich Request as a Sign of Homeless Dilaudopenia.

"We're also thankful that I.D. chose to hang out in produce so we could them all our toxic sock syndromes."

After just one week of Walmart rounds, the Infectious Disease teams started handing out gloves and yellow gowns after seeing dozens of their C. difficile and MRSA patients man-handling the grapes.  "Less than six months after starting our infection control program in produce, we noticed a statistically significant 76% reduction in mold on Walmart strawberries," said Dr Daniel Messer, the ID doctor who routinely refuses consults for bilateral cellulitis on principle.

Over the last three years, the Pulmonologists working cigarette checkout discovered  87% of their patients did not quit smoking last week, 92% forgot to bring their oxygen with them and 98% did in fact have $30 lying around for their copays. "They're basically just a bunch of liars," said Pulmonologist Dr. Stan Spencer, himself a two pack-per-day smoker.

While hanging out in baking, ortho  routinely spilled olive oil and waited for a fracture in unsuspecting lol's.  Appalled by the caveman like approach to medicine, many ortho students tried to escape to Dermatology hanging out in skin care, but realized they didn't usually show up until 11:00 am and were usually gone by noon for a long F.A.C.

Not so for the trauma doctors. They found Walmart to be fertile training ground for excited young surglings.  "The Walmart Scooter Club  has been a  gold mine for our young trauma doctors.   We see at least at least one high impact scooter-scooter collision every Friday.  Anything can happen when you've got two 500 pound objects colliding at break-neck speed," said trauma surgeon Dr Stan Harlow.

Even the Hospitalists used Walmart rounds as a quality improvement project after they discovered none of their patients ever showed up to their PCP follow-up appointment
within a week of discharge.  "We started scheduling follow-up at our Walmart rounds and discovered a 72% reduction in 30-day readmission rates over the last three years," said Dr John Fender, Director of Outpatient Hospitalist Medicine.

Two specialties in particular, Psychiatry and Pediatrics, have both abandoned their hospital training programs all together for a full time Walmart residency experience.  "We just couldn't replicate the level of pathology seen at Walmart in our hospital," said the hospital CEO.



New Granny Dumping Law Excites Doctors and Nurses.

Minneapolis, MN - Hospitalists and ER doctors clapped loudly Monday after Minnesota Governor Mark Dayton signed legislation SF 18342, making it illegal for families to drop elderly relatives off in the ER and then leave.  The offense is a misdemeanor with a fine of up to $2,500.

Granny Dumping Law hopes to reduce Vacation Observation admissions.
Dubbed the Granny Dumping Law, officials hope this puts an end to the practice of using expensive emergency rooms and hospitals as a holding tank for the state's at-risk elderly community while their children take family vacations to warmer climates or simply want a weekend alone without their parents or in-laws.

Doctors and nurses say they can see a granny dumping case from a mile away and are tired of being used as daycare staff by uncaring children who use the state's hospital system as their vacation kennel.

"At least once or twice a day every winter, we see families decked out in Tommy Bahamas, driving slowly through the ER parking lot in a minivan pilled high with suitcases before calmly wheeling granny up to triage to say something is wrong with nana and then driving off, " said ER triage nurse Adrian Bremer.

The legislation allows doctors and nurses to hand out fines on the spot, after being deputized by the state, when they suspect cases of granny littering in the ER.   The minimum fine is $1,000 but quickly rises to $2,500 for cases involving poocanos or toxic foot syndrome.

In today's age of entitlement, some families don't even try to hide their desire to rid grandma for the weekend. "I had a guy last Friday drop off his mother-in-law with a box of Kellogg's Raisin Bran ® saying he was having a big poker game this weekend and he'd be back Monday to pick her up," said Adrian. "When I told him that wasn't appropriate, he said 'EMTALA bitch' then asked where his satisfaction survey was."

Instead of working up these patients, ER doctors have started to call the hospitalist to directly admit them from triage for Vacation Observation (ICD-10 code 33.10.9).

"We used to call the families after everything came back normal except the gratuitous contaminated UA, but they never answered their phone and we aren't allowed to send an old person home from the ER," said emergency doctor James Johnson, who claims that's a hospital policy and he's just doing his job.

But hospitalists say the already busy winter months have become increasingly more intolerable with the rising number of vacation related admissions.

"I'm averaging three vacation observation patients a day on my list and they are the hardest to please.  I think the families are telling them we are a 5-star hospitel." said hospitalist Dr. Jenny Howell.

Even some community doctors have starting using Vacation Observation as a reason to clear their census for their own family vacation.

"It was awesome.  I had my Physician Assistant Assistant's nurse call the hospitalist last Friday evening and make up a story about how all seven of my patients needed a higher level of care so I could clear my census for vacation," said one Family Medicine doctor who wished to remain anonymous because he knew what he was doing was just plain shitty.




Pharmacist Pill Color Debate Goes Viral.

The color of the dress, that is clearly black and blue, take a strange and unusual turn Friday after a Walgreens pharmacist posted a picture of some Advil gel cap pills on his Facebook account asking, "Are these pills green or black?"  Thousands of pharmacists painfully debated the color for hours with both camps escalating the discussion to profound levels with ever more creative variations of cat pictures and  Michael Jackson eating his popcorn, resulting in a nationwide pharmacist shortage for hours.

At the height of the viral argument, thousands of pro-spanking, vaccine denying, and end-stage fibromyalgeurs hijacked the debate and concluded, without a doubt, that vaccinating unspanked children causes fibromyalgia.

The internet is a strange and wonderful place.  And now it's a public utility!  Congratulations.  You just wasted another minute of your live reading this!

 What color are these pills?
What color are these pills?  


Troopers Nab Drug-Seeker Trying to Fill Script for '1 Pound of Mofine'.

Dallas, TX -  Texas State Troopers arrested 47-year-old Harold Stanker on Tuesday after Walmart pharmacists reported a man trying to fill a prescription for 1 pound of mofine written by an ER physician named The Doctor.

'1 pound of mofine' prescription tips off Walmart pharmacist
The suspect told officers he got the prescription during a recent visit to the hospital. "The doctor gave it to me after sum dude knocked me out while I was mindin' my own business," said Harold, an ER frequent-flier known for his almost daily pain complaints after altercations with sum dude.

Walmart pharmacists say they have received extensive training in prescription fraud, but admit it's getting harder and harder to separate the fake scripts from the real ones.

"It doesn't help that we actually have a self-humoring ER physician on file named The Doctor who frequently writes his scripts on napkins or other random paper products and signs them with a smiley face,"  said Walmart pharmacist Allen Bensen.

Allen admits it wasn't the chocolate stained napkin or even the misspelling of morphine that tipped him off.   "We're so used to the obnoxiously bad spelling and handwriting of doctors that we don't even pay attention to that stuff anymore.  Now we just take our best guess on the phonetic spelling of the script and go with it.  Besides, when we call physicians to clarify, we usually get a voice mail telling us to call the pharmacist for any prescription related issues," said Allen.

The Walmart pharmacist says he actually became concerned because of the unorthodox weight based dosing of the drug.  "If he had written the script for 2000 mofines, I probably would have filled it, no questions asked," said Allen.

When officers searched Harold, they also found prescriptions for 2000 oxycottons, a bag fulla hydacodas and a handful of fenergins.



Medicare Agrees to Pay For Reverse and Reverse-Reverse Transgender Surgery.

Medicare -  In 2014, The Department of Health and Human Services (HHS) lifted a three decade old law banning Medicare transgender reassignment surgery coverage for patients experiencing gender dysphoria, an intense discomfort or mismatch with biological sex and gender identity.

Medicare now provides expanded coverage for transgender dysphoria
However, a lawsuit by the American Civil Liberties Union (ACLU) claimed the policy discriminated against gender reassignment surgery patients experiencing transgender dysphoria, an intense discomfort or mismatch with their reassignment sex and transgender identity described in in the most recent DSM-5 2.0 update.  Medicare officials agreed and decided last week to provide expanded coverage for reverse and reverse-reverse transgender reassignment surgery.

Transgender advocates hailed the new policy as a step in the right direction.  "We are happy with expanded coverage options, but we will continue to vigorously reject any limitations on surgical transgender interventions," said Silver Storm, head of the political action committee Right to a Transgender Medicare Life.

"I've got several diabetic friends from my bridge club who've had parts of the same leg removed over six times before finally getting the whole thing cut off.   As a transgender Medicare patient, it's discrimination to only pay for up to three sex change operations.  What if I need four or five or six?"  said Silver.

A rash of transgender dysphoria cases last year helped convince Medicare officials of the need to expand coverage.  Quin Jensen, a 72-year-old transgender Medicare patient explains.

"Ever since I was a little boy, I've dreamed of living my life as a post-menopausal elderly woman. But after the surgery, I realized it wasn't what it was all cracked up to be.   After the surgeon gave me boobs that hung to the floor, I knew I had transgender dysphoria and wanted out of that body," said Quin.

In another case, 76-year-old Elm Tree realized she made a terrible mistake transforming into a male after finding out the average male in the United States only lived to 77 years old.  "After one of my friends told me women live five extra years, I told my surgeon to change me back, but it wasn't covered until last week.  Thank you Medicare for giving me another five years of life!"  said Elm.