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.

The Joint Commission Cracking Down on Wrong Twin Surgery.

Oakbrook Terrace, IL -  The Joint Commission (TJC) announced new hospital safety mandates yesterday after 27 more cases of wrong twin surgery were reported this week alone.  American hospitals documented 1,492 cases of wrong twin surgeries last year, a 114% increase from just two years prior.

The Joint Commission hopes to put an end to wrong twin surgeries.
"After years of nitpicking, we almost ran out of stuff to investigate.  This twin thing is going to keep us busy for years," said Dr. Alan Fleming, President of TJC.

In one wrong twin surgery incident last week,  42-year-old Stan Wilson accidentally had his tonsils removed after the registrar failed to correctly enter Stan#2 into the hospital's computer system.

"I grew up in a time when you didn't question the doctors.  So, I got confused when they took my  Stan instead of  Stan#2 to surgery, but they're the doctors so I just figured they knew what they were doing," said the twin's mother Samantha.

Last week Jane and Jan Morrow took advantage of their similar names to get free breast enlargements.   Jan was whisked off to surgery after the registrar accidentally entered Jan instead of Jane.  Plastic surgeon James Cutsworth realized his error when Jane showed up for her post-operative appointment asking for something bigger.

"This is the fourth twin BOGO free boob job I've had to do in a year," said Dr. Cutsworth, who failed to catch the error despite following standard pre-surgery checklist requirements.  "The Joint Commission decided to ding us anyway for not having a wrong twin surgery protocol in place."

To help reduce the risk of wrong twin surgery, TJC now recommends both twins be present on the day of surgery so doctors can write "NO" on the wrong twin.  For identical triplets and other multiple gestations, TJC does not currently have policy mandates.  "But we're working hard to make this stuff up as we go," said Dr. Fleming.

"What if I told you The Joint Commission is cracking down on wrong twin surgery."

What if I told you The Joint Commission is cracking down on wrong twin surgery photo wrong twin surgery_zpspfrwqepm.jpg

24-Hour tPA Stroke Window Making Physician Lives So Much Better Now.

Dallas, TX - Twenty years of  physician suffering ended abruptly Monday after the American Stroke Association (ASA) announced a dramatically expanded 24-hour tPA stroke window protocol to better accommodate doctors' increasingly hectic schedules.

24-hour tPA stroke window brings relief to doctors everywhere!
"Recent apologies by the American Board of Internal Medicine forced us to reevaluate our priorities as an organization.  We now understand just how disruptive our three hour tPA window has been on doctors' lives and for that we are deeply sorry,"  said ASA President Dr. Jan Fleming.

With the new 24-hour window, ASA officials are hoping to give doctors much greater flexibility in planning emergent tPA administration around their busy days.

"Now is the time to start putting physician satisfaction first or we're going to be left with a nation of doctors who only work at The VA Spa," said Dr. Fleming, the ASA's first private practice ASA President.

Some neurologists wasted no time taking advantage of the new doctor-friendly protocol.  "Last month I would have quit after the first nine [holes] of a stroke alert.  Now, I can get in 36 holes, watch Tiger, drink a couple beers and not have to worry about showing up late to the tPA window," said Dr Bazyli Baczewski, a neurologist who has never made it to a stroke alert before the 3-hour window.  Not ever.  Not even once.

Other neurologists have already started pushing for once-daily tPA rounds at their hospital in conjunction with a hospitalist run 24-hour hemiplegia observation unit.  "With the new 24-hour window, it doesn't make sense for me to interrupt my drug rep lunch, miss my kid's soccer game, or cancel my front row tickets to Taylor Swift for emergent tPA.  Homonymous hemianopsia can wait until the morning for whomever is on call at that time," said Neurologist Dr. Agnieszka Sobkowiak, the world famous homo hemi expert.

Unfortunately, not every community is lucky enough to have within-24-hours access to a tPA Neurologist.  Since 2003, tPA decisions for stroke patients in rural America  have generally been punted to the on-call physician assistant.  In critical access hospitals with only access to nurse practitioners, the American Academy of Physician Assistants (AAPA) recommends transferring tPA candidates to other critical access hospitals that employ physician assistants.  President of the AAPA Don Witmore explains.

"The American Academy of Family Physicians (AAFP) and the American Association of Nurse Practitioners (AANP) got together a few years ago and decided since tPA has PA in it, we were the most natural fit to make the call."

But, with the growing army of  physician assistant assistants caring for rural America, having PAs make the call isn't the straightforward decision it used to be.  "We are teaming with pharmaceutical companies to develop tPAA so we can finally pass the torch and avoid getting stuck holding the bag," said Don.

With the 24-hour window now the standard of care,The American Academy of Emergency Medicine (AAEM) responded by officially punting tPA decisions out of the hands of ER doctors forever.  "Now that we've added tPA to our master list of drugs outside the ER scope of practice, we are proud our doctors only ever have to memorize six drugs to make it through their shift:  Phenergan, Dilaudid, Levaquin, Lasix, Lorazepam and Colace." said AAEM President Dr. Stan "Dilaudicet" Wilson.

Some ER physicians have already noticed a dramatic rise in their Press Ganey scores by allowing them more time to focus on patients threatening to call the CEO and less time on hemiplegic patients who can't even hold a pencil to fill out the survey anyway.

"Last week I had a mother complain about waiting for six minutes to have all seven kids seen for problems listening to her.   I quickly wrote orders to admit my tPA candidate  to the hospitalist and then to call them when the patient got upstairs so I could immediately attend to the mother's needs.  Every kid got Levaquin and I got seven perfect scores.  Bam!  That's how the game is played," said one ER physician.