Feet First |
|
|
“It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.” - Sir William Osler Email Dr. Alice
Sites I Like
Useful Links Area Codes Zip Codes A Handy Temperature Converter Body Mass Index Calculator The Mailbox Locator Current Events With Attitude Instapundit Ace of Spades Coalition of the Swilling Weather Sites California Regional Weather Server NOAA Weather BBC Shipping Forecast Gastric Blogs What I Cooked Last Night Eggton Red Kitchen The Cheap Cook Traveler's Lunchbox Archives 10/01/2002 - 11/01/2002 11/01/2002 - 12/01/2002 12/01/2002 - 01/01/2003 01/01/2003 - 02/01/2003 02/01/2003 - 03/01/2003 03/01/2003 - 04/01/2003 04/01/2003 - 05/01/2003 05/01/2003 - 06/01/2003 06/01/2003 - 07/01/2003 07/01/2003 - 08/01/2003 08/01/2003 - 09/01/2003 09/01/2003 - 10/01/2003 10/01/2003 - 11/01/2003 11/01/2003 - 12/01/2003 12/01/2003 - 01/01/2004 01/01/2004 - 02/01/2004 02/01/2004 - 03/01/2004 03/01/2004 - 04/01/2004 04/01/2004 - 05/01/2004 05/01/2004 - 06/01/2004 06/01/2004 - 07/01/2004 07/01/2004 - 08/01/2004 08/01/2004 - 09/01/2004 09/01/2004 - 10/01/2004 10/01/2004 - 11/01/2004 11/01/2004 - 12/01/2004 12/01/2004 - 01/01/2005 01/01/2005 - 02/01/2005 02/01/2005 - 03/01/2005 03/01/2005 - 04/01/2005 04/01/2005 - 05/01/2005 05/01/2005 - 06/01/2005 06/01/2005 - 07/01/2005 07/01/2005 - 08/01/2005 08/01/2005 - 09/01/2005 09/01/2005 - 10/01/2005 11/01/2005 - 12/01/2005 12/01/2005 - 01/01/2006 01/01/2006 - 02/01/2006 02/01/2006 - 03/01/2006 04/01/2006 - 05/01/2006 05/01/2006 - 06/01/2006 06/01/2006 - 07/01/2006 08/01/2006 - 09/01/2006 09/01/2006 - 10/01/2006 10/01/2006 - 11/01/2006 11/01/2006 - 12/01/2006 12/01/2006 - 01/01/2007 01/01/2007 - 02/01/2007 02/01/2007 - 03/01/2007 03/01/2007 - 04/01/2007 04/01/2007 - 05/01/2007 07/01/2007 - 08/01/2007 08/01/2007 - 09/01/2007 09/01/2007 - 10/01/2007 10/01/2007 - 11/01/2007 11/01/2007 - 12/01/2007 12/01/2007 - 01/01/2008 01/01/2008 - 02/01/2008 02/01/2008 - 03/01/2008 03/01/2008 - 04/01/2008 06/01/2008 - 07/01/2008 07/01/2008 - 08/01/2008 08/01/2008 - 09/01/2008 09/01/2008 - 10/01/2008 12/01/2008 - 01/01/2009 01/01/2009 - 02/01/2009 02/01/2009 - 03/01/2009 03/01/2009 - 04/01/2009 04/01/2009 - 05/01/2009 05/01/2009 - 06/01/2009 06/01/2009 - 07/01/2009 07/01/2009 - 08/01/2009 08/01/2009 - 09/01/2009 09/01/2009 - 10/01/2009 10/01/2009 - 11/01/2009 11/01/2009 - 12/01/2009 01/01/2010 - 02/01/2010 02/01/2010 - 03/01/2010 03/01/2010 - 04/01/2010 04/01/2010 - 05/01/2010 05/01/2010 - 06/01/2010 06/01/2010 - 07/01/2010 07/01/2010 - 08/01/2010 08/01/2010 - 09/01/2010 10/01/2010 - 11/01/2010 01/01/2011 - 02/01/2011 02/01/2011 - 03/01/2011 03/01/2011 - 04/01/2011 04/01/2011 - 05/01/2011 05/01/2011 - 06/01/2011 06/01/2011 - 07/01/2011 07/01/2011 - 08/01/2011 08/01/2011 - 09/01/2011 01/01/2012 - 02/01/2012 02/01/2012 - 03/01/2012 04/01/2012 - 05/01/2012 08/01/2012 - 09/01/2012 09/01/2012 - 10/01/2012 01/01/2013 - 02/01/2013 02/01/2013 - 03/01/2013 03/01/2013 - 04/01/2013 09/01/2013 - 10/01/2013 09/01/2014 - 10/01/2014 10/01/2014 - 11/01/2014 12/01/2014 - 01/01/2015 02/01/2015 - 03/01/2015 03/01/2015 - 04/01/2015 05/01/2015 - 06/01/2015 06/01/2015 - 07/01/2015 10/01/2015 - 11/01/2015 12/01/2015 - 01/01/2016 07/01/2016 - 08/01/2016 09/01/2017 - 10/01/2017 04/01/2018 - 05/01/2018 12/01/2018 - 01/01/2019 11/01/2019 - 12/01/2019 12/01/2019 - 01/01/2020 01/01/2020 - 02/01/2020 04/01/2020 - 05/01/2020 05/01/2020 - 06/01/2020 07/01/2020 - 08/01/2020 01/01/2021 - 02/01/2021 02/01/2021 - 03/01/2021 03/01/2021 - 04/01/2021 04/01/2021 - 05/01/2021 05/01/2021 - 06/01/2021 05/01/2022 - 06/01/2022 06/01/2022 - 07/01/2022 07/01/2022 - 08/01/2022 08/01/2022 - 09/01/2022 09/01/2022 - 10/01/2022 10/01/2022 - 11/01/2022 11/01/2022 - 12/01/2022 12/01/2022 - 01/01/2023 
|
Friday, December 16, 2022
Thoughts On Social Media
In the wake of the Night of the Long Knives on Twitter (if you weren't aware, Elon Musk deleted several journalists from the website), I have been wondering whether building a presence on social media really has the value it has been credited with for the past several years. Last night's episode, if nothing else, highlights how transient social media presence is. Leaving politics aside, I can think of two major issues that complicate "building a brand" (a term I hate). This doesn't apply to casual fun users, but to those who have made it a significant part of their careers. First is financial. There are rumors that Twitter is currently in financial trouble, and this isn't the first time that has been the case. If a pundit or celebrity goes to a lot of effort to build a presence on a selected website, and then said website goes bankrupt and disappears, all that work is wasted. A big part of the reason social media became so popular is that it's simple, cheap and fast to register. The problem is that those factors influence the audience of the site. "Fickle" would be a good word to use here - a reader that may like you today may block you tomorrow, or simply get bored and leave. Plus, a following does not translate to money. For example, Alexandria Ocasio-Cortez has a huge following on social media yet her recent book did poorly. It appears that few of her followers were willing to buy it. Second is the proliferation of social media websites. One way for a pundit to hedge their bets is to register on multiple sites, but how well does that really work? The more sites there are, the fewer members each one is likely to have. Is it worth it to spend time on multiple sites rather than investing that time in writing, researching or creating product? Plus those sites are not guaranteed to function well. From what I have read of Mastodon, it is more like a series of fiefdoms than an open site such as Twitter. Each node on Mastodon is run by separate individuals or groups, each of which can block anyone they want. Quite a few recent users have found this out to their dissatisfaction. I don't have any answers here, but I do think the issues I have mentioned play a large part in keeping analog or "old school" public presence alive. It will be interesting to see what happens in social media over the next few years. Labels: Random Thoughts, Twenty-First Century Crap Monday, January 11, 2021
So Here We Are Ridiculous, yes? - to run a medically-based blog and to have no specific posts addressing the defining medical issue of the early twenty-first century. I drafted a post on COVID months ago but never got around to completing it, but it's nearly a year later and here we are. We continue to be plagued by The Virus and the vaccine is just beginning to be rolled out. Like everything else about the COVID phenomenon, the vaccine is surrounded by fierce argument and conflict. There are groups who state that preference should be given to various groups based on age, race, profession; or conversely that these groups should NOT be given preference as there are other groups that need it more. All of these arguments have a grain or more of truth. But as happens so often, each group is ignoring or downgrading the needs of other groups at the expense of their own. Not to mention that there are many potential recipients who plan to refuse the vaccine for various reasons. The good news is that testing accuracy has improved, and the majority of those who get COVID don't get that sick. For those who do get really sick, the immediate and long-term consequences are severe. I type this as I sit at home on my last day of quarantine (I tested positive on January 2). I was one of the exceedingly fortunate ones who never got that sick. It was the equivalent of a nasty cold, and I still can't smell or taste much of anything. This thing spreads. Our little epic began just before Christmas when one of my parents' caregivers informed me that she had tested positive. Her husband and son are two of the other caregivers and they tested positive a day or two later. Then everybody else got sick. Do you know how difficult it is to find people willing to care for COVID-positive elderly? Pretty damn hard. My mother was coughing heavily and after examining her it was clear that she had bronchitis at the very least. I dragged my parents in to our urgent care on December 26; they tested positive and I was negative. I helped care for them as we frantically searched for a home health company willing to take on COVID positive patients, and finally found one. (My mother is bedridden and can't even sit up by herself, so this was necessary.) One week later with the onset of cough I retested, and this time I was positive. One of our regular caregivers and her daughter both wound up in the hospital with low oxygen, but my parents never ran a fever and their oxygen levels remained good. We were so, so lucky. Many were and are much worse off. Plenty of people younger than I have died from COVID or are still disabled from it with severe shortness of breath, memory issues and cardiac problems. The US was unable to react to the infection in an organized manner, as we run more on a state-based system than federal; so some states reacted better than others, plus travel was not locked down as soon as it could have been. (I'm looking at you, New York.) This assisted the spread of the virus over the holiday season last year. Speaking of New York, many state/county/city governments packed the elderly into nursing homes like sardines and then we had to watch them die, in many cases alone and abandoned by terrified health care workers. The fact that 2020 was also an election year contributed to the general chaos as blame was thrown like hand grenades, resulting in a massive delay and waste of effort which could have been put to much better use in reacting to the pandemic. I have been among the privileged few in the medical field in that I retired just before the whole thing kicked off. I don't do hospital work. I have been doing both in-office and telemedicine visits - my first experience with telemedicine, and I must say it has gone rather well. Everyone is pinning their hopes on the vaccine. Many feel that now the election has passed and a new (demented) sheriff is in town that things will be handled better; I myself don't agree, but I do hope that government leaders everywhere will learn from this and prioritize planning for potential future pandemics. You never know when it will happen again. Labels: Los Angeles, Medicine, Science, The Doctor's Life, Twenty-First Century Crap Thursday, July 09, 2020
In Which Dr. Alice Enriches an Orthodontist He's a nice fellow, if a little too prone to making tooth-related puns. Such as, "If you don't treat this it'll come back to bite ya!" Sigh. But he was recommended by my regular dentist, whom I have been seeing for years. He certainly has a lovely office and I'm pretty sure I just made his next month's rent payment for him. Very well organized, everyone masked and hand sanitizer everywhere. They have incredibly fancy equipment which allowed my teeth to be scanned and a mold visualized in less than five minutes. No more biting into a concrete filled mold and fighting gag reflex for what feels like forever. There is something to be said for the twenty-first century after all. In related news, this afternoon I drafted a query to the administrators of my medical group about my lack of remuneration for the past five weeks. I'm still working there as an hourly employee now that I have retired (semi-retired, I suppose, is more accurate) and had to fight the temptation to email "WHERE MY DAMN PAYCHECK AT" instead of substituting something more diplomatic. Well, I can't spend money on a vacation this year due to the Virus, so I may as well spend it on my teeth instead. I go back in about a month for my first fitment. Labels: Science, Technology, Twenty-First Century Crap Tuesday, July 07, 2020
Virtual Medicine My group uses a video program which is part of our electronic medical record system, as well as an alternative which is simpler to use called Doximity. (We can also use FaceTime or Zoom, but these systems are discouraged because they don't have the same privacy protections as the other two options.) Mostly they work well, but there are issues from time to time.
We can always resort to telephone visits, but the group strongly emphasizes video visits when possible. The amount of data you can get on a video visit is obviously greater than on a phone call - you can check the patient's appearance as well as their surroundings (are they dressed neatly, disheveled, short of breath, pale?) And to be honest, reimbursement for video visits is better than for telephone visits. These days that is no minor issue. The clinic has reopened but patients continue to be reluctant to come in. Certainly not all patient issues can be addressed via video, but I would say that overall this system has worked well. My biggest problem with telemedicine is that I need a chair with better back support. After sitting at my desk for four hours straight it's almost impossible to move... Oh, and edited to add that it's really special when you realize after a four-hour shift that you've been interacting with patients all the while you have a big food stain on your shirt. On the up side, though, you can work barefoot and wearing shorts because no one can see you below the waist. So there's that. Labels: Medicine, Technology, Twenty-First Century Crap Thursday, October 22, 2015
Horse Manure! (It's Therapeutic!) I invite you to read this eye-opening article run by the New Yorker some time back about therapy animals. It's truly ridiculous what people can get away with these days. I found the article entertaining, as I have run into similar requests at work. About a year ago in my office my partner was confronted by a therapy rat. Yes, a rat. The rat was in a bag around the patient's neck and it perched on her shoulder while she was having her blood pressure taken. I give the medical assistant credit for not shrieking during this process. After a hasty discussion with risk management the rat was placed into the patient's mother's custody and evicted to the hallway. Legally speaking, the only formally recognized service animals are dogs and miniature horses. ("You mean ponies?" I asked. "No, miniature horses" was the reply.) I have gotten my fair share of requests to write letters allowing patients to take their pets - they are not service animals - just about anywhere. I usually decline, unless the patient has a known psychiatric or medical issue which really requires taking the animal with them. If it's psychiatric, they need to be seeing, or to have seen, a psychiatrist. It bugs the heck out of me when I see people playing the system like this. Labels: Medicine, Twenty-First Century Crap 
|