If you don't trust doctors...

I get that some parents don't trust the medical profession.  I get that they think medications are poison.  I get that they think doctors care about money more than patients.  I get that they think nature is better.  What I don't get is why they bring their kids to the hospital, then refuse to let us do anything!  Why?!?

The Not-So-Affordable Care Act

We were assured, when the ACA was passed, that all Americans would have affordable insurance that would cover their medical costs.  That, apparently, is not true:

http://www.nbcnews.com/health/some-say-obamacares-affordable-coverage-isnt-affordable-them-4B11241833

Not only will some people have to pay out of pocket and wait for the subsidies, there's another sneaky little problem.  When the government is calculating whether the insurance your employer offers is "affordable,"  they look at what it costs just to cover you-even if you have a family to cover.  They don't look at what it costs to cover your family.  You may be able to afford coverage for yourself-but not for your family.  Don't count on getting affordable coverage if you are in the middle class.

Some of you may be thinking, Doc Rugrat's in the medical field; I bet Doc has good insurance.  And you're right.  But not all of my family and friends are that lucky.  And if I have family and friends who are in trouble, they can't be alone.  Unfortunately, even if the ACA were reversed right now, it's too late.  Companies that raised their premiums aren't going to lower them again.  We must find a way out of this mess.

Not clear on the team concept

Vanderbilt University hospital is apparently cutting its housekeeping staff and will have the nurses do much of the cleaning.  Great.  When I need a nurse to push drugs in a code, I don't want to have to look for one who isn't suited out, mopping the bathroom after the last diarrhea patient.

http://emergency-room-nurse.blogspot.com/2013/09/vanderbilt-university-medical-center.html

Sometimes the PARENT is the problem.

The kid is just fine with getting the shot, IV, whatever-until the parent goes apeshit with "oh, baby, it won't hurt, you'll be just fine, I'm right here, it'll be okay, it'll be over soon" and so on and so forth.  Then the kid bursts into tears, terrified.
THANKS, MOM!

Back to school time

It's that time of year when I am soooooo glad I don't have an outpatient practice.  All the parents who haven't bothered scheduling their kids' back to school physicals are frantically calling, and they don't understand why they can't get in immediately.

But all is not wonderful on the inpatient side, either.  The little dears who can't bear to go back to school are showing up in the ER complaining of abdominal pain.  They put on award-winning performances that get them admitted to the hospital after the million-dollar workup.

Once school starts, the kids who have kept their germs to themselves all summer start sharing generously with their classmates, and we start seeing the fall viral surge.

Oh well.  The pediatrician summer vacation is over.

The little "angels"

Whenever you see a kid on TV with a chronic illness-whether it is a real kid in a fundraising ad or a fictional character in a show-that kid is portrayed as being a sweet, brave soul, enduring medical torture with no complaints at all.  A few of them really are that way.  But, dear readers (if any of you exist), please let go of that mental picture.  Nothing about chronic illness automatically makes a child into a saint.
How a kid responds to chronic illness depends on the kid's underlying personality as well as what kind of parenting he gets.  Some parents spoil their sick kids rotten to "make up for" the illness; those kids are just pure evil for health care professionals to deal with.  Some are just scared of painful procedures, and who can blame them?  But the uncomplaining ones are rare.

"Affordable Care Act"--affordable for who?

I saw a news article this week saying how some insurance companies are starting to get nervous about the requirements of the "Affordable Care Act," aka "Obamacare."  The companies knew they would no longer be allowed to refuse to cover pre-existing conditions, and that there would be a cap on how much they could charge sick people in premiums.  But all that was okay, because everyone was gonna have to buy insurance.  All those young healthy people paying premiums and not making claims would balance the books.

But the young healthy people can do math.  When insurance premiums are $3000 per year, and the fine for not having insurance is $100 per year, their choice seems simple.  And the insurance companies are starting to sweat.