Well, well, well. Found this blog written by a surgeon sm
Posted By: Regular on 2007-05-11
In Reply to:
who says what he REALLY thinks about the JCAHO. Funny, I found it on Google when I typed in JCAHO and q.i.d. since I wasn't sure what to do about q.i.d. ........
The Death Star of American Medicine
I wish I had written this ( JCAHO Unplugged; registration required), because it gives voice to the feelings that I (and probably 99% of the physicians in this country) have about the Death Star of American medicine -- JCAHO. A few excerpts (emphasis is mine):
That is why it really upsets me to watch the JCAHO people walk through my hospital like they were navigating a toxic waste dump. What upsets me even more is the utter paralysis of normal activity that occurs months before their visit and the huge sums of money spent on mock drills and consultants to prepare for the JCAHO invasion. JCAHO (the Joint Commission on Accreditation of Healthcare Organization) arouses more fear in hospitals than MRSA gone wild, and their "visit" has a greater institutional paralytic effect than circulating a neuromuscular depolarizing agent through the ventilation system.
A few unsigned verbal orders, or an anesthesiologist carrying a syringe of Anectine in his or her scrubs, or not locking up I.V. bottles of normal saline will result in conditional or provisional approval, and failure to take remedial action within 30 days may result in the death penalty, which for the hospital means bad PR, and more significantly, loss of all federal money. That's right, you can get the chair for parking tickets in the JCAHO world.
It doesn't matter that the hospital admits 50,000 patients a year, saves countless lives and performs daily miracles. Write q.i.d. twice and you can get your liver transplant someplace else. !["](http://photos1.blogger.com/blogger/2910/889/200/death_star.jpg") A response by Russell Massaro, MD, FACP, Executive Vice President Accreditation and Certification Operations, JCAHO, follows Dr. Cossman's screed. The only thing I can say about it is that he makes clear that unannounced surveys will be forthcoming in 2006. Oh, joy! A lot of the press in the past few days has been discussing issues such as oversight, accountability, and clearly expressed legal authority. JCAHO operates without any real semblence of these niceties, and does so with all the subtlety of a bureaucracy run by Darth Vader. Watching hospital administrators lose bowel and bladder control the minute a JCAHO inspection is brought up has always reminded me of Vader's underlings wilting in his presence --- and for good reason. Without the JCAHO seal of approval, they cannot operate an otherwise well-run, caring facility. The organization, as it was originally intended, was designed to ensure a basic level of safety for all hospitals. It has now become yet another "certifying" agency which must come up with new "critical" problems to fix in order to ensure its ongoing existence (those of you who have gone through the most recent mental masturbatory experience of banning QD and QID in orders know what I mean). What is most galling to me, however, is that hospitals must fork over a hefty sum for these frequent torture sessions, and the inspections are done not by practicing physicians or nurses, but by folks who long ago gave up the difficulties of actually caring for patients for the safety of a clipboard to hide behind. Maybe I have my metaphors mixed up --- JCAHO comes in like the Death Star, but leaves no room for different institutions to solve problems in their own way. The JCAHO mantra can really be translated as "Resistance is futile. You will be assimilated!" As a result, I suppose JCAHO is really The Borg.
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I found it written this way, from a very
"He appeared comfortable and in no acute distress."
This appeared in an journal article I read published by the Cleveland Clinic. Don't think you can get more reliable than that.
I found the other links I had written down.
digiscript, transcripts.tv, and fantastictranscripts. You can Google them to find the websites. The only place I actually ever worked was emediamillworks/FDCH.
I just had a surgeon ask...
his PA if there was such a breast size as F, get an affirmative, and then say, "so she's a double FF? She has the largest breasts I've ever seen". It made me laugh out loud, I don't know why, maybe it was his tone of disbelief or that fact that he's been around a long time and has surely seen many boobs in his day...thought I'd pass it along.
One surgeon I know always says...
when a patient is ready to be discharged, he always says "____ is peeing and pooping normally." Slays me every time! I just find myself giggling like a little kid whenever I hear it! Peeing and pooping are such a great words...embrace them!
Isn't there a book out there called "Everybody poops?"
I have not seen a surgeon yet.
I want to get my finances ready before I schedule the surgery. My previous experience with surgeons and disability is "go back whenever you feel ready"...they don't seem to want to comit to a timeline. The last time I had surgery I went back way too soon and had complications, so would like to avoid that this time around.
Thanks to everyone who has replied, this is all good advice and info. I think I will plan for the worst at 6 weeks or so and hope for best at just a week or two. It certaily won't hurt to have some extra money saved. 
One surgeon
I transcribe for has many times told them to pipe down in the background. I am not sure if it is because he cannot think with the noise or if he is doing it for my benefit, but either way, I appreciate it.
On the other hand, I had an Indian doctor the other day who sang/chanted his entire report. If you have ever been to a Catholic mass and have heard the priest do that singsong kind of thing, well that is how he dictated his entire report. Every now and then he would hold the note a little longer. It was the weirdest thing.
oral surgeon...
I had a similar situation a few years ago. I paid and the ins. co. paid, dentist kept both payments. After 3 phone calls to the office, no money. So, I wrote a letter to the dentist, put PERSONAL AND CONFIDENTIAL on the envelope, put a cc to the state dept of insurance at the bottom of the letter (dept of ins. scares them more than the AMA (if dealing with MDs) or American Dental Association).
Got my money 2 days later.
checking out a surgeon?
is there a way to check out a surgeon or doctor before making an apt with them? (complaints, track record or anthing else). I've never been comfortable with the "referral" from your primary or whoever it might be because I can't shake the idea of friends referring to friends and not based on qualifications. thanks
need a plastic surgeon
Does anyone have any personal experience with Dr. Michael Petrosky with Plastic Surgery Center of the South in Marietta, Georgia? I am considering using him as I consulted with him and I really liked his manner and explanation of the surgery. I would like to talk with someone who has used him before just to see if he is a good doctor, but how can one go about doing that with the HIPPA laws? The only way I know to find out about patients of his is to ask their office and of course they aren't going to give me names/phone numbers. If anyone has any info on this doctor's practice would you mind sharing with me please? Or if you know of a way that I can talk to a few people who have used him, etc. Thanks very much.
Take it to a blog
No one is telling you not to communicate, just get a blog where you all can meet and "discuss" to your hearts content while your children starve and your bills pile up. You have our sympathy, now have some sympathy for us and take your whining to a blog. To me this seems like a no-brainer. If you need the health coverage, fine, stay, but get another MT job that will pay your bills. If MQ has no work, working at another company should pose no problems. But at some point, you have to decide, stay and do something else at the same time to improve your situation or go. But quit subjecting the rest of us to your pity parties. Take it to a blog.
I saw on your blog that you like
I cannot find a local station anymore that plays this type of music. I have asked others what artists played/sang this I really do not know where to look it up at. Could you give me some sources or recommendations. I would love to listen to this music again -- perhaps it would make me young again since I listened to this in my teens and early 20's!
blog
I have sent out an email with this link in it. My friends like to forward EVERYTHING to EVERYONE! lol This should zip around the US in no time flat. I also have bookmarked it and will post my response here in the next couple of days. Thanks for taking the time to post this. Hopefully some good will come out of it.
Your Blog
I just looked at your transcription blog. I love it! I had added to my favorites. What a great idea.
Linda
He has a blog
His blog is Talonsnest.blogspot.com
I just went through your blog ... sm
Great job! You really captured the everyday issues and challenges that we face in this business.
Welcome back and good luck in your new job.
Went to an oral surgeon for a consult for
my son to have his wisdom teeth removed. Charged us $75.00 for the consult. I didn't like the oral surgeon and his office staff were very standoffish can I did not make an appointment with him for surgery, but with another oral surgeon. I had to pay the $75.00 up front - no problem, but they filed the insurance with the money coming to them. It has been 5 weeks now since they received payment and I have called twice asking for a refund. They told me the insurance company had 90 days to come back and ask for the money, but I PAID upfront so what difference does that make, they aren't out anything and they have $52.00 of MY money on top of the $75.00. They said they would issue a check next week, but is what they told me 2 weeks ago. It isn't a lot of money, it is the principle of the thing.
Went to another oral surgeon and they didn't charge me anything for the consult and the amount I have to pay upfront is $300.00 less than what the other office quoted me.
Seeing an oral surgeon is very premature! nm
nm
ASR funny. The surgeon has just done a robotic....sm
radical prostatectomy and signing off he says "Please send a copy to Dr. John Doe and to the prostate, and to the chart. End of dictation".
I think the difference here is surgeon quality
and also patient demographics.
Be sure you are seeing a top cataract surgeon who is doing 6-8 a day and has satisfied patients. Do not wait until you're 90 to see an ophthalmologist. Those patients do tend to have problems with surgery.
I have plenty to say, such as, Take It To A Blog. nm
:)
Whiners take it to a blog
I am not advocating to just quit, move or walk away. If you have read my posts, I have offered suggestions that don't require brash action, just common sense and ambition. Public boards should be for differing view points on different subjects. They should not be about pity parties. It would be much easier for the whiners to have their own blog, where maybe between them they could come up with one good idea as to how to improve their situation. Leave the public boards for the general public, not a few whiners who only rehash the same thoughts.
I loved your blog (sm)
What a jolt to reality. Reminded me of things I'd forgotten I liked about this type of work. Too easy to concentrate on the negatives day to day. I have a cat too but he is not as much company as yours seems to be. Nice spot for him by the window--I'm sure he is very content to hang out with you during the day.
loved your blog
Just finiished reading your blog and I loved it. I also requested you as a friend if you don't mind, cannot wait to read more.
next blog entry is up for those of you who like it
http://violatingamerica.blogspot.com/
Good Blog
I just took a brief peek, but it looks like a nice site; and I got a kick out of your writing about the ESL doc who ties too hard.
I have a sweet female foreign dictator who ties so hard. I get frustrated when she keeps changing her mind on patients' lab levels, and then I realized she just forgets which numbers are called what. I'm sure it has to be exhausting and frustrating for them as well. :)
Do you have any info about yourself on there? I sometimes read blogs but often cannot find any info or photo of the person, so I lose interest. Guess I just need something to connect with. - Not giving a name (at least not full or real name) is fine, but some info and maybe a photo makes it more fun.
I will be visiting your blog site again ... good job!
Blog Link?
Can someone point in the direction of the blog? Thanks.
I made an appointment with an oral surgeon and he
You have to start at the very bottom and be as conservative as you can. A dentist can take x-rays and fit you with an appliance. I went and found out whats causing my jaw pain and on the x-ray my bones overlap. I was thinking I needed surgery, but we are going with pain management. Since i've had the appliance, no pain, that was a week ago. Very rarely will you need surgery, everyone's jaw "clicks" but if you are a night grinder, this makes it an even playing field for your teeth so they're not fighting against the jaw to become "even" if that makes sense. Good luck.
I transcribe for orthopedic surgeon who utilizes EMR
He dictates notes such as if the patient is having out of hte ordinary symptoms to cover himself should the situation lead to a court room setting. But, yes, between EMR and voice recognition, I believe MTs will over time be less than necessary.
The cost is a major factor. Especially with the population aging like we are. Baby boomers will all be on SS at same time and if health care doesn't figure something out, there are predictions being made that are nightmarish, like the collapse of the health care system. This was said by a person (Dr. Andrew Weil) being interviewed by Larry King.
I do work for a plastic surgeon, insurance will only pay from what I can tell IF - sm
there is a health issue, i.e. continous rash from the folded skin, irritation that medicine will not resolve. But all conservative measures of treating have to be exhausted before they agree to pay for an abdominoplasty. Good luck....I need to lose about 80 pounds and wondering if I will have any sag when done...I have very sensitive skin too so expect some problems (and if so I hope they are enough to warrant my insurance to pay for the removal procedure...otherwise I plan to save up for it)--
I worked for a plastic surgeon for 3 months...sm
and people having face lifts and tummy tucks are in incredible pain after their surgical procedure. My sister chose to have breast implants done and she was in severe pain for about 3 days after surgery. No way am I interested in having elective things like this done!
An oral surgeon can do it in his office, give you an IV and you won't
feel a thing.
Having worked for a hand surgeon who deals with WC and a MT..this is what I know.
The poster below me, Just Me, is pretty correct. A lot of our patients filed worker's compensation, but because there are a lot of things you do with your hands in your personal life, it is a diffcult situation to prove. For instance, we had one lady who was an MT for a few years but was also an avid quilter..she lost her case. We have had people who say have worked for the hospital as an MT for 13 and had no other real side hobbies or jobs outside of that that won her case. They only have so long to approve or disapprove your claim. From what I have seen, anyone who has worked multiple jobs at that same time are not going to win the case because the employer you filed on will fight you and tell them that you were working multiple jobs so how do they know that it was your job with them that is solely responsible. So, depending on your circumstance, employer (you do have to file a claim on an employer whom you will name), you could get worker's compensation which would pay for surgery if needed, PT, and time loss benefits after surgery. The first step is filing a notice of injury with your employer and then they submit it to their worker's compensation carrier. I was the hand surgeon's worker's compensation biller so I speak the truth LOL. If you have anymore questions or what to share you personal story and get my honest opinion, I'm here. I've seen every kind of WC claim you can imagine. Most people are honest but some are not and WC is the first one to nail you. They have even had a private investigator follow people. We had one carpal tunnel WC patient who stated he couldnt work because he was in such pain yet he was videotaped making an extensive bird sanctuary, actually building it with his bare hands.. Can you say busted.. I knew you could.
The plastic surgeon on "The Doctors"
is very reputable. I would go to his website (can find through the show's website) and either email him or call for information/opinion.
The key is to deal with someone you know is on the ball and above board.
Have you ever thought of starting your own blog
or do you have one? It would be a place for you to write like you have here. Just wondering.
I'm 48. I use to blog, to stay in touch with
others with similar interests, to share pictures, to keep an eye on what my older teens and their friends are doing (yes, they know and comment me all the time). Try it. You might just discover that you might gain an appreciation for something new.
I visited your blog--very nice!
It looks so professional and all fancy-like! Keep it up! 
Let's start with a blog to unite
or is there one already?
I am starting a blog..need links
I am starting a blog about this offshore deal. If you have any links to stories related to the downside of this, links to contact the government or news sources, please e-mail them. I will post a note here as soon as i have it set up...probably later today.
Offshore concerns blog
I mentioned this a few messages below, but the blog has its first post. I am NOT supporting any Ad things on there and will not be making anything off this.
http://violatingamerica.blogspot.com/
If you have a link that would be useful to others to write their gov't reps, companies, news sources, etc, feel free to post them or e-mail me so i can get them up there. I am also looking for any news stories or any information we can get. One way or the other, we might be able to make a difference.
I received a check today from the oral surgeon. nm
I would see an oral surgeon, since dentists cannot perform surgery and that is probably where they
would send you to next.
Dot Richardson, olympic athlete turned ortho surgeon. nm
x
Oh, I hope you're right. The surgeon just gave her the info and kind of let her sit on it.
He didn't have time to go over it in a lot of detail. She tried to call back to have him give her more info., but he had left for the day and won't be back until Thursday. So, we'll see. Thanks for posting:)
Hi all! I have started a blog and am looking for opinions - care to indulge me? sm
 http://mtfiles.blogspot.com/
Take it to a blog and spare the rest of us the pity party. nm
:)
I like your blog. It is a very interesting one. when Tournament is Boy it will Win Mistery: http://w
Excellent! I enjoyed reading your material. to Fetch Table you should be very Coolblooded , Full is feature of Green Opponents Standard TV is always White TV , Mistery can Play Game when Chair is Tournament it will Roll Player
Is there someone willing to write a form letter? See blog post
I will put in on my blog and promote the heck out of my blog.
Oh, I found it really creepy when you said you found the flowers not so skillfully arranged on your
steps, and from your own flower bed. That's what I was worried about, having gone thru some psycho kids myself with my pups. Someone's been in your yard and in your garden and at your door without your knowledge. Its just creepy to me, and I'd still be very, very careful. Especially valid sounded the other MTs warning you about potential fake molestation charges. You just NEVER know nowadays, and these people have already turned on you big time once. Luckily (though I don't believe in luck), you had it on film to save yourself and your puppy. You might not be that lucky next time, and the whole thing just sounds very unstable to me right now. I know you feel sorry for the little girl, but probably the only time I have ever made BAD decisions regarding my life is when I felt sorry for someone, particularly kids. My son even has an evil kid in his life, but one who has a million reasons for sympathy, and I was saying how we should "be bigger" than the situation and invite this kid over to play. Thankfully, I regained my sanity long enough to remember - ever time I have done something like that on a personal basis for someone just because I feel sorry for them AFTER horrible behavior, it has always been a disaster... Be kind, but you don't have to risk your family again. Be kind from a distance. Its sorry she went thru this horrible experience, but YOU didn't cause it, and its not really your problem. But it could be your problem if this kid acts out in your life. Know what I mean?
One of mine would "tinkle and flush" an open heart surgeon true - @O
nm
I will stay in Podunk and make a living wage if you will take it to a blog. sm
Is that concept so hard to understand? I you cannot understand that simple idea, maybe that is why the lot of you don't have the sense to do something about your situation other than just whine. Take it to a blog, where maybe between you will be able to help yourselves. Or better yet, think of it this way,,, take it to a blog and then you won't have to navigate around the other posts to whine to each other.
I like your blog. It is a very interesting one. Loose Plane is very good TV: http://www.enn.com/ , G
Nice job. I'm planning to come back here in the future. Curious, Curious, Curious nothing comparative to Superb , Slot will Stake unconditionally when Table Destroy Boy Expect , when Circle is Opponents it will Roll Table Con Bet Make - that is all that Stake is capable of
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A response by Russell Massaro, MD, FACP, Executive Vice President Accreditation and Certification Operations, JCAHO, follows Dr. Cossman's screed. The only thing I can say about it is that he makes clear that unannounced surveys will be forthcoming in 2006. Oh, joy!
