loved your blog

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I just looked at your transcription blog. I love it! I had added to my favorites. What a great idea.

or do you have one? It would be a place for you to write like you have here. Just wondering.

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.

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.

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.

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.

She came every other week and charged $15 and hour. She would spend 4 hours and she was a white tornado in those 4 hours let me tell you. I loved, loved, loved having her.

Unfortunately, i had to let her go when i moved into rehabbers paradise. No sense in paying someone to fight a losing battle until rehabbing is over say in about 10 years :(

was wondering if the walking tour is only a group tour or is there a map and written directions so that one could walk the tour alone (or with a friend, etc.).

the MT info is good but i am much more interested in NY and seeing it from an *insider's* point of view. i know that is not the purpose of the blog but maybe you could do something on that line regarding NY??

I enjoyed reading this post. I guess it was that punch line that really got to me LOL....

Your real-life doc kinda reminds me of Dr. House on TV, though Dr. House seems to have become more contrite during the last 10 minutes of the season finale.

I've always thought that there could not possibly be real life docs out there like House, at least not ones who would be allowed to see patients, but now I am not so sure.

Have you ever thought of a second career in which you take real-life experiences and fictionalize them, send the scripts to the people who make movies and TV shows? I think you would be very good at that.

I just wish I could afford to get my own right now. It takes a little getting used to, but not too bad and it's soooooo comfortable.

Burt Reynolds: "He was a wonderful man and a fine actor, and we will all miss him."

American television actor Dennis Weaver best known for his roles as sidekick "Chester Goode" on TV's first "adult Western" Gunsmoke and as Marshal Sam McCloud on the NBC police drama McCloud, died Friday, age 81.

Weaver passed away from complications of cancer at his home in Ridgway, in southwestern Colorado, it was reported Monday by his publicist, Julian Myers.

Burt Reynolds, Weaver's co-star in "Gunsmoke" stated: "He was a wonderful man and a fine actor, and we will all miss him."

Weaver was born in Joplin, Missouri to Walter Weaver and Lena Prather. His first role on Broadway came as understudy to Chapman as Turk Fisher in Come Back, Little Sheba.

He eventually took over the role from Chapman in the national touring company. Solidifying his choice to become an actor, Weaver enrolled in The Actors Studio, where he met Shelley Winters.

During this time--the start of his acting career--he supported his family by doing a number of odd jobs, including selling vacuum cleaners, tricycles and women's hosiery.

It was while delivering flowers for one of these jobs that he heard he had landed his biggest break � the role of "Chester" on the new television series Gunsmoke � the highest-rated and longest-running series in TV history (1955 to 1975). He received an Emmy Award in 1959 for Best Supporting Actor (Continuing Character) in a Dramatic Series.

He began appearing on the series McCloud in 1970, for which he received two Emmy Award nominations: in 1974, he was nominated for Best Lead Actor in a Limited Series and in 1975, for Outstanding Lead Actor in a Limited Series. His frequent use of the affirming Southernism, "There you go", became a catchphrase for the show.

In 1978, he played the trail boss R.J. Poteet in the television miniseries Centennial on the episode titled "The Longhorns". Dennis Weaver also appeared in many acclaimed television films.

In 1980, he played Dr. Samuel Mudd, who was unjustly imprisoned for the Lincoln assassination, in The Ordeal Of Doctor Mudd. In 1983, he played a real estate agent addicted to cocaine in Cocaine: One Man's Seduction. Weaver received probably the best reviews of his career when he starred in the 1987 film Bluffing It, in which he played a man who is illiterate.

In February 2002, he appeared on the animated series The Simpsons (episode DABF07, "The Lastest Gun in the West") as the voice of aging Hollywood cowboy legend Buck McCoy.

For his contribution to the television industry, Dennis Weaver was given a star on the Hollywood Walk of Fame at 6822 Hollywood Blvd, and on the Dodge City Trail of Fame. In 1981, he was inducted into the Western Performers Hall of Fame at the National Cowboy & Western Heritage Museum in Oklahoma City, Oklahoma.