Friday Musings

Another week down, and only one more week to go for my bride. In case anyone is actually reading this, Beth’s last day at ABQ Health Partners is a week from today. It’s been a long hard road, made evident by much writhing and complaining. I don’t think I have ever witnessed such a bad fit between physician and practice as I have witnessed this past year. It started with Beth’s stint in urgent care (“……you have no strength in any medical practice”) to her inundation in primary care (“….we’ll schedule you for patient visits in the morning only, but because you’re schedule is so short, we’re taking away your medical assistant”). I want to try to document her time in the McMedical industry as an example of how hard it is to fit in the corporate culture if you are a doctor that tries to provide care tailored to a patient’s best interest.

I’m getting my A-grade dry suit back from the shop hopefully this weekend. I had the overly confining turbo-hood removed and replaced with a standard neck seal and latex hood (w/purge). The shop also repaired two small holes (!!) in one of the boots and on the same leg. I wonder if I bought the suit like that or if I somehow managed to damage it when I was trying it on. I definitely need to try it on before I get it wet, as I need to trim the neck seal. Since diving is now an approved past time, I can get Beth to zip me in so I don’t rip up the zipper again. I still need to try to repair my B-grade suit, but I don’t think I’ll send it in. The B-grade has the sport air inlet valve, which is not compatible with the valve on the A-suit. Not really a problem, but I need to remember to bring both hoses with me if I decide to bring both suits on a dive trip. Woot….I can’t wait to actually go on a dive with a dry suit and not have half of the suit fill up with water. Now maybe I should start bugging Tim to finish up his cert course.

Joseph is planning on coming out the third weekend of August to go on a check out dive with me to Blue Hole. I hope to make at least one trip out there before his arrival.

It’s kind of ironic that my work site is about half a mile from Calibers shooting range, yet I’m not allowed to transport my Berretta in my car since I park it on City property. It’d be fun to go shooting one in while over lunch. Oh well.

I’m allowing myself to read my favorite right wing crackpot blog again. Once the outrage subsided with realizing that the author is truly bigoted, I am able to absorb his, and his readers, rants much more leisurely. While cruising blogs, perspective is critical to my understanding of the various topics being discussed. For example, no matter how sincere an author might be in their anti-global warming screed, the science behind global warming is sound and unanimous on the existence of human caused global climate change. Any climate denier’s attempt to portray global warming as some sort of mysterious political plot does nothing but put the rationality of the denier into question.

The same can be said with the sky-is-falling attitude about the Obama administration that so many of the climate deniers also portray. If the past eight years didn’t destroy this nation, than the appearance of a leader like Obama can only serve to provide all of us with some hope that we can move forward as a better society.

Chemical and Engineering News

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Healthcare

The righties are all about freaking out on the proposed health care reform.

OMG!!! Rationing!! (It's happening right now as insurance companys brag about cutting back on "unnecessary" procedures) It's OK If Your A Private Insurer. The right wing stands there and states, with a straight face, that the public option plan suddenly gives government total control and oversight of health care. What don't they get about "you can keep your insurance just the way it is if you like it"? The corporate insurance interests have no stomach for the competition that a not-for-profit health plan will bring to the table.

The depth of the Obama derangement syndrome is almost unmeasurable. The desire to leave things in the country exactly as they are with no consideration to the future well being of the common citizen on whose shoulders the wealthy ride is amazing. How much longer can the right wingnuts expect that they can lie to us and try to convince us to vote against our better interests?

I am such a procrastinator. The last blog entry was in January of this year. Up until then, I had made a good effort at posting entries at least every couple of weeks. So here it is, my mid-year update. Mea culpa. Mea maxima culpa.

On the personal front, a lot has gone on and there have been some significant changes made. Beth has finally had enough and has tendered her resignation from Albuquerque Health Partners. The state of medical care and the sheer greediness of both the individuals and the corporate overseers have forced one of the best doctors in Alb. to stand down. The workload imposed on her while with AHP has been impossible to meet with the resources she has been given. Doctors are expected to not only provide their own dictations, but to also prepare and submit all patient billing. This would probably be workable if the actual number of patients scheduled during a day allowed for a doctor to complete the paperwork on an ongoing basis instead of having to wait until the end of a day filled with 15 – 20 minute appointments, including new patient visits. The end result is Beth regularly puts in 50 to 60 hour weeks, with some work being done at home on the weekends. Any bonuses that may be offered are only based on the number of patients she sees with no consideration of medical outcome. The system as it exists now does nothing to promote health care or health education and only responds to the number of warm bodies that can be billed against at the end of the day. Hence the 15 minute appointments. Every time a patient has to come back to the office for an appointment, AHP can bill some insurance company for an office visit as well as collect a co-pay. Never mind that the issues leading to the return visit could have been addressed in the original visit, if the appointment would have allowed for an actual 20 – 30 minute appointment. Beth was seeing new patients during a scheduled 15 minute appointment. How can a new history be established in that short a time frame? Of course it can’t, but that doesn’t really matter as long as the billing is completed and the co-pay is collected. The system is run on greed, and will never change until the profit motive is removed from the health care system.

Is there a chance an actual change can be forced onto the health care system? I’m beginning to have my doubts. Unless a strong public option is created that eliminates the profit motive from health care, I don’t think anything will change.

Why can’t the right-wing noise machine get their minds around the simple facts that the private market health care industry is not particularly concerned with the overall public health? Why bother with health education when all that means is that people might not require medical attention because of bad health practices?

So even with all this happening, Beth is actually doing fairly well. I’m still concerned about her drinking, but she has been mostly successful with avoiding depression. I can take some credit, I think, for this, since I’ve really tried to avoid whining and complaining about my perceived problems while focusing on more positive thoughts.

After all of the above, Beth is going to stop working and could possibly be moving into retirement. I’m overjoyed that I’m getting Beth back into my life on a full time basis. If the money holds up, we will soon have the opportunity to travel again and to address some of the things at home that have been put on hold. Things like clothes glaciers and dying landscaping to name just two. Beth has also been very excited about the opportunity to enroll both of the pits in obedience and agility training classes. That would be awesome!!

I’ve also made some changes in my employment. As of this week, I have taken a job with the local Water Utility and am no longer involved in private engineering consulting. I realize that working my way into a new job is going to take some time, but damn, the public sector pace is, at best, leisurely. To be honest, my first instinct is to run away screaming “I f******d this up, let me out of here”. But c’mon, its been all of three days, with the first day dedicated to an orientation session. Patience is.

I took up scuba diving again at the urging of Joseph. Diving is such a blast, but I forgot how incredibly gear intensive a sport it is. This is especially true since I need a fair amount of help with getting all of the gear on in preparation for a dive. Once I’m in the water, it’s not so bad, but my disability does create buoyancy and basic gear use issues that complicate my diving experience. I’m pretty sure that more practice will make it easier for me and my dive buddies, but it’s certainly a challenge. I love using the stuff, and its fun getting all dressed out to dive. I’ve always wanted to get good enough at diving to go on some exotic dive trips, so I’m sticking with this until that happens.

Finally, I want to start linking up to sites that address the current issues of the day. I’m going to feature primarily liberal viewpoints; however I want to be fair. If the crackpot right-wing noise machine can present a fair & balanced analysis of the issues, I will make an effort to acknowledge that. I will, however, never stoop to the bilge-like self aggrandizing drivel that I have happened on through chance. Who would’ve thought that I would stumble on a climate change denier, right wing bigot’s blog by looking up links for the Chaiten volcano?

So I’m back. Hopefully more often, but I’ve certainly said all of that before.

Peace.