Well now you’ll be able to buy them off the deep web with bitcoin.
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Yeah, I got asked the other day - and I think it was by a healthcare provider - “Do you have access to a fax machine?”
WTF? It’s nearly 2020. Fucking e-mail that shit to me. Or how about a web portal where I can grab the docs?
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I had to “pick up” a copy of my X-rays a few years ago. A girl no older than 25 hands me the sleeve containing a compact disc.
Me: What am I supposed to do with this?
Her: Put it in a CD-ROM drive.
Me: Where can I get that? An antique store?
Her: (-_-)
Me: Is there ever any talk back there about updating to modern technology?
Her: No.
I dunno if there’s some issue like complying with DICOM standards or PACS servers being a security risk, but for fuck’s sake, are there even any retail stores that carry CDs today? And I know it’s not really for me but I keep my own records and have to image the discs.
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They always blame HIPPA with me. I’ve been through it so many times.
“Can I just sign a release saying I consent to email?”
“No, you can pick it up or we can fax it to you.”
FFFFUUUUUUUUU
It’s like law firms right - there’s no incentive to upgrade any technology.
Half the programs that run some instrument in the exam room still have the Windows 3.1 buttons, maybe Win 95 if you’re lucky.
It’s ridiculous that faxing is considered secure.
We no longer have a right to life, liberty and the pursuit to happiness.
We have a right to generate as much revenue as possible for the ruling class and our corporate overlords, and to scratch and claw for some air to breathe and food to eat in the meantime, while hoping we don’t get sick so they can take the last of it from us. Cause so what if that woman has to become homeless or go hungry or both? As long as the medical overlords get their money! I mean, sure, she could keep generating more revenue through her labor going forward, but fuck that right? I mean, corporate overlords gotta eat, right?
We’re still running Windows 95.
IMO, a huge part of the blame goes to (Surprise!) Congress. When EMR’s became a thing, there was a chance to require that ALL EMR’s speak to each other between hospitals and health care systems, so moving data/images/results would be seamless. Of course, that didn’t happen because reasons, and so stuff gets sent by paper/CD when stuff is sent between hospitals. Getting stuff HIPPA complient is a four-star fucking nightmare, because the turds who supervise that stuff know less than nothing about taking care of sick people, insist on all sorts of arcane/stupid hoops that you have to go thru, with a good chance that some manic-depressive bureaucrat who’s girlfriend dumped him will decide to cite you for some stupid issue that will cost a shitpile of time and legal resources to sort out. So just ship the stuff like we did back in the 1990’s.
As an amusing aside, the VA system runs dot matrix printers to send their stuff, and apparently is only able to send every thing that ever happened to a vet in their system when they transfer us a patient, which happens all the time because they have no specialty coverage after 4pm or on weekends or holidays - so when my GI bleeder shows up at midnight, he comes with a fucking phone book sized binder of stuff that includes lab results from 1984 and 27 different iterations of his medication list, which the patient helpfully tells me include 4 different white pills that his wife gives him twice a day for some reason, and she’s not here, because the cat is sick. Added points if they shuffle the pages up, and copy them just off center so the page numbers are left off. About 5 years ago they stopped sending hard copies of CT scans because it cost 10 cents or so a copy, so instead they burn the images on a CD disc that uses a program so obsolete that our IT department had to set up a special dedicated computer to run it on, and about 50% they don’t send the disc because Fuck you that’s why - so we just repeat everything that was done two hours ago a half mile away so we can figure out why the hell they sent the patient. I LOVE the VA.
It’s awesome.
MM MD
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That reminds me: fucking MICROCENTER was still printing receipts with a dot matrix printer up until a few years ago.
If they don’t send the CT what happens? I’m assuming there’s a radiology report already and this isn’t a fresh CT. Do you just get another? Are you LNT?
no surgeon is going to operate on a patient with nothing but a report by some nighthawk radiologist - especially since VA reads are…interesting at night. I dunno what LNT means.
To be clear, if someone gets shipped in from the VA at 9pm on a Friday with appendicitis, I’ll be generally able to convince the surgeon to take the patient to the OR with a read and a decent story even if they don’t send a disc. OTOH, we routinely get stuff like “perforated bowel”, no images, and that leaves the surgeon in the dark in terms of what operation to do and what to look for. So we rescan them so we can get a read from OUR radiologist, because our radiology group/hospital won’t overread outside studies if they’ve been read by someone else UNLESS they have the images and the previous read, for med/mal reasons. (Yes, they’ve been screwed in the past, generally on incidental finding that weren’t so incidental) Vets can’t sue the VA for anything short of murder, but when they get transferred to us those rules don’t apply anymore.
Basically, it’s stupid, inefficient, and aggravating.
MM MD
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LNT = linear no-threshold
It’s been a really hot debate in the journals the past five or ten years. I am not on Team LNT fwiw.
As John Boice, Jr., president of the National Council on Radiation Protection and Measurements (NCRP), has aptly stated (3), “LNT is not TNT, but differences in opinions sometimes appear explosive!”
Siegel et al. provide a detailed discussion of why the assumptions of the LNT model are counterintuitive and difficult to reconcile with the biology of DNA repair and the well-established decrease in radiation toxicity by dose fractionation in clinical radiation oncology. Nevertheless, the LNT model is currently recommended by advisory bodies such as the NCRP (6,7), the International Council on Radiation Protection (8), and the United Nations Scientific Committee on the Effects of Atomic Radiation (9) and has been adopted by regulatory agencies such as the Nuclear Regulatory Commission (10).
Conclusion:
Although the debate over LNT will not be resolved anytime soon, one point should be abundantly clear, as reinforced by the article by Siegel et al.: the scale of the associated uncertainties is such that it is not appropriate to use such risk factors for clinical decision making and the management of individual patients.
Literally murder.
I have noticed that a surprising number of rental car companies still use dot matrix printers. At least a third of all the ones I’ve used in the last 5 years.
Colonoscopy/endoscopy update: the anesthesia was eventually approved - but only because of the throat tube I think. For the butt tube only I can apparently be awake but sleepy. So like a tylenol PM or something then Moon River.
However I recently got a distressed phone call from the company that arranged the whole thing. She said she had spent all day fighting with my insurance company to cover my Pepcid AC.
Apparently they won’t cover it because it’s over the counter. So first she had the doctor prescribe something similar, but like 10x more expensive - because that would be covered. But my pharmacy couldn’t get it. So she went back to fighting them on the Pepcid AC. I told her it’s fine I’ll just buy it (it doesn’t work anyway). I thought she was going to cry from relief.
Of course lost in all that billing craziness over a $9 bottle of pills was the result of a biopsy to tell me if I have cancer. Minor detail. She had to call me back the next day to let me know that apparently I do not have cancer or pre-cancer, but I do have acid reflux. Yay and duh.
Good thing government isn’t involved in USA #1 Healthcare or there might be some inefficiencies in the system.
Lol I posted this on FB and it immediately asked me if I wanted to add a Donate button.
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ZuckCare! Zuckerberg for America 2020!
Also, glad you don’t have cancer!
Have you tried anything else? PPI might do it if H2 blockers won’t.