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Thursday, April 19, 2012

42 undeniable truths about healthcare

Surely some of these may be controversial, as the truth often is.  Yet the following are the 42 undeniable truths of the healthcare industry:
  1. All medical professionals have an inert yearning to be self reliant and use the education and experience they've obtained
  2. The way to improve the healthcare system is to get the government out of it.
  3. The RT (doctor, RN) at the bedside knows what's best for the patient more so than an order set
  4. Order sets are are socialistic and are an excuse for doctors and nurses to be lazy
  5. Protocols are capitalistic and encourage thought
  6. I am not arrogant
  7. Supervisors quickly forget what it was like to work on the patient floors
  8. The way to reduce healthcare costs is to make everyone pay for each service
  9. DRGs increase medical waste and lying about a diagnosis just to assure reimbursement
  10. Keystone Committees are an attempt to enforced socialized medicine
  11. Evidence Based Medicine is a nice way of saying everyone must do it the same
  12. Intensity of Service is an excuse for doctors and nurses to lie
  13. Quality Assurance Analyzers are only needed because the government is involved in healthcare
  14. Tylenol is not a default cure for all that ails a patient
  15. Throwing everything at a patient in the hopes something works is not common sense
  16. Regulating hospitals does not make for better healthcare, it makes for fewer hospitals
  17. We need more humor in healthcare
  18. Bronchodilators treat shortness of breath due to bronchospasm and nothing more
  19. They hypoxic drive theory was a hoax created to make respiratory therapists relevant in the 1960s
  20. Xopenex is the same as Albuterol with the same effect and same side effects. 
  21. IPPB does not work better than patient coaching with an incentive spirometer to treat and prevent atelectasis, and studies prove this.
  22. Too many patients are put on a ventilator out of panic rather than logic
  23. Much of what respiratory therapists do is either a waste of time or delays time
  24. Dyspnea with exertion is not asthma and should not be treated with a bronchodilator
  25. If it's audible it's not bronchospasm
  26. If it's coarse it's rhonchi.
  27. The best way to hear lung sounds is to use a stethoscope on the patient's chest
  28. The best way to assess a patient is by touching the patient (not by talking over the phone)
  29. It's immoral to NT suction an awake, alert and orientated patient
  30. Respiratory therapists are not ancillary staff (they are professionals knowledgeable in an area beyond the scope of most physicians)
  31. Doctors and nurses who are stupid about respiratory therapy don't know they are stupid about respiratory therapy and most will never admit it
  32. If you refuse to do a breathing treatment that isn't indicated you are not being lazy
  33. BIPAP does not help fulmonating edema by forcing fluid out of the lungs, it reduces fulmonating edema by reducing venous return and therefore reducing cardiac output so the heart can catch up
  34. Supplemental oxygen will not treat anemia, and is not indicated just because someone has chest pain because if all the seats on a bus are full, the extra passengers won't get a seat
  35. The truth hurts before it makes you better
  36. Scientific evidence disproves that albuterol will treat pneumonia, CHF, rickets, cystic fibrosis, lung cancer, pulmonary embolism, pneumothorax, pleural effusion, detox, dehydration, and even emphysema and chronic bronchitis.  It only benefits these patients if asthma (hyperactive airways) is a component of said ailment.
  37. All that wheezes is not asthma
  38. All dyspnea is not asthma
  39. If a patient is obnoxious, annoying, belligerent, rancid, or has maggots, respiratory services are not automatically indicated
  40. Order sets and physician convenience are not indications for using the word stat.  
  41. The clinical picture doesn't always match the science (i.e., hypoxic drive hoax, hoaxenex, and studies showing inhalers work the same as nebulizers)
  42. Some studies are conveniently ignored by the medical community (such as beta adrenergic receptors don't exist in lung parynchema and renal tibules.)


Anonymous said...

First, I love your blog. Please don't stop.

I disagree with a couple of points, but no more so than #1. Point #1 was such a given for so many years that Medicare operated on the honor system.

If you subscribe to Medicare's mailing lists, they do weekly summaries of why certain procedures or equipment were denied: more than half the time, it isn't fraud, it's plain laziness.

The flip side of regulation is delineated in your other points. But #1 is a logical fallacy - rendering points 2-42 to be merely a glass house built on sand.

Anonymous said...

Funny, cause im respirathory therapist in brazil but seems some problems are the same... specially about indicate us for annoyed patients :)

Griffin said...

"6. I am not arrogant" is an undeniable truth about healthcare? 0-0