Going through my inbox this morning, I find a note regarding my patient seen in ED, AI assisted documentation. What does it mean?
Patient is a kernel of corn, this cooked, deep in his ear redneck to his eardrum
This is a part of a medical record now. 
Retirement beckons, man. Very seriously. Right there, just teasing me…
Sometimes I have to submit SOAP notes to file claims on an insurance product I have. Something like this would get the claim rejected out of hand. Sheesh.
This would be a kind of laughable poetry if it weren’t so utterly, utterly fkd up.
Expect more Unlooked For Poetry™ in the coming minutes/days/years (whatever span we are having to contend with AI). I wish I could be more hopeful. Maybe this is as good as I can do for right now:
https://www.writing.upenn.edu/~afilreis/88v/burroughs-cutup.html
Ahhhhhh, Surrealism, my old friend. I was wondering when you’d clock in today. Here we are again, mon vieil ami. [… le sigh… ]
(To the tune of Sound of Silence (Disturbed version))
Heh, before I read your comment, I toyed with that bizarre conglomeration of words that way, choppng it in my mind in various lines, looking for yes, a poem!
What a shame that poetry has receded so far from us, into such a distant corner of society’s junk drawer. (Hey, that’s kinda poetic!)
I suppose we still have occasionally “poetic” song lyrics. And may we soon have “poetic justice” too!
So to apply for healthcare, I need to figure out how many hours I work each week.
But I’m 1. a game designer and sometimes writer, it’s not a regular job, and 2. chronically ill, so sometimes I need to take several days off.
Some people recommend using time tracking software. I use 2 different operating systems, but might be able to use my tablet’s reading timer, somehow. Or I could figure how long my research keeps me up, subtract time for eating and washing up, and divide the rest in half.
As a consultant, I use a stupid old spreadsheet. I start a stopwatch on my phone when I sit down to work, stop it when I’m not working, and when I hit an hour I add it to the spreadsheet.
I was shocked how I was discounting my hours before I started doing that.
Two key food safety advisory committees have been terminated—the U.S. Department of Agriculture’s (USDA’s) National Advisory Committee on Microbiological Criteria for Foods (NACMCF) and National Advisory Committee on Meat and Poultry Inspection (NACMPI).
…
Prior to its termination, NACMCF was working on advice related to significant and deadly foodborne illness outbreaks, to prevent similar issues for reoccurring. Most recently, NACMCF was charged with reviewing USDA’s Food Safety and Inspection Services’ (FSIS’) regulatory approach for Listeria monocytogenes, prompted by the fatal listeriosis outbreak linked to Boar’s Head deli meats that occurred in the later half of 2024. Other issues NACMCF was addressing included Cronobacter in powdered infant formula for FDA, in response to an outbreak caused by Abbott Nutrition infant formula that resulted in the death of two infants in 2022 and precipitated a nationwide shortageof formula.
Recent NACMPI meetings focused on USDA-FSIS’ definitions for establishment sizes and use of inspection technology, as well as ways in which FSIS could enhance engagement with underserved communities to promote equity while strengthening the food supply chain and ensuring compliance with food safety regulations.
I had to get prior approval (by the same MD who prescribed it) for Zofran while I was on isoniazid. And they only sent me 30 instead of 60.
These fucking companies need to be torn down.
Patient is cooked all right! But did they get the corn out of his ear? Or was his eardrum just being judgemental?
They did not. All judgement was mine.
This a long, twisted tale of a hospital takeover gone wrong - a healthcare tale as old as 2010 (when mergers & acquisitions accelerated). A non-profit system was purchased by a for-profit company, hospital services were gradually reduced, facilities were closed, and now the purchaser has declared bankruptcy. Even though the sale happened 8 years ago (and reductions/closures and attempts to sell facilities have been making news for the past 4 years), now the public outcry is on FB.
I don’t know if this is the first time folks on social media are learning about the situation, but pols have been posting updates there because some constituents are screaming that the gov’t should have somehow prevented this. 
Keep in mind these are the same folks with a history of posting pro-business, small government, and anti-tax increase stuff. 
They’re now getting schooled on: a) waiting until it’s too late to pay attention to local news, b) letting Big Biz of any kind go unchecked leads to outcomes like this (the government did try to keep them in line using contracts and lawsuits, but that failed in the end), c) they wanted small gov’t but now they want gov’t to fix everything (without it costing them anything), and d) wasting energy blaming pols instead of the Big Biz groups harming them helps Big Biz victimize the public twice.
We’ve got a very Blue gov’t now, and advocating throwing those pols out to go back to the bad old days of the GOP has people reminding them what Felon47 and Elno have done for them so far this year. Still, the sudden community focus on FB really left me wondering. What actions can people and government take to prevent hospitals from going from non-profit to for-profit, and are there some positive examples they can follow? The media makes the case that going for-profit tends to increase costs and undermine care, but organizations wind up seeing it as the solution to financial struggles:
More on non-profit hospitals accused of waste and/or financial mismanagement in comparison with for-profit organizations:
So, for-profit is viewed/promoted as the more responsible, well-managed solution - even though they prioritize profit over care. Governments see the track records of some healthcare sector vultures, and try to keep those organizations in check. This is the part that led to groups fighting each other in PA:
Some point out that systemic changes are needed in hospital and insurance business practices:
https://www.thirdway.org/report/end-hospitals-anticompetitive-business-practices
Others suggest strategies to stop the mergers:
At the point when facilities have been raided and are at the point of closure, the path forward is unclear. Allowing the sale to another for-profit group seems like going from the frying pan into the fire. A government takeover doesn’t seem feasible, because of inexperience. We’ve had privatized facilities dumped on local government before, and it took a long time (and a lot of funding) to fix what should never have been broken.
On top of everything else, any solution involving federal assistance isn’t likely to work during the current regime. In the meantime, the healthcare desert this created is being partially filled by urgent care centers. Pols are left trying to manage the mess, put new legal restrictions in place, and put the blame on private equity:
This shows the impact of the closures in terms of patients, employees, and facilities:
Back in December I talked about me screwing up my taxes and being denied a subsidy.
I appealed it and was denied, my final chance was an actual hearing in front of an actual official.
They scheduled the hearing. Once the hearing was scheduled someone contacted me and informed me I could get a temporary subsidy while the process played out but I had to agree to pay it back if my appeal failed.
I had the hearing a couple weeks ago, after the hearing someone contacted me at the request of the person who ran the hearing to answer more questions. Then we waited.
The hearing required affidavits and swearing under oath, very formal stuff.
A few days ago I got the decision, I got the subsidy retro active to January 1st and I was eligible for cost sharing with my deductible and maximum out of pocket.
I tell that story because it was totally my fault and talked to no less then 10 different people over the last 2 months.
Every single one of them was kind, empathetic, compassionate, and never made me feel bad.
I also told every one of them how kind they were and made me feel at ease.
An extremely stressful 2 months trying to figure out what to do if we lost health insurance was made easier by those kind people.
I like to think that the majority of our country is like them and not like the monsters making all the decisions right now.
Our health care still sucks in this country but the ACA people hired to help us wade through the system are awesome.
I hope they stay away from those people but I did read the orange guy was looking at shortening the open enrollment period because that would make it easier for people to get insurance, you know, giving them less time to figure out life changing decision for health care.
Funny, I have had a very similar experience. I managed to have two separate problems with both State and Federal tax issues - one my fault, one theirs. And while it took a long time and was sometimes frustrating, both were characterized by kind and genuinely helpful people, and both were eventually resolved in my favor.
What the MAGA idiots fail to realize is that this is what will go missing if they destroy government agencies - the labyrinthine laws and difficult systems will remain but without the experienced, kind people there to help us navigate it.
Can confirm.
My daughters are under strict orders to never trust what the insurance company says, but to always go through the ACA Marketplace. Our situation wasn’t as harrowing as yours, but with two seriously disabled people in the family it was scary enough. The Marketplace CSRs are professional, knowledgeable, and kind. Such support.
