Lindsey

lol....you described my man. Does that mean I'm a sexist biatch???? linz -- A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

Wow! That's expensive. I pay $86/year for my motorcycle insurance, and that's the "year around" insurance. (Up here we can get 9 month insurance or full year because they figure no-one's going to be riding a motorcycle in winter.) lol...yeah, but you live where? Wisconsin???? You prob'ly ride one of them off-brands too.... j/k don't be mean back to me.... linz -- A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

just means that the hogs'll have to beat the shit out of LSU too before anyone takes 'em seriously. Gonna send Jack a hog-hat. Will he appreciate that??? lol. linz -- A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

Maybe it is like freefall Maybe you meant purgatory instead of limbo? No. I meant limbo. Purgatory's far to demeaning to contain me. Freefall's not a bad choice however.... -- A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

yeah....you're prob'ly right. Off to the garbage heap for me....lol. I don't think I can take it though. Wonder what limbo's like. linz -- A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

Ummm....that was 3:20pm by my clock. That was this afternoon. Not tonight. Shouldn't be so hung up on time, though, I was just thinking as I notice that my legs really do look 40 years old. It's prob'ly time to go ahead and die....arghhhh. Is there a good analogy for that???? linz -- A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

I think you have to be president. shit. I don't have that kind of ambition. Just looking for a little relief. May have to resort to masturbation....lol linz -- A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

Sorry, I'm not into research tonight, just arguing! lol....but you haven't argued against anyone's analogy yet tonight. Surely you're not gonna hang it up before you say, "Lousy analogy," or "crappy analogy." Where's your spunk? linz -- A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

If being in college doesn't mean you can be stupid, does being out of college....and out of graduate school....and out of medical school eventually qualify one for being able to be stupid? I'd really like, someday to be able to sink into to my stupidity. When is it okay? linz -- A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

Michelle....this "potential for a life" argument just doesn't matter to me. "Potential" is everywhere. Sometimes it's wasted, and sometimes it's not. Potential for life is not the same thing as life. In my mind the meaningful question is "when does life begin?" It's frustrating to not know the answer, but it's a question that's fun to think about. To go a little further, I really don't care that much if it's life. I care more if it's life that's capable of feeling and rudimentary thinking. Who cares if it's alive but can't comprehend the experience of life. I can say that a clump of 16 cells...or 64 for that matter....doesn't constitute life in any meaningful sense. To use these clumps of cells for research is to be a good conservationist. But the people who are so adamantly against the use of embryonic stem cells for medical research aren't generally good conservationsits, are they? If you're gonna talk about morality, the problem I foresee has to do with creating embryos for the sole purpose of medical research, which is bound to be a racket down the road. The problem there, in my mind, has less to do with the use of the embryos themselves than the intent with which they are produced. Somewhere in there, there's a moral problem for me. But that may not be a moral problem for the next person, and who is to say that my sense of morality trumps the next person's. I'm glad that our thinking about what's moral and immoral has evolved over the years. I can hope that my prudishness will give way to better thinking in the future.... linz -- A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

As scary as it is to not just let this thread die.... Our noon conference today was given by the business office. What I learned is easy to sum up. We lose hundreds of thousands of dollars in our ER because of the way we handle non-emergent cases that come to us. Apparently, if a patient has Medicaid we can evaluate that person's condition and be paid for our what we reasonably need to do for assessment purposes. However, if we treat a person with a non-emergent problem, we are reimbursed $18. If we do the same assessment and DON'T treat with any prescription medications, we're reimbursed for most of the assessment...hundreds of dollars as opposed to $18. If we assess them and find that the condition is non-emergent, the ER is paid if we send them back to their primary care docs for treatment. For the most part, this is what I try to do anyway. It bothers me that Medicaid encourages physicians not to treat, though, by paying us not to treat what they deem non-emergent. This even goes for things like STD's. How many people do I diagnose with Chlamydia every week???? Too many. According to their guidelines, chlamydia is a non-emergent condition and should not be treated in the ER. I usually treat Chlamydia with a one-time dose of doxy. I give it in the ER, and that way I know they're treated. When I do this, I cut the ER's reimbursement down to $18. AMAZING! And here I've been thinking that I was being kinda bold not giving someone cough medicine who's been couging for the past week. Silly me. linz -- A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

But sometimes I wish the Puritans had gone to Australia and the criminals had come here....but I wouldn't want to wish that on Australia either. linz -- A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

A guy at the next table said, "You know what all 50,000 or them have in common? They just....won't....listen." Cold... linz -- A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

heh. Cracked me up that when I had a job that required me to fill out a timesheet one of the codes was for time spent filling out the timesheet.... Oh my. I think posting on dz.com is more productive. linz -- A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

Hey! Speak for yourself. I say you've gotta be at least 45. In honor of this thread, here's a t-shirt I saw in Texas last weekend.... -- A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

When the disparity between rich and poor becomes great enough, the pitchforks, shovels, and torches will come out. It's happened before. Which is why we have the programs that we do. I think our social welfare programs are as much a means to keep people "content enough" as they are charitable. When the masses have basic needs met, they're not as quick to take up the pitchfork. -- A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

To answer your original question, I think he *could* be more of a pig....if he grew a snout, a little curly tail, and went around oinking. linz -- A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

lol...yeah. If he'd just take his medicine more regularly, we wouldn't have to look at him shake like that. And the drooling, and that stupid little walk of his.... Whether he takes his medication or not his disease will still progress. His "steady as he can be" is not the same as most people's "steady as he can be." Medication won't change the course of his illness and it won't ever allow him to function like a person without Parkinson's. It truly sucks for him. Nothing wrong, as far as I can see, with him showing people just a little bit of what a disease like Parkinson's does to a person. linz -- A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

For such a smart guy, how come you missed "in general"? Guy....arghhh. I didn't miss "in general." I'm just pissy because of this damn headache that won't go away and I wanted to lash out at you....lol. I guess I just don't think of athletes "in general" as stupid. linz -- A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

Don't confuse college athletes with college students. Different animals, in general. Hmm. I was a college athlete and student. For such a smart guy, that was kind of an ignorant statement. -- A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

Candy is also rewarding :) linz -- A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

Wondering if any of y'all Texans (or thereabouts) were at the Boo Run. It was a great weekend, and I'll be interested to see how much money was raised. $25,000 was raised at the auction last night...so said Boo this morning. Boo Benefit (www.boobenefit.org) is a bike rally held each year in Jefferson, TX. This year was the 9th. Raises money for a kids' burn camp in Louisiana. I read that last year over $100,000 was sent to the camp. Always have to post a few pics. These are of us, some of the bikes, a couple of stops on the poker run (the chuck wagon was at TC Lindsey and Co Store, and the lake is Caddo Lake), the Jefferson Hotel (a hundred forty some-odd years old), and us having bloody mary's in Auntie Skinners. Will it let me post that many? We'll see.... linz -- A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

CT scans??? I'd be happy if you simply allow them through the door of the ER. Ummm....they have to get through the door to be seen. I don't think people should not even be seen. I just think that a whole lot of people can be medically screened (seen/examined by a physician) and sent away without treatment and/or further workup if they don't require emergent care linz -- A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

Every time you have a headache....every time you have nausea/vomiting....do you go for a CT scan? What would you think if your doctor wanted to work you up for every one of these? He/she wouldn't be practicing long, because every managed care plan would drop him quicker than he could blink. It would be deadly to our healthcare system. You can go on and spout all you want about me. Bottom line is you're wrong. You'll argue your point until you're blue in the face because it's your style. But if you really sit and think about how ridiculous it would be to send everyone with a headache to the CT, then maybe you'd get a clearer picture. How do you determine which to work up further and which not to? Maybe you'd ask your mother.... ER doc'll tell ya (they tell me) that they take care of them in the ER (that doesn't mean doing a big work-up either....it means treating rather than sending them to get treatment elsewhere) because they wouldn't have a job if they didn't treat these people, and because it's just easier to treat rather than deal with patients constantly bitching about them. linz -- A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

While I agree with you in principle, these people came to the ER because they were truly concerned about their health. That's really not the case many, many times. People come to the ER for a work excuse. People come to the ER because they have a cold and want cough medicine. People come to the ER because they got a bug bite. See what I mean? Your decisions would, sooner or later (statistically speaking), turn away the URI that actually was masking early heart failure, bronchitis, early asthma or innominate artery tracheal compression. The headache patient that was actually a slow but potentially deadly sub arachnoid bleed, the gastroenteritis that was a beginning bowel perforation in an ulcer patient. If a URI is masking early bronchitis then they need to go to their primary care doc. Asthma and heart failure are pretty easy to differentiate with a decent set of eyes, a little history, and a stethoscope that you actually know how to use. I've treated people (and seen them die from) with a sub-arachnoid bleed when the ER nurses wanted to blow them off as drug-seekers. There's no comparison between that headache and the recurrent migraine, tension headache....you left out temporal arteritis, which also has a unique set of clinical findings. Then the gastroenteritis. (I did have one patient this spring who had me a little worried with her gastroenteritis. She was in pretty excruciating pain, and I actually did a very thorough work-up on her.) The difference, and what makes you worry or not, is the degree of abdominal symptoms....the acute abdomen, or what looks like it might be heading that way. It's not hard to differentiate if you have some genuine concern for your patients (and you can have concern whether you triage them away or not) and you pay attention to signs, symptoms, and history. Nobody should be sent away in respiratory distress or with a respiratory condition that is rapidly deteriorating, with a headache bad enough to cause worry about an intracranial bleed, or a bowel perforation. But those aren't going to be casually missed at triage. When those are missed, it certainly shouldn't be at the point of triage. And it is okay to work something up that turns out to be nothing more than a regular ol' headache or gastroenteritis if it looks like it could be more. What I think has no business in the ER are those things that are very obviously not emergent, and they come in droves, and certainly NOT because they're truly concerned about their health. That's naivete in the extreme, or it's that idealism that you see so often in the college crowd. They cost taxpayers an enormous amount of money. Most of them have no intention of ever paying a dime for the care they receive. I have no qualms with sending them back to their primary care doc where they should've gone to begin with. However, let's be honest, small town general practicioners covering the ER (who generally get a fair amout of time in their sleep room), really want to get back to their sleep room. In addition, they refer the patient to their local docs (themselves!). I have no doubt their main motivation is they really don't see an emergent problem, but I suspect full time certified ER docs realize that making that call in the waiting room, following a few second conversation with a potential patient is not the way to go. I think what's clear is not that primary care docs can't recognize the difference between what's emergent or has the potential to be and what's very clearly not....but rather that YOU can't (based on your own lack of training). Umm...and referring nonpaying patients back to yourself really doesn't do much for business edited to add as an aside: what I see too often from small town GPs is that they often treat things themselves that they need to send away to a facility with more support. The things that deteriorate faster than you think they're going to are the ones that worry me. Personally, when I work in a small-town ER I'm usually less likely to triage someone away than when I'm in the busy ER that keeps me hopping for 24-hours at a time.... linz -- A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail