June, 2008 Archive

New Zealand Medicine from an American Perspective, Part 2

sherring — Mon, 02 Jun 2008 00:00:00 -0600

Note: This is Part 2 of Dr. Herring’s observations during a recent international assignment. Part 1 explained medical training and a doctor’s progression through the medical ranks.

About the practice of medicine

In general – No malpractice, sort of. If a complaint comes up, a government-appointed board decides whether to pay the patient/family some money for damages based on the merits of the case, and may take disciplinary action against the MD if indicated. This is ‘socialized’ medicine, so all residents and citizens get their care covered, but they have to pay for some things. For example, $20 to see your GP, or maybe $5-15 for some drugs (drugs are cheaper everywhere outside the US).

Emergency Department – Similar to working in American EDs about 20 years ago, as far as I can tell. On the minus side, you might have to wait up to four hours for a CXR because the radiographer is tied up in theatre. Also, you might have to convince a radiologist that a CT scan is really is necessary. On the plus side, you can make a clinical diagnosis without having to ‘rule-out’ everything under the sun with expensive tests to avoid litigation. Also, patients referred to the hospital for surgical or medical consultations are seen by those services in the ED and will only ask for your help if they need you.

Hospital credentialing for locum tenens physicians - a few important changes you should know about

rsimmons — Mon, 09 Jun 2008 00:00:00 -0600

The last time we visited the wonderful world of hospital credentialing for locum tenens assignments, we focused on the ever important ‘documentation of procedures’ or procedure log. As I mentioned in my last blog, paperwork and more paperwork is the norm now when applying for hospital privileges—whether it’s for a permanent position or a locums job. Although not a recent or extraordinary request, I am seeing more and more hospitals require documentation of all physicians’ TB skin test or PPD taken within the past year.

As a physician you probably realize there are a lot of you out there with positive TB tests who have no symptoms. Hospitals realize this and are fine with those results as long as we can provide them with a copy of a chest x-ray as supporting documentation. In most cases copies of your TB test and the chest x-ray are all that are needed. However there are a handful of hospitals that may ask for additional documentation from the physician who performed the TB test, and in extreme cases they may require you to take a TB test during your locum tenens orientation process prior to seeing patients.

So….like the procedure log, it’s a good idea to keep a copy of a recent (within the past year) TB test and a chest x-ray if your result is positive in your locum tenens credentialing file. I’m certain that over the next few years it will be a requirement at every hospital and clinic regardless of location.

Locums licensing alert—several boards backlogged

sshanley — Mon, 16 Jun 2008 09:23:26 -0600

Once again we are in the very busy time for both locum tenens and permanent licenses. Many boards are overwhelmed with new resident licensure. Here is a list of boards that have advised us of how far they are behind.

Arizona – two to three months behind with applications and verifications
Alaska – one month behind in going through the mail. Once the application is complete and ready for executive review it is taking three weeks to be reviewed.
California – 90 + days just to process the application. The board is also not able to respond to emails or message left on the phone.
Texas – Not able to commit to dates. They report that it is currently taking 9-12 months from start to finish of a license.
Wisconsin – Reports that they are six months behind.

New Mexico renewals: If a doctor received his or her license prior to September 1, 2007 and is up for renewal, the doctor will need to submit fingerprint cards as part of the renewal process. There is an additional charge of $34.00 to process the fingerprints. This process will be in effect during the 2008, 2009 and 2010 renewals periods. All New Mexico licenses expire on July 1.

Locum tenens and wildlife photography—both require a team approach

hgarber — Fri, 20 Jun 2008 15:55:51 -0600

Since 1983, I have worked as an emergency physician at small and large hospitals all over the Western U.S. and Alaska. I find that there are many similarities in my two professions. Every day I spend as an outdoor photographer is different and full of surprises. The same could certainly be said for a day spent as a locum tenens in an emergency department. And in the same way that providing good health care is a team approach, my success as a photographer depends on multiple factors--weather, planning, animal behavior, and luck. While the contribution I make to a community as a locum tenens is easy to measure, I still feel challenged to use my photography as a tool for improving the world. I can’t help feeling that artistically capturing pure beauty seems hedonistic and socially irresponsible at times. Yet it is important to document what we are trying to save as well as what we are destroying at a fast pace.

VISTA note: Howie Garber/Wanderlustimages.com is currently featured in a solo exhibit of his nature photography at Evolutionary Health Care Gallery, 461 East 200 South, Suite 100, in Salt Lake City, Utah. The exhibit is titled “The First 18 Years of Wanderlust.” Howie is introducing new prints to his fine arts collection. He has done landscape, wildlife, and environmental photography on seven continents. You can meet the physician/photographer at a Gallery Stroll June 20th from 6 to 9 p.m. He will be donating 20% of photo sales to Utah Physicians for a Healthy Environment and Utah Moms for Clean Air. The exhibit will run through July 15, 2008. You can view Howie’s photography on his website www.wanderlustimages.com.
Photos courtesy of Howie Garber, MD.

Straight From the Heart

fdaniels — Mon, 30 Jun 2008 00:00:00 -0600

One evening, I was cruising through downtown Boise on my favorite Harley, Boomer, and as always, I was flying a 3-by-5 foot U.S. flag on it. I went through an intersection and heard a lot of hootin' and hollerin' behind me. I turned around and there they were, at a sidewalk café, about 20 Army personnel in uniform. Some even stood at attention! I waved back, and kept going but I thought: that was awesome. I should get back there and tell them I appreciate their service to this country. So I went around a few blocks, and pulled my obnoxiously loud badass machine onto the sidewalk, right by their group. They went nuts. They said it was the greatest thing that I flew that flag, and they thanked me for it. I replied: No, I ought to thank YOU all for your service and I want to buy the whole group a round of drinks. No, they said, that was not necessary, just flying that flag was good enough. Of course, I insisted. They may pay for me with their lives, so my paying for their drink is a no-brainer. It cannot begin to compare. They invited me to sit with them. What an honor! Every single one of them had been in either Iraq or Afghanistan. We then parked the bike in the middle of the street and got the bartender to snap a few pictures of the whole group gathered around it. At the end, each and every one of them shook my hand, and the tall serious looking guy in the middle of the back row (he could be a Russian extreme fighter) looked me straight in the eye and said:" Sir, it is people like you who make me proud to serve this country. Thank you, SIR!"

Folks, it doesn't get any better than this. God Bless these superb people and God Bless America.

Straight from the heart,

Frank Daniels
Boise, Idaho

P.S. Happy 4th of July from VISTA!