The system did not break. It is working exactly as designed.
Four of them. The second one should not be legal.
SEND this to whoever fights this queue with you.
Email: "Exciting news — our practice has joined a new partner network."
Me: "Who owns us now?"
Admin: "A fund."
Me: "A fund owns the room where I decide whether someone gets a clot-busting drug in the next twenty minutes?"
Admin: "The fund is very excited about your throughput."
Me: "I need a Spanish interpreter."
Clinic: "The tablet is on cart four."
Me: "Cart four is in the other building."
Clinic: "Then use the family member."
Me: "The family member is the person I am here to ask about."
Records: "We cannot accept the outside MRI electronically."
Me: "How should it arrive?"
Records: "On a disc."
Me: "My computer has not had a disc drive since 2016."
Records: "Then bring it to the third floor."
Case manager: "He does not meet inpatient criteria."
Me: "He cannot walk."
Case manager: "Since when?"
Me: "Since yesterday. That is the reason he is here."
Case manager: "Is it expected to last two midnights?"
Me: "I am a neurologist, not a fortune teller. And also yes."
EXPLAINED (ACCURACY-CHECKED)
(1) Intravenous thrombolysis for acute ischaemic stroke is a time-critical physician decision: the probability of a good outcome falls with every minute of delay from symptom onset to treatment, which is why door-to-needle time is a tracked quality measure. (2) Using family members as ad hoc interpreters is discouraged because it introduces omission and error; in a cognitive evaluation the accompanying relative is also the informant, so the roles are in direct conflict. (3) Image exchange between unaffiliated health systems still frequently depends on physical CD-ROM transfer despite the existence of electronic image-sharing standards, causing repeat imaging and delay. (4) Under the Medicare two-midnight rule, inpatient admission status turns on the physician's expectation that medically necessary care will span two midnights, which requires a prospective prediction about an unpredictable course.
PERMANENT LINK
https://cerebrospinalectomy.com/jokes/email-exciting-news-our-practice-has-joined-a-new-partner-network/
Reprint anywhere, non-commercially, with attribution to cerebrospinalectomy.com. We punch at specialties, the system, and ourselves — never at patients.
CEREBROSPINALECTOMY