Tuesday, February 21, 2017

You are being recorded

A few years ago, I had the following conversation with a patient:

Patient's mother: "My daughter told me you told her X and Y."

Me: "Hmm.  Well, I'm not sure I said that to her.  Maybe she misunderstood."

Patient's mother: "You did! And I know you did, because she recorded you talking to her and played it for me!"

Me: "..."

So that was horrifying.  I don't know how many patients are actually secretly recording me, but it's not something I had ever considered before.  I'm pretty sure it's illegal without my consent, a fact that I decided it was best not to bring up in this conversation.

Later, the patient apologized to me for recording me and was very embarrassed.  She said she can't remember conversations unless she records them, so she records all doctors' conversations.  Which is fine, but shouldn't she ask permission first???

Friday, February 17, 2017

Mystery package

I live in an apartment complex... one of those places that's made up of dozens of little two-story buildings that have about 3-4 apartments each.  I live on the first floor and we have a little enclosed patio that opens through glass doors off our living room.  I haven't been out there recently due to cold/snow.

Yesterday, my daughter was looking through the glass doors and said, "Hey, there's a package on our patio!"

Me: "No, there isn't."

Her: "There is."

Me: "It's just an empty box."

Her: "No, it's a package."

So I looked, and sure enough, there was what appeared to be an unopened package on our patio.  We retrieved it, and discovered that it was an Amazon box, and that it was addressed to our neighbors.  It was postmarked about a week earlier.

I have to say, I am 100% baffled as to how our neighbor's package got on our patio, which is nowhere near our front door or ANYONE's front door (it's in the back).  There is also no apartment number on the patio, so nobody would know which patio belonged to which apartment.  The delivery people from Amazon may not always be stellar and sometimes packages get delivered to the wrong door, but I have to believe that Amazon wouldn't just throw a package onto a random patio.  

Has this ever happened to anyone here?  Any thoughts?

Monday, February 13, 2017

HIPAA violations

I don't understand HIPAA.  I mean, I do understand it, but I don't always understand why one thing violates it while and other doesn't. For example, when I go to the doctors office and they call out my entire name in the waiting room, isn't that a violation?

I was in the middle of a phone call yesterday that somebody at work claimed was a violation, but I'm sure that it was not. I was calling the daughter of a patient of mine per her request, and even though there was no voicemail message, I left the following message:

"Hi, this is Dr. Fizzy.  I'm calling about your mother. She's doing great, but I just wanted to touch base with you about her care. Please call me back at 555-5555."


I can't for the life of me figure out how this violates HIPAA, but feel free to educate me.

Thursday, February 9, 2017

Flexible spending update

So I made a post recently about how the payroll place gave me such a hard time about getting back the $5,000 I set aside for childcare.  I wanted to give you an update:

I was sent a check in the mail.  For $4,999.80.

I don't understand this.  What happened to that extra 20 cents?  I clearly spent over $5,000.  Why did they deduct that 20 cents?  I went to the website and it just said the 20 cents were "pending."

Obviously, I don't care about 20 cents.  But I find it perplexing.  Why didn't they give me that 20 cents.  Is this some sort of scam where they take 20 cents from every client and it ends up somehow adding up to millions and skip off to another country?

Monday, February 6, 2017

An expensive trip

Recently, I went with my family to the aquarium. I did the best I could to save money on the excursion.

Since tickets to the aquarium cost nearly $30, I got the discount passes from the library for ONLY $10 each.  So I congratulated myself on spending only $40 instead of $120 on the tickets.  But then the parking cost $40.  And even though I made sandwiches for myself and one of my daughters, lunch in the cafeteria for my husband and other daughter (a cafeteria-grade burger and pizza) cost $25.  So in spite of some efforts, we still spent over a hundred dollars on the trip.

We don't really need to save money--it's just instinctual for me after growing up with a single mom.  But the thing is, we have more money than most people.  Yet I could see that most people were paying full price for the tickets.  And the cafeteria was so packed with people buying food, you couldn't even get a table.  And the parking garage was nearly completely full of people willing to pay $40 for parking.

Granted some of these people could have been tourists taking a yearly trip.  But it's hard to believe that the aquarium was packed to the brim (there was a line to enter after the line for buying the tickets) with people who were so excited to go to a not that great aquarium in the dead of winter.  It seriously wasn't that special. It's just fish. We all agreed after two hours that we were totally bored.

Why are there so many people willing to spend close to $200 for a day at the aquarium?  Who are these people?

Thursday, February 2, 2017

Revenue

As some of you know, I've got a few books for sale on Amazon. At the end of the year, I get a tax statement telling me how much income I earned from these books. I'm awaiting my UK statement, but I got the US statement last night and was personally happy with the number I saw.  So I decided to share with my older daughter, who wants to be an author herself.

Me: "Guess how much money your mom earned selling the books I wrote on Amazon?"

Daughter: "Ummmm..... 700?"

Me: "700 dollars?"

Daughter: "No, um.... 700 THOUSAND dollars."

Me: "700 THOUSAND dollars!!!!"

Daughter: "No, I mean... one... thousand.  One thousand dollars."

Me: "I earned $24,000."

Daughter: [disappointed] "Oh."

Fine.  I didn't earn $700,000 last year.  But hey, $24,000 isn't bad. (I did donate a chunk of that money to charity, but that's my choice.) A lot of people rag on me about how self-publishing isn't legit and I should submit my book to a real publisher, but all in all, self-publishing has been good to me.  I've probably made maybe $60K total since I started in 2013.  And I've given away hundreds of thousands of free copies of my books, which makes me feel like I would never get this kind of visibility if I'd used a traditional publisher.

With all that in mind, I've written a sequel to The Devil Wears Scrubs.  Await publication in the spring.

Monday, January 30, 2017

Flexible spending

I could rant for a long time about flexible spending.

Excuse me if I misspeak on any of this because it's not something I entirely understand.  So every year, I'm allowed a $5,000 flexible spending account for childcare, which means that $5,000 is taken out of my paycheck before taxes and I can then get this money back in full at the end of the year.

Let me just say that $5,000 is a laughable amount of money for childcare for a family with two working parents.  At the maximum, I was paying $40,000/year to our daycare.  Now I've got two kids in public school, and I STILL pay about $15,000 for afterschool and summer camp.  But fine.  $5,000 is what they allow so I guess I'll take it.

But what I really resent is that every single year they make me fight for it.  Without exception, they have rejected every single one of my initial claims.  This is MY MONEY.  I just am trying to get my own $5,000 that was taken out of my paycheck back.  Do they think if they make it hard enough, that I'll just give up and say I don't want my $5,000?

Examples of why they rejected my claims:

Last year they ignored one page of my receipts.  They looked at the first page, calculated $3,500 in care, then said that was all they would give me.  When I called and said WTF, it turned out that they HAD the other sheet and just decided not to look at it for unknown reasons.  I mean, it was only two pages.  It wasn't like it was 10,000 pages and they missed one page.

This year, when I was filling it out, there was a section that it said you didn't have to fill out if you had receipts.  So I just wrote "see attached" in that part.  Then yesterday morning, I found out I was rejected because I didn't fill out that part.  The part it said not to fill out.

Why?  What's the point of all this?  They're going to give me the money eventually... does it really pay off for them to waste everyone's time?

Monday, January 23, 2017

Eliquis

Can somebody explain to me the deal with Eliquis?

Eliquis is one of the new anticoagulants that is starting to take the place of Coumadin.  It's a wonderful thing, because Coumadin has to be monitored so carefully with blood tests and interacts with everything. The newer anticoagulants don't need to be monitored in the same way and have lower risk of bleeding.  Win-win, right?

Except the problem with Eliquis is that it's not reversible.  If you're on Coumadin and you have a big bleed in your head or GI tract, they can give you Vitamin K to reverse it and hopefully stop bleeding.  If you're on Eliquis, you just have to wait for it to get out of your system.

I could accept this risk because of the benefits of Eliquis except that there are other newer anticoagulants such as Pradaxa that have lower risk of bleeding, don't need to be monitored, and they are reversible.

I can't figure out why people keep prescribing Eliquis instead of a reversible alternative.  It's the most prescribed of the newer anticoagulants, yet I've never heard a physician give a really good reason why they would pick that over something reversible.  I casually looked up the literature and I don't see anything compelling there either.

I don't get it.  Can somebody please explain this to me?

Thursday, January 19, 2017

Drawing

I was picking up my five-year-old the other day, and I saw that she was working on a drawing that looked like this:


Maybe it's just me, but I got worried that my daughter was drawing what appeared to be... a giant bladder with a penis coming out of it?  I asked her what it was and she said, "I'm not done!"  Then she added this:


And I was like, this isn't better!

Thank God, it did eventually turn into something non-phallic:


Monday, January 16, 2017

Obamacare

I know everyone hates Obamacare, but there's this thing called the Affordable Care Act that's actually pretty good, and I hope it sticks around.

Seriously though, I would say that I'm a fan of ACA and I think it will be a mistake to repeal it with no replacement in mind.  Some stuff about ACA that is really great:

--No denials for pre-existing conditions.

--Free preventive services for women

--No copays on birth control -- something that's actually CUT BACK on abortions

--Premium equality that keeps insurance companies from charging exorbitant amounts just because you're over 50 or a woman

--End of lifetime caps on medical spending.

Just to name a few things.

One thing that some people argue about is the mandate to purchase insurance.  For the record, I read that Republicans were in favor of this mandate prior to it becoming a staple of ACA.  Anyway, there SHOULD be a mandate to have health insurance.  Because hospitals have a mandate to treat people who are having an emergency, which is something that you don't have in any other industry.  You can walk into an ER and be treated without any proof that you can pay.  Where else can you do this?  You can't walk into a car dealership and get a car without proof you can pay for it.  You can't walk into a supermarket and buy a candy bar without proof you can pay! Yet you can easily wrack up tens of thousands of dollars in hospital bills without any money in the bank or health insurance.

So until we start saying that hospitals can turn away people from the ER (which obviously, would be horrible), then there NEEDS to be a mandate that people should have health insurance.

Everyone needs health insurance.

But if there are any better ideas out there than ACA that Paul Ryan is keeping secret from us, I'd certainly be open to listen to it.  God knows, the ACA isn't perfect.  But it's just better than taking away health insurance from 20 million people.