Haute Dog

Read this review of a new hot dog restaurant in Pasadena. It's called Slaw Dogs. Never heard of a hot dog restaurant? These just aren't any old hot dogs. How about a chicken Caesar salad hot dog? Or pictured here, the TNT super dog. It looks like a giant burrito stuffed with chili, bacon, pastrami, french fries, grilled onions, fried egg, and off course a ten inch sausage. Yum. Check it out if you're ever in Pasadena. I know I will, after I've downed a bottle of Lipitor.

Porsche 918 Spyder Hybrid

Now this is my kind of environmentally friendly green car. Unveiled at the Geneva Auto Show, Porsche displayed this stunning 918 Spyder plug in hybrid concept car. Check out the stats. 500 HP V8 engine. 214 HP electric motors. And the most impressive statistic: 78 MPG! With four different driving modes, it can go all electric for up to 25 km up to Sport Hybrid mode that uses the electric motors to supplement the V8 (I bet it won't get 78 mpg then). Zero to sixty is 3.2 seconds with a top speed of 198 mph. The capabilities of hybrid power trains just keeps getting more fantastic by the year. This is one car even Ed Begley, Jr. and Al Gore would love. If they could just price this thing at about the Boxster S level, the dream would be complete. No word yet on pricing or whether it will even be built.

Computer Security Madness

I was just notified by our IT department that my computer password is about to expire. That means it's time to come up with another inscrutable yet easy to remember password so I can log into my hospital's email system. The rules are pretty onerous.

1. The password must be at least 8 characters long.
2. The password must contain at least one capital letter.
3. The password must contain at least one number.
4. The password must have at least one symbol ie/#&$.

The password also cannot cannot contain any part of your name and it has to be different from your previous five passwords. Got that? Actually it's not that bad. Only three of the four criteria need to be met, not all four. Ha ha. These rules are so difficult to follow that I actually had to call our IT guy to help me come up with a password that would pass muster. He was very friendly and obviously had helped lots of people with this problem. After about three attempts I finally came up with one that the security system would accept. Hopefully I'll still remember it by the end of the day. After all, you're not supposed to write it down anywhere lest somebody found it and hacked into your account. Some computer browsers helpfully remember passwords for you and automatically log you in. But that kind of defeats the purpose of these security measures, doesn't it.

The New York Times recently had an article about the kinds of computer passwords that are commonly used. Believe it or not the top three passwords people use are 123456, 12345, and 123456789. Obviously none of these, or even the top 32 on their list, would pass the scrutiny of our computer security. There must be a way for the IT guys to come up with a security system that doesn't drive its users to madness, or feel like they are having early Alzheimer's. Perhaps some sort of biomechanical security measure like fingerprint identification or retinal imaging? But of course that is a little sci fi for our hospital. Our network still runs Windows XP! (IT promises that we are upgrading to Windows 7 by the end of the year.) So in the meantime I better start working on my next password since this new one will expire in only six months.

If He's Done The Crime...

It is now official ABA policy. The American Board of Anesthesiology has decided that any board certified anesthesiologist must not assist in carrying out capital punishment. Based on the ancient dictum of do no harm, the ABA states that an anesthesiologist risks losing his board certification if found to be helping the execution of a death row inmate.

I wrote of my feelings about this situation last year. If a person (?) can rape and murder an innocent child with his bare hands, why should he get the expertise of an anesthesiologist in getting an IV started? Is it really cruel and unusual punishment to get poked with a needle multiple times trying to get an intravenous line when he has committed a heinous act? Let him get poked until he resembles an acupuncture model. Why should he expect a nice little subcutaneous lidocaine injection to ease the discomfort of an IV? Many of our normal patients don't need it so why should death row inmates expect it? I say if he's done the crime, he should serve his time, for all of eternity. Just don't expect to get there on a pillow cloud of empathy from the rest of civilized society.

Medicare And Anesthesiologists

There is a lot of handwringing in the medical blogosphere today about the 21% cut in Medicare reimbursements. Some are advocating dropping Medicare patients completely as a sign of rebellion. With Medicare payments so low, many doctors feel they can do better by not accepting Medicare. After all, what's the point of keeping these patients when the payments are below the cost of rendering services. It's like the clueless retailer who sells goods below cost but tries to make it up in volume. The numbers just don't add up. Some people say that because doctors are obligated by the Hippocratic Oath to treat the sick that we should just suck it up because it is the ethical thing to do. What I never understood is why it is the physicians' responsibility to go into bankruptcy to take care of patients when the public and the government refuses to pay for such services? If people feel that strongly about taking care of the elderly and the disabled then maybe they should do some sacrificing of their own, such as paying higher taxes, to treat them.

Anesthesiologists are in a different boat. True we will still get 21% less for treating Medicare patients. But unlike primary care doctors we don't have the option of dropping these patients from our practice. When anesthesiologists sign up to provide services for a hospital, one of the requirements usually is acceptance of Medicare. Otherwise the surgical services would be completely chaotic. If a surgeon brings an elderly patient in for a hip replacement, it would be detrimental for all involved if the anesthesiologist cancels the case because he doesn't accept Medicare. So you see anesthesiologists pretty much have to grin and bare it when it comes to accepting below cost Medicare payments.

The Senate is set to introduce legislation that will put a temporary patch on these Medicare cuts. This will give them time to find a more permanent fix but I'm not holding my breath on that one. They'll just put in another one year fix because they can't come up with the money for a real repair of Medicare's SGR formula. In the meantime Congress is still debating passage of healthcare reform that will permanently decrease the pay of physicians regardless of what Medicare does.

Tsunami! Not.

We had a tsunami warning here in Southern Cal yesterday due to that awful 8.8 magnitude earthquake in Chile. Of course like morons who run towards a fire to watch its destructive powers, the hordes were amassed at the beaches to watch the tsunami. They were disappointed. The tide was less than three feet high. Most people didn't even know it had come and gone. The above picture is a cool graphic of the height of the expected tsunami across the Pacific Ocean.

A Life Saved By D-Cups

An LA area woman's life was saved when she was shot in the chest and the bullet's energy was dispersed by her large breast implants. Lydia Carranza was at her dental appointment last year when a gunman barged in and killed his wife, an employee at the office, after she filed for divorce. He then proceeded to fire his semiautomatic rifle around the room. He aimed his gun point blank at Ms. Carranza's chest. Luckily for her, the bullet went through one of her implants and stopped short of her heart. Point blank from a semiautomatic rifle and the bullet still stopped short of the heart? Sounds better than Kevlar.

Ms. Carranza's tissue wound has now healed but she needs to replace her breast implant. Her Beverly Hills plastic surgeon is asking her to publicize her story in the hopes she can get donations to help pay for the implants.