Flu shot rant

It's the beginning of October in the northern United States. Usually this means that the leaves are changing colors symbolizing the fall season. The weather is starting to get cooler. Halloween is at the end of the month which means that the Thanksgiving and Christmas holidays are not far behind.

It also means that the annual flu shot fiasco is going to start soon. You've seen this before. Once flu shots are mentioned on the morning national newscasts, the office phones will ring constantly until December. These annual news stories usually have someone from the CDC asking how bad the flu season is predicted to be. Then, typically, questions about the rumored flu shot shortages that will take place.

Meanwhile, back to our office, our patients are demanding that their flu shots be given to them today. "Hey, all the local pharmacies have them. Why doesn't your office have them yet?" "Is your office going to forget to call me again this year?" "Is your office going to run out of flu shots again this year?" "Don't you care about all your patients and not those you classify as 'high risk?'"

Why does this have to happen every year? Why do people have to get so angry at our office and our staff? I have no control why the pharmacies get the flu vaccine before doctor's offices and nursing homes. No, it's not a conspiracy. I would sure like to find out why this happens.

Why does our office wait two and three weeks after the pharmacies have their flu shot clinics? Well, for business, it's good to be the first on the block to get your flu shots out there so that you can use up your supply and not have any extra inventory. From a medical standpoint, we wait just in case the flu season may last another two or three weeks longer than expected next spring. That way you're still covered.

Why do people insist that the flu shot causes the flu? It doesn't. The flu shot doesn't prevent the common cold, and that's what you probably have. Estimates are that between 10-20% of the US population are infected with the influenza virus each year -- About 100,000 need hospitalization and about 35,000 die each year from influenza. But, don't worry, that won't be you. And, no, I won't just give you a prescription for tamiflu, just in case - just get your flu shot.

I'm just getting ready for the annual anger and aggression that will take place over the next few weeks when I'm not able to give their flu shot -- on demand -- for one reason or another. Don't worry, I still think you're a good person, but one of my many patients caught up in the annual hype.

Oh by the way, in case I miss you this time, you can still get a flu shot in December and January. Flu season goes through spring. Better safe than sorry, right?

Perspective

As you know, I like golf. Ok, I admit it, I can't get enough of golf. No, I can't play golf, but I follow it through the year. And, yes, I watched Tiger Woods win his sixth tournament in the last three months yesterday - even though it was on tape delay from England, and even though I already knew the result hours before I watched it on television.

For those of you who don't follow professional golf that much, some would call winning six professional tournaments a decent career. Tiger won six tourament in the last three months and eight tournaments in all for 2006.

The sports press is using words like "domination" and phrases like "Tiger's best year as a professional golfer." But, during the winner's press conference yesterday, he called 2006 a "loss." These are not the words of a professional golfer always striving for perfection in his sport. These are words of a son mourning the loss of his father earlier this year.

"I mean, people asked me that there on the 18th [hole] here, how do you consider this year," [Tiger] said. "I consider it as a loss. In the grand scheme of things, golf, it doesn't even compare to losing a parent."

I admit that sometimes I put the sports superstars that I admire on a pedestal. So much so that I forget that they're people, too. Even though Tiger Woods is the best golfer of my generation, and arguably the best golfer ever, his statement yesterday made me admire him even more. After all the accolades, adulation, and admiration, thanks for reminding me about what's really important in life.

Blog hot or not

A little something different today for you. Someone sent me this link to bloghotornot. I thought it was kind of cute. I don't know what it is, but I feel this need to be liked by others - maybe a character flaw. Anyway, as you can see by my sidebar, I have this thing for numbers and rankings.

I'd appreciate it if you click on that little graphic in my sidebar and let me know what you think of my blog. And, of course, also feel free to leave a comment as well.

Numbers update: I'd like to thank everybody again for visiting my blog, I really appreciate it. My average daily visits have increased by 95.4% to about 380 visits a day, according to site meter and the truth laid bear. So, thanks again! I'm starting my 15th week of blogging. And, I'll work as hard as I can to maintain the quality of my blog, so you'll return again and again.

BA in space

No, this is not an actual blogaholics anonymous meeting. It's just me being jealous. How cool would it be to blog from space? The topics would be endless. Well, this actually happened to Anousheh Ansari who is an American business woman.

According to the Sydney Morning Herald, she paid a cool $20 million to be a space tourist on a Soyuz vehicle. She touched down yesterday in Kazakhstan with her Russian cosmonaut counterpart.

[And] she wrote about the smell of space - at least the space inside the orbiting lab: "It was strange … kind of like burned almond cookie."

I read some of her blog, and it's interesting stuff. How soon will you and me get to check out space like that? Maybe sooner that you think, if Richard Branson has anything to say about it (according to this article from space.com). At the slightly cheaper price of $200,000, you too can spend time in space - about 2.5 hours which would include a more than a few minutes of weightlessness.

“If it was ready next week, I’d be there,” Alan Watts, who has traded in two million Virgin Atlantic frequent flyer miles for a ride on SpaceShipTwo, told SPACE.com. “I’m really looking forward to it.”

Trading two million frequent flyer miles for a chance to travel in space? Hmmm. Is this guy nuts? Does he know how many useless magazine subscriptions he could get for two million miles? Some people just don't think sometimes -- HA!

Germ zone

I finally figured out where I got this cold I've been dealing with for the past week. It started last weekend when I was in DC. According to this article from this morning's Boston Globe, my hotel room could have made me sick.

When sick hotel guests leave their rooms, they frequently leave something important behind: the virus that gave them their colds.

During an overnight hotel stay, people with colds left viruses on telephones, light switches, and television remotes, researchers said yesterday at an infectious disease conference in San Francisco.

We've all heard about not coughing on people and not sharing cups with people who have colds. Now, apparently, you're going to have to ask if the people who had the hotel room before was sick. Wouldn't that be interesting? When it comes down to it, I agree with Dr. Owen Hendley, University of Virginia Health System, who led the research.

"It's an interesting study," he said. "But they haven't shown infectivity. I'm not going to go around opening doors with my elbows."

Big apple fat

Usually when you mention the word "trans" in New York City, you mean something completely different. But, right now, NYC's hottest "trans" is trans fat. Why? Because earlier this week, the New York City Health Department proposed a near ban on trans fat in NYC restaurants. As you already know, trans fat is found in fast food, cookies, cakes, and basically anything I think is good to eat.

"Trans fat causes heart disease. Like lead in paint, artificial trans fat in food is invisible and dangerous, and it can be replaced," New York City Health Commissioner Thomas Frieden said in a statement. (quote from Scientific American)

In the following quote from SFGate.com, by proceeding with a ban of one substance seen to have health concerns, this sets the precedent and opens the door to a laundry list of possibilites of future food bans.

There's also the issue of what should be banned. What about high fructose corn syrup? Sodium? Cases have been made that they're just as harmful as trans fats. Should we put a cap on the number of calories that people are allowed to order in a restaurant?

I always love when the government tries to legislate behavior. By making trans fat, in a sense, illegal, doesn't it then make it more attractive? This may seem silly, but I see drug dealers turning into trans fat dealers. They would hang out outside of NYC's swankiest (is that a word?) restaurants with one side of the raincoat with cheap Rolexes and the other side with illegal donuts to bring into restaurants. Sales of crack, heroin, and meth will fall off dramatically in favor of french fries.

The other thing I can't wait to see is "New York's Finest" food police. Can't you see the TV show right now? "Tonight at 8pm - Dr. A stars as Detective Emeril (BAM!) - In Cold Food Files." Bon Appetit, NYC. Pass the donuts!

Resources

This story from the Hamilton Spectator kind of hits home for me. It talks about a small hospital and what hospital administration does to try to improve the hospital and the community.

Why wouldn't Hamilton Health Sciences (HHS) put more money into emergency rooms to attract and keep doctors? Why wouldn't HHS top up emergency physicians' salaries to ensure stability and appropriate levels of service? It makes good sense.

Especially for small hospitals and small communities like this one and like mine, there are limited resources and priorities have to be made on where and how resources are managed. I'm all for getting the best docs and building the best facilities, but there are consequences to that.

The problem with emergency staffing seems to be double-edged -- crummy working conditions and pay that's not great. HHS has chosen to address those issues to ensure adequate emergency services.

Don't get me wrong. I'm not trying to lead you down a path here - especially with my posting yesterday of paying docs more. Like I said above, my small community and my small hospital are going through this right now.

On the one hand, having the best and most modern facilities can attract docs and other medical professionals to our small town and hospital. Who doesn't want to work with the latest and most technological toys?

On the other hand, something has to give. Sometimes that means pay freezes and/or pay cuts to the rest of the staff whether it be nursing, respiratory, secretaries, custodians, etc. Or, short staff situations. This can have effects on patient care and hospital morale, and other areas. I don't have the perfect solution. I'm curious what you think.

Question: If you were CEO of a small hospital with very limited resources, how would you help insure the best medical care for your community?

Family Docs Rock!

I'm Dr. A, and I approved this message... (Story from WBAL-TV in Baltimore)

WASHINGTON, D.C. -- A rally was held in Washington D.C. Wednesday to bring attention to a shortage of family physicians.

The American Academy of Family Physicians said they want Congress to increase medical payments to family doctors.

They also said they want voters to question candidates about health care.

A workforce report by the group showed the number of family physicians has dropped by 50 percent as younger doctors opt for specialties that offer better pay.

Grand Rounds

GR 3:1 is hosted this week by Enoch Choi, MD from Tech Medicine. I wasn't aware that GR has been going now for 2 years. Congrats to Nick Genes. Anyway, Dr. Choi is kind of having a "Medical BA meeting" over there with appetizers and everything else. I'm under the "Who's Hot and Bothered" section.

Dr. Anonymous considers the FDA a bureaucracy without merit and next week's Grand Rounds host thinks clinical trials are sometimes without merit as well.

Got back home late from DC last night. Can't believe I'm back at work today. Oh well. Checked the site meter and it was over 400 yesterday, thanks to all of you! That's the highest it's ever been, at least for me. I haven't had a chance to review all the comments and my e-mail yet. Hopefully, I'll be able to do that in the next couple of days. However, I'm on call tomorrow. Sheesh! Thanks for coming to the DC BA meeting yesterday.

BA in DC

I'm Dr. A, and I'm a blogaholic. Welcome to the latest edition of the Blogaholic Anonymous meeting. What is Blogaholics Anonymous all about? Well, this is only for those who are hopelessly addicted to blogging. If you're not, then stop reading this right now! LOL

As you already know, this edition is from Washington, DC. I did not get to see everything here, but I will take you on my short walking tour - all I could do in a few hours. Below are some reflections as I walked around the city.

White House: I wanted to come here first. Regardless of your politics, if you've never seen this place up close, you must make a point to someday. The first observation I made was all the people. Just to be funny, if I was President (yeah right, like that would happen), one day, I would run out on the balcony, and yell, "Hey! All you people, get off of my lawn!" Maybe that wouldn't go over very well. I tried to take a tour inside, but they absolutely did not want any cameras in there. And, traveling by myself, I guess I couldn't go in.

Of course, there were the obligatory protestors. Don't get me wrong, not belligerent, just wanting to make a statement. It was nice to see some cub scouts doing some cleaning in the park across from the White House - wonder what those scouts were thinking. As I went from the north lawn to the south lawn, I saw more people. Even people playing football and soccer, "Yeah, let's meet up Saturday afternoon on the south lawn for our game." Very cool.

Washington Monument: This was my first sight as I was driving into the city Friday night. It is as majestic in the daytime as it is at night. You really don't know how tall this structure is until you're at its base. I did not get to go to the top of the monument because all of the viewing tickets were already given out for the day. This a good point to see a lot of the other monuments. Looking north, you see the White House. Looking south, you see the Jefferson Memorial. Looking east, you see the top of the capitol building. And, looking west, you see the Lincoln Memorial and the World War II Memorial. I guess I should have figured it out, but all the monuments are national parks. And, what do people do in the park, they play sports. An interesting sight seeing people play sports with the backdrop of the monuments.

World War II Memorial: I've seen this on television, but have never been there before. It's definitely a beautiful place with all the fountains and all the people talking about their experiences during the war. I saw many families there and many veterans talking to their grandchildren about their life experiences. What a perfect location between the Washington Monument and the Lincoln Memorial.

Lincoln Memorial: The reflecting pool lies between the WWII Memorial and the Lincoln Memorial. I even saw some airplanes in the sky above, as they go to Reagan National Airport. As I was walking to the monument, I imagined all the history that has taken place here throughout the years. Then, suddenly, I had my Martin Luther King moment. I saw him on the steps of the memorial and I imagined all the people surrounding the reflective pool. I had to pause - quite moving.

One of the things I didn't realize was all the steps to climb to get to the top of the monument. I realize I'm really out of shape, but I felt it was quite an achievement for me to get to the top of the steps. The first thing I did was look back east to see the Washington Monument, its image in the reflecting pool, and the capitol building in the background. Felt very patriotic at that moment, and a smile came across my face.

Vietnam Veterans Memorial: In contrast to the WWII memorial, where there was a lot of energy and noise, this place was very solemn and quiet. People have told me this before, but it doesn't really hit you until you're there. There's no glitz; there's no glamour; just names on a wall. Kind of felt like hollowed ground starting at one end of the memorial and descending to its midpoint and then walking up and out of the memorial again. People left flowers. People used pencil and paper to trace the names of their loved ones from the wall. Powerful sight to see.

Capitol Building: I just had to take a break after that. I got some water and made my way back past the Washington Monument and walked to the Capitol. This was a long way (for me), so I found a bench near the metro/subway station. As I sat there for a few minutes, it was interesting to see the people come up from the subway station, especially the children, as they saw the monuments for the first time. I also noticed many international people in the city. I heard a lot of languages spoken, and you could tell that they were happy and proud to be here - the home of democracy. Americans definitely take democracy for granted, and that was emphasized to me in observing these people from other countries.

Final Stops: Continuing walking east, I saw the Library of Congress and the Supreme Court. I didn't realize the size of the court door until I walked up all the steps and saw it for myself. There were some students gathered in front of the Supreme Court building talking about how to effect change and the impact of court decisions. Who says American students don't know anything about how their government works? I finally got some food at Union Station, which is a fully working train station for those who do not know. As I was having lunch, I saw travelers rushing into and out of the building, much like an airport. I was so tired, that I took the subway back to the hotel.

For the visual part of my essay, I encourage you to check out my Flickr file and leave some comments as well. I hope you enjoyed a quick walking tour of Washington. I'm on my way back home later today. Thanks for checking in!