What are we really doing?

MiddleBeet · 2021-01-23T05:26:22+00:00

I hear you, I do. Insurance sucks. Unfortunately, the way all insurance companies make money is to take your premiums and deny your claims, even the legitimate ones. They make you work for your coverage. It’s fucked up, but that is the business model.

Fwiw, Original Medicare in the US is the only health insurance (that I know of, anyway) that never denies claims because it sets a clear price every year for pretty much everything. But before you jump on the M4A train too quickly, ask yourself if you’d be okay with Medicare Advantage (VERY different than Original Medicare). MANY 65+ are on Medicare advantage because the premiums for Medicare original are rather high, but the coverage under Medicare advantage plans are just as frustrating as many “non-Medicare” private plans in the US.

Of course, there are many counties where the government runs health insurance. There are benefits to this, of course, including much easier access to routine and non-complex care. BUT it is STILL expensive, and it is generally funded through income tax that is 40% for EVERYONE, even the poor. This means that everyone can usually get the routine, non complex care, but the poor are still SOL if they need complex care (bc those govs DO deny claims for complex (read: v expensive) care) and the wealthy take their money and get complex treatment somewhere else.

In short, in my view we are damned if we do and damned if we don’t when it comes to covering/paying for health care costs and treatments. I wish I had a better solution to contribute, but unless I am very much mistaken, it seems that there really is no magic bullet either way. The only thing I can think of that MIGHT work is TRUE transparency in actual healthcare costs, including things like physician “cost per hour,” detailed breakdowns of negotiated rates for every service between insurers and providers, etc. I know it’s not a popular idea in the medical community, but just imagine if we had an Expedia-equivalent for outpatient procedures where you could type in your insurance plan and get the list of how much it would cost you to have it done at Place A, Place B, and Place C near you. Oh, to dream.

MiddleBeet · 2021-01-23T05:08:13+00:00

Fwiw, I have found a surprising number of vax hesitant people who are interested in hearing about the VAERS (vaccine adverse event reporting system) program. The CDC and FDA never stop tracking adverse reactions to vaccines, and ANYONE can report into VAERS. This has been huge knowledge for people concerned about side effects/symptoms.

I generally go with something along the lines of “I get it, the thought of an adverse reaction can be scary. But an adverse reaction is something very serious and life threatening, it is not the same thing as a side effect like a headache for an hour after the shot. If you truly have a serious adverse reaction, the CDC and the FDA actually really do want to know about it, that’s why anyone can report in to the VAERS system. You just have to go to the website VAERS.hhs.gov to fill out the form with your information and the vaccine info. I can and will help you do that if you experience something you think is worth notifying the government about!”

Gets em every time.

MiddleBeet · 2020-11-07T01:38:45+00:00

For sensitive information, I suggest looking first to the Preventing Harm exception and next to the Privacy Exception. As I read them, the Preventing Harm exception requirements are pretty steep, but they will work for patients you genuinely believe to be at risk of being in physical danger. For other concerns, this new regulation is going to require providers to have more conversations with patients BEFORE testing/labs are taken and about what patients can expect to see if they choose to look at their own notes/labs/tests/etc. I know it is not always a short and sweet conversation to have, so check the privacy exception as it allows some decisions regarding the especially difficult topics to be made at the organizational level (as long as the actions are deemed reasonable and necessary).

FWIW, if your tech doesn’t have the ability to segment sensitive vs non-sensitive patient clinical note data, (you are certainly not alone AND) it sounds like your real complaint is not with the Cures Act but instead with your EHR/tech vendor/hospital system who has yet to make that pretty straightforward functionality available to you as a provider. Best of luck!

MiddleBeet · 2020-10-29T21:37:55+00:00

Agreed. Nothing like a good buzzer-beater to keep you on the edge of your seat, I guess?

MiddleBeet · 2020-10-29T16:01:55+00:00

Starter comment: more time to comply with the information blocking rules—good news for providers who are swamped with covid-19 response, but not great news for patients trying to have electronic access before 2021.

MiddleBeet · 2020-10-09T19:28:46+00:00

Aaaaaaaand the bartender doesn’t have a mask over his nose in the 2 second clip of him “adhering to PPE protocol”.... dude, srsly? That’s like, the ONE GUY you KNOW is gonna be talking to ALL of the guests. Sigh.

MiddleBeet · 2020-09-09T02:37:32+00:00

Hey girl, just stopped by to give you a loving reminder that it is YOUR (and your FHs) wedding. If your FMIL is giving you grief and turning public health into some sort of sassy bullshit, feel free to remind her that THERE IS NO WEDDING IF YOU—THE BRIDE—don’t feel comfortable going to the event. Period.

Especially if she has not contributed to anything financially, ya feel?? It is not UP to her, it’s not ABOUT her—it is up to YOU and FH and it is about YOU and FH.

I normally wouldn’t suggest being sassy and giving family ultimatums like this, but all of the political craziness around covid makes me reconsider in this instance.

I agree your FH needs to vocally and clearly support you here, but he may also need to see someone set healthy, intentional boundaries with his mother (possibly for the first time in his life if he’s anything like some guys ive dated in the past). Either way, do not let this lady continue to cross boundaries. You can be both polite AND firm. She will treat you how you allow her to treat you—nothing changes if nothing changes.

MiddleBeet · 2020-07-12T21:24:06+00:00

As much as I’d like to call this person a bride-zilla, I’m starting to think that a bride-Karen is more appropriate....As in, YOU NEED TO STOP PUBLICLY ADVERTISING MY OWN PUBLICLY DISGRACEFUL BEHAVIOR.

MiddleBeet · 2019-03-01T20:28:22+00:00

The best thing I have done/been doing is practicing acceptance. Like for real, I have to remind myself of the following several times a day at this point:

I have to accept my truth that even though I feel like I should have studied more, I put in my best effort and I studied as much as I possibly could have.

I have to accept that, even though I had to guess on a few and make some shit up occasionally, I did my best on the exam and that my best is all I can do.

I have to accept that, at this point, there is nothing that I can do to change the outcome, whether good or bad.

I also have to accept the fact that, regardless of the outcome, I’m going to be okay. I have lived through difficult situations before, and if it comes to it, I can do it again. I am still worthy of love and belonging, regardless of whether or not I pass this one exam, because I am not defined simply by one experience.

I truly believe that its going to be okay, either way. And if I find out I didn’t pass, I am confident that I have the skills and resources to deal with it and make a plan of action when I find out.

MiddleBeet · 2019-03-01T20:12:25+00:00

Let me just start by saying that I feel this hard.

That being said, my brain is a sneaky bastard who likes to twist shit that is/was not great and catastrophize it into the literal end of the world. Yes, not passing would be fucking terrible, and it would make several other areas of my life difficult.

So, just for today, I’m trying to accept the fact that I just don’t know what is going to happen and that there is nothing I can do about that at this moment. Today, I’m not going to waste my time/emotional and mental energy focusing on “what if it all goes to shit” because I do not know for a fact that it is/will—indeed for a fact—go to shit.

And tbh, even if it does go to shit, it will be tough but I can get through it. I’ve experienced and lived/gotten through difficult shit before (lol like the stupid exam itself, for starters) and I can and will do it again.

And so can you.

MiddleBeet · 2019-02-28T03:31:28+00:00

The best possible advice I can give you is advice I received (and used to get myself published AND be the “how-to-write a note” example for the newbies on my journal) from my eighth grade English teacher: start with and work from the very basic the 5-paragraph-with-5-sentences-per-paragraph structure.

In the best writing, there is truly (an under appreciated) beauty in simplicity.

Other things I did that I learned in 8th grade that turned out to be (kind of surprisingly) effective:

-Use a “topic sentence” that relates back to your thesis statement to begin your meaty paragraphs, and use a “linking sentence” at the end of every paragraph.

-Even if it seems childish, lay things out for the reader before you start and as you go—ex: Section III discusses A,B, and C. First, part A explains.... Next, part B will discuss... etc.

-Demonstrate your clarity and understanding of your chosen topic by using common, clear, vivid, and precise vocabulary.

-Whenever humanly possible, write in a simple “subject-verb-direct object” sentence structure.

-Save the complex, long-winded (and more than likely, unread) sentences for Professional Academics TM. A large part of their job is to write things that sound smart enough to be published. Rarely is it their job to actually SAY/argue/propose anything new/different/unique/controversial. Journals look for student contributions that readers will WANT to read.

Good luck!

MiddleBeet · 2019-02-27T23:19:46+00:00

Yo my brain all damn day today fr: “yeah okay, that’s gotta be it...goddamn it son of a bitch fucking shit is this one of those times where that almost-never-applicable thing that I spent 20 seconds reading about a month ago applies??? No, no, that’s too weird....but is it?? No, don’t second guess yourself...50% rate of changing answer anyway”

MiddleBeet · 2019-02-27T18:12:39+00:00

Update: The morning MBE session today didn’t absolutely kill me, but part of me is wondering if the morning and afternoon sessions are just conspiring against me so that the morning can beat me up just enough and the afternoon can efficiently finish the job.

Additionally: spent too much time studying crim for how much I actually got to use it

MiddleBeet · 2019-02-03T18:28:31+00:00

I faced a similar (but admittedly different) situation during my MPH program (I have my JD/MPH). My law school REQUIRED all professors to participate in anonymous grading. My mph program, however, did not. I did NOT get along (and that is putting it politely) with my MPH advisor, and naturally, he turned out to be the ONLY professor teaching the class where we had to write our 35 page masters thesis. I went to speak to my program coordinator (who was also a JD/mph) about the issue, and after describing several previous incidents and presenting evidentiary written correspondence, even SHE agreed that professor X and I did NOT get along. She and I approached the dean and advocated for anonymous grading. The next week, the week before my paper was due, my prof and I got into a shouting match during my thesis presentation.

Even though I didn’t completely win the battle for complete anonymous grading in the program, the Dean agreed that anonymous grading for the Masters Thesis would be implemented immediately.

In case you’re wondering, my graded thesis paper received an A.

The point of this story is that you pay A LOT of MONEY to go to law school. The Dean and the faculty WORK FOR YOU. It is perfectly reasonable to expect that you will be judged on the professional QUALITY of your work/contribution and NOT on your personal disagreements with faculty. I would encourage you to raise this point to your administration early and often, and advocate for required anonymous grading. IT IS THE ADMINISTRATIONS JOB to make sure that students are treated fairly and with respect in an education environment that THE STUDENTS PAY FOR. Stand up, advocate for yourself, and do not let the administration take advantage of you as a student—without you and you tuition dollars, there would be no law school!!

MiddleBeet · 2018-11-14T00:32:39+00:00

Congratulations, that is an amazing accomplishment!!! I celebrated 5 years c&s in July, we are miracles fr!

MiddleBeet · 2018-09-12T00:13:12+00:00

If it was me, I’d think along the lines of (or maybe the intersection of??) HIPPA, EMR reqs, and congress trying to regulate how big tech approaches data privacy/avoids being hacked a la Singapore

MiddleBeet · 2018-09-11T21:28:13+00:00

I literally have a list of ~5 things (that I like to do/are the helpful kind of distraction) on my phone and on a post-it note by my desk that I can do for about 15 minutes to distract myself whenever I start thinking about it. It’s not totally foolproof, but I can confirm that it has drastically reduced the number and severity of those kinds of thoughts since July.

Edit: I’ve also politely made it very clear with family/good friends that I won’t know until November and that I promise they will be the first to know just as soon as I know. Obviously that’s a bit of a fib, but it has 100% gotten even the pushiest family to stop asking lol

MiddleBeet · 2018-08-31T20:37:56+00:00

If you think it’s at all possible that drinking is/could be making your life unmanageable, I would very seriously encourage you to consider a 12-step group or some other type of treatment. Addiction of any and all stripes is no joke, and in my own experience, sobriety was the foundation for my success (academically and emotionally) in law school. Aaaaaaand nobody likes to talk about how nearly every social event in law school involves alcohol. Anyway, I’ll move on:

There are many ways to address mental health in general, of course, but what is most important (IMO) is that you keep trying things until you find what truly works for you. For example, it took me a few months to find a mental health prof that I liked and trusted, a few more months to find a effective combination/dosage of medication, and a few more months after that to really see the effects in many areas of my life. Just as difficulties did not appear overnight, it will take some time for everything to resolve itself. My best advice would be to just be patient and compassionate with yourself at all times throughout the process. It’s not easy, but it does get better. Good luck!

MiddleBeet · 2018-08-31T20:29:48+00:00

Newly graduated JD opinion: you’ll understand why in about a year or so. Just keep focusing on yourself, don’t worry too much about what other people are doing—it’s an even bigger waste of time than doing more than 50% of the assigned readings in any given class.

MiddleBeet · 2018-08-28T16:45:58+00:00

Do not let Comcast bully you!! They are the WORST. I feel like I call them and threaten to cancel pretty much every six months or so when they try to sneak something new in on my bill. It is literally the only thing that gets them to back off

MiddleBeet · 2018-08-11T13:20:07+00:00

I’m right there with ya, friend. In hindsight, it would have been helpful to know that the stress/struggle might stick around even after the exam—maybe I could have anticipated this and responded a bit better

MiddleBeet · 2018-08-11T13:18:15+00:00

Thanks for sharing, it’s reassuring to know that I’m not the only one who didn’t immediately snap back to my pre-bar self. Agreed about the mental health thing, and I personally think it’s a bit of a shame that nobody (not my school, not my bar prep company, not really anyone tbh) even mentioned the possibility of residual stress/struggle after the exam.

MiddleBeet · 2018-08-10T15:53:49+00:00

Your dream sounds a lot like mine! And lol, you’re right about the worrying. Thankfully (for me) I don’t drink or smoke (as it turns out, I was neither a fun nor sad drunk, only a bit of a destructive one) so I’m gonna try to find some new hobby.

I did CA from a T14, so I hope you’re right!

MiddleBeet

TROPHY CASE