Sunday, August 30, 2015

The Level 2 Inpatient Encounter

Ever what a doctor needs to type for a 20-minute inpatient visit? Here's what it took me:

(Note: my poor typical skills are evident in the repetitive pounding on the "Delete" key...)


P.S.: Here's the data from a carefully-conducted "study" on age vs. typing skills I conducted some time ago.


Anonymous said...

Will anyone be covering the reductions in RVUs for cardiology codes including heart caths, peripheral interventions and stent with AMI? I thought that the ACC was the advocate for cardiologists yet they have been the cheerleaders for reduced reimbursement. If ACC national is questioned, they respond that you should be thankful that the reduction was only 20% and not the 40% that CMS requested.
To have four wisdom teeth removed, it is $2500. A cardiologist is paid $200 for a heart cath that carries a risk of death, stroke, MI, bleeding, etc. etc.
Our profession has been thrown to the wolves thanks to the ACC ingratiating itself with CMS so they can be the data collectors and beneficiaries of selling our info so penalties can be enforced via value based purchasing.

Anonymous said...

The 80's culture. When pigs fly.

80's investing culture.

abim is their own worst nightmare, not you. They will bring themselves down, not any of us. Consider carrying a press card. Interview those with the influence and insight. Don't waste time interviewing lightweights. Include an occasional crisp concise interview to your blog. Record it. (and free-lance it).

Explore problems, related human interest stories, evidentiary revelations and responses. Focus. Publish less. Rest more.

Fun facts.
"Conspiracy Theories"

AIG 10/31/90 9/12/97 9622.99 43,685.31
GE " " 514.08 2435.13
SLB " " 6328.21 17,630.30

Anonymous said...

Yes, ABIM, you are good at making extra money and take pleasure in investing it, but where's the test.

How much did you spend on creating the means of certifying your specialist. Not much.

Go back to an essay style initiation and just pass everyone.

Pass out cigars and warrants to purchase an esoteric investment product for your clients as a symbol of public trust.


There is a lot of history in just one page! The trades are spread out through multiple pages. Not an easy to read document from 1838 Investment Advisors. (All former Drexel employees fleeing the SEC and Rudy Giuliani.

Other brokerage houses from the time have more orderly (transparent) accounting for tax purposes that were easy to follow. 1838 was intentionally obscure, imo. Just the sheer number of pages of rambling trades and dates does get your heart pounding and eye brows locked in high position.

SLB date sold 9/24/97
purchase date

page 13 (other trades for the same security SLB are all over the place)
filed 1998

Also Form 3115 Request to change accounting method for the ABIMF is noteworthy.

Freedom of information act. You are a client, taxpayer, and member of the press.
Have a formal request for copies of everything you want in terms of documents.
Contact a legislator that you can trust, brief them, and ask them to write a 'letter of concern' to the ABIM.

Many first steps that are simple. Get advice. Kurt should have been doing this already. He needs to get them to open up the doors. Even the test is untested.
It must all be examined. Why so much trading activity and deposits into the ABIMF.
Groomed nice faces, from coy/savvy to nice politician. Copyright is an issue. The government should not issue copyrights for what is essentially government property/taxpayer's intellectual property. Funding of most science is subsidized by me and you. Arora case was settled. ABIM got money.
They wanted 1,000,000 dollars threatened to take away his house, everything. He buckled under. Stated to me he could have won, but did not have the time or money to fight them. Claims he could have won as they violated his privacy, right to assemble. No one talks to him, but he has plenty to say and reveal about the ABIM.
The new latest case against a physician is troublesome in that we see the same faces destroying physicians. Negligence, recklessness, selfish leadership at the ABIM. He is countering in his own suit for 15,000,000 in real damages, not bogus ABIM copyright crap. And the young physician is asking for 1,500,000 in lost wages from ABIM violations. He may get it if it goes to court.

This is all news that should be all over the place. Where is the reporting. Where is the research? Where is the digging. I don't see it. Yes, from you, but every physician and every patient and the media has to bite down on this issue of being dictated to by corporate devils of deceit with their medically sound at first blush initiatives, but is only factually speaking BS propaganda.

Anonymous said...

1988/07/22 "'According to Brown, 96 percent of the former unit's clients have agreed to transfer their accounts to 1838 Investment Advisors.'"

Anonymous said...

"There are no statistics to prove you're honest." -

1986 03/16 "'There are no statistics to prove you're honest.'' So long as those questions about integrity remain open, Drexel is unlikely to get many sensitive merger and acquisition jobs. Competitors, many of whom learned how to kick and gouge watching Drexel, are exploiting the opportunity for all it's worth, going after underwriting clients and the junk bond buyers who were so crucial to Drexel's success. Says Drexel's Balog: ''If one of our competitors was a wounded animal in the jungle, I don't know that we wouldn't do the same.'' How far Drexel ultimately falls will hinge on what the SEC finds. It seems safe to assume that Drexel will survive even if investigators uncover the worst. But it seems equally certain that Drexel's days as the world's most fearsome money machine are past.'"

Anonymous said...

"Arora case was settled. ABIM got money." If the ACGME-accredited residency programs recommended and funded Arora's ABR, where is the government's share of the recovery. Do you see the fraud and lack of oversight of our money. Taxpayer and physician money. This money is being put to the question right now in Puerto Rico. Taxpayers funded a young physician to attend a highly acclaimed course ABR. ACCME, ABIM, ACGME approved. Most of the program directors are high ranking AMA and or ACP. Where was the warning for residents?

None, because there is no problem if you don't make waves to the mutually beneficial system of corruption. Money for your account and money for me and money for all of the others if they just get on board and in the racket.
RICO would crush everyone, but a simple letter of concern or reprimand would certainly go a long way just to bring the Drexel-Burnham-Lambert-like practice of deceit in the medical industrial complex to complete attention.

I don't take one dime for my research or my time. It is a duty as citizen to bring egregious crime to the attention of the authorities. If you can find any that have no conflict of interest.

I used to help political figures get elected. I know the game.

Anonymous said...

1838 Investment Advisor's Seamless Transition. 1988.

Lots of sangfroid at the New Drexel. I mean the old traditional Drexel, no I mean 1838 Investment Advisors.

Speaking frankly. A conversation with Mr. Brown.

Investor: So, who are you 1838 gentleman really? Aren't you just the same old W. Thacher Brown, I've been trusting my portfolio with since 1975?
Please tell me again how anything has changed here? Is my money still safe with you? I'm having trouble following the changes and why you are making them, Mr. Brown. I was very happy with the steady bond and stock performance, especially my junk bonds.

Listen here, Brown, I just read this news headline yesterday. Take a look at this local newspaper article on the front page:
"Drexel's W. Thacher Brown and James Balog "buyout" their own 'new' entrepreneurial enterprise with 10 managers, also from Drexel, and print lucrative stock for themselves."

Why didn't I get a telephone call or letter about this? It's as though you...

"We have the same fast service. And you can ride the same stocks just like a professional stock jockey as before. No worries there. We pick. You ride.
And just to satisfy that part of you that has a low risk tolerance, we will top off our portfolio with new proprietary mutual funds and bonds to get our 'new', I mean old clients like you, acquainted with--including a nice front-end load of x%. The front-end load just secures the fund from..."

"'This is really the original Drexel & Co."

"'The new company will remain [here]at 3 Mellon Bank Center, where Drexel Burnham maintains its Philadelphia retail-brokerage operations.'"

Excuse me, Mr. Brown, why form a 'new' group with a new name if traditionally it was 'Drexel and Company' and you express nostalgia for your old roots? Isn't it just Drexel-Burnham-Lambert status quo? Why all the sangfroid? Tell me if I'm wrong. And what's this I hear about the SEC and Rudy, that young NY district attorney, what's his last name...?

"This is really a way of going back to our roots. [It's Giuliani, by the way, good friend of Jim and myself.] There is a lot of tradition in our business in Philadelphia. This is really the original Drexel & Co., I'm assuming the title of president and chief executive of 1838 Investment Advisors."

"'This is an extremely friendly deal with Drexel. We will be in the same offices, have the same telephones, the same furniture. All of the employees--33 people--are coming over with us,'"

Mr. Balog, why then are you staying in New York continuing on as chairman of Lambert Brussels Capital Corp., a Belgian-owned holding company that owns 25 percent of Drexel. Jim, I'm confused. You mean to tell me you are chairman of 1838 and also Lambert Brussels Capital Corp., which owns how much of it 25%?

"Not to worry! Jim is going to be taking care of some loose ends in New York and then he'll be joining us here soon."

I'm concerned about that Milken investigation...and that new guy Levine.

"Look, Mr. S. we will cut our managerial fee to x% if you stay with the team here at 1838. It really is the same team, the same family. Trust me. Besides, look at who's hanging there on the meeting room wall. A lot of corporate nostalgia. It's a prized possession from Drexel's corporate history--a self-portrait of Francis Drexel--it will remain in the conference room of 1838 Investment Advisors. The portrait, is part of our history, not theirs."

Alright, but I'm still confused and apprehensive.

"No sweat! You just leave that concern and worry behind with me."

Anonymous said...

Waived the yearly account maintenance fee also. $65. What a ride they provided!

Anonymous said...

Bulls make money. Bears make money. Pigs are smarter than we think.

Anonymous said...

This is not just a story, it is not just about issues and policy wielded on the world from this shielded is not about anything like that kind of detachment. It is literally feeling the importance of people's lives. How it is trodden upon by callous, yet sensitive people with dual natures like all of us..yet
How could anyone be so detached and harm another human being or any living breathing life. That is my profound grievance with the organization. To invade home and property in the name of what...They say our military defends the constitution...
My father gave his life for this country's freedom...I'm not sure that was the whole story, but I know he would tip his wing in salute at you Col. Wes...
He would be truly be proud of you! You are what freedom is all about...protect it...
Freedom IS our country...

Anonymous said...

The "1998-2014" equities graph can be extended back to 1990 with a 'quasi-logarithmic' formula inputting data for each stock or using historical charts on a simple trading platform.
Even simple fractions with rates of increase - using purchase and sell dates.
Each method shows the market trends which were up most years. Big gains. 300, 400, 500% or more in seven year cycle for many stocks. Mostly gains overall.
Date of initial deposits cannot be known but only assumed.
Increased liquidity at the end of 97, but went right back in the market.
If they pulled out when Rubin left the government in 1999 they would have kept much more profit by avoiding the big staggering losses that wiped out many companies in 2001 and just after.