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EPtalk by Dr.Jayne 12/17/15


Time is flying and it’s hard to believe that HIMSS16 is barely two months ahead. My annual preparations have started, including the creation of the social schedule. It can be difficult to juggle meeting up with colleagues I only see once a year, sessions, sponsor events, and of course stalking the exhibit hall with some of my BFFs.

I booked my flights really early this year and didn’t realize that HIMSS had shifted to the Monday start, but it was easy to fill Sunday with some spa time. I have a penchant for something called Watsu, which is water-based Shiatsu massage, and there aren’t many practitioners in my part of the country. The Bellagio has a wonderful therapeutic pool, so I’m definitely going to get my Watsu on so I’m plenty relaxed for the week.

Flu season is upon us and we’re already being inundated with patients, many of whom opted out of vaccination. It’s not too late to get yours if you’re interested. Although it takes several weeks for them to reach maximum effect, flu season runs through April, so it can still be useful.

I was surprised to learn that payers are playing games with vaccination payments. Vaccines are one of the most cost-effective interventions we have in our arsenal and the flu vaccine is pretty inexpensive in the grand scheme of things. We have one payer who refuses to cover any vaccines when administered at our practice, simply because we’re an urgent care. Even if a patient comes in with a laceration that merits a tetanus shot, we can’t give it unless the patient pays out of pocket.

Patients are already paying big dollars for their healthcare premiums and don’t want to have to pay cash on top of it, so some of them decline and plan to follow up with their primary care physician. That can lead to gaps in care, and frankly PCPs have better things to do than give vaccines sometimes, like managing chronic illnesses and diagnosing new problems. Plus, the hardship of patients having to go two places to be treated for a single problem when we should be able to do it all at once is just a waste of resources. Just another aspect to our broken healthcare system. Although coverage is mandated, payers are finding a way around it.

I’ve been spending a lot of time in the practice and have picked up some kind of a respiratory virus. If we weren’t so focused on patient experience I’d love to hang out a sign that says, “If you’re not sicker than the doctor, you need to go home and try some cold remedies.” That’s not how we roll, though, so I apologize to the patients who are subjected to my sniffles. I like to think that I’m providing some level of patient education, since if I’m still sniffling it’s clear there’s no magic bullet to resolve all the symptoms.

I’ve been sad ever since the decongestant phenylpropanolamine was pulled from the market, because it actually worked. One of the most-used products around, phenylephrine, has been re-examined and found to be ineffective. But it’s easier to obtain than pseudoephedrine, so a lot of people try it anyway. Still, I’ll keep up with my humidifier and hot tea and hope for the best.

I’ve been playing around this week with my new technology purchase, a Microsoft Surface Pro 4. I am enjoying it, although I can’t get Outlook 2016 allow me to set up my inbox like I had it on my old computer. The change is just enough that it’s making a mess of my muscle memory, but I’ve tried everything I can think of. The settings screen looks just like it does in Outlook 2013, but it doesn’t behave the same way. Maybe it’s a bug or maybe I should just get used to it.

Speaking of bugs, the American Medical Association emailed yesterday to offer me tips and resources on how to pass the USMLE Step 3 licensing exam. Since I’ve been licensed for more than 15 years, they’re a little late. They did send a follow-up email asking me to disregard it and to enjoy my complimentary 2016 resident membership, which is even funnier.


Speaking of funny, I spent some time surfing Glassdoor looking at reviews for a couple of employers that are clearly in a downward spiral. A friend had sent me a few links and the email arrived at a time when I really needed a laugh. For the one employer, it’s clear that they have someone occasionally posting anonymously that the company is great, but 95 percent of the other reviews are negative and the themes go back several years.

I’m sure disgruntled employees make up a good chunk of the postings, but everyone has disgruntled employees and when you look at similar companies, you don’t see that kind of skew towards the negative. If you’re in HR and you haven’t looked at your own employer’s reviews, it might be worth a few minutes of your time. Reviews with titles like “Rome is Burning” should definitely catch your attention.


I’ve also been catching up on my holiday baking, and in the spirit of the holidays, I’ll share one of my favorite recipes. Double Chocolate Peanut Butter Chubbies are one of my favorites the last few years. They’re insanely chocolatey and you can modify the recipe by using different kinds of chocolate (or non-chocolate if you prefer) chips or different kinds of nuts. Personally, I like mine with Hershey’s Special Dark chips and chunky peanut butter.

What’s your favorite holiday cookie? Email me.

Email Dr. Jayne.