Supervisor...

I was checking my blog and I just noticed that I haven't posted since I started my FIRST SUPERVISOR MONTH! Phew... it's been a ride for sure. I can say one thing - I'm learning a ton every day and I'm grateful for that. I am building confidence faster than I thought possible. I don't think I've had this feeling since I started residency more that 16 months ago... I just hope that I can sustain my energy level from here on out - it'll be tough.

Oh yeah, I passed Step 3! Now I can look into moonlighting next year. Extra cash = good! So... it's actually getting late (I know, 9:30 doesn't seem that late but believe me, I'm so sleep deprived I could go to bed at 6). Here's to a future of responsibility and (hopefully) rewards!

Neal Anson, MD

Home again!

Well I'm back home for one day before I have to go back to work - though as you could probably tell from my prior posts, this month is not that stressful. Next week, I'm taking my third round of licensing board exams known as "Step 3". I've been preparing for it by studying here and there but really have not put forth a concerted effort to hit the topics I've missed out on during residency. I'll be trying to play catch-up this week to get where I need to be. Right... that's it!

Neal Anson, MD

Vacation Amazin!

It's been far too long since I've updated the blog site. I'm out of the NICU and on Dermatology. What a great rotation. I'm learning a lot of good information about rashes and other diseases that will be useful in private practice. At the same time, I'm not having to work all that hard because this is my "call free" month. Currently, I'm in Pittsburgh, PA enjoying my vacation with my brother-in-law and sister-in-law. It's just nice to be able to go to bed and wake up on my schedule...

I'll soon be starting my first month as a supervisor. It'll be on hospital medicine also which makes me a little nervous. I'll be responsible for all the codes in the hospital - scary. I'll be studying up on my ACLS cards before then. I know other residents go through the same anxiety and soul searching I am before they supervise other interns, but that doesn't really make it any easier. I think it just takes practice to really feel comfortable in the role.

Neal Anson, MD

NICU Round 2

So, I'm back in the NICU and it's a whole different experience the second time around. I'm at a bigger hospital in CMH and there are more interesting cases to see. I think that I may be getting to a point where I am starting to enjoy residency a bit. I think after you get over the first year stressors or "intern blues" things really do get better.

I'm also excited for some upcoming time off. I am taking some vacation time in October - exciting stuff. Haven't yet decided what I'll do but right now it doesn't really matter to me much - I'll be off work and that's enough for me.

The next step coming up is starting my supervisor roll - at SLH. That will be interesting. I'll need the time between the switch to prepare myself for the medicine side again. Yikes! Anyway, that's all I have energy enough to write about for now.

Neal Anson, MD

Resident Work Hours

Here's an interesting new article in USA Today about resident work hours... and the study was done in the field of pediatrics.

Article

Neal Anson, MD

Upcoming Elections

Well, since I've had some free time this weekend I thought it was important to read up on the presidential candidate's health care plans and to be completely honest, they are both very vague and mostly similar. As could be expected, they are worded in a way that would appeal to the broadest of groups but I can say the following about the plans:

- Obama's plan is very heavily dependent on the federal government. There will be a National health insurance "exchange" which he states would "help individuals who wish to purchase a private insurance plan". He goes on to state that the plan would act as a "wachdog" for private insurance companies and would act as a "standard".

- McCain's plan emphasizes the importance of placing the control of health care back with the "patient's themselves". The major way he plans to do this is to provide tax incentives in the form of $2,500 for individuals and $5,000 for families to find additional plans other than what their employers already provide. He also talks about a guaranteed access program (GAP).

I can find problems with each viewpoint.

First off, I feel that Obama's plan essentially expands medicare to the entire population which would likely do two things:
1. decrease the overall quality of care across the population (i.e. providing minimal coverage to uninsured while lowering standards for those who are insured already)
2. provide incentives for a further split between those who can afford quality care and those who cannot. In other words, his plan would drive a wedge further into the disparities already present in our system...

Okay, now McCain's program seems more concrete but is probably just a bandaid over the hemorrhage within our healthcare system. His GAP program is not fleshed out enough and the tax incentives will work for those who already pay taxes. Unfortunately, the under/uninsured patients will not see these incentives because they would be unlikely to even file taxes. So... they remain under/uninsured in the end. He also mentions expanding health savings accounts but doesn't say how he will do this.

The rest of their ideas are worth mentioning but are universal within each proposal, so they do not help in defining the candidate. They are:
- promoting preventative medicine
- increasing IT funding for advancement toward a universal medical record
- lower drug costs via reimportation of medications
- tort reform
- making healthcare available for traditionally "uninsurable" patients (i.e. pre-existing conditions).

It should mentioned that Obama makes a point to insure all children while this point is notably absent from McCain's website. This is a strike against McCain in my opinion.

Ultimately, I feel that neither offer a clear solution at this point and both plans make me a little depressed about where we are headed in the future but based solely on this issue, I would put my weight behind McCain. I can't see expanding an already very flawed system like medicare.

Check out the websites for yourself and I'd love to hear comments on this:

McCain

Obama


Neal Anson, MD

Back to the Heart

So I started the cardiology clinic today and it was suhweeeeet. I really do love the things you can do and see in cardiology. Now, I can even see why pediatric cardiology is interesting - so many congenital defects that can be surgically corrected to give somewhat of a normal life to a child who would have most likely died otherwise. Amazing!

I'm really looking forward to the next month and all that I intend to learn. Don't get me wrong, the NICU was great too but this outpatient stuff is just fantastic! Plus, I have NO OVERNIGHT CALL this month - I'm stoked. Alright, enjoy the following video of a crazy german guy simulating EKG tracings with his body..... wild stuff....



Neal Anson, MD