Wednesday, October 27, 2010

775 Big Bob the Medical Mechanic

775 Big Bob the Medical Mechanic

They don't call him Big Bob for nothing. The man is w i d e. He's a retired military guy, probably an ex-colonel because no one below that rank lets himself get that size. And now he's a Medical Mechanic. Which means he runs what's euphemistically called a "Health System."

We're in a sleek conference room with about $130,000 worth of furniture and maybe another 20 or 30 thousand worth of show-and-tell equipment. This is in the back corner of a medical building, quite some distance away from a waiting room full of patients. Each has been waiting at least half an hour beyond his appointment time. They're pretty near a sign that says "If you are more than 15 minutes late for your appointment, you may be asked to reschedule." No one in the waiting room says "well, if you're more than 15 minutes late, doc, YOU may be asked to reschedule." No one in the waiting room. But in the sleek conference room, that's the topic on the table.

The patient asks Big Bob "You ever hear of Rube Goldberg?" "I don't think so, he replies." Now he has. And he has his own copy of a Goldberg Cartoon about a machine that takes 78 steps to swat a fly. "This, sir," says the patient "is how your system runs. There should be a sign with a motto that says "Never let a patient get in the way of office procedure."

Bob's "system" is expanding, and fast. He says "it's like we're trying to build the airplane while in mid air." He has no illusions. He knows. There's no on site Information Technology department. They have to go elsewhere for that. The phone system spits out "caller i.d." numbers and when you call them back, the machinery tells you "this is not a working number."

"Oh, we fixed that," says Bob. And "it took some doing to computerize all our medical records." Great. Now you can lose individual electronic documents instead of the patient's complete record. What happens when this system crashes? "We call headquarters and they send a guy down to fix it right away." "Headquarters" is 50 miles away.


--A Time Magazine article reports that barbershops could be good places to have your blood pressure checked. That's in a piece about how African American men have way higher incidence of hypertension, largely because it goes undiagnosed. It's a pretty good idea for all of us, but some medical privacy BS probably will gum up the works, ask Bob.

--Iran is starting to fuel its latest nuclear reactor and this is causing worry in the west, as it probably should. But before you get all shook up, recall how efficiently that happens here in the US (Think Shoreham and Indian Point.) They'll run into the same screwups as we do and this "fueling" which should take days, is likely to take months or maybe forever.

I'm Wes Richards. My opinions are my own but you're welcome to them.®
©WJR 2010

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