Thursday, December 10, 2009

ok.... im moving my blog over to wordpress. (just take out the 'blogspot'). let me know if you like it over there.

Wednesday, December 9, 2009

I'm thinking of moving

Im cosidering a move over to Wordpress. new blog is at (no

do you like the layout better here or over at wordpress? and why? discuss. comment.

Monday, December 7, 2009

Just Unlike Everyone Else

My power ranger son Brandon's hockey game was at 715am yesterday (Sunday!!). Those of you involved in hockey with your kids know that its not just a recreational sport, its a lifestyle- getting up before the sun rises, hot chocolate at the games, donning and doffing all the equipment, its quite an experience.

My son and the other 6 year olds weren't even the first game scheduled to play. As we entered the arena, we could hear the cheers and scraping noises generated by the two teams already on the ice. Brandon felt the excitement and ran into the rink area. There, he saw the game going on, but also the unexpected- the players were on custom built sleds of a sort. Each of the hockey players had a condition, whether it be a missing leg, a missing arm, or the like. Notwithstanding the sleds, the game was like any other- proud parents cheering, random spectators watching, even the guide dogs watched intently in the bleachers. To answer in a form Brandon could digest the barrage of "why" and "how come" questions that her rattled off was truly an art form. The players got off the ice at the end of the game, most with the help of family. The answer to Brandon's last question was the shortest, yet most profound: "Daddy, why aren't they crying?" "Because they aren't sad," I told him. Brandon sat in the bleachers, and watched with humility as all the players disengaged from their sleds. His hands lightly touched his own body parts as he looked on. He listened to their comraderie. He felt their triumph. My little power ranger didn't move from his bleacher seat until they all left. It was his way of saluting them.

Brandon's teammates began to arrive and ready themselves with their equpment. Another six year old boy near us was accompanied by his father. The boy began to whine about the fact that the neck guard he was required to wear before getting on the ice was uncomfortable. "You shouldn't cry," Brandon told the boy. I responded to a car accident later that day. I wanted so badly to say the same thing to the lady I had in the back of my ambulance on the way to the hospital. There wasn't a scratch on her.

I just got done prepping a client for tomorrow's deposition. He suffered a fractured ankle, wore a cast for 7 weeks, and did some physical therapy thereafter. As we explored the topic of how the trip and fall accident for which he is suing affected his life, I thought of those hockey players. "Do you like hockey?" I asked my client. "Love it" he said. I invited him to meet me at the hockey rink next Sunday.

Saturday, December 5, 2009

Health Insurance Companies suck dot com

Health insurance giant Aetna is planning to force up to 650,000 clients to drop their coverage next year as it seeks to raise additional revenue to meet profit expectations.

In a third-quarter earnings conference call in late October, officials at Aetna announced that in an effort to improve on a less-than-anticipated profit margin in 2009, they would be raising prices on their consumers in 2010. The insurance giant predicted that the company would subsequently lose between 300,000 and 350,000 members next year from its national account as well as another 300,000 from smaller group accounts.

"The pricing we put in place for 2009 turned out to not really be what we needed to achieve the results and margins that we had historically been delivering," said chairman and CEO Ron Williams. "We view 2010 as a repositioning year, a year that does not fully reflect the earnings potential of our business. Our pricing actions should have a noticeable effect beginning in the first quarter of 2010, with additional financial impact realized during the remaining three quarters of the year."

Aetna's decision to downsize the number of clients in favor of higher premiums is, as one industry analyst told American Medical News, a "pretty candid" admission. It also reflects the major concerns offered by health care reform proponents and supporters of a public option for insurance coverage, who insist that the private health insurance industry is too consumed with the bottom line. A government-run plan would operate solely off its members' premiums.

Aetna actually made a profit in 2009 but not at levels that it anticipated.

"They were surprised by an acceleration in medical costs in 2009 which pressured their earnings," Josh Raskin, an industry analyst for Barclays Capital, told the Huffington Post. "In an effort to get back to a more profitable level, they are raising their prices to match cost trends. When you raise rates, you run the risk of losing your membership. Health insurance is a very competitive marketplace."

As Williams told investors on the call: "The pricing that we put in place for 2009 turned out to not really be what we needed to achieve the results and margins that we had historically been delivering."

Aetna is one of the largest insurers in the private market, covering roughly 17.7 million people according to its 2008 annual report. It is also a major player in the current health care debate and inside Washington D.C. The insurance company has spent more than $2 million on lobbying just in 2009, according to the Center for Responsive Politics.

American Medical News, which first reported the story, noted that this is not the first time the insurance giant has cut the rolls in an effort to boost profit margins. "As chronicled in a 2004 article in Health Affairs by health economist James C. Robinson, MD, PhD, Aetna completely overhauled its business between 2000 and 2003, going from 21 million members in 1999 down to 13 million in 2003, but boosting its profit margin from about 4% to higher than 7%."

A spokesperson at Aetna did not return calls and emails for comment.

My comments: Here is my favorite part of this article... "Aetna actually made a profit in 2009 but not at levels that it anticipated." Please... someone explain to me how the people at Aetna sleep at night. Makes me sick.

Tuesday, December 1, 2009

I Swear To Uphold The Constitution (Sometimes)

No one really goes to law school, takes courses in Constitutional Law I and II and aspires to be a personal injury attorney, or a workers compensation attorney. But if asked, we all adamantly state without reservation that we will uphold the Constitution of the United States. It's to the point where I 'solemly swear' to uphold the Constitution of the United States a few times a year now, for one professional or volunteer organization or another. But no one will ever be able to arrest me for perjury though. I never use my real name. I just say "I, state your name". I just have to be careful now not to change my real name to 'state your name', and I will never get caught. For anything. Ever. I'm so friggin smart, like Wile E. Coyote, Super Genius!

The authorities don't enforce the law of the land anyway. It was about 9pm, dark and rainy the other night when a "Delta" call (Advanced Life Support Tech required to respond) came over the frequency right after the tones that rang specific for Brentwood. 'Infant trauma'. The adrenaline rushed through my veins. My heart beat faster. Immediately I began organizing the tools in the ambulance I would need to go with (my crew and i were already on the ambulance returning from another call). The ambulance did a hockey stop skid in front of the house. I moved briskly to the front door and knocked somewhat feverishly. I peeked through the window and saw at least 6 hispanic adults scatter about. The hispanic woman who answered the door would only open it a crack, "no here, no here, maybe around back" she muttered and then shut the door on me. The lady was indicating the side area of her house that was without any outside lighting. So around the house we go, where we stop nobody knows. The police department arrived on scene. We fanned out a bit, turned on our flashlights, and stumbled over cracked flagstone onto a broken cement path, which led to a stairwell without lights or handrails, that led to a basement door. There was what looked like a tool shed out to the right about 25 feet, which might have housed another family as well.

We entered the basement door, and found another maze of hallways and bedrooms, and the infant who was (thankfully) peaceful in her grandmother's arms. The baby, 13 months old, had a smile the lit up a room, and shiny bright eyes that seemed to notice every detail around her. She had fallen out of a bed, and the multitude of families living in the basement reacted by calling 911. One of the cops asked to see the baby's crib so that we could determine the height from which the baby girl fell. The police officer and I followed one of the many basement residents into a small, makeshift room with a single bed. "Where's the crib?" I asked. "This is where she sleeps. She doesn't have a crib" the man said. No railings around the bed to be seen or found anywhere. I wonder how many times this little girl had fallen out of this bed before. "Where's mommy?" I asked. "She no here. She in hospital". But none of the many basement occupants could really provide her contact information, or tell me why mommy was in the hospital.

We took the little girl to the hospital just to get checked out, but I'm sure she's fine... for now. The cops left too. No investigation. No tickets issued. Nothing done. Nothing. Nothing about the fire code violations in the basement. Nothing about checking to see where mommy was. Nothing about making sure the baby returned from the hospital to a place where she would have a safe place to sleep, like a crib or a bed with rails. Nothing about an investigation as to whether any of the residents in this house actually paid their taxes. Nothing about the lack of lighting, nothing about investigating whether people were actually living in the shed in the backyard.

So, you see, while we are a nation of laws, and we often swear to uphold the Constitution, we really don't on a consistent basis. Not even the officers of the law do it consistently, maybe some don't at all. Even when the health and safety of a 13 month old baby girl is at stake. The whole thing is more than slightly bizarre to me really. Go to law school to study the law that no one follows or enforces anyway. And then raise your right hand and swear to uphold the Constitution so that everyone listening can feel better about you becoming a member of an organization to which they too belong- just don't take the oath too seriously.

My tour ended after midnight. There were no cars on the expressway as I drove home, except for the one with the red and blue flashing lights behind me - WHAT!!! The cop pulled me over. "I see you have firefighter/EMT license plates". "Yes, sir, I volunteer as a firefighter and an EMT, just going home from my tour tonight." "This won't take long, I will be right back he said. I wasn't worried. Until he came back and handed me a ticket, and wished me a nice night. Oh, the irony!

Monday, November 30, 2009

Ma'am, that was not a Seizure, that was a Dance Move.

How many of you EMS providers in/around Brentwood Legion and those that work at SSH have had this patient at least once a day?

iPhone apps for EMS Providers

There have been some really great apps released for EMS providers who are iPhone users. Here is a link to a list of them:

I highly recommend the paramedic protocol app. It's extremely organized, and very useful especially if you operate in two different EMS jurisdictions, like Nassau and Suffolk Counties on Long Island. You can go to the app creator's website to see all of the jurisdictions he has protocols already loaded into the app. The creator is extremely responsive to requests for additional protocols and feature adds. If you don't see what you like, just email him directly.