When Concepts Don’t Match Up

Some of you have probably noticed I’m not writing at the same pace that I normally do. Once again life has gotten in the way, this time with my grandmother falling and breaking her hip and my having to be out of town to support my mother.

It’s been interesting, frightening and frustrating over the last bunch of days. The interesting part was when I called 911 and they sent the fire chief and two firetrucks before the ambulance arrived; my grandmother would have loved watching that spectacle if she could have moved as she loves sitting in the window watching the day.

The scary part was first trying to figure out just how badly she was hurt, learning she had a broken hip and required surgery, and trying to determine what kind of surgery she needed. Turns out it was only the hip and a fracture, which only required 2 screws, and the surgery and initial recovery only took about 3 1/2 hours; whew.

Then the frustrating part, which leads to the title of this post. I went back home because they said all was going to be well, so to speak. Then the next day I get a call saying she’s nonresponsive and won’t eat. This is frightening because she’s 90 and hadn’t eaten in 3 days. I drive back to get Mom and go back to the hospital, worried that these might be the last days for her and wondering if anything could have changed things. Not that she’s been the physically strongest person over the last few months but this just seemed to come on really fast.

We get to the hospital and she’s sleeping. We let her sleep while trying to let a few people know what might be going on. Then the nurse finally shows up and says they tried to get her to eat but she wouldn’t respond to them and wasn’t talking. So I try and indeed she’s not talking, but she’s responding to yes and no answers with, well, yes and no sounds. I ask what we can try to give her and after hearing it all I suggest we run with the lemon ice, since I know she likes lemon.

I get it open, put a little bit onto a spoon, say “Miss Hazel, here comes something you might like” (yes, I call my grandmother Miss Hazel; she likes that), put the spoon on her lips, and she opens her mouth and takes it in.

Mom was stunned; the nurse was stunned. I wasn’t stunned. What I was is frustrated and irritated because of the scare I’d had with the phone call. See, something that working in hospitals teaches you is the patterns of people with certain responsibilities. My mind had been thinking that something nurses really don’t fully understand is that sometimes a person just can’t feed themselves for whatever reason. The talking is one thing, but as I said, she’s 90 and hadn’t eaten in 3 days, has had surgery and anesthesia and was kind of weak to begin with; what were they expecting, miracles?

Actually, yes. See, hospitals aren’t equipped to be nursing homes; it’s not in the make up of the people that work there, nurses or anyone else. They don’t think about trying to feed people; they don’t have the time. But I knew I had to give that a shot because it would tell me whether she was alert or whether she had decided it was her time. She consumed the entire cup of lemon ice; I had my answer.

So here we are at the dilemma stage, although it’s kind of a foregone conclusion. She has to be moved to either a skilled nursing facility or a nursing home. She needs rehab, but right now she also needs someone to feed her. Mom can’t handle either of these at this stage, and hospitals aren’t equipped to do it either.

Everyone at the hospital has been nice and everyone has played their role the way it’s supposed to be played. But I need to now make them step up and make themselves seen, as the only doctor I’ve seen in the time I’ve been there was the surgeon; that’s not going to get it done. But I know how to do it; funny, but there’s a swagger one can have when they work in certain types of places, and I noticed I had that swagger yesterday, as if I was still at a level to demand and request certain things without question. What a feeling!

So, I’m hoping I’m close to not being as sporadic with so many things as has been the case over the past week. I’m so far behind on work and blogging, but family always takes precedence. And I hope through this little story I’ve given you a little more education on how hospital people think.

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Marketing Help Needed; Yup!

As y’all know, I work for myself. I do okay, but certainly not great. Marketing has always been my downfall, and it’s disconcerting after so many years.

by McKay Savage

Of course, I understand the concepts of social media marketing well. I’ve followed my own advice when it comes to that, and it’s helped to a degree. My biggest problem is that my main business doesn’t do online stuff all that well. You may remember that along with a lot of other things I’m a health care finance consultant. Many more hospitals have a web presence now, but that’s about as far as it goes.

I rank number one for my search terms, but hospitals don’t go online to research vendors (that’s what they call us; I prefer the term ‘corporate partner’) for services. Instead, they go to events and ask people they’re not afraid to share information with who they might recommend or who they’ve heard of. Now, by ‘afraid’, I mean to say that hospitals really don’t like other hospitals that are located close to them to ever know they might have some type of problem. It’s kind of stupid because almost every hospital has the same types of issues but that’s the way the world goes.

Anyway, that makes marketing to hospitals difficult. Overall they’re not close to each other. They don’t like making recommendations that might help a competitor. If you’re an independent you just can’t rely on word of mouth when it comes to hospitals; physicians maybe.

What’s a guy to do? I’ve done the traditional route. I’ve sent letters. I’ve sent flyers. I’ve sent postcards. I’ve even picked up the phone and called, although not that often; I hate doing the cold call thing. That plus, unless you personally know the CFO, you’re not going to talk to them. I’ve had 3 different sales professionals who have tried and each one of them told me the same story, and I already knew it because that used to be my life. Well, except I didn’t have a secretary screening calls for me; if it was from out of town & I didn’t recognize the number, it went to voice mail.

Anyway, I’m always on the lookout for more marketing tips. A good source for me as been my friend Shirley George Frazier’s blog Solo Business Marketing, and right now she’s giving away a pdf called 42 Top Tips For Solo Marketers. That’s the link to her site, not to the download. Her site is replete with tons of information, and I have followed her for a couple of years. I do pick up some things here and there, and I really need to start applying more of what she has to offer. It’s a great resource, and I’m happy to mention her here.

Of course, all of this ties in to other topics I’ve brought up this year and in previous years. The best marketing strategy is to find ways to increase your influence. I’ve been trying to do it a lot through social media, interviews, and networking.

Networking, by the way, is how I’ve gotten most of my health care contracts as well. Through email, I do have a list of people I can network with when I really need to get something. The issue for me is that at my age now I’d love having more projects that are closer to home. Some people might think going across the country is always glamorous; trust me, it’s not. Even flying first class, making 2 or 3 stops to get to your final destination, and those long layovers, is irritating and uncomfortable. Now, if I were on a speaking tour, making $3,000 or more a day, I’d suck it up and be happy about it; who wouldn’t?

Anyway, check out Shirley’s blog, and if you have any ideas on how you market your business to the offline world that’s effective, please share.

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A Political Health Care Rant

The last time I did a rant of some kind, I touched upon a lot of issues that really weren’t related to each other. This time, though it might not seem like it, it’s all mainly about one thing, health care, though I might go off the range a couple of times. It’s time for this, though; I’ve written about it often enough in posts on my other two blogs, but not this one. I just need to clear the air, so here goes; and no, the image has nothing to do with this post, as we all know by now.

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On Saturday night, the House Democrats finally pushed through the first stage of what will be a very massive and comprehensive health care bill. Well, at least they pushed through a bill, on a vote of 220 – 215. How comprehensive it will be is still in dispute by everyone outside of the House of Representatives.

Why? Because we have no idea what’s really in the bill. What is it going to cover? We already know it’s not covering abortions, but we have no idea what it’s going to cover. We’ve heard that it’s going to be funded by fees and cuts to Medicare. What kind of cuts to Medicare, and why? What kind of fees? I know that if it still has that stupid provision I heard about back in late September about charging individuals $900 and families $3,800 if they decide not to get onto a health care plan, I don’t support that at all. After all, the President said that any health care bill he signed wouldn’t hurt the middle class; just who do we all think those fines, or fees, will be laid upon? The rich have enough money to not have to worry about it, and the poor have Medicaid.

What I have heard is that they won’t allow insurance companies to not cover someone for preexisting conditions, which is a biggie because I got caught under something like that back in 1984 (and still have my tonsils because of it). They also won’t allow insurance companies to drop you if you’re already sick under the plan, unless insurance premiums stop being paid. That’s actually another good thing. I tell you, in general I don’t trust insurance companies and it’s because of stuff like this. However, in my mind, they should have passed these laws years ago, instead of tying it to a health care plan.

Okay, let me go on the record by saying this; I do believe this country needs to have a health care plan to protect everyone who doesn’t have insurance. Having said that, without knowing what this plan is, I don’t know if this is the plan we signed on for. The President said in his 8 principles that any plan Congress came up with has to NOT increase the deficit. Suddenly, this plan is coming with a $1.2 trillion price tag over 10 years; how the heck is that not going to raise the deficit?

Now, raising the deficit is something the Republicans seem to be hanging their hat on, but those phonies and hypocrites were responsible for getting this country into the mess it’s in now, with unemployment finally reaching 10.2% and more than 15 million Americans out of work. They say that they’re worried about the financial burden on our kids; yeah, they’re worried about the money but they could care less about the environment, which they say doesn’t matter to them and that they don’t believe there’s anything wrong with, as Greenland is about to lose its ice mass and glaciers, Alaska has already lost much of its glaciers, ice is melting at both the North Pole and Antarctica at alarming rates, and the snows of Kilamanjaro are disappearing rapidly. Sure, there’s no threat of global warming; please!

And, why is it that these same Republicans, the party of NO, the party that just today supposedly came up with its own version of a health care plan that not only isn’t a health care plan, but is something that half the states in the union have already had in place for nearly 30 years, couldn’t decide to work with the Democrats and actually voice their concerns about portions of the bill while the debate was going on? Why didn’t they offer anything? Oh yeah, because their lobbyists would have had a field day and their political funds would have dried up (I just dropped receiving email from the lobbying from my local Chamber of Commerce because these people obviously have no compassion for anyone except businesses). Someone tell me how rich people are supposed to care about anyone else being able to have health care? Heck, months ago a Republican representative said health care was a privilege, not a right; who elected this moron?

Also, just who were these idiots (yes, I’m name calling) who were showing up at these town meetings over the summer and screaming about the potential for a health care plan instead of engaging in some kind of civil discussion. Here’s the thing; no one took you seriously except for the Republican politicians who were hoping that some kind of public outcry would scare people off this plan. Most of you who were being convinced that a health care option would be a bad thing are the very people who probably need this health care. Rich people don’t march, so they didn’t care. You made jerks out of yourselves and no one heard a single thing you said. I tell you this, it’s certainly a good thing I’m not a politician because I’d have walked right up to you, got in your face, and dared you to keep screaming at me. Threatening? You bet! People tend not to act stupidly when they’re called on it.

One final point; this idea of a public option. Folks, let’s just call it what it is; a government sponsored health care plan to compete against other insurance companies. I’m not sure whether I’m for it or against it, but I don’t think it’s needed. Instead. what would spur competition of prices would be to lift the lid on insurance companies across the country to be able to market their insurance in any market they saw fit. Too many communities have only 2 or 3 insurance company options at the most from which to choose from, and all of them have somewhat inflated rates. For all these people griping about how much the government health care plan is going to cost, who hasn’t at least a couple of times this decade had double digit insurance premium increases at work, where the average seems to be at least 8% every year, and the cost of pharmaceuticals going even higher? With more competition, prices would naturally have to come down, and that might solve some of the problems instead of the government funding their own insurance plan, which they already do through Medicare and Medicaid.

Now, if people were complaining that, instead of a health care plan, we should have been concentrating on improving the economy, I’d have gotten behind that. Sure, we had this stimulus package, but most of that was undercover, to the point that some people are just getting their stimulus money, and others have used it in ways that weren’t its purpose. This wasn’t supposed to save jobs; it was supposed to help create new jobs. But, in my opinion, most of these politicians had no idea how to create jobs. I had my ideas on how to create jobs, but no one ever asked me. What happened to our money czar? Oh yeah, she couldn’t take the job because she had illegal help that she didn’t pay any taxes on; sheesh (okay, we actually do have a new money czar, but I was on a roll here)!

By the way, I had my own version of a health care plan that a colleague consultant didn’t like, saying it wouldn’t be effective, and he came up with his own health care plan, which would have been effective. However, in retrospect, my plan over 10 years would have come to $500 billion at the most, while his would have come to $2 trillion; I still win fiscally.

Morally, this country needs a health care plan. Only the United States and Italy don’t have one for its citizens. Financially, I’m not sure we can afford this one, especially if the figures I mentioned earlier are still a part of the plan. And also, if it’s taking money away from Medicare, which is going to end up closing hospitals at the same rate, eventually, that banks are closing now, a health care plan won’t matter because we won’t have anywhere to go. That plus there’s already a shortage of doctors and nurses in this country because reimbursement is too low and malpractice insurance is too high.

I keep wondering if I were in Congress how I would have voted on this bill. This is something that most people don’t think about; these bills that get put before our elected officials almost never have everything we want in them, and sometimes have stuff sneaked in that has nothing to do with the bill. That’s how the anti-gambling statute got pushed in, through another bill that protects our borders, and why every American who’s paying to play poker online is actually breaking the law. With the little bit I know, this bill wouldn’t be close to my first choice. I might have had to hold my nose, but I think I’d have probably voted for it in the end.

Nope, glad I’m not a politician. Certainly glad I’m not a Republican (I’m not a Democrat either, by the way), since it seems that, so far, in this year they haven’t come up with a single proposal to try to advance something. Think that’s the wrong way to look at it? Prove me wrong. At least they did come together last week with the Democrats to vote for an extension of unemployment; can you imagine how bad that would have looked?

Okay, off the soapbox now. I’m not expecting this one to be read that much, so back to the lighthearted fare most of us are used to tomorrow; whew!


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How Ready Are You To Give Up Your Rights?

By now, everyone has heard about this new H1N1 virus that the United States is trying hard to encourage people to take. What many folks don’t know, unless they live in New York, is that the health commissioner of this state has determined that every health care worker who has any patient contact must take the shot. It’s the only state in the nation that’s made the shot mandatory; even the federal government didn’t make it mandatory for anyone except military personnel. What they’ve done that’s sneaky is not told hospitals what they should do about those employees who won’t take the shot. This way, it absolves them of any responsibility if hospitals fire employees, which is pretty much what’s going to happen.

My wife works at one of the hospitals in this area, and it’s being very aggressive in trying to get people to take the shot. They’ve gone above and beyond in trying to comply with the state mandate. They’ve decided that everyone who works at the hospital has to take the shot, even people who don’t work directly in the hospital and never see patients. They’re sending out daily notices to those people who they see haven’t taken the shot yet, and are sending daily emails out to other people with a list of names of people who haven’t taken the shot and asking them to encourage these other people to take the shot. Also, the employee health doctor at this hospital isn’t just accepting the letters that some doctors are filling out saying their patients shouldn’t take the shot. He’s asking inappropriate questions, then telling some of these people that they have to take the shot or else they will be fired.

Oh yeah, there’s two other things I need to mention here. One, the federal government has absolved the maker of this drug from being allowed to be sued if anyone gets violently ill and passes away, and since you can’t sue the federal government, it seems somewhat suspect. And two, my wife’s hospital, though trying to force everyone to take this shot, is also making them sign a piece of paper absolving them of any liability if people get sick from being forced to take it. Once again, that’s pretty sneaky.

These last two, by the way, are a violation of patient’s rights. Telling everyone else in the hospital who hasn’t taken a shot is not only a HIPAA violation, but it’s an employment violation, since it basically tells everyone else who might be on the list to be fired, which isn’t anyone else’s business. And forcing people to do something against what their doctors have recommended is a violation of privacy, since even employee health doesn’t have the right to override what a patient’s physician has said, whether they’re a physician or not.

This issue has brought up a very interesting conversation in this state. People who aren’t in health care are saying “why don’t they just take the shot.” They see it as “if the state says they should take it, then they should take it and protect us from them.” Sorry, but life just isn’t that straight forward.

Many years ago, when states across the country began instituting the seat belt law, I remember telling some friends of mine that this was only the first step, and that there were going to be a lot more punitive laws coming after this one. They laughed at me at the time, saying I was being paranoid. I’ve always worn my seat belt, and even though I believe everyone should wear one, I’ve always believed that people should have the right to do whatever they feel like doing in something they paid for.

Now, here we are, and we have helmet laws for not only motorcycles, but for bicycles. We have smoking laws all over the place. We have cell phone laws, and many states are looking to ban cell phones in cars altogether. We have more and more locales installing hidden cameras to catch us speeding or going through stop signs without completely stopping. There are rules for how you have to dress when you’re in the car. And, going further, we now have all these punitive laws going against kids for being kids, even at ages as young as 5 years old, and mandatory suspensions for some of the stupidest stuff you’ve ever heard of.

In other words, we’ve given up our rights of self determination. I will honestly say that some of those laws above I’m happy for, but I still have somewhat of a problem with them. I believe that when one passes a law that’s for the good of a group of people, such as outlawing smoking in restaurants because one smoker pretty much impacts a single room, as well as forces employees to deal with things such as second hand smoke, which could give them lung cancer at a later time in life, that it’s a much different thing than talking to someone on a cell phone. I might be wrong about that, but it’s how I feel.

But let’s come back to these H1N1 shots. Hospitals have never forced any of their employees to get a regular flu shot. As much as the World Health Organization wants to push this thing as a pandemic, there are still more people getting the regular flu than the Swine Flu, and more people around the world dying because of the regular flu than the Swine Flu. That’s issue number one.

Issue number two, who decides that you have to be forced into getting a shot in the first place? Shots are invasive; we all should have the right to decide if we want invasive procedures done on our bodies. This flu shot concoction is new; many doctors are saying it’s safe, but it really hasn’t been tested. They said the same thing in 1976; not many people remember that one. Many doctors are also saying that other shots are mandatory and that workers have never complained about that. Actually, though it’s true now, it’s not true at the time these shots were created and workers were encouraged to take them. That, plus let’s see, how many people had been killed by a proven deadly disease called smallpox before there was a vaccine that was allowed to be distributed?

Everyone has a point at which they’ll acknowledge that they feel their rights are being violated. The funny thing is that they never see it as being an issue for anyone else until they’re personally impacted by it. Well, I’m lucky in being a consultant; I’m not taking the shot. I’ve taken two flu shots in my life, and got sick for 4 months both times; that’s not happening again. As it is, with this shot, though some of these TV doctors are saying it’s safe, some health care workers have gotten really sick behind it, and have been out of work for up to two weeks. Shouldn’t that be a choice the potential recipient deserves to make for themselves as to whether they want to be put through that or not? And, as I said, no one can be sued for forcing it; how fair is that?

As I asked up front, how ready are you to give up your rights? I’d really like to know.

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Five Personal Lessons On Health Care

It’s rare for me to be gone from this blog for more than a day, but I had a very compelling reason. Although I don’t want to get too much into it, my mother is suddenly having some health problems, which has prompted me to spend some time with her and my grandmother, and thus my life has centered around them for the past few days. Even now, I won’t be back home until Friday at the earliest; thank goodness for laptops.

Even so, without getting into too much detail here, there are some lessons on things that have gone on that I can hopefully impart to some of you who read this, because, in some fashion, you’re going to probably go through something similar, whether it’s your parents or your children or even you. On some of this you’re getting expert knowledge; on some you’re getting historic opinion. Take it as you will.

Lesson one; high blood pressure is nothing to poo-poo. It can affect you in ways you’re not expecting. If it’s a family member, especially an older parent, you might have to ask questions about things like this. I knew my mother had high blood pressure, but I didn’t know she’d been having problems with it lately. What this did was prompt the physician to put her on some risky medication. I’m not sure the medication has caused this problem with my mother or not, but in any case, there’s now a problem. It’s called Hydroxyzine, and it’s given to relieve stress. It also has a laundry list of possible side effects. Before you take anything a physician gives you, check it out and decide if you agree with taking it anyway. And, if you do and it’s got lots of risks, make sure someone who can do something about it knows you’re on the stuff.

Second lesson; if you’re in the emergency room really late at night, there are certain tests they’re just not going to do. This is an American thing, just so you know. The reason is financial, though most people don’t know it. If a patient stays in the hospital overnight, and it’s not related to a surgical procedure that requires a stay to come out of anesthesia, the hospital is supposed to bill that claim out as an inpatient. However, if the diagnosis doesn’t qualify as an inpatient diagnosis, the hospital has to rebill, which often requires sending money back then trying to collect it again. That’s a mess, but that’s the law. My mother needed a CT scan, but they knew that no matter what the results were it wouldn’t qualify her as a true inpatient. So, we left the hospital after almost 7 hours just under an hour before midnight. Now, I could have tried getting ugly, but that wouldn’t have solved anything; Rochester is a big city with lots of patients in the emergency room at all times. Just know there’s probably nothing you can do at that point.

Third lesson; it’s hard to get answers from people who either aren’t waiting around for you to talk to them or say they don’t have enough information to tell you anything. In this case, my mother’s primary doctor was out of town, and the person replacing her couldn’t give us any advice except to stop taking the bad medication and to drink lots of water; heck, I’d already told her that! Also, at the hospital, until late, I couldn’t get anyone to stand still long enough to even talk to me. Very frustrating, and you know I understand how the health care process works. One of my medical friends earlier today told me I should have pulled rank more and forced the issue; I would have had she been in pain, but she wasn’t. However, every once in awhile I was able to get someone to stop and give me an answer to a question that I knew they could answer; I was at least that forceful. Pick your spots.

Fourth lesson; doctors don’t know everything. That may be a lesson many of you know, but I’m coming at it from a different direction. Suffice it to say that my mother has some strange eating habits, and some other strange habits; hey, where do you think I got it from? When I finally got a chance to talk to her doctor on the phone, when she called me to apologize for not being able to see her until Thursday (can you believe that? It’s why I’ll be here the entire week,… well, one reason anyway), I asked her about the medication she’d given my mother, why she gave it, then asked her if she had any idea about my mother’s eating patterns.

Suffice it to say, when I told her how Mom ate she was amazed, and agreed that I was correct in wondering why she had given the type of medication she gave, as well as the dosages. See, we as patients sometimes don’t tell our physicians enough. As much as I say I hate doctors, when I have my appointments I tell my doctors everything I’ve been doing, because I don’t want to take any chances that they’ll give me something I shouldn’t have. But older folks don’t always do that; neither my mother or grandmother have ever said a word. So, now the doctor has an education, and if I have to I’ll tell her more stuff because she needs to know what’s going on before she gives my mother any more medication. She may even tell Mom to eat better and more often; that wouldn’t depress me one bit.

And five. If you have elderly parents, or family members who might not be in the best of health, you need to be prepared just in case you need to go and stay for a bit, or get out of the house fast. Last Thursday it took me 90 minutes just to figure out how to get out of the house; that was freaky. On Sunday, it took me 45 minutes; at least I got the time in half, but I really still wasn’t prepared. Right now, I’m covered on a few things, but I still don’t have everything I need. Luckily, I’m close enough to meet my wife halfway on Wednesday so I can get more stuff. That, and of course some files I really needed; backing stuff up sometimes isn’t enough when you only do it once every couple of weeks, but you’re producing stuff daily. The Boy Scout motto of “Always Be Prepared” is a good one; I need to start living by it a bit more.

And there you go. I’m glad to be here with my mother, as I see her going through some changes, and sometimes it’s sad, but other times it gratifies me when she’s better. There are a bunch of things I might have to figure out if things get worse; I also have my 88 year old grandmother living here, and her memory isn’t all that good either.

Still, I’m getting by. We’ll all be fine, but if I’m not all that regular here for awhile, at least now you know why.

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