Powerball Numerology

You may not have noticed, but the Powerball^TM Jackpot is up to $600 Million ($376.9 Million cash value.)

The odds of winning the jackpot are 1 in 175,223,510.00.

They’ve got BALLS!

For the sake of argument, let’s assume everyone bought the standard $2 ticket.  That’s 300,000,000 million tickets sold.  The odds of winning are slightly less than half that.  Therefore, the odds of someone (or some ones) matching tonight’s drawing are actually pretty good.

I think most people buy a ticket, and then PRAY that those numbers come up.

Like any gambler, I’m always in search of an edge over the house.  Some of us are really poor at math, and refuse to be constrained by silly laws of probability that apply to the rest of the human race.  I hoped to find a way to PREDICT which numbers were going to come up, rather than sitting back and waiting and praying for them to match.  I wanted to be PROACTIVE!

So I downloaded all the winning numbers since 11/1/1997.  The numbers are actually listed in the order in which they are drawn.  I decided to look and see what was the average number drawn for each ball, fully ignoring understanding that the chance of any given ball being drawn at any given time is always the same.

I discovered something interesting–or not so interesting if you consider the Law of Averages.  A truly random sample over a large number of attempts will eventually reflect the underlying probability.  There are white balls numbered from 1-59, of which five are drawn.  There is a set of red balls numbered 1 through 35 which represent the powerball; one of these is drawn.  One must match all six to win the big prize.  So with an event that has an equal chance of drawing a number between 1 and 59, the average should fall between those two–roughly 30.

But when I did the calculations, the average number of the first ball drawn was . . . 27.

At first, this was a head scratcher.   If the odds are that the first ball will be less than the expected average, I may be on to something here.  Perhaps there is some variable which we cannot see or understand which keeps some of the higher balls from falling first.  Maybe the amount of ink on the ball–single digits have less.  I don’t know!  I am starting to tingle!

The lottery states that the odds of matching one red ball (the power ball) is 1 in 55.41 rather than 1 in 35.  It’s not because they are cheating, but rather that is the odds of matching ONLY the red ball, and none of the white balls.  The odds of matching a red ball are still 1 in 35, but some of those people will also match white balls, which makes the odds of getting only the power ball slightly higher or less likely.  But I digress.

After a little research, I discovered that the power ball drawing used to pick five balls from a pool of 55, rather than 59, and the power ball used to be drawn from a selection of balls numbered 1 through 42, rather than 35.

Twenty-seven is roughly the average of a sample between 1 and 55.  The tingling, it turns out, was from my butt going to sleep spending so much time doing these calculations.

So then I checked the other numbers.  The average number drawn for the second number was . . . 27.  The third . . . 27.  The fourth–and fifth . . . you guessed it, 27.  Damn you, statistics!

I can’t play a ticket with nothing but 27′s?

So then I reordered the picks into numerical order.  If the actual draw was 6, 23, 19, 43, 13 then the new array was 6, 13, 19, 23, 43.

So guess what the average lowest ball to be drawn each time is?

Nine.

The second lowest ball to be drawn?

Eighteen.

The third lowest ball to be drawn?

Twenty-seven–same as the overall average for the picks in order.  Do you see a pattern emerging here?

The fourth lowest (or second highest) ball to be drawn averages 36.

The highest ball drawn for over more than a decade of draws is 45.

A ticket with 9, 18, 27, 36, 45?  Try again.  That combination NEVER came up since 1997.

The stats seem to affect the Powerball a little more.  The average Powerball drawn is 20, which is higher than what you would expect for 35 balls (17 or 18 depending on how you round it off) but lower than when they used 42 (which would be an average of 21.)  That number will supposedly start to creep down towards 18 as more draws are done with only 35 numbers.

In the end, I bought a quick pick (letting the computer randomly pick my numbers since I haven’t the faintest idea what numbers to pick) and will spend tonight praying and promising God a percentage of my winnings if only He would let me win.

Six numbers for $600 Million?  That can’t be too much trouble for the Almighty?

The Other Light: A Mother’s Day Story

That only a Mother can love.

When I was younger, my dad and I went out shopping for Mother’s Day.  Maybe it was Christmas.  I don’t know.  This is Mother’s Day so it was a Mother’s Day gift.  Dammit, Jim, I’m just an eye doctor!

My mom wanted a new lamp for our end table in the family room.  The one she had still worked.  Neither my dad nor I could understand why a perfectly good lamp needed to be replaced.  Seriously . . .do you change the bulb before it burns out?  But I digress.

So we went in search of a lamp.  At a furniture store–which also sold “accessories.”  It really wouldn’t have mattered if we went to a lamp store.  We were both clueless if we couldn’t find it in the hardware store.  And even then . . .

After wandering around with glazed looks on our eyes, a sale person finally took pity on us and helped us find a lamp.

Neither my dad nor I could find anything wrong with the lamp.  It looked nice next to the display furniture that looked nothing like our family room, but we could kind of picture it on the end table.  Who am I kidding?  The sales clerk said it was a nice lamp.  We were getting hungry and woozy.  Therefore . . . it was perfect.

My dad questioned the price, because it was apparently more than what he wanted to spend on a lamp.

The lady explained to him that the lamp was actually sold as a set of TWO lamps.

My dad told her we only wanted one.

She explained that this was not the way lamps were sold.

He explained that we only had one end table and one lamp to replace on that end table.  (He also explained that the current lamp worked just fine, and he was still unsure why we were here.)

She would have to check with her manager.

Breaking Up is apparently hard to do.

After  what seemed like days of debating to a teenager who would rather be home watching TV and filling my young mind with important things, the manager finally relented and sold my dad ONE lamp–for slightly more than half price.  This apparently was an accord of epic proportions like the Sadat-Begin Treaty (which I believe was going on around this time–eventually signed in September of 1978.)  You would have thought we were breaking up Sonny and Cher!  But I digress.

I think we also wrapped up the scissors in the box.  The paper mostly stayed on until she opened it.

She loved the lamp!  Success!

But then she looked around and with the most curious look on her face, she asked, “where’s the other lamp?”

My dad replied that we only needed one for the one end table.  This was it.

“But they usually come as a set.  I want to put the other one over there.”

My mom did eventually get the other lamp.  The sales clerk at the same furniture store that sold her the unmatched lamp to the one she had told her this amusing story about the two guys that refused to buy both lamps.  They didn’t think they’d ever be able to sell this odd one, and they were thrilled my mom was willing to buy it by itself.  My mom didn’t mention my dad or I.  I’m pretty sure she pretended she didn’t know us.  The store clerks may still be laughing about this in their retirement.

So here is my Daily Prompt letter to Mom:

Dear Mom:

          It was all dad’s fault.

          I love you.

Me

Heisenberg Must Have Played Golf

Have you ever played golf?

No?  If I hum a few bars, do you think you could play it?

If you have, though, I am sure there have been times that you stand over that little ball on the green and ask yourself, ‘why didn’t I go bowling today?’

You are faced with a daunting task.  Your ball is here.  The hole is over there.  If you’re like me, it’s waaaay over there.  And you have to figure out some way (other than picking the ball up and dropping it in the cup, which although that makes perfect sense, is not allowed by the rules of the game) to get the ball from here to there in the fewest tries.  In short, you can’t get there from here.

Who came up with this?

Sure, it’s not that big of a problem for Tiger Woods, Jack Nicklaus or Sammy Snead, but you and I, my friend, are not professional golfers.

If we somehow manage to map the landscape of the green and predict the probable trajectory of the ball, we are sure to hit it too hard or leave it short.  If by some stroke of luck we find the proper putting swing to impart the correct speed on the ball, it will not roll in the direction of the hole.

This, in a nutshell, is the Heisenberg Uncertainty Principle.

The uncertainty principle also called the Heisenberg Uncertainty Principle, or Indeterminacy Principle, articulated (1927) by the German physicist Werner Heisenberg, that the position and the velocity of an object cannot both be measured exactly, at the same time, even in theory.

In other words, it is impossible for me to know the location of the ball and it’s speed during a given putt–I may not know either, for that matter.  But it would appear that it is just dumb luck if I manage both trajectory and velocity at the same time.  Ergo, it is not my fault I can’t putt.  It’s physics.  I’m sure if I research this long enough, I’ll be able to prove why I can’t drive, chip or hit an iron straight.  Hopefully, I’ll be able to eventually come up with a Unifying Theory of the Universe to explain why I can’t cook, do laundry or vacuum the house.

And as for the professional golfers . . . they are either the luckiest bunch of macrophysicists on the planet, or the Laws of Physics don’t apply to them.

Ask Not If The Glass Is Half Empty

But if you can have a free refill.

The Daily Post asks the question, “Is the glass half-full, or half-empty?

To be honest, I always thought the real philosophical issue at stake here was not whether my glass was half-empty or half-full, but rather who drank half my beer!

After all, it’s just a matter of perspective.  I went golfing last week.  I can brag that I was at least putting for a par on every hole.  Of course, more than a dozen of those putts were from the fairway or the sand, sometimes a hundred-yards away, but I still putted for a potential par on every hole!

I read somewhere once that the optimist sees the glass as half full, the pessimist sees the glass as half empty, and the realist simply drinks the rest.

Which got me to wondering . . . what do other people think about this question?

The opportunist sees a chance to sell you more beverage.

The surrealist sees a glass with arms and legs beneath a green sky with three moons.

The fundamentalist wonders if the glass has been saved.

The scientist wonders what is in the glass, and what would happen if he heated it with a Bunsen burner.

The psychiatrist wonders how the glass feels about this.

The artist sees a still life.

The perfectionist sees that the glass is too large.

The minimalist thinks there is too much fluid.

The stock analyst wonders if the level will be going up or down.

The racist is sure that a minority is responsible.

The plagiarist took the glass from someone else and claimed it as his own.

The diarist plans to write about the glass tonight.

The jurist will look for a legal precedent, but either way, will take 40% of what’s left.

The masochist won’t drink it no matter how thirsty he gets.

The sadist will make the masochist drink it, even though he doesn’t want to.

The therapist will try to make it feel better.

The dentist wonders if it is sugar-free.

The optometrist focuses on the glasses.

And the centrist is ecstatic.

I’m sure you can come up with more . . .

Dialectable

This week’s writing challenge implores writers to analyze, discuss and otherwise blog about a word or phrase “unique to your cultural background.”

http://boringpittsburgh.com/forum/pittsburgh-chat/post-your-pittsburgh-related-license-plates-and-car-pics/

Yinz has come to the right place, doncha know.

And while my grandmother would talk about Warshington D.C. while eating feesh for dinner on Friday, my all time favorite is when my mom asked us to “red up our rooms.”

And while my sisters and I always knew what she meant, even if we didn’t want to do it, it was very strange the first time I encountered someone (probably not from Pennsylvania) who had no idea what I was talking about.

“I’ll be with you in a minute . . . I have to red up my desk.”

“Are you going to paint it red?”

“No, you silly hobknocker.  I’m going to clean up my desk!”

“So why didn’t you just say that?

“I did!”  Not in so many words.  Actually red up and clean up are the same number of words, so I’m not sure it’s a time saving convention as much as it is an etymological one.

Insects?  Really?

Etymological–not entomological.

Where was I?  I have to red up this blog or I’ll never be able to find the end.

I guess, when you think about it, it is kind of a strange phrase.  I always assumed (and you know what happens when you do that!) that it was short for ready up something or get it ready, as in clean it or neaten it.  Of course, in that vein, the proper phrase should be typed “read up” where ‘read’ is the past tense of the verb to read, as in ‘I read that book last year.’  And if next year is this year then that would make this year last year?  Capiche?

But if that is not confusing enough, the Word Detective claims that it comes from a Scottish word ‘redd’ which actually means to clean or clear, and probably is related to the origin of the word rid.  I made that last part up, but it could be true.  Another source claims it is Danish, from the words rydde op which means to clean up.  Tomato; tom-ah-to.  A Danish is something you eat at breakfast, and scotch is something you drink.  Or tape packages with.  But I digress.

In fact, I have seen the term in print as “redd up.”

Pittsburgh’s Mayor even has a “REDD UP ZONE” to clean the streets and reduce blight.

Lamont Redd up his room–this is the Big One

But there was another phrase my mom used a lot growing up that I have not seen or heard anywhere else–and Google failed to find any hits in the first few pages I took the time to scan.

Whenever someone farted or there was a bad odor, she would say “Someone needs to go outside and scrape a leg.”

Scrape a . . . what?  Mom?  Did your auto-correct go on the fritz?  Unfortunately, I heard this before cell phones (before cordless phones!) or texting.

I have no idea what this means.  Did someone get dog poop on their leg and they need to scrape it off?  A shoe perhaps.  But a leg?

What else could they be scraping off their leg that smells so bad?  I’m afraid to find out!

I probably should have asked her what it meant.  But we all knew what she was talking about.  And since I was probably the source of the odor in most cases, I didn’t want to press the issue.

And I still hadn’t redd up my room yet.

Off Target

 

I went shopping at Target (pronounced Tar-jay) today.

Me, only male and without the heels.
From: DumpaDay.com

My electric razor broke so it was either this or risk decapitating my head trying to manually shave myself with a blade.  I haven’t used a blade since college and I wasn’t very good at it then.  I’m now on low-dose aspirin, so I think I would probably bleed to death if I tried.  I tried to fix the old razor.  The one head has been coming loose for months, but I kept snapping it back in.  And it falls out when I try to clean it.  This morning, it kept falling out while I was trying to shave.  It annoys me.  It would have to for me to go shopping.

I pull into the parking lot , which isn’t terribly crowded for a Sunday morning, and as I am pulling into a space, a woman gets in her car right in front of me.  I think to myself that this is great, because I can pull on through to her space when she leaves, and then I won’t have to back out when I return.

Have you ever tried backing out in a Wal-Mart or Target parking lot?  Any parking lot?  Pedestrians are stupid.  Or blind.  Because surely they can see a car backing out, but that doesn’t stop them.  And they all walk down the middle of the lane instead of near the cars.  Do you walk down the middle of a road or highway?  Hellooo?  McFly?  That’s where the cars go, folks.  And if you see back-up lights and a car pulling out, you’d better stop.  Or at least PICK UP YOUR PACE.   With blind spots and trying to see around today’s big SUVs, the driver probably can’t see you.  But I digress.

So I wait for the woman in the white car to pull away.  And I wait.  I pretend to look over at the store, as if I’m waiting to pick someone up, instead of waiting for her parking spot.  I don’t actually want to make eye contact with her.  I don’t know why.  I just don’t.  I open my phone and pretend to text.  I delete a few old messages from my inbox.  May as well get some useful work done here while I’m waiting for Mrs. All The Time In The World to get moving.  Her car engine is on and her brake lights are on, but nobody’s at home on the gas pedal.

It felt like I waited five minutes–perhaps I did, but it might have only been two or three.  WTH.

I finally turn my car off and get out, figuring she must be smoking a pack or eating lunch or something.  She pulls away.  If it wasn’t intentional it was the most perfectly unplanned coincidence in the history of parking.  But I showed her.  I jumped back in my car, restarted the engine, and took her spot.  Take that Bitch.

Inside, I head to the Health and Beauty section.  It’s not as though shaving makes me beautiful, or improves my health, but I figure that is the section that is most likely to have a razor in it.  And it does.  Blades.  Shaving gels.  After-shave.  Pre-shave.  Epilators for women.  Everything but an electric razor.

So I try electronics.  Ipods.  Ipads.  But no Irazors.  Well, the guy behind the camera counter raised his Ibrows at me, but that doesn’t count.  And now I can’t possibly ask him where they might be.  I don’t know why.  I just can’t.  It’s a male thing.  Like asking for directions–well, in this case, it is asking for directions.  I can’t do that.

I wander aimlessly among the aisles like Moses in the desert.  I try “Small electrics” but find only coffee pots and other well, small electric devices.  Which should include a razor, but it did not.

I call my wife, who is at Sam’s Club and the reason why I am on this shopping quest and not her, and she says the razors should be in Health and Beauty past where the curling irons are.  I didn’t see any curling irons.  I go back to Health and Beauty but I cannot find any curling irons or razors.

I continue to browse the aisles aimlessly, my eyes glassing over.  I think I’m hyperventilating.  Or hypoglycemic.  I’m beginning to get a bit woozy.  I should have grabbed a bag of M&Ms from the candy aisle.  At least I could have a sugar high, and I could leave a trail of candy to mark which aisles I have already wasted part of my life in.

I finally break down and ask the camera counter guy.  Without even thinking about it, he tells me aisle E-14 and points past Home and Garden.  I think Mr. Ibrows knew all along what I was looking for.  Either that, or he is going on break and he just sent me on a wild goose chase.  But what do I have to lose but another few hours of my life?  I’ve already lost my dignity.

I didn’t even know the aisles were marked.

But his directions were on Target, so to speak.

And now I can shave again.

Meaningless Use

Has your eye doctor asked you to disrobe and bend over for a prostate exam?  You might want to think about getting a new eye doctor if your answer was yes, but that scenario might not be as absurd as you think.

The United States government, in all its infinite wisdom and good intentions, is changing the way your doctor takes care of you.  Now this is a government that can’t adequately fund or run the Social Security System, Medicare or Medicaid, but they know what is best for your health.  They can’t run the Post Office without a loss, but they know the best way to deliver your health care, and starting in the near future, in addition to no mail you likely won’t be able to get health care on a Saturday.

After all, what would a doctor know about delivering health care?  They went to medical school instead of business school!  They weren’t elected to protect your rights!

Enter Electronic Health/Medical Records (EHR or EMR).  Physicians are “mandated” to computerize medical records.

According to Michelle Malkin:

Buried in the trillion-dollar stimulus law of 2009 was an electronic medical records “incentive” program. Like most of President Obama’s health care rules, this top-down electronic record-sharing scheme is a big fat bust.   Oversight is lax. Cronyism is rife. The job-killing and privacy-undermining consequences have only just begun.   The program was originally sold as a cost-saving measure. In theory, modernizing record-collection is a good idea, and many private health care providers have already made the change. But as with many government “incentive” programs, the EMR bribe is a tax-subsidized, one-size-fits-all mandate. This one pressures health care professionals and hospitals across the country into radically federalizing their patient data and opening up medical information to untold abuse. Penalties kick in for any provider that hasn’t switched over by 2014.

Like so many federal programs, the EHR incentive is advertised as an optional program.  I don’t have to convert to medical records if I don’t want to.  But, oh, by the way, if I don’t convert by 2014, Medicare is going to penalize me.  The federal government has a long history of such extortion–think of the 55 mph highway speed limits that were enforced in the 70′s and 80′s.  States could legalize higher limits, but then they would lose federal funding.  You don’t have to participate . . . but we know you will!

I don’t have to participate in Medicare, but here is the reality:  80-90% of my ophthalmology practice is Medicare.  If I don’t participate, my waiting room will be empty.  The vast majority of Medicare covered patients can’t afford to pay for services out of their own pockets, so they will go to physicians that do accept the coverage. I can’t blame them–I would too.  So I participate because I have to–not because I want to.

And such is the case with EHR.  I can’t afford to collect less from Medicare.  Seriously.  The reimbursement for a cataract surgery today is 1/3 what it was when I started in practice in 1994 and about 1/4 of what it was in 1986 (I now perform THREE surgeries to get paid the same as I used to get paid for ONE!)

Think about that for a moment.  If you are a farmer, you must now plant and harvest three fields to make the same profit you used to get for farming one field.  If you are a salesperson, you must now sell three times as much to keep your salary the same.   Or keep it even more simple–if you are paid an hourly wage, you must now work three hours to take home the same pay you used to work one hour for.  That sounds fair, doesn’t it?  And that is without taking into account inflation and the fact that a 1986 dollar is worth more than a 2013 dollar, not to mention the fact that cataract surgery today is safer and more predictable than it was in 1986.  When you factor in inflation, it is criminal what the federal government has forced upon physicians.  And now there is the 2% sequestration loss on top of all that.

The worst part of the whole thing is that I spent 12 years of my life (four years of college, four years of medical school and four years of residency) and well over a $100,000 for my education, and I am only trained to be an ophthalmologist.  It’s not like I can take my training and skills set and join another company.  I’m not qualified to do anything else, except consulting in some capacity or teaching ophthalmology.  Judging by the page views on this blog, I couldn’t make a living doing this!

So the government dragged me into EHR kicking and screaming, but I have not yet seen one cent of any “incentive” that was promised.  Why?  It’s not because we aren’t using EHR–all of my new patients and 90% of my old patients are now computerized.  It was a long, arduous and frustrating process.  It was expensive.  Anyone in our office that needs access to a chart–from technicians, schedulers, phone operators and insurance filers–must now have a computer and each computer has to have a rather expensive software license.  And every time we submit to get our incentive, there is a new reason why we failed to meet the criteria. No soup for me!

And if the computers go down–I can not access a new patient’s information.  It’s backed-up somewhere, but I can’t get to it until IT figures out what the Hades is wrong with the software or server.

The whole process of computerization and data collection sounds nice on the surface.  This site outlines the process like this:

Improved communication, quality measures, patient access and efficiency are all wonderful buzz words that make it sound like a fairy tale come true.  But it’s the details of the process that are horrendous. It’s the “meaningful use” of that technology that is problematic.  The fine print for meeting these criteria include 15 CORE objectives for physicians, apparently regardless of specialty (“one size fits all”):

1.  Computerized provider order entry (CPOE)
2.  E-Prescribing (eRx)
3.  Report ambulatory clinical quality measures to CMS/States
4.  Implement one clinical decision support rule
5.  Provide patients with an electronic copy of their health information, upon request
6.  Provide clinical summaries for patients for each office visit
7.  Drug-drug and drug-allergy interaction checks
8.  Record demographics
9.  Maintain an up-to-date problem list of current and active diagnoses
10.  Maintain active medication list
11.  Maintain active medication allergy list
12.  Record and chart changes in vital signs
13.  Record smoking status for patients 13 years or older
14.  Capability to exchange key clinical information among providers of care and patient-authorized entities electronically
15.  Protect electronic health information

If you are a non-physician and you look at this list, you are probably thinking to yourself that physicians should probably be doing these things anyway–and in fact, good physicians have been doing most of these things on paper for years.

Who wouldn’t want an electronic prescription as opposed to a scribbled, illegible one from the doctor?  Or an office note that is typed and legible rather than scrawled by a dyslexic platypus?   Have you ever used a computer?  Have you ever mis-typed a text message or email?  Clicked the wrong icon?  Have you ever tried to submit an on-line form that was refused because you missed one of the starred items or entered something incorrectly?  Have you ever sent a text or email that someone didn’t get?

In the short period of time we have been adhering to the eRx mandate, we have had multiple calls from pharmacies where patient’s are waiting to pick up their eye drops but no prescription was received.  Our computer says it was sent.  I know you probably find that impossible to believe because computers are perfect and people are not, but how many essential prescriptions do you think might be lost and the patient not realize they didn’t pick up all the meds they were supposed to?  Or what if the doctor clicked the wrong medication in the drop down menu by accident and didn’t pick up the mistake because he was trying to save encounter time so he could ask you about smoking (see below)?

It’s not as though folks couldn’t forge or change their prescriptions before to get controlled drugs.  They did.  But how long do you think it will take hackers to figure out ways to illegally transmit prescriptions for controlled substances, if they haven’t already?  (Actually, I think controlled substances still need a paper Rx, but as an eye doctor, I haven’t written for a controlled substance in 21 years, so don’t quote me on that.)

We are on the Titanic chugging along here folks, and this is only the TIP of the iceberg.  Medicare is telling us to move ahead full speed!

Number 12 mandates that we “record and chart changes in vital signs.”  Sounds like a good idea, doesn’t it?  Why didn’t a doctor think of that?!

Here is what your hard-working government–and I swear they employ people to stay awake all night thinking up ways to screw all of us–is doing for you:

Record and chart vital signs: height, weight, blood pressure, calculate and display BMI, plot and display growth charts for children 2-20 years, including BMI

So you show up for your eye appointment.  Your doctor’s assistant asks you to step on the scale.  They calculate your BMI (body mass index) and determine that you are overweight.  Wait a minute, you came here for glasses, didn’t you?   Or a cataract?

Your podiatrist now is asking you about smoking.  And they are handing you materials about smoking cessation.  All you had was an in-grown toenail.  WTF?

How long will it be before I have to put my patient, who is getting glasses, into a paper gown and ask them to turn their head and cough?

Or better yet, “I’m sorry Mrs. Jones, but before I can take out your cataract, Medicare requires I document a rectal exam!”

Don’t laugh!  They are changing these rules as we speak.  And I’ll give you a hint–they only make it worse.  The Academy of Ophthalmology fought the Centers for Medicare Services (CMS) for relief from having to buy scales and waste clinical time discussing your weight instead of your eyes, but I am still being forced to ask my patients about smoking.  And while that does have a modicum of relevance for macular degeneration patients who are at higher risk for the wet type as smokers, for the vast majority of patient encounters, it is just one more thing we must document for no other reason than to make Mr. Obama and his merry band of legislators happy.

We are treating the computers (and legislators)–not our patients.

Seriously, if you are a smoker, you probably know already from the media and lawsuits that smoking is bad for you.  Your general medical doctor, lung specialist or cardiologist should discuss that with you.  But if you are being checked for cataract or getting contact lenses, is that really necessary?  How many people are really going to stop smoking because their eye doctor or foot doctor or proctologist told them to do so?

But wait!  There’s a pamphlet for that!

Vital signs should be appropriate to the specialty–blood pressure and pulse for the cardiologist, respiratory rate for the pulmonologist, vision and eye pressure for the ophthalmologist, etc.  But the government system won’t allow for individuality or common sense.  There are universal protocols for everything, from infection control to marking a surgical patient, regardless of what the infection or surgery may be.

And it only continues to get worse.

So maybe you don’t care if your eye doctor is making less money as you sit in the over crowded waiting room (because I now have to see three times as many patients to maintain my income AND pay for this new computer system I don’t want.)

But if you have to disrobe and bend over, you might just start to care.

I just hope it isn’t Obamacare.