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We have to buy new computers for the clinic because of fungking ICD10. Bump from 17,000 diagnosis codes to codes to 42,000 and major pain in the butt. All new, all different, so hypertension is no longer 401.1. My five year old computers "work" but don't have enough memory for the Amazing Charts Electronic Medical Record update. Need to go ahead and do it because medicare is supposed to be accepting the new codes now (in theory. I haven't checked if our local medicare provider Noridian really is accepting them.)So I can practice with the stupid new codes until they go full on live in October.

Will this make medicine more precise and give us better data? Well, fungk no. I think we will lose even more of the solo providers and small practices and medicine in the United States will be even more controlled by big corporations. Why do you care? (That is, if you are from the US. If you are from a civilized country you are laughing at us.) Well, for example. In 2012 I was in my local hospital emergency room, and I am a physician who worked for our local hospital district from 2000-2009. The emergency room doctor did a CT scan of my neck. I thought, this is the wrong test, he should be doing a lateral neck film, but hey, I was septic. Maybe I was confused. He put in his notes that he'd ordered a lateral neck film and the CT scan was an error.

They charged me and the insurance company anyhow. I went through my records and wrote to them this year. They paid me back the 900.00$. They say it's "too late" to pay back the insurance company. If I can figure out which stupid insurance company I had in 2012, I will notify them to bill the hospital.

So read every single note in the clinic and the emergency room if you are a patient in the United States. And ask for the itemized bill. And complain to the patient advocate. Just check out how much they charge for the stupid little fungking socks they "give" you. Fight back.

I wish I lived in a country with civilized healthcare not fungking corporate healthcare.

Great. The medicare website has a countdown clock to the initiation of ICD 10. The main advice to doctors is to have "3-6 months" of overhead money stashed, since they expect it to be a mess and we won't get paid for 3-6 months. Right. Do the work anyhow and cross your fingers and fungking pray.

Bet half or more of the doctors/hospitals/clinics in the country have to buy new computers. Watch your bill climb.....

A UK noder asks about ICD-10 international. No, that's not what the stupid US is going to use. ICD-10 international has 14,000 codes that can be stretched to 17,000. No, we are going to use our own stupider version of ICD-10 with 42,000 codes so that more insurance companies can refuse to pay for more visits. Meanwhile, ICD-11i will be released in 2017.

The stupid frigging US has multiple electronic medical records that don't talk to each other, so yes, I can sort of code with my computer except I have to look lots of shit up, like "bruise", aka contusion, and any stupid "cut", aka laceration because the search sucks. I was trying to find prehypertension the other day. The electronic medical record lists it as "elevated blood pressure without diagnosis of hypertension". Great. I have a coding book in each exam room. By October, I will have a massive pile of coding books in each exam room.

Last night I did not sleep well so today I slept until noon after I woke up to make breakfast before school. While the table was set, we ended up not using many of the dishes I had laid out. We're still getting used to this new arrangement and I'm sure further refinements are in order, but I'm still pleased with the progress overall. This past weekend my middle sister and her husband put up a pergola so I was shopping for patio furniture that I thought that they might like, and found some that I thought might work for either my patio, or the sunporch. When the girls were small my sister painted the sunporch and while I still like the color scheme, I'm wondering if it's time for an update. I found a white table and chairs that was still available, but the person selling it isn't available on the days that we are so I think I'm going to keep looking as I really didn't care for the tone they used in their email back to me.

The heat wasn't working last night so the girls were cold and shivery after their baths. I shouldn't have put the winter bedding away so promptly I thought to myself as I pulled the covers closer, listening to the wind rattle the windows that need to be replaced. I tend to be a very impulsive and compulsive person so deciding to let the patio furniture I wanted go was a big step in the right direction. I would also like a different dining room table. We thought we were going to move, the three places we liked best sold in the same day so after making a big push to get rid of furniture and other posessions, we had to work with what we had left. The table we have now is from my in-laws, and I actually don't mind the style, but it's too tall for us. I gave my sister the chairs that go with it, that's part of the problem, but even after we get the chairs back the table will be a height that is less than optimal. Can I live with this? Yes. Should I? Maybe. Will I? Probably not. I should feel comfortable in my own home since everywhere else the seating tends to be problematic.

Yesterday I felt industrious and productive, today I'm drowsy and more relaxed. I wasn't in the mood for any of the books I had been reading so I dug out Quiet Places by Vinny Lee. Just looking at the pictures is calming, soothing, and gives me new ideas and fresh ways to see things. I worked with a boss who wanted people to see things with fresh eyes. He rarely adopted suggestions others had, but he was also fairly limited by the decor that we had. I think I was a thorn in his flesh when I was there. When he stepped down a woman came in to manage the office and I'm trying to think of a woman who was colder and less friendly than I was. She wasn't a producing broker, she was there to manage us and now that I know more about leadership and innate ability, learned skills, and kindness, I'm kind of surprised she wasn't let go not long after she started. We were a difficult crew since our former manager had been a go with the flow type who mostly let people do what they want as long as it didn't cause problems for others. In that respect, we learned what we had once it was gone.

There are so many things I want to work on that it makes me anxious and nervous. It helps to say to myself that I have to let things go temporarily until I can devote the time and energy that these other things deserve. Today I needed sleep more than I needed to get started on another project. My next organizational category is paperwork. The girls bring things home from school and we need a better filing system since I took apart the one that my mom had put together for me. Hers wasn't bad, but it didn't work for anyone in this house so I'm going to redo what she did so we can locate important papers we need and discard those that are clutter. I would like to have the heating and cooling people out to check our furnace. I took my car in for work and now the power steering is goofy so I have to call on that and the dentist called back about my youngest daughter's mouth while I was sleeping so I have to call them back too.

There are things I need and want to get done. I'm thinking that I should try to have a rummage sale this weekend, but with highs in the fifties, I'm not sure who will be out. I guess it really doesn't matter, I need to do it sometime and the forecast is mostly sunny which may bring more people out of doors. Most of the things I'm planning to sell are already out in the garage, but they need to be laid out and there are a few things out there that I haven't decided on selling since I know others who could use things like winter boots and snowpants that my daughters outgrew. My plan is to have the girls run this and let them keep half of the money. I told them 10% initially, and I want to reserve the right to stick to that if I end up doing most of the work which I have so far, but to be fair to them, I haven't asked them to do much and some of it is there are things that only I can do. The weather is making me so tired I want to crawl back into bed, but I have to pick up my youngest in an hour and a half so I'll probably just finish my book and lay around thinking about how I'm going to instill quietude in areas of the house that are currently lacking tranquility

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