Happy Thanksgiving

because wine…

Happy Thanksgiving everyone. Hoping that your day is surrounded by the love of friends and family.


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hungry at work?

When I was doing my general surgery residency, I used to say that I could smell chocolate and/or baked goods from a mile away… this card is totally me.


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There is no such thing as a straight man with a six pack.  Unless it’s a straight up six pack of beer.

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I’m just going to leave this here…

I posted this yesterday on Facebook but this really is the tweet of the week. But by all means – let’s complain about red cups.  *sips tea*

syrian refugee christmas story heartless tweet

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Shop around much?

Pregnant or thinking about having a baby? Wish there was a Consumer Reports type of website where you could find the best doctor for the best price?

Well… if you live in California, you might be in luck.  Back in September, California launched a new website designed to allow residents to compare the cost and quality of providers for five specific services: childbirth, hip and knee replacement, colon cancer screening, diabetes, and back pain.  And the website also gives cost information by county for 100 procedures, ranging from treating a broken ankle to cancer chemotherapy.  The site, California Healthcare Compare, was created by researchers at the University of California – San Francisco in conjunction with Consumer Reports with a federal grant from the Centers for Medicare & Medicaid Services.

Researchers are hoping that having publicly available information may help patients choose high quality providers that may be of lower cost.  Price variation in California mirrors that across the country, and even within the same city.  For example, the average out-of-pocket costs for an uncomplicated birth would cost a less in San Mateo County ($920) than in Alameda County ($1,300), Santa Clara County ($1,500) or Orange County ($1,800).

The difference with the California website is that it is the first to pair both cost and quality.  For example, the Centers for Medicare and Medicaid Services website HospitalCompare website offers quality data but not cost.  Similarly, the LeapFrog group also gives hospitals a quality and patient safety grade – but no mention of costs.  That’s because data on health care costs can be hard to gather.  Much of the data is closely guarded by both hospitals and insurers – or much as was reported in the TIME magazine Bitter Pill series, many hospitals don’t actually know their costs but rather solely what they charge.

The creators of the California Department of Insurance’s new site, California Healthcare Compare, tried to push past those hurdles by gathering data from multiple sources, including HospitalCompare, the Integrated Healthcare Association, California Maternal Quality Care Collaborative and insurance claims data.

In the end, what really matters is if consumers will actually use the website and “shop around” for their health care.  While the site breaks down average out-of-pocket costs for consumers and average costs that insurers pay, it can be difficult for consumers to figure out what their own costs will be.  The site links consumers to online out-of-pocket cost calculators maintained by major insurers including Kaiser Permanente, Aetna and Anthem Blue Cross, but some insurers still lack them. And consumers often find the medical terminology surround the total cost of a procedure, what insurers and consumers jointly pay to a provider, and their own out-of-pocket costs to be confusing.

Hopefully California can keep the site funded, and then expand and improve.  Ideally, other states will follow along.  Some already have, but more need to follow suit.

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War on Christmas?

Yes… the Christmas decorations and holiday music are already out there.  And we still have plenty of time until Thanksgiving.


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So when you spot violence, or bigotry, or intolerance or fear or just garden-variety misogyny, hatred, or ignorance, just look it in the eye and think, ‘The good outnumber you, and we always will.’

~Patton Oswalt


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