warriorsavant: (Chimerae)
DuckDuckGo. Does anyone else use this? It's an alternative search engine to The Borg. Their claim to fame is that they don't keep track of you/don't create a profile that follows you around. So far, their searches seem to give reasonable results, but I haven't done a head-to-head comparison with other search engines.

Office & Staff. Evil Secretary was actually out sick for almost 2 days. She takes sick days about once every 7-8 years. I came in Monday and she looked green, told me she'd just thown up, and needed to go home. Fortunately we have T on board now. Even though she's here as a nurse, she has secondary duties of filling in when ES isn't here. Also fortunately, it was a little slow, so she jumped in and did just fine. Yeah, lots of small things weren't perfect, but so what, this isn't her primary job and she's only been here a month. ES had initially told me she thought she'd need to come in for 1 day to clean up whatever mess was left, but there wasn't any. Good. Not having reliable back up of ES has always been a slightly worrisome issue for me, but this is another instance of T seeming to work out well.

RAMQ, fighting with. That's the government medical insurance bureaucracy in Quebec. Despite all our complaining (both as patients and providers), they generally get things done with a minimum of fuss. Had a couple of issues that I had to fight with them about yesterday, which is to say had to get on the phone with someone. Doesn't happen often (as best I can tell, most doctors in US spend more time fighting with gov't and/or insurance companies than actually seeing patients), and at least I got to speak to a human being.
     The Good. A patient who was falling between the cracks. He has horrible psoriasis, was put on one of the new biological medications with great results when he lived in Ontario. He moved back here, and the requirements are a little different, and I've been trying for > 6 months to get him approved. Discussed with them for 10 minutes, and today got the approval. They generally figure that if a doctor is willing to take the time to call them directly, it must be important.*
     The Bad. Only "medically necessary" acts are insured, which is reasonable. (Some of the backstory is not reasonable, but irrelevant here.) For example, a cyst that is not inflamed, infected, or physically troublesome is not covered for removal, so the patient has to pay. They may not like the cyst (or other benign growth), but the world is full of things one doesn't like, and that doesn't mean someone else has to pay for it. Anyhow, removed a cyst from a patient this past summer, duly warned him he'd have to pay for it, which he seemed to accept, duly charged him… and then he complained to RAMQ asking for reimbursement. Last fall they sent me a nastygram, asking for my notes on the patient and my justification. I sent that back, including a direct quote from their manual. They just sent me a letter saying basically, "illegal charge, we're collecting it back from you with a penalty." I spoke to someone who took the info, "and will get back to me." This is seriously annoying, but I am going to smack them down. If I let it go, besides the money immediately involved, it sets a really bad precedent. I've gotten the Assoc. Derm. Quebec involved, and they will help me for the same reasons. We'll win, but annoying.

*More on fighting for patients. It's part of the job. I'd hate to have to do it for every patient. Frankly, wouldn't have time to earn a living if I had to do that, but every 2-3-4 weeks, something comes up and I need to do it. It comes with the turf. Sometimes it really shouldn't be my job on a particular patient, but if he/she has been bounced around enough times, and is sitting in my office, I figure that morally it has defaulted to being my job, and I'll at least take the time for find out who should really be the one to see him/her, and make sure it happens.
warriorsavant: (Default)
Hedgefund likes to help her Papa. Even (or especially) giving me pills, whether antibiotics or vitamins, or anything else, she likes to hand them to me, if not actually put in my mouth. (Hold that thought for when I'm 90+, kid.) I don't take many, but not even really pleased with taking Lipitor. Today she handed me my pills, then asked "are you sick?" What ran through my mind was, "no kid, just old." *Harrumph*

BIL came over with his kids today for a couple of hours. We like them, and we really like that the cousins get together. HF loves it, WS sort of does, and their cousins do too. I think they (the cousins) enjoy it for a couple of hours, but as they're getting older, if they spend too much time, it feels like babysitting. A couple of hours seems about right. BIL helped me with a few things setting up the house that were too heavy or bulky for me to do alone, or even me and Nom to do. First, was setting up a huge parasol on the deck.* BIL was the provenance of that also, in that it had been left at a house he'd bought to rent out. When he rented it, he'd told his tenants that it was to go to me and Nom, whenever we actually had our house renovated. (When we moved, the movers made a stop to pick it up, as well as a stop to pick up stuff we'd stored and Nom's parents house. Apologies if already posted about this.) Between the two of us, we managed to assemble it, and man-handle it into a position where it shaded the deck when open, but didn't block the doors from opening. We also carried a large table down to the basement, put the TV on its stand, the stand on said table. They're set up in front of the exercise area, which was the plan all along.** He also helped set up some other stuff. Really very kind of him.

Even before got the TV set up, I managed to do some exercise the other day. Was watching the kids downstairs.*** If they are playing well, this is mostly boring. Brief flashes of "aww, they're so cute," but mostly boring. So I finally plugged in the treadmill, and got on it. As exercise goes, it was rather lame, barely getting up to a normal walking pace. My heart rate went up, but scarcely aerobic training level. On the other hand, it was actual exercise, for the first time in I-don't-know-how-long.



*Or umbrella if your prefer. Basically same thing, depending on whether the weather is sunny or rainy.
**Only just got cable installed. In our old place, Bell provided both internet and cable, via "Fibe" (fiber optic connection). Fibe doesn't reach our new place, and the city limits satellite dishes to 18". Which would be fine, but the smallest one they have (which they tried to install) is 24" and we couldn't get a variance from the city. (Well, they would have let us install one on the roof, as long as it was bolted to the roof, thereby breaking the waterproof membrane and voiding our roof warrantee.) In the end, we're keeping Bell for internet (because that's my email and it's too much trouble to change), and going with Videotron for cable. I'm sure you found this tale of bureaucratic nonsense fascinating.
***Don't know if I mentioned, but in a flash of brilliance, we covered the concrete basement floor entirely in gym mats. No more expensive than even cheap tiles or carpeting (and way cheaper than most), plus when kids fall down, they bounce and laugh, instead of break and cry.
warriorsavant: (Computer-steampunk)
After my computer crash, I could access emails on my phone, and was able to answer many of them. Others required access to files on my computer (or were to be saved on said computer), and I put them in a "hold" file on my server until such time as was back up and running. In the 10 or so days I was doing this, I accumulated 130+ emails. In between more important tasks such as nibbling toes, I spent hours yesterday and today dealing with them (plus paper files I'd set aside). I'm down to single digits. It's amazing how much stuff has to be dealt with in modern life in that short period of time. I think we spend half our lives just doing the administrative side of having a life.
warriorsavant: (Computer-steampunk)
Ever since both my email server and my laptop "updated to serve me better," I've been having problems accessing my mail correctly. After over 3 hours of online "help" from the email server company, they told me problem was with my computer (a MacBook using Mail as email program). Got on the chatline to Apple, who said I needed to upgrade my operating system, which included upgrading Mail. I have been reluctant to upgrade the OS, even though it's free, because from all reports, the newer one doesn't do anything really different, and last time I upgraded, it totally screwed up my computer, and I had to take it down to the Apple Store to wipe it and re-install everything. (Fortunately, I keep backups.) Anyhow, they told me that upgrading the OS had to be done, and "it might take a few hours." Shoulda asked them to define "few." 18 hours later, was still downloading, and suddenly kicked out with an error message saying download had failed and try again. *&%$#!@. Not to mention: !*&4•º%$§#¢£!@¡
Have just restarted the download; at least it seems to be restarting just from where it kicked out before, but I really have better things to do with my time than nursemaid this nonsense.
warriorsavant: (McGill)
McGill sent me an email, which for more information on the subject, and a link to click. Which brought up a page on which I had to select a tab, whose only info was a link to click, which brought up a document with links...

After six clicks, got to a broken link.

Finally emailed the person who'd sent me the original email, who then sent me a link to the page I actually needed to look at, which after reading it, realized it didn't apply to me anyhow.
warriorsavant: (Computer-steampunk)
So the Next BigThing is the "Internet of Things." Apparently this means putting Wi-Fi-connected microprocessors in everything. After all, it's important that your desk lamp be able to talk to your refrigerator. Or something. And since they learned their lesson from computers, security is built into all these devices. Except it isn't. Not even slightly. The potential for your life to be hacked will expand exponentially. Do you think it isn't already an issue? Tesla (the electric car company) just announced they were putting out a security update/patch for the computers in their cars. If they are doing that, then either there's already been an incident, or they at least recognize the potential for it.

There are at least two reasons to worry. First, if your microwave or furnace can be controlled from your phone, tablet, or laptop, then there is a link between them, and if there is a link between them, signals can go both ways and the cheap, commonplace, now-Internet-linked, household gadgets can be used to hack your phone, tablet, or laptop, and from there, your bank account and everything else you own.

Second, the devices can be directly hacked either for blackmail, or shear malice. As an example of the former with computers, consider reports of people having their computers hacked for blackmail/ransom. When you try to use your computer, everything is locked except a message from the hacker demanding money: pay up and they will unlock your computer, don't pay and they will wipe your hard drive. Now imagine you try to get into your entirely-wired house, and get such a message: pay up and we let you in, don't pay and we lock you out, and wipe all the Things-of-the-Internet you've connected together. Worse, imagine if you are "driving" your self-driving car, and your car display gives you a similar message: pay up, or we crash your car.

In a way, this is simply hacking-as-crime (or malice for the fun of it), egalitarian-ized, in the same way other crimes have been. Non-Internet examples? Armed Robbery for one. If you want to go in for Armed Robbery, you could follow Sutton's Law and rob a bank. It's high payoff, but also high risk and requires lots of planning. Because of the risk, there really isn't that much bank-robbery going on in the developed world. Much easier to knock over a gas station or convenience store: lower payoff, but almost no risk. Another example is kidnapping. In South America and the Middle East, kidnapping used to target only the rich. High payoff, maybe a million dollars a pop. However, requires lots of planning, good organization, and lots of risk; rich people can afford bodyguards, and they just might take out a contract on you later. Now, apparently, it is more common to grab the kids of local, middle-class or even poor people. Grab them, stuff them in a car, make them call their parents, and demand $100 ransom. Less payoff, but minimal planning needed and minimal risk.

So, I may be a Luddite, but I'll stick with my non-wired environment, Internet of the Internet, life. If my television set wants to talk to my stove, it will just have to walk into the kitchen on its own.
warriorsavant: (Computer-steampunk)
Apparently I'm to be congratulated, because of my many achievements, I was "recently chosen as a potential candidate to represent my state and profession in the upcoming edition of "Women of Distinction" for 2015. Very Few are selected each year to be included into 'Women of Distinction Magazine'."

Somehow, I'm just not feeling honoured. Must be some lack in me. Wait, let me check with my inner female side... nope, she's not feeling honoured either.

If I may copy shamelessly from Ethics Alarms  (http://ethicsalarms.com/2015/07/23/ethics-dunce-women-of-distinction-magazine/):
        "This is in the category of incompetent fraudulent advertising.
         It is an insult to all direct marketing scamsters, liars and slimeballs,
         who work hard at their profession, despicable as it is, and have standards, dammit.!

         This kind of self-destroying garbage makes the whole field look bad.
         Or good.
         You know what I mean."
warriorsavant: (Chimerae)
There are many things in life that I'm opposed to, but often I find myself disliking the people opposed to them more than I dislike the thing itself. Public smoking for example. The self-righteousness of the "anti's" so completely turns me off. These are the sort of people who would burn witches for the public good. They'd be appalled to think that applies to them, they're all in favor of wiccans, dontchaknow.

At the moment, I'm thinking about indignation on the Internet about certain people who have indeed committed loathsome acts. Bill Cosby sexually, Lance Armstrong's doping & cover-up, are recent examples. I don't support them or what they did. However, what repulses me, and amuses me in a sardonic way, is the commentators' indignation that their targets are still around. Don't they know that the commentators and all their friends and like-thinkers have thundered down righteousness on them on twitter? How dare they still exist! They have been criticized on the Internet and should admit their sins, curl up in a corner in die.

[livejournal.com profile] eattheolives noted a book called So You've Been Publicly Shamed, Jon Ronson (http://eattheolives.livejournal.com/960662.html), which points out that any of us have moments that could be held up as our being evil. If everyone is evil, then no one is evil, but the Internet intensifies taking one item out of context and making it the basis for an entire hate campaign. Sure, sometimes the cat has been let out of the bag and it's all justified; sometimes it isn't. Is everything in your life pure? Was there never one comment made in the heat of passion that you regret? Do we have the full story? Do we know your side of it? Is what was "reported" even a fact? No matter, crank up the indignation and burn you at the digital stake.
warriorsavant: (Sword & Microscope 1)
I know you spend a long time with each of my patients who comes to consult with you. They sit in your office, and the two of you have a long and very attentive dialog, and you tailor your recommendations and treatments to the specific needs of the individual patient. As such, I know I should take your advice very seriously when the patient comes to my office armed with that.

However, may I point out that if you recommend a medication only available in New Zealand, it won't do much good. I understand New Zealand is a lovely country, but it is quite a long trip from here, and my license isn't valid there.

Thank you for your understanding.

Warmest regards,
Dr. WS

Dear... No

Jun. 19th, 2014 08:37 am
warriorsavant: (Meh)
Dear Many People:

Three people yesterday in particular. You know who you are, even if you aren't actually reading this:
No.
No, you are not a doctor.
No, Google isn't a doctor.

Insisting that I'm wrong because you read something on the internet doesn't make you a smart, knowledgeable, informed, insightful person. It makes you an idiot who happens to know how to use a computer. The internet is full of facts. Some of them are even true. However, it contains no wisdom, and no way to let you know which facts are relevant to your particular problem. I don't mind (briefly) dispelling whatever wrong facts, myths, and nonsense you came across, but continuing to insist that you're right "because I read it on Google," only embarrasses you further.

Sincerely,
The guy in the white coat who's actually done this before.

PS: Just to set this in persoective, I love what I do. Had a dinner conference last night (good conference, great dinner). In and around a short bitchfest venting session about things like the above, the four of us sitting together agreed that on most days we loved what we do, and are likely never going to retire. I was the youngest of the four, the oldest is 80-something and still going strong.
warriorsavant: (Computer-steampunk)
On the ‘computers suck,’ list, especially Apple, just found out I lost my VPN access to McGill Library. (See below.) I know all Apple owners are supposed to be blindly loyal, but frankly, if I wanted a new religion, I would become a Buddhist (available in a household near me...) I think I mentioned somewhere my tales of woe of making the mistake of updating the operating system to OS X 10.9.something “Mavericks,” thereby crashing my computer, almost losing all my data (fortunately I’m good with backups), and spending hours of time restoring everything. The new operating system doesn’t even play nice with Apple programs, much less others. Have finally gotten most things working right.

A VPN is a ‘Virtual Private Network,’ which means that, from home, I can log onto the McGill system, and it treats me as if I’m actually at McGill. It’s a huge perk of being faculty. The great benefit is that I can access the library, and from there access on-line subscriptions to major journals (especially medical) everywhere. In ‘ye olde days,’ if I wanted to read an article in a medical journal I’d have to hie myself to the McGill Medical Library, search through the stacks, and read it there. (Have some stories about how that can be enjoyable.) Now I can just tap in from home and read on my own computer. Sometimes modern tech is indeed wonderful. Except thanks to Apple’s upgrade, the VPN disappeared off my computer. I spent half-hour on the phone w/ McGill IT Tech Support, who were quite helpful. I have reloaded the VPN, can click on the icon, it says it’s working, but it doesn’t. The tech said something about Mavericks having this problem from some computers but not others. Have managed a work-around of going directly to the website and logging in there, without the benefit of the VPN, but I’m just waiting for the other shoe to drop.
warriorsavant: (Space-horsehead nebula)
So Google, Twitter, Microsoft, and the other tech monsters are upset about government electronic surveillance. They are upset that the government is collecting communications data on people, and possibly even demanding their data. They are hastening to reassure Americans that they are safeguarding people's data. In other words, they want to continue to be able to spy on Americans and collect massive amount of data on them with no oversight, but they are shocked - shocked! they say - that the government does the same.
warriorsavant: (Computer-steampunk)
Posted a bit ago about my new TV system with a myriad of features I will never use. Tried to use one of the features that I did use (Roku to connect netflix to a TV). It did not work. After taking the appropriate actions (swearing, turning it off-then-on-again, swearing some more), I realized that when the technician set up the cable, he had to reset my modem, which meant a different WiFi and password. Had reset my computer, iPad, Blackberry,  toaster, microwave oven, and a few of the local field mice to log onto the new WiFi, but hadn't done the Roku box yet. All better now.

NYC 1

Oct. 14th, 2013 10:03 am
warriorsavant: (Staten Island Ferry)
Taking a few days to look in on Dad and WWC. Right now Dad is asleep, with one of the cats (Oreo, aka Danger Kitty, a true love slut) curled up on his stomach. They seem to go well together, either sleeping together, or Dad petting Oreo, with much purring (from Oreo, not Dad). Probably going to be me and Hedgefund in a little while (minus the purring). Actually, babies take a lot more caring for than cats, but so be it.

Flew out of Burlington VT (much cheaper flight to NYC than from MTL). Pleasant drive, with the autumn leaves happening. Used to make that drive at least once/month when I was in the VT National Guard; this was always my fav time to drive it.

WWC is currently minding Leo, the elderly dog of a friend who is hospitalized. Probably should say "dog," as it's more a large fluffy rat. In my mind, dogs are larger and less yappy. We took it out for a walk last night. Definitely damaged my macho image to be walking such a creature, but I'll get over it. WWC had various errands to do; I was walking very slowly down the street while she popped in-and-out of stores. "Slowly" partly b/c my foot is still hurting from the gout, partly b/c Fluffy Rat (uh, Leo) kept stopping to sniff things. Didn't really mind, poor thing doesn't actually get out much and was enjoying himself. Also stopping to piddle on fire hydrants and such. Sniff, piddle, sniff, piddle. It's the canine equivalent of Twitting or Wastebook. Hey, maybe their IPO would have gone better if they'd used that analogy: "Wastebook, it's like a fire hydrant for humans."

Staying at a hotel a few blocks away, which is being renovated. I keep ending up at hotels in the middle of renovations, b/c that's the only way to get a half-decent hotel in Manhattan for a half-decent price. I think this one is run by the Brits, b/c they haven't turned on the heating yet. *Sigh* I'm a tough Canuck, I can handle it. Trip going well so far, other than missing my ladies (all 1.5 of them).
warriorsavant: (Me-composite)
The internet allows patients to carefully research their problems, then come in to see me, completely assertive about already knowing their diagnosis, even when they are completely wrong.
warriorsavant: (Sword & Microscope 1)
It's a long weekend here. Victoria Day. (Look it up: http://en.wikipedia.org/wiki/Victoria_Day  I've also posted about it before.) We're at my place. Nom is feeling under the weather, so she's upstairs, watching Netflix on my iPad. I'm downstairs working at my computer. When she wants something, she texts me. We're so information age.
warriorsavant: (Computer-steampunk)
At one of my meetings today, I found out that I have an email box on the hospital system. Didn't know about it because never had any reason to use it. Seems I had 487 emails, 5 of which were of mild interest and 482 of which I couldn't care less about. Will have Evil Secretary check it remotely once or twice/week and show me anything that is actually important.
warriorsavant: (HHG-Typing)

The question before us, Gentle Readers, is whether eBooks and reading on-line increased or decreased literacy/reading. (And I realize the potential irony of asking this in an on-line forum). This springs partly from a discussion I had with my siblings, and partly from one I had with a patient who was a university professor and had his eReader with him.

I love books. Physical books. Walking into a bookstore or library is a joy for me. Just stand there and imbibe the atmosphere. (Plus books don't need charged batteries and the operating system never crashes.) Some part of me always wanted to own a bookstore. Yet, no doubt, when bound books came in to replace scrolls, the ancients felt the same way that some folks today feel about eReaders. I love books, but I love reading more. I equally enjoy reading physical books and reading books on my iPad (does that make me ambidextrous, bilingual, or ACDC). Although attention spans have been getting shorter, I don't think the Internet or eBooks have caused the death of literacy. A movie comes out based on a book, and people buy or download the book. Have to remember that no business model is sacred - if the Internet changes the way people do business, so be it. Similarly, no model of preserving knowledge is sacred - be it oral tradition, scrolls, bound books, or eBooks. We adapt. Each has made the knowledge more accessible to more people.

warriorsavant: (White Lion - Jabulani)

Full title: And they call me a Luddite: reflections on weirdness in modern life, as witnessed today.

1. Was having trouble doing some things on/with my “smart phone.” Went to the store to have one of the service reps talk me through these simple little issues. (Tried to do it on-line – good luck to me figuring out their website. Then I tried the customer “service” number – after 6 levels of voice menus and 20 minutes on hold I gave up). Anyhow, these were simple little things I wanted to do. So, after about an hour, and two experts working on it, it sorta got figured out. Well, the 21st century is amusing in small doses, but I’m heading back under my 19th century rock right now, where we at least knew what we were doing.

2. Spent the morning at the office of a colleague to pick up tips on a certain procedures. (Insert circumcision joke here, even though that wasn’t what we were doing.) Three of the four patients who were supposed to have it done cancelled. These were patients who specifically wanted this done, confirmed that they would have it done today, then cancelled at the last minute. Two claimed they had a wedding to attend. What, a surprise wedding? An emergency wedding? The only type of “emergency” wedding I’m familiar with is the Ozark type: Nattie comes home one morning and she’s in trouble. That night Paw oils up the shotgun, and the next day the young’uns are ‘taken suddenly married.’ The people signed up to have this procedure done are not exactly that socio-cultural set. Although I am a sophisticated (sorta) modern (not really – see first paragraph) urbanite (well, that one is true), I’m not trying to sound superior to the Appalachian set. If I am ever gifted of a girlchild, the second she is born – heck, the second ultrasound confirms might be female - I will place an order for a shotgun. One of those automatic, repeating models, with a laser sight.

3. In between patients, we looked at part of a presentation on a certain cosmetic technique. Rather than referring to the skin as “old,” or “weathered,” or “looks like hell because spent too much time in the sun,” the narrator, who had a very charming, cultured, British accent referred to it as “dehydrated.” Also, when talking about the upper chest in a woman, he referred to it as “the décolleté,” except for the time he said (in that very cultured accent) “the décolleté, sometimes called cleavage.” Heck, dude, if you are trying for the “man of the people,” touch, there are a lot of other names for that.

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