Drive-by Posting: Prescription Silliness
My entries have been fairly serious recently, but there are a few lighter moments on service...
So among the reams of official-like stuff we're required to do is a comprehensive health assessment, one component of which is obtaining our fasting cholesterol and blood glucose levels. Both of these are things easily obtained from a visit to one's primary care physician. The only problem was, I didn't *have* a primary care physician here in St. Louis, yet.
At Michigan, I used the Student Health Service, which I was no longer eligible for here at Wash U; and the employee health service was for occupational health related issues only. Somehow, the health assessment required as a condition of our employment benefits doesn't count. And trying to find a primary care physician and make time for an appointment, etc. etc. etc. just to get those lab values would be an awful pain. Really, all I needed was some physician with priveleges at BJC to write me a prescription, so I could drop into the Barnes-Jewish outpatient laboratory, get my blood drawn, and get my lab values.
It was then pointed out to me that, well, *I'm* a physician with active priveleges at BJC. Why not just write *myself* a prescription to check myself into the outpatient lab and get my own lab values on my own authority? After all, I had an entirely functional DEA number and authorizations -- used them literally hundreds of times -- so why not just use them to order lab tests for myself?
It doesn't sound like something one would be allowed to do. But when I called the outpatient lab, I was informed that it was entirely kosher for me to write myself into the lab. Was in fact specifically permitted by a recent hospital memo clarifying the arcane billing rules we all exist under. It even solved the messy privacy issues involved...
Patients, of course, are entitled to copies of their own medical records at all times. Patients, however, must get copies through the hospital's medical records department, after filing the right forms, crossing the right t's and dotting the right i's. It is *not* allowed for physicians to get copies of those records directly through their electronic medical record access, when those patients are not directly under their care. A parent, for example, cannot get copies of their underage child's test results directly through their physician access to the electronic medical record system, even if they themselves would be the parent giving the permission. In fact, a physician is not allowed to access their *own* medical records through the electronic medical record system, but are supposed to go through the same paperwork trail as anyone else wanting copies of their own medical records.
Unless, of course, one *is* one's own physician. If you're the one who wrote the orders to have studies done on yourself, you can look at your own patient results, on the authority of also being the physician who wrote the orders in the first place. So turnberryknkn the patient is not allowed to use turnberryknkn the physician's access to look at his lab results -- but turnberryknkn the physician who wrote the orders for turnberryknkn the patient *is*. So by writing my own orders on myself, I enable myself to look at my own results without going through the paperwork hoops first.
And so instructed, I got a hospital blue pad out of a drawer and a Bic out of my coat pocket:
As usual, click thumbnail for expanded photo
Took my own prescription down to the lab, checked myself in, got my own blood drawn, and later that evening watched my own lab values pop up on my terminal.
I admit having been slightly concerned, given that I'm not precisely a light eater. I'm the kind of guy who likes to eat steaks the size of my head. I'm the kind of guy who orders the 3-4 person medium Giordano's stuffed pizza as my own personal dinner. I'm a guy who enjoys good food in good quantities, a whole lot of it deep fried and/or originating from cows. There have certainly been a few nights at Pizza House after Cynnabar Thursdays and Growler's after Three Rivers Thursdays, as well as generous helpings at all the lunches we get with educational sessions here at Children's. (And here would be where the Usual Suspects bring up the Lasanga & Cheesecake incident at missysedai's...)
So I was quite pleased to discover that, despite lots of ice cream and deep dish pizza and onion rings and a near-total disregard to anything like calorie counting, my blood pressure, BMI, and cholesterol numbers were well within even the most hard-core recommendations. (Normal folks are encouraged to keep their LDL cholesterol under 130. Cigarette-smoking, obese, heart attack survivors are recommended to keep their LDL (bad) cholesterol under 70. Mine is 59.) Huzzah!
I proceeded to celebrate my lab results by having a nice healthy mid-30hr-shift dinner of cheese sticks, fried chicken tenders, and more onion rings. With a side of ranch dressing. :-)