PATIENT INFORMATION FORM

There are many (many) reasons - so I'll list a few of the ones that I can think of off-hand.Here in the U.S. - we have a multi-party system: Provider-Payer-Patient (unlike other countries that have either a single payer - or universal coverage - or both). Given all the competing interests - at various times - incentives are often mis-aligned around the sharing of actual patient dataThose mis-aligned incentives have not, historically, focused on patient-centered solutions.  That's starting to change - but slowly - and only fairly recently.Small practices are the proverbial "last mile" in healthcare - so many are still paper basedThere are still tens/hundreds of thousands of small practices (1-9 docs) - and a lot of healthcare is still delivered through the small practice demographicThere are many types of specialties - and practice types - and they have different needs around patient data (an optometrist's needs are different from a dentist - which is different from a cardiologist)Both sides of the equation - doctors and patients - are very mobile (we move, change employers - doctors move, change practices) - and there is no "centralized" data store with each persons digitized health information.As we move and age - and unless we have a chronic condition - our health data can become relatively obsolete - fairly quickly (lab results from a year ago are of limited use today)Most of us (in terms of the population as a whole) are only infrequent users of the healthcare system more broadly (cold, flu, stomach, UTI etc....). In other words, we're pretty healthy, so issues around healthcare (and it's use) is a lower priorityThere is a signNow loss of productivity when a practice moves from paper to electronic health records (thus the government "stimulus" funding - which is working - but still a long way to go)The penalties for PHI data bsignNow under HIPAA are signNow - so there has been a reluctance/fear to rely on electronic data.  This is also why the vast majority of data bsignNowes are paper-based (typically USPS)This is why solutions like Google Health - and Revolution Health before them - failed - and closed completely (as in please remove your data - the service will no longer be available)All of which are contributing factors to why the U.S. Healthcare System looks like this:===============Chart Source: Mary Meeker - USA, Inc. (2011) - link here:http://www.kpcb.com/insights/usa...

Could be many reasons.Most common is that you are a new patient and after all that paperwork filling out you want to see the doctor as soon as possible. After all you came to see the doc, not fill out paperwork, right?So after you fill out the paperwork your answers are still in the papers and not in your electronic health record (EHR). Most of the answers aren’t even for the doctor: they are for insurance, billing and legal purposes. All that information will have to be scanned or entered by the nurse or medical tech, but he’s already on to another patient. He’ll have to do it later.The doc has just seen another patient. She’s only had time to fill out a skeletal note in the EHR for that patient that she will have to finish after she’s done seeing patients and before she goes home. If she doesn’t complete that not in 48 hours she could face fines and in some cases, dismissal depending on state or health system.Now she picks up your folder. There is a sheaf of forms and a blank health record with likely only your name and insurance number in it. Would you rather she spent 15 minutes reviewing what you wrote or actually meeting with you and asking some of those same questions?Most patients will likely choose the latter. Again, you’re there to see the doctor, not to fill out forms.And guess what? It’s only going to get worse as health care becomes more bureaucratic.

Prolapse tends to resolve by itself without the need for surgery in many cases.Rectal prolapse is graded according to its severity, and are categorised as: Internal prolapse – the rectum has prolapsed, but not so far as to slip through the anus. This is also known as incomplete prolapseMucosal prolapse – the interior lining of the rectum protrudes through the anusExternal prolapse – the entire thickness of the rectum protrudes through the anus. This is also known as complete or full-thickness prolapse.Treatment depends on many individual factors, such as the age of the person, the severity of the prolapse, and whether or not other pelvic abnormalities are present.Diet and lifestyle changes – for example, more fruit, vegetables and wholegrain foods, increased fluid intake and regular exercise. This option is often all that’s needed to successfully treat rectal prolapse in young children Securing the structures in place with surgical rubber bands – in cases of mucosal prolapse. Not every prolapse patient requires surgery.

Hospitals attach those matching bracelets on mom and baby. However, I was still given the wrong baby!This was 2001 in a reputable hospital near Philadelphia. It was my second child so I knew the drill. A few hours after birth they took my son for tests and whatnot. I slept a little and woke to the nurse bringing him into my room. She told me he was doing well but was still spitting up a lot of mucus. Then she left. I thought, still? he hadn’t been mucusy when he left. He was wrapped completely in blankets with only his gorgeous little face visible. He started to whimper so I picked him up and thought I would try to nurse him a little. The whimper turned to a cough and then he began to choke on that mucus. I was alarmed. I turned him over, gently tapping on his back. Pressed the nurse button. A prickly feeling that something wasn’t right began to grow. As I patted the baby I quickly scanned the card on the bassinet. It said Andrew. I hadn’t named the baby yet, but Andrew had been a contender. I wondered if it was possible my husband had told them his name was Andrew without speaking to me? Decided it wasn’t likely. Andrew is still choking, I press the nurse button again. Then turn him slightly to see his ears. They were both perfect. My baby had had a strange fold in one ear. Now I know definitively that I am holding someone else’s baby, and this someone else’s baby is choking in my arms. All this takes places in seconds. As I’m about to go into the hallway on my rickety post-delivery legs to find help, the nurse rushes back in. She says she realized what she had done. She takes the baby. Resolves the choking (I don’t remember how). Apologizes. Apologizes again. I ask her if my baby is with Andrew’s mom? She says, no, no. But I can’t tell if she’s lying. She leaves and comes back a few moments later with my unnamed, ear-deformed, but otherwise perfectly healthy baby. I don’t tell anyone about the mix-up except my husband, but we don’t let baby leave my room without us after that. We decide not to name him Andrew.Baby Not-Andrew and his strange ear

Added more….Our answers to the below questions will determine how dirty our mind really is. Let’s go…Q 1: What goes in dry and hard, but comes out wet and soft?......A: Chewing gum :PQ 2: Your finger fits right in it. You play with it when you're bored. Once you're married, you're stuck with the same one forever. What is it?......A: A ring! Get your mind out of the gutter!Q 3: What's at least 6 inches long, goes in your mouth, and is more fun if it vibrates?......A: A toothbrush. What did you think? :PQ 4: You play with it at night before bed. You can't be seen fiddling with it at work. You only let very, very special people touch it. What is it?......A: Your Smartphone! DUH.Q 5: What's long and hard and has cum in it?......A: A cuCUMber. Haha, got you.Q 6: What goes up, lets out a load, and then goes back down?......A: An elevator. Wonder what you thought!Q 7: Arnold Schwarzenegger's is really long. Michael J. Fox's is really short. Mickey Mouse's isn't human. Madonna doesn't have one. What is it?......A: Surname. Did you really think... Oh my god.Q 8: It’s fun to do, but you hate knowing your parents do it, too. What is it?......A: FACEBOOK. WOW!!! You're so twisted.Q 9: Every man has one, some are big, some are small. Blowing them feels great, but they drip if you aren't careful. What are they?......A: Noses. They're noses. Why would you even think... Ugh.Q 10: What gets longer when pulled, fits between breasts, slides neatly into a hole, has choked people when used improperly, and works best when jerked?......A: Seatbelts… Hahahahahahahaha. I know what you were thinking...Edit 1:Q 11: Which four-letter word ends in “k” and means the same as intercourse?......A: Talk.Q 12: You stick your poles inside me. You tie me down to get me up. I get wet before you do. What am I?......A: A tentQ 13: What four-letter word begins with “f” and ends with “k,” and if you can’t get it you can always just use your hands?......A: A fork.Q 14: I’m spread out before being eaten. Your tongue gets me off. People sometimes lick my nuts. What am I?......A: Peanut butterQ 15: What is hard and hairy on the outside, soft and wet on the inside? The word begins with “c,” ends in “t,” and there’s a “u” and an “n” between them.......A: CocunutQ 16: When I go in, I can cause some pain. I’ll fill your holes when you ask me to. I also ask that you spit, and not swallow. What am I?......A: DentistQ 17: What is beautiful and natural, but gets prickly if it isn’t trimmed regularly?......A: The lawnQ 18: I have a stiff shaft. My tip penetrates. I come with a quiver. What am I?......A: An arrowQ 19: Over 1,000 people went down on me. I wasn’t a maiden for long. Something really big and hard ripped me open. What am I?......A: The TitanicQ 20: I assist with erections. Sometimes, giant balls hang from me. I’m known as a big swinger. What am I?......A: A craneIf you got all the answers right, your parents should be proud of you. If you didn’t, you are not alone :PCheers.

Not at the diagnosis itself but getting here has been kind of amusing.A few years back, a doctor looking at a chest x-ray noticed that I had a healed crushed vertebra. I knew that I had hurt my back a year earlier but didn’t realize it was a crushed vertebra. When I told her that I got it lifting a shop-vac into my pickup truck, she was suspicious. As a (then) early 50’s male, I shouldn’t have bones getting crushed for something that innocuous. She ran some tests that showed that I had abnormally low bone density but everything else was fine. She suggested that I see a specialist.After a (long story) while I get to see an hematologist/oncologist. They start doing some measurements of protein in my blood. The value keeps rising. Bone marrow and biopsy tests from my hip shows unusual cells. The doctor says I have Waldenstrom’s macroglobulinemia. But … they keep testing and the protein value roughly stabilizes. It’s too high but not high enough for a definitive Waldenstrom’s diagnosis. I have Monoclonal Globulinemia of Unspecified Significance, MGUS. Treatment is to watch and wait to see if it develops into something more serious.This summer, I crush another vertebra lifting up a computer. MRI scan shows a tumor in the crushed vertebra and the vertebra next to it as well as some other damage. Diagnosis? Multiple myeloma.I get signed up for a clinical study for multiple myeloma. Doctors need to get another bone marrow and biopsy from my hip to baseline my condition before starting treatment. Diagnosis? Not multiple myeloma. It’s Waldenstrom’s.The hematologist wants to have a back specialist take a look. When I see the very experienced back specialist he says that he’s never seen Waldenstrom’s lead to crushed vertebra. Diagnosis? It’s probably multiple myeloma.But, importantly, he says we can’t keep guessing. We need to get a bone marrow and biopsy test from the vertebra to be certain. Result? It’s Waldenstrom’s. Everybody is now in agreement.I know way more about my immune system than I ever expected to know.

I think that I may have answered this question a few years ago.It concerned a gentleman who had just been to the bathroom, and had forgotten to zip up his fly!The individual was walking down his stairs, and when he got to the last couple of steps, he tripped and fell. Unfortunately, his vacuum cleaner was still running, and was upside down, and his fall positioned him in such a way that his penis, very unfortunately, disappeared into the vacuum cleaner and was badly macerated.The history was provided for me by a totally straightfaced patient, with his desperately worried and concerned partner sitting at the bottom of his bed, such that one would have thought, by the unfortunate individual’s demeanour, that this was a routine injury that occurred every day!It feels like last week, although it must’ve been about 35 years ago! The junior urological surgeon, red-faced, embarrassed and clearly totally at a loss to know what needed doing, was seriously considering performing an amputation, as the damage appeared to be far too great for preservation of the organ. In fact, fundamentally, on careful observation, it looked a great deal worse than it actually was.As an anaesthesiologist, I felt the patient needed a more senior opinion, and I suggested that the consulting, consultant in the United Kingdom, a Mr. Clarke, was called in at 2 o’clock in the morning, for an opinion.On the one hand, he wasn’t particularly pleased at being in the hospital at that time, but on the other hand, he felt that the situation was almost certainly recoverable, and he spent most of the next two hours doing his best to appear totally professional, and determined to maintain complete clinically appropriate discipline under very trying circumstances!He was able to perform a very impressive, complex, neat and tidy plastic surgical repair to the rather battered and sad looking organ, and he left a silastic implant where the urethra should have been, in order to keep it patent and open.In fact, the rather clever, difficult and tricky procedure, was worthy of its own patent, although to the best of my knowledge, this was never explored!He then fashioned a suprapubic catheter, by inserting a wide bore needle through the abdominal wall into the bladder, such that it drained into a large Winchester bottle.This meant that the urine could exit freely from the bladder, although the urethra was completely blocked off by a device that was calculated to keep it open, and vaguely circular in an attempt to prevent future obstruction and scarring.The patient was very fortunate, and despite not having the very best visibly optimal and attractive result, he was able to avoid having a total amputation of his penis, including a totally functional result!When everything had healed, all sutures removed, the suprapubic catheter extracted and the Silastic implant gently teased out, all appeared to function normally, as far as the casual observer could determine.Two weeks later, the surgeon assured me that the organ had achieved 100% normal function!Many of my friends and colleagues did not initially believe me when I explained the events of that night, so I was very pleased to have taken a before and after Polaroid photograph of what had occurred!To this day, I do not have the patient’s permission for publication, so the images are probably best kept at the bottom of a large drawer, to avoid damage by sunlight, not to mention litigation!Steve

In some cases, yes.It largely depends on the hospital you take them to and if you have the correct contact information for that hospital.If the hospital you transported to was your medical resource hospital, it’d be very easy to find out how your patient is doing. You may not be privy to extensive information about the patient, but generally you can know what their diagnosis was and how they’re doing. This is great when you have those patients that left you scratching your head or you could not confirm a diagnosis from your interactions and interventions.If the above is true and the patient needed to be transferred to a higher level of care hospital, it maybe be difficult to find out more than just that. The other hospital may not provide you with anything as they don’t know you, nor have any obligation to do so.If you were the crew that transferred a patient from one hospital to another for an inter-facility transfer, you probably won’t find out anything, even if you called and went through the proper channels.In cases of psych patients, you probably won’t find out anything at all. These patients and their identities are protected and you’ll be left to wonder.I’d say in my time in EMS and working in hospitals, about 75% of the patients that I did seek their status on, the hospital provided me with at least some degree of information. Usually if they were admitted, their diagnosis and if they’re stable. I’ve gone as far as to even visit a few of the patients, too. This is usually very well received by the patient and their family.Hope this helps!

Well, our (ESE 2014 Batch) medical examination was conducted after the interview and before the declaration of the final result. The medical centers were allocated based on the permanent address mentioned in DAF.  Before 2014, they used to conduct medical examination after the declaration of the final result. There is no difference between them, just different timings and it is conducted only once. My ESE interview was on 22nd January 2015, and after the interview got over I was thinking of hanging out with some friends there for some days but after a day or two we all got a mail mentioning the dates and venues of our medical examination. It was quite frustrating and surprising for us. Mine was scheduled on 2nd Feb, 2015 at Central Hospital, Maligaon, Guwahati. So I had to book tickets soon (obviously tatkal), came from Delhi to Kolkata and then headed for Guwahati. I signNowed Maligaon on 2nd Feb at 2am. It was quite chilly outside. I was too tired to move, was sleepy too. I could not see any means of transportation outside the station at that time. So I kept on waiting at the station and at last there  it was, a rickshaw. I told him to take me to a nearby hotel and he acknowledged so by nodding. He took me to a hotel, yes it was closed at that time, called them, no one picked up.  Then another, no vacant bed. Then another, same story. I told  him to leave (he already did more than what was he asked to) when I found some policemen there on the roadside and decided to ask them for help. I told them my purpose of visit. They were quite cooperative and helped me find a decent hotel nearby the Central Hospital.  So it was almost 5am when I signNowed the hotel and I dozed off instantly. Could not sleep more though, had to wake up soon enough as the reporting time was 9am. Woke up, freshened up, drank a lot of water ( just to make sure urine test goes well :D ) and had some light breakfast. I took a huge water bottle with me and headed for the hospital. signNowed the hospital at 8.46 am (yes, that was the exact time ) and saw some of the candidates were already there at the hospital premises. Some came alone, some came with their parents. We 9 were present there for medical examination that day. Slowly we started interacting with one another and were discussing what might gonna happen in the medical test in a light mood. Little did we know that the administration was gonna give us a hard time. Sometime later we figured out that medical examination was never scheduled at Maligaon Central Hospital before. That was the first time and as a result the concerned administration was quite messy and inefficient. We kept on waiting, lunch time was over and they were still busy with the paper work and all. Time was 4pm, still nothing. We all got angry, agitated, frustrated to the core and approached the medical officer there. He seemed least bothered about the delay. And the first two words out of his mouth, just dumbfounded us. "Come tomorrow". Like seriously? We had booked our respective train/flight return tickets for the same day. Who'd compensate for that? After a short discussion we decided to call the railway board and told them about the whole scenario. The response from the railway board was quite satisfying, they understood our problem and gave us assurance of prompt action. And yes! It did work. It was 4.40 pm and the medical officer came to us and assured that the medical examination would happen that day itself. So after all those hassles and infinite waiting period our medical examination started at 5pm. What a sigh of relief! We filled up some forms and completed the necessary paperwork. First test was x-ray. It was over in a jiffy. 2nd test was urine test (disgusting and dirty bathroom, felt like vomiting). 3rd test was physical fitness test(height, weight(tip: underweight people stuff yourself with enough food and water ;) :) , chest expansion, BP and all) . 4th was ENT test. Then last and the most important, the Eye Test which was quite exhaustive.  And it all got over by 7pm. Just a few phone calls to the railway board made all that possible. So after our medical  examination got over, the medical officer called us to his office and apologized to all of us for the inconvenience. He also assured us his further assistance in case we needed any. So we left the hospital at around 7.30pm after completing the final paperwork and leaving our contact for further communication.  Yes it was quite a long day for all of us!P.S: 5 out of 9 candidates were in the final list of ESE-2014 :)

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