Medicare Agrees to Pay For Reverse and Reverse-Reverse Transgender Surgery.

Medicare -  In 2014, The Department of Health and Human Services (HHS) lifted a three decade old law banning Medicare transgender reassignment surgery coverage for patients experiencing gender dysphoria, an intense discomfort or mismatch with biological sex and gender identity.

Medicare now provides expanded coverage for transgender dysphoria
However, a lawsuit by the American Civil Liberties Union (ACLU) claimed the policy discriminated against gender reassignment surgery patients experiencing transgender dysphoria, an intense discomfort or mismatch with their reassignment sex and transgender identity described in in the most recent DSM-5 2.0 update.  Medicare officials agreed and decided last week to provide expanded coverage for reverse and reverse-reverse transgender reassignment surgery.

Transgender advocates hailed the new policy as a step in the right direction.  "We are happy with expanded coverage options, but we will continue to vigorously reject any limitations on surgical transgender interventions," said Silver Storm, head of the political action committee Right to a Transgender Medicare Life.

"I've got several diabetic friends from my bridge club who've had parts of the same leg removed over six times before finally getting the whole thing cut off.   As a transgender Medicare patient, it's discrimination to only pay for up to three sex change operations.  What if I need four or five or six?"  said Silver.

A rash of transgender dysphoria cases last year helped convince Medicare officials of the need to expand coverage.  Quin Jensen, a 72-year-old transgender Medicare patient explains.

"Ever since I was a little boy, I've dreamed of living my life as a post-menopausal elderly woman. But after the surgery, I realized it wasn't what it was all cracked up to be.   After the surgeon gave me boobs that hung to the floor, I knew I had transgender dysphoria and wanted out of that body," said Quin.

In another case, 76-year-old Elm Tree realized she made a terrible mistake transforming into a male after finding out the average male in the United States only lived to 77 years old.  "After one of my friends told me women live five extra years, I told my surgeon to change me back, but it wasn't covered until last week.  Thank you Medicare for giving me another five years of life!"  said Elm.



The Joint Commission Cracking Down on Wrong Twin Surgery.

Oakbrook Terrace, IL -  The Joint Commission (TJC) announced new hospital safety mandates yesterday after 27 more cases of wrong twin surgery were reported this week alone.  American hospitals documented 1,492 cases of wrong twin surgeries last year, a 114% increase from just two years prior.

The Joint Commission hopes to put an end to wrong twin surgeries.
"After years of nitpicking, we almost ran out of stuff to investigate.  This twin thing is going to keep us busy for years," said Dr. Alan Fleming, President of TJC.

In one wrong twin surgery incident last week,  42-year-old Stan Wilson accidentally had his tonsils removed after the registrar failed to correctly enter Stan#2 into the hospital's computer system.

"I grew up in a time when you didn't question the doctors.  So, I got confused when they took my  Stan instead of  Stan#2 to surgery, but they're the doctors so I just figured they knew what they were doing," said the twin's mother Samantha.

Last week Jane and Jan Morrow took advantage of their similar names to get free breast enlargements.   Jan was whisked off to surgery after the registrar accidentally entered Jan instead of Jane.  Plastic surgeon James Cutsworth realized his error when Jane showed up for her post-operative appointment asking for something bigger.

"This is the fourth twin BOGO free boob job I've had to do in a year," said Dr. Cutsworth, who failed to catch the error despite following standard pre-surgery checklist requirements.  "The Joint Commission decided to ding us anyway for not having a wrong twin surgery protocol in place."

To help reduce the risk of wrong twin surgery, TJC now recommends both twins be present on the day of surgery so doctors can write "NO" on the wrong twin.  For identical triplets and other multiple gestations, TJC does not currently have policy mandates.  "But we're working hard to make this stuff up as we go," said Dr. Fleming.

"What if I told you The Joint Commission is cracking down on wrong twin surgery."

What if I told you The Joint Commission is cracking down on wrong twin surgery photo wrong twin surgery_zpspfrwqepm.jpg



24-Hour tPA Stroke Window Making Physician Lives So Much Better Now.

Dallas, TX - Twenty years of  physician suffering ended abruptly Monday after the American Stroke Association (ASA) announced a dramatically expanded 24-hour tPA stroke window protocol to better accommodate doctors' increasingly hectic schedules.

24-hour tPA stroke window brings relief to doctors everywhere!
"Recent apologies by the American Board of Internal Medicine forced us to reevaluate our priorities as an organization.  We now understand just how disruptive our three hour tPA window has been on doctors' lives and for that we are deeply sorry,"  said ASA President Dr. Jan Fleming.

With the new 24-hour window, ASA officials are hoping to give doctors much greater flexibility in planning emergent tPA administration around their busy days.

"Now is the time to start putting physician satisfaction first or we're going to be left with a nation of doctors who only work at The VA Spa," said Dr. Fleming, the ASA's first private practice ASA President.

Some neurologists wasted no time taking advantage of the new doctor-friendly protocol.  "Last month I would have quit after the first nine [holes] of a stroke alert.  Now, I can get in 36 holes, watch Tiger, drink a couple beers and not have to worry about showing up late to the tPA window," said Dr Bazyli Baczewski, a neurologist who has never made it to a stroke alert before the 3-hour window.  Not ever.  Not even once.

Other neurologists have already started pushing for once-daily tPA rounds at their hospital in conjunction with a hospitalist run 24-hour hemiplegia observation unit.  "With the new 24-hour window, it doesn't make sense for me to interrupt my drug rep lunch, miss my kid's soccer game, or cancel my front row tickets to Taylor Swift for emergent tPA.  Homonymous hemianopsia can wait until the morning for whomever is on call at that time," said Neurologist Dr. Agnieszka Sobkowiak, the world famous homo hemi expert.

Unfortunately, not every community is lucky enough to have within-24-hours access to a tPA Neurologist.  Since 2003, tPA decisions for stroke patients in rural America  have generally been punted to the on-call physician assistant.  In critical access hospitals with only access to nurse practitioners, the American Academy of Physician Assistants (AAPA) recommends transferring tPA candidates to other critical access hospitals that employ physician assistants.  President of the AAPA Don Witmore explains.

"The American Academy of Family Physicians (AAFP) and the American Association of Nurse Practitioners (AANP) got together a few years ago and decided since tPA has PA in it, we were the most natural fit to make the call."

But, with the growing army of  physician assistant assistants caring for rural America, having PAs make the call isn't the straightforward decision it used to be.  "We are teaming with pharmaceutical companies to develop tPAA so we can finally pass the torch and avoid getting stuck holding the bag," said Don.

With the 24-hour window now the standard of care,The American Academy of Emergency Medicine (AAEM) responded by officially punting tPA decisions out of the hands of ER doctors forever.  "Now that we've added tPA to our master list of drugs outside the ER scope of practice, we are proud our doctors only ever have to memorize six drugs to make it through their shift:  Phenergan, Dilaudid, Levaquin, Lasix, Lorazepam and Colace." said AAEM President Dr. Stan "Dilaudicet" Wilson.

Some ER physicians have already noticed a dramatic rise in their Press Ganey scores by allowing them more time to focus on patients threatening to call the CEO and less time on hemiplegic patients who can't even hold a pencil to fill out the survey anyway.

"Last week I had a mother complain about waiting for six minutes to have all seven kids seen for problems listening to her.   I quickly wrote orders to admit my tPA candidate  to the hospitalist and then to call them when the patient got upstairs so I could immediately attend to the mother's needs.  Every kid got Levaquin and I got seven perfect scores.  Bam!  That's how the game is played," said one ER physician.



Vaccination Outbreak Forces Orange County To Declare State of Emergency.

Orange County - Shortly after Disneyland became ground zero for the largest vaccine preventable disease outbreak the United States has seen in decades, unvaccinated children of Orange County families overwhelmed doctors' offices and local healthcare clinics fearfully seeking immunizations against measles, mumps, rubella, whooping cough and other childhood illnesses.  This surge in vaccination cases left government officials no choice but to declare a vaccination state of emergency.

Officials are working feverishly to stop the vaccination outbreak.
"Due to the actions of a few thousand heartless pseudo-anti-vaxx parents who abandoned their principles at the first sign of a little measles, we are now faced with a vaccination outbreak of epidemic proportions,"  said Stan Walters, Director of Orange County's Public Health Department.

Last week alone, public health officials reported nearly 23,000 children in Orange County were unnecessarily vaccinated after  misinformation by pro-vaccination terrorists was widely disseminated on Facebook, Twitter and Google Plus.  This brings to 100,000 the number of children vaccinated since the measles outbreak began in late 2014.

Public health officials have been pleading with the public to remain calm.  "Those vaccinators are relentless.  We are working 18 hour days to help our citizens avoid making any rash decisions," said Mr. Walters.

The citizens of Orange County have always lived in unvaccinated  harmony with nature, oblivious to the dangers of childhood vaccines.  The percentage of some Orange County schools with fully vaccinated children has remained less than 30% for many years, but the recent vaccination outbreak has changed that and many anti-vaxx parents now worry about the effect vaccinated children will have on the wellbeing of their own child.

"I used to send my kid to school everyday with the comfort of knowing most of their schoolmates were unvaccinated. But now that 95% of Jimmy's classmates got vaccinated, I have to live in fear everyday wondering which one of these kids is going to give my child autism.  No parent should have to live like that,"  said the mother of one anonymous anti-vaxx parent who just returned from her biweekly botox injection.

Officials promised to do everything they could to stop the vaccination epidemic in its tracks. "No child in Orange County should ever have to go through the mild pain, occasional swelling and discomfort of vaccines ever again," said Mr Walters.



Tesla Motors Receives 5-Star Suicide Safety Rating From American Psychiatric Association.

Arlington, VA -  Premium car company Tesla Motors, maker of the all electric and emission free Model S luxury vehicle, proudly accepted the coveted 5-Star Suicide Safety rating on Friday from the American Psychiatric Association's Suicide Prevention Board (APASPB).

Tesla Motors is proud to be the pseudocidal car of choice.
During over 40 years of independent suicide testing, the APASPB has never given out a 5-Star rating to a car company because of the exceptionally high risk of carbon monoxide poisoning and general risk of death experienced during closed garage suicide field testing.

"We are thrilled to be recognized by the APA as a leading manufacturer of safe suicide technology.  Our engineers have worked countless hours perfecting the Model S to  provide the safest possible suicide attempt for sad and lonely rich executives and their children lucky enough to pluck down $100,000 for a big-ass battery,"  said  Tesla Vice President of Engineering Ben Franzen.

During two years of field testing, Tesla asked depressed volunteers to park a Tesla inside an enclosed garage structure, turn the vehicle on and wait. "Our data confirms a 0% death rate at 1 hour, 4 hours and 12 hours, which is much longer than any adolescent has ever been known to keep interest in anything.  We know Americans have many transportation choices and we want parents to know their children can attempt suicide in our Tesla with confidence, "  said Mr. Franzen.

While Tesla is not the first emission free vehicle on the market, it is the first to earn a 5-Star Suicide Safety rating because of its sleek body design and clean lines. "Form and function have always been deciding factors to achieve a 5-Star rating from APASPB and Tesla Motors is the only car company to rise to that occasion," said Dr. Jane Faulkner, President of the APASPB.

Prior to Tesla, no car company had ever earned more than four stars because of design flaws that caused some teenagers to feel like they wanted to die instead of getting caught riding in the car. "The Prius and Leaf actually increased suicidal ideations among tall, skinny, white middle-class suburban teenage males with acne.  We had to knock a star off their ratings until they found a less pathetic design,"  said Dr. Faulkner.

The 1976-1987 Chevy Chevette never received more than a 1-Star Suicide Safety rating from the APASPB in 12 years of production before being forced into retirement by the National Highway Traffic Safety Administration (NHTSA) because of its ugly design.

"Over 20,000 teenagers a year committed suicide to avoid getting seen driving around in the Chevette, followed closely by 7,000 suicides a year attributed to the Chrysler's K-car", said Dr Faulkner.

Despite Tesla's perfect score, some ER doctors questioned whether the 5-Star rating was warranted.  "We get at least two or three teenagers a month coming in intubated by squad after being found unresponsive in the front seat of their Tesla with the engine running and the garage door closed.  We had to finally tell EMS to quit intubating them,"  said Dr James Fenergin, an ER doctor who frequently roles his eyes when attention seeking wrist cutters present with an estimate loss of only 5 red blood cells.

Snarky ER nurses confirmed the rising incidence Tesla related pseudocidal attempts. "These kids are usually 12-volts short of a battery."

The American Psychiatric Association hands out very few 5-Star Suicide Safety Ratings.   Most recently, Johnson & Johnson, the parent company of McNeil Consumer Products Company was given a 5-Star Suicide Safety Rating with their 1 mg Tylenol tablets.  " J&J has never had a successful case of suicide with this suicide protective dose.  What we found over and over again was most females got bored or full after swallowing just 50 tablets and texting their boyfriend that they were about to die, before calling 911 themselves."

While they've never handed out more than 5-Stars in their 5-Star rating system, the APA is currently thinking about giving 6 out of 5 stars to the soon to be released 1mg Tylenol-Mucomyst combination pill to compliment the 12/10 pain experienced by doctors and nurses managing Acute Attention Seeking Behaviors.