Friday, June 29, 2012


Message to NovaRad, a small PACS company with a somewhat lesser known product:


I've received two comments on generic posts with not very cleverly disguised links to NovaRad's NovaPACS.

If you are resorting to this bottom-feeder approach to advertising, you guys must be having some significant problems. You just earned the DON'T BUY designation from yours truly. Of course, your customers probably don't read my blog anyway....

Sunday, June 24, 2012

Give 'Till It Hurts!

As a public service to my readers, I wish to extend the fine opportunity offered by the PRESIDENT OF THE UNITED STATES, Barack Hussein Obama, to forgo giving gifts to friends and loved ones, and divert the funds to the President's reelection campaign, where they will do much more good.  You may use this link.
Register with Obama 2012

Got a special milestone or event coming up?

Instead of another gift card you’ll forget to use, ask your friends and family for something that will go a little further: a donation to Obama for America. Register your next celebration—whether it’s a birthday, bar or bat mitzvah, wedding, or anniversary—with the Obama campaign. It’s a great way to show your support for a cause that’s important to you on your big day.

Just log in or sign up to build and customize your page—and congratulations!
Let's review...THE PRESIDENT OF THE UNITED STATES is asking you to ask your friends to donate to his reelection campaign instead of giving you stuff. How noble. How patriotic. How...well, come up with your own epithet.

Personally, I think this goes way over the line. THE PRESIDENT OF THE UNITED STATES is pandering to newlyweds, 13 year-olds, birthday babies, for money to boost his campaign coffers past $1 BILLION, so he can stay in office four more years (at least). I can't think of any other candidate for PRESIDENT OF THE UNITED STATES who has appealed to CHILDREN for money. The man is asking for kids to give up their birthday presents for Heaven's sake! Perhaps all the Bar Mitzvah's are supposed to include a prayer for reelection? I've got a good prayer, borrowed from "Fiddler on the Roof":  May God Bless and Keep Mr. Obama....FAR AWAY FROM US!!!!

So, what's next from THE PRESIDENT OF THE UNITED STATES? Oh, I've got it!


"Michelle says the nation is too fat, so stop putting your money where your mouth is, and put it in my hands!"
How about this:

"You know you don't need to take that big gas-guzzling SUV out today. Save the cash and send it to me so I can run over the opposition! Or better yet, sell the darn thing and send me the proceeds!"
And finally:

"If you overweight folks cut down on the intake with my SKIP A MEAL FOR BARACK program, you won't be needing as much toilet paper. Instead of buying that extra roll of Charmin, send me the cash, so I can wipe Washington clean!:"
Personally, I just want to vomit. This is the most sickening performance by a politician I've ever seen. Can't wait until November...

Tuesday, June 19, 2012

Too Big Not To Fail?

Our Agfa IMPAX 6.5 failed for over three hours this past weekend, and that's not the first time that's happened. This sent the three hospitals it services into complete pandemonium, as you might expect. At the moment, there is no hardware disaster recovery option. Hopefully, this will be implemented...eventually.

Fortunately, I was not on call when this little disaster occurred, but I certainly heard about it. To this point, we don't know quite what went wrong, but bouncing the servers seemed to fix it.

I guess we should be quite grateful, as the IMPAX installation in Western Australia continues to misbehave. I've received no word from Agfa as to why they think this might be happening, nor when it will be fixed Personally, I would hesitate to buy anything new until I knew the answers to these questions.

I have to contrast the IMPAX experience with our other hospital (and our group-owned system) that uses AMICAS Merge PACS. Merge (I still have some trouble with the concept) is a simpler product, using Windows Server and SQL databases instead of the supposedly more robust Oracle and Unix boxes galore. But it is much more stable. We've had perhaps two or three hours total unplanned downtime in the past 8 years.

PACS is not rocket science. It is simply a database of images and associated text. But the images are rather large, and have MEDICAL stamped on them, and thus has grown the culture of complex, expensive, and cantankerous big iron systems.

Most of the next generation of PACS are not a whole lot more than web-servers and associated databases. In this manner, they are robust, (relatively) simple, and while not quite bullet-proof, they have fewer points of failure, and are more easily maintained.

Could it be that the legacy designs are so complex that there is no way to avoid failure? I have to wonder...

Thank You For Funding Imaging Advantage

You may remember the string of articles published here on concerning Imaging Advantage.

In brief, Imaging Advantage insinuates itself between radiologists and hospital administrations, promising the latter huge benefits and screwing the former. Think Enron and the energy market, and you have the idea. IA's most famous take-over and subsequent flop in Toledo is well documented here and elsewhere.

The model is one only a doctor-hating administrator could love. IA claims that they are usually able to successfully hire on the group they are displacing from the hospital, and ultimately that group loses a good chunk of its salary, which goes back to IA, and probably is kicked back in some subtle form to the hospital. Administrators seem to be buying into the platitudes, as IA claims "hospitals and partners across 14 states."

Since I've declared my love for capitalism on numerous occasions, the Socialists out there are probably just drooling (more than usual) over the opportunity to point out that IA represents the "free" market in action, so how could I possibly object? Basically, this is anything but a free market scenario. C-Suite types, who make these decisions, are NOT the end-consumer of my product. They are choosing IA and their ilk in theory to "improve care" which somehow never seems to happen. Perhaps they think they will save some money on those horribly expensive rads, although how this happens when most hospitals don't directly pay rads is a mystery to me. My personal theory is that these interlopers take over the interpretive revenue stream from the rads, and somehow promise, maybe surreptitiously, to return some of that to the hospitals. No, this is about as much of a free market operation as the collection of protection money.

But only greedy capitalistic administrators would fall for this greedy capitalistic scheme? Wrong, borscht-breath. Your very own United States of America is buying into the inflated egos of Mr. Hashim and company. I assume our pal Naseer still runs this thing...the IA website isn't very informative these days.

Read this and weep:

Health Care Innovation Awards: Illinois

Notes and Disclaimers: 
  • Projects shown may also be operating in other states (see the Geographic Reach)
  • Descriptions and project data (e.g. gross savings estimates, population served, etc.) are 3 year estimates provided by each organization and are based on budget submissions required by the Health Care Innovation Awards application process.
  • While all projects are expected to produce cost savings beyond the 3 year grant award, some may not achieve net cost savings until after the initial 3-year period due to start-up-costs, change in care patterns and intervention effect on health status.


Project Title: “The right exam, at the right time, read by the right radiologist"
Geographic Reach: Illinois
Funding Amount: $5,977,805
Estimated 3-Year Savings: $14,935,320
Summary: Imaging Advantage LLC, in partnership with Vanguard Health Systems and other hospital systems in the Chicago metropolitan area, is receiving an award to re-engineer the end-to-end workflow process for hospital-based imaging services, including by leveraging technology to integrate immediate consultations with radiologists and other decision-support tools into the “front-end” of the patient-care continuum, where imaging exams are ordered and critical care decisions are made. A key objective of the program will be to reduce duplicative and/or clinically unnecessary advanced imaging exams. The program also will (1) deploy a unique disruptive innovation — RealTime QA® — which applies “double-blind” interpretations to high-difficulty exams in advance of patient treatment, (2) eliminate preliminary (or “wet”) reads after-hours and (3) materially improve exam turn-around times.  As a result, the program will reduce inappropriate advanced imaging utilization, improve quality assurance and, ultimately, improve patient safety and experience. A 30% decrease in CT use and decreased utilization of other imaging modalities is expected. CMS will also be evaluating planned centers in Detroit, San Antonio, and Boston.
Over a three-year period, Imaging Advantage LLC will train 495 workers in health care-related jobs. The new workforce will include clinical staff as well as IT development and operational staff.
Yes, folks, that would be about SIX MILLION DOLLARS out of YOUR pocket and mine, to fund this "experiment". There's a sucker born every minute, and most go to work for the government or become hospital administrators, it seems.

IA is doing nothing more than slapping a few buzz-words on its anything-but-clever "Real Time QA", labeling it a cost saving measure, (which is like wrapping a turd in fancy paper) and selling it to the morons civil servants at CMS.
Imaging Advantage is committed to advancing patient care and optimizing radiology services healthcare by introducing our RealTime QA Program. Imaging Advantage is the first in the healthcare industry to create a program specifically designed to address issues and resolve discrepancies while the patient is still present in the hospital, clinic or imaging center.

How it Works
Using our double blind parallel reading and review process, targeted high-risk cases are selected and interpreted simultaneously by two radiologists. If the results differ materially, the interpreting physicians review and resolve discrepancies, and correct any reported results prior to the patient being discharged. Simply put, higher quality of patient care is provided if discrepancies are resolved prior to the patient leaving the facility.

Why it’s Important
Catching mistakes before they are made, our RealTime QA Program adds value to healthcare facilities by:

--Reducing errors in high-risk exams lowering malpractice claim potential
--Reducing the need for patient call-back or report addenda
--Improving operational efficiency
Anyone who buys into this should be committed, in my humble opinion. What is a "targeted high-risk case"? Where are the most errors made? Probably mammo, but I don't see them applying this in that venue. How many of these double reads will be forced on the already overworked and underpaid rads? And I suppose cutting imaging utilization is the primary goal of a company that makes money from imaging utilization? Sure it is. Actually, utilization was cut at the IA flagship in Toledo, according to one of the displaced rads there, as clinicians took their business elsewhere.

If you aren't happy about your tax dollars supporting this, let your Congressman know. As an aside, and this is my PERSONAL OPINION, not reflective of anyone or anything else...any rad who signs on with IA had better have one incredible collection of extenuating circumstances which forced him to do so...otherwise don't ever come to me looking for work. Favorable consideration will be given, however, to those displaced by this operation.

New GE Optima NM/CT640 SPECT/CT Scanner Gets 32 MPG!!!

GE has announced another SPECT/CT scanner, the Optima NM/CT640:
Optima NM/CT640 offers brilliant CT image quality enabled by high speed 1 second CT rotation minimizing motion artifacts while keeping dose and ownership costs low.

Miami, Fla June 11, 2012— At the Society of Nuclear Medicine this year, GE Healthcare is introducing the latest addition to its Nuclear Medicine 600 series with a new performance SPECT/CT system—the Optima* NM/CT 640 — that offers nuclear medicine physicians the optimal balance of image quality, patient dose efficiency and low total cost of ownership.

Based on the innovative 600 series SPECT technology found in the Discovery* NM630, this system integrates the latest generation general purpose camera with a newly developed 4 slice CT designed for hybrid rather than standalone CT use. The CT, available in 2.5mm and 5mm slice thicknesses to optimize dose and resolution required for particular procedures, offers clinicians confidence with routinely low CT dose at 1-2 mSv for a 40cm abdomen CT scan.

The Optima NM/CT 640 can be fully upgraded on location from a Discovery NM630 SPECT only system, and may be upgraded in the future to a 16 slice Discovery* NM/CT 670, expanding not only its clinical capability, but offering the potential for research use. This upgradeability helps protect clinicians’ and healthcare providers’ investments as the needs of their department evolve.

With its small footprint (5.7m x 3.6m) the Optima NM/CT 640 requires minimal renovation and installation costs. With the benefit of optimized CT power, shielding and control room requirements are often eliminated; saving as much as $100,000 compared to higher CT powered systems...

“Building off of our extensive experience in SPECT/CT, the advances we’ve made to our Infinia Hawkeye 4 platform and incorporating the SPECT technology of our Discovery NM630 camera, we’re striving to give our customers unsurpassed diagnostic confidence,” added Hermony.

GE Healthcare believes in nuclear medicine as a powerful diagnostic tool that is efficient, precise and sophisticated and we’re dedicated to harnessing its power. We have a strong vision for the future and with continued investment in technology advancements like the Optima NM/CT 640 and breakthroughs like CZT. In the end it’s a commitment from a global company that’s dedicated to solving big challenges everywhere – all for the benefit of clinicians and their patients.

*Trademark of General Electric Company

†Shorter acquisition times and dose reduction capabilities are possible with Optima NM/CT 640 system only when used in combination with the relevant features offered on the Xeleris 3 processing and review workstation.
Good stuff.

However...I'm a little worried about the diagnostic quality of the "newly developed 4-slice CT", and given the mention of CZT, I'm assuming this is an attempt to create a nicer Hawkeye, with better SPECT, and maybe, possibly a bit better CT acquisition. Otherwise, why emphasize the ability to upgrade to the 670, which has "real" CT capability? Apparently, GE sees a market for the more limited version that doesn't need shielding, and continues to offer the "low dose" enticement in trade for lesser image quality. We'll know when the spec sheet becomes available.

In the meantime, anecdotal reports from the one owner in the neighborhood of the NM/CT 670 has been less than enthusiastic. As in "why didn't we get the Siemens?"

But what I would really like to know is this: How much did GE pay Kia for the rights to the name "Optima"? What? Kia doesn't even know about it? Uh oh...

Tuesday, June 12, 2012

The Case Of The Vanishing Vibrating Underwear (And iPad...)

Radiologists are no more immune to weird behavior than anyone else. However, it is probably not terribly wise to call attention to yourself when indulging in such. I won't source this, and the names have been redacted, but you can easily Google a snippet of the text if you just have to know more...
A hotel guest told police he was missing two iPads and his vibrating panties after an encounter with a woman in his room.

Dr. X told police he had purchased the items on Tuesday.

Later that day, Dr. X met a woman and invited her to his room.

Dr. X believes the items were still in his room after he took the woman back to her room at another hotel at around 9 p.m.

Wednesday morning, Dr. X left his room at 7:30 a.m. When he came back that night at around 6:30 p.m., he realized the iPads and panties were missing from an open piece of luggage in his room.

The front desk told Dr. X the only access to his room during the time he was gone was by housekeeping at 12:30 p.m.

Dr. X told police he believes that either the woman he met or hotel housekeeping is responsible for the theft.

He told police the woman he brought to his room still had a key.

An officer asked the front desk for the door log for room 405, but the employee who has access to the logs had left and would not return until June 7 at 9 a.m.

Police are still investigating the theft.

Dr. X, who shall remain nameless, turns out to be an interventional radiologist working for one of the BIG radiology corporations, being put up in said hotel. Not that it's pertinent, but Dr. X trained in a nation in the Middle East that is not Israel. I am unfamiliar with the customs in that particular wooded nation relating to reporting of missing items of a personal nature.

You filthy-minded perverts out there, otherwise known as readers of, are almost certainly jumping to the wrong conclusion. Clearly, Dr. X was in the process of an incredible breakthrough in interventional radiology, using the oscillating lingerie as a tactile feedback device during cases. I haven't quite worked out all the details for this yet, but I'm guessing he had modified the electronics in the panties with a WiFi access point for open communication with deep signal penetration, perhaps with an adcock ad hoc architecture.  The two iPads were then made to interface with the lacy drawers (although perhaps he preferred burlap). If I were doing this, I would use some sort of very sensitive probe at the tip of my catheter which could transmit sensations back to the first iPad, which might then map its trajectory. If the catheter bumps and grinds up against the smooth lining of the vessel wall, a sensory cascade might then be triggered causing the vibrating unmentionables to, well, vibrate, thus warning the operator of an impending state of no return. I'm would assume the woman in the article was a technologist or engineer helping Dr. X to perform a wet-run of the prototype device, perhaps helping him guide his catheter.

Or maybe they were both just watching His and Her porn on the iPads.

Anyway, nice to know that the BIG radiology companies deliver rads of such immense quality. Yes indeed.

Saturday, June 02, 2012

"How Can Dalai Be A Jewish Conservative???"

Disclaimer Number One: This is a non-PACS post. If that bothers you, skip on to some of my older work.

Disclaimer Number Two: This post favors conservative thinking. If you are a Left-Wing Nut Job (definition: someone who calls conservatives Right-Wing Nut Jobs) please leave now. You won't like what you see. 

This is a post I've been wanting to write for quite a while, now. I'm getting around to it thanks to a relayed message from fellow blogger 23 Skiddoo, who tells me that one of her friends just cannot understand how a Jew can be conservative. Personally, I cannot understand how a Jew can be a liberal/leftist, so I decided to learn more.

An article by Rick Richman appeared rather fortuitously on, which helped me congeal my thoughts on this matter. Titled "Jews, Jewish Leftists, and the Anti-Semitic Left," it outlines several talks given at a recent seminar, "Jews and the Left" sponsored by the YIVO Institute for Jewish Research. Read the summary, but the bottom line is this: the Left is becoming more and more Anti-Semitic, or at least revealing itself to be so, and Jews that still adhere to the Leftist philosophy do so at odds with their heritage. This is the part I have tremendous difficulty understanding. Why would someone support an ideology that just barely hides its desire for his destruction? For many self-loathing Jews (and they do exist, quite a few in Israel as a matter of fact) that may be what they want. There seems to be some lemming-like drive among quite a few Jews to finish what Pharaoh, Haman, Hitler, and Stalin, among many, many others, tried to accomplish. (Joke's on them...we're still here!) Some think the self-destructive psychosis relates to the Stockholm Syndrome, with kowtowing to those who are perceived to hold one's lives in their hands. Perhaps it's just simple embarrassment at being different...diversity is for those who LOOK different, but not for us (mostly lilly-white) Jews, yes? For some, it's simple personal economics...there are too many disadvantages, financial and social, to being a Jew, but conversions and name changes only change the superficial, and when you run away, you take your baggage with you. The genetics are true. Just ask the Nazi's about that.

As it turns out, I am a minority within a minority within a minority: I am a (mostly) politically-conservative, Republican-voting, Reform Jew. There ain't many of us. In general, the more Orthodox a Jewish fellow is, the more politically conservative he will be. Why is this?  From Front Page Magazine:
Put simply, the more Jewish is the person, the more they reject the policies of the Democrat Party. This should not be the least bit surprising as Modern Liberalism – the dominant ideology of today’s Democrat Party – is the very antithesis of Judaism.

The great gift of the Jews was a concept virtually unknown to humanity prior to the advent of Judaism – justice. Prior to the advent of Judaism, reward and punishment were typically predicated on the whim and the will of the powerful. Step on the Pharaoh’s toe and it might cost you your life. The oft-misunderstood (one presumes often intentionally) “An eye for an eye and a tooth for a tooth,” far from being a call for vengeance was, in reality, exactly its opposite, it was – for one of the first times in human history – an insistence that the punishment must not exceed the crime and that, not matter who the person “wronged” or the wrong-doer might be, the consequences must be meted out fairly. But the Modern Liberal rejects the concept of justice (in fact he rejects the concept of right and wrong, good and evil, better and worse, truth and lies and all other such ideas central to the pursuit of the just.) So self-evident is the Modern Liberal’s antipathy for justice that he himself admits that his quest isn’t for justice but rather some modified version of it which is why he inserts the modifier “social” prior to the word “justice” in explaining his agenda.

The Modern Liberal’s definition of “Social Justice” is that the evil and failed should be rewarded and the good and successful must be punished. After all, if all men are created equal, then something must have happened to the rapist to turn him from good into evil and therefore he is the victim (in fact, the great Thomas Sowell argues that, to those with this “vision” the criminal istwice victimized, “first by the special circumstances that provoked his crime and then by those wholust to see him punished.”) Similarly, those who are good and decent and hard-working should enjoy no special rewards for their efforts because clearly they had the advantage of good parents and a good upbringing and thus they had an unfair advantage. Justice demands that the good and hard-working be rewarded and the evil and the lazy be punished (if only by the withholding of the rewards of doing the right things.) Modern Liberalism demands that the good and hardworking be punished as the recipients of an unfair advantage and that the evil and the lazy be rewarded, their acts of evil and their failure all the proof the Modern Liberal needs that somehow they have been victimized by forces out of their control.

Obviously, these two beliefs are diametrically opposed and mutually exclusive. Just as obviously, those who more fully embrace Judaism’s quest for justice are more assuredly supportive of the Republican Party and the conservative movement while those who are least Jewish (even if they call themselves Jews) are more likely to fall into the camp of the Democrats and support the non-Jewish concept of “Social Justice” where good and right is punished and evil, failure and wrong championed.
I'm sure there will be howls of indignation from my more Left-leaning readers on that one. You'll never admit that the above is true. But it is, and deep down, you know it. It just isn't politically correct to say so in front of your other Leftist "friends".

As an aside, there are Liberal/Leftist Jews who are convinced (or have tried to convince themselves) that the Liberal Agenda parallels Jewish Law. If that were the case, the allegiances would be just the opposite, with the Orthodox being the more Liberal among us. No, what we see is the adoption of a New Law by Leftist Jews, more accurately a new religion which worships the State, "diversity" and looting of the producers, and ultimately feeling over logic, and really even death itself (to quote Ayn Rand), instead of the Almighty. (The diversity thing is really sad in many ways...they trumpet how wonderful "diversity" is, and squawk if a Jew dates other Jews exclusively. But most who intermarry don't raise their children as Jews, and thus homogenize into the rest of the population, which destroys diversity.)

23 Skiddo, answering in my defense said simply, "Dalai is a very strong supporter of Israel," which apparently satisfied her questioner. You see, the Left, and particularly Leftist Jews, have a very strong love-hate relationship with Israel. For them, it simultaneously embodies the best and the worst. They "love" Israel, but cannot come to terms with Israel's (99.99999% fictional) persecution of the poor, downtrodden "Palestinians." The Left MUST have a victim to "protect" and in general, brown trumps white, and Islam trumps Judaism or Christianity. (I pity the mental gyrations my Leftist friends must go through when they consider Darfur, where Muslims kill Africans.) Leftist Jews have to hate Israel "The Aggressor" while professing to still love its people. But Leftist Anti-Zionism is Anti-Semitism by another name, and the philosophies do coincide. From
Mitchell Cohen, who as co-editor of Dissent has bravely held out against this trend, began the first day of the conference with a presentation on “Anti-Semitism and Anti-Zionism on the Left,” in which he toured a horizon all too familiar to most of the attendees. “Does the left have a Zionist problem? Yes,” Cohen declared, going on to quote anti-Zionist and quasi-anti-Semitic statements by luminaries such as the American Jewish literary theorist Judith Butler, who has spoken indulgently about Hamas and Hezbollah, and the leading French philosopher Alain Badiou, who as Cohen put it is “obsessed with Jews and Israel.”

Cohen deftly united the two themes of the conference by arguing that the part of the left that is currently anti-Zionist is the same part that “hasn’t learned from the twentieth century”: that is, the left that still indulges in nostalgic reveries about Communism and revolution. On this view, the struggle over left attitudes to Israel carries on an ancient struggle for the soul of the left, which has always vacillated between hostility to Jews, as symbols of the capitalist order, and defense of Jews, as victims of reactionary anti-Semitism. In his speech, the British Marx scholar Norman Geras traced this dualism back to Karl Marx—specifically to Marx’s notorious essay “On the Jewish Question,” which is full of the most vile anti-Semitism, calling Judaism a religion of money and bargaining, and calling for the emancipation of mankind from Judaism. Yet in the same essay, Marx also called for national liberation and self-determination, a call that historically attracted many Jews to the banner of the left.

The problem for the left today is that it has gone over largely—but not, Geras and others insisted, wholly—to the negative view of Judaism as an obstacle to human progress. Israel, Geras held, “has been an alibi for a new climate of anti-Semitism on the left,” a development whose full venomousness can only be seen in Europe. (“I don’t think people here realize,” he said mournfully, “what it’s like to be a Jewish leftist in Britain today,” comparing it to living in a sea of poison.) This is the atmosphere that the Anglo-Jewish novelist Howard Jacobson evoked so powerfully in his recent novel The Finkler Question: one in which hostility to Israel is a reflex and insinuations about Jewish power and the “Jewish lobby” go unchallenged.

If the left in Europe and, increasingly, the United States is so hospitable to anti-Zionist and anti-Semitic ideas, what does that mean for the future of “Jews and the Left”? Michael Walzer explained the historical Jewish affinity for the left as a straightforward matter: “We have supported the people who support us.” The historical insights of the “Jews and the Left” conference suggested that things were never so simple—or mutual. So, when that basic equation no longer holds—if the left are no longer “the people who support us”—will we continue to support them? The “rising generation” of the left will contain its share of Jews, maybe even more than its share; but whether it will be a Jewish left, as it was in the past, is very much in doubt.
The hatred of the Left for Israel AND for the Jews is more succinctly stated by none other than H.G. Wells, as quoted in SultanKnish:
To understand why Anti-Semitism and Anti-Zionism are one, we need look no further than H.G. Wells who wrote, "Zionism is an expression of Jewish refusal to assimilate."

That one sentence is the final thesis on the left's ugly legacy of hatred for Israel and the Jews. It demonstrates why Anti-Zionism cannot be detached from Anti-Semitism, because behind it is a denunciation of Jewish identity. That is the ideological fuel behind the Anti-Zionism of both Western liberals and their Arab allies. The Western liberals demand to know why the Jews just won't assimilate. The Arabs demand to know why the Jews weren't happy being second class Dhimmis in their own country. Anti-Zionism is the denial of the rights of the Jews as a people based on Anti-Semitism, the denial of the equality of the Jews. That double standard joins Anti-Semitsm and Anti-Zionism into two words for the same idea, that the Jews should not exist.
How can Dalai be a Jewish conservative? My God, how can any Jew (or anyone with the slightest degree of intelligence and compassion) be part of the Left? It makes no sense whatsoever.

Some Random Thoughts At The Foot Of Arenal

The Arenal Volcano, from Springs Resort, La Fortuna, Costa Rica

I'm reporting today from The Springs Resort, in the shadow of the Arenal Volcano in central Costa Rica. We are just at the edge of the Rain Forest, and at the beginnings of the rainy season, so you can imaging just how lush and tropical the surroundings are down here. (And by the way, when it rains, IT RAINS!!)

ABC filmed an episode of The Bachelor on the grounds of The Springs, which is how Mrs. Dalai learned of it, and so here we are for Dalai, Jr.'s high school graduation present. Words cannot do this place justice, and the photos on the website don't begin to convey just how wonderful it is. I would place it just below Jade Mountain (another former Bachelor venue) in beauty of the facility and the surroundings. In fact, the view of Arenal is really reminiscent of the Piton in St. Lucia. The service here has been just as good, and by that I mean incredible. 

We even made a new local acquaintance, SeƱor Gato, although I suspect the next occupants of the room won't appreciate our cultivating his friendship...

For better or worse, there is WiFi in the room, and so I've managed to keep in touch with the outside world.

Let's start with the "for better"...From lifeIMAGE comes word of some tools to ease image exchange from within any other system, which means that if IT cooperates, my PACS could talk to your PACS:
Newton, Mass. – May 29, 2012 – lifeIMAGE announced today it is releasing certain open application programming interfaces (APIs) that can be used by developers of healthcare information technologies (HIT) or imaging devices to enable the secure exchange of medical images and related patient records directly from their software.

The lifeIMAGE network has been used to share over 160,000,000 medical images across diverse healthcare providers representing 40,000 affiliated physicians. lifeIMAGE is the go-to network for on-demand  clinical exchange of imaging exams along with related information such as reports or EKGs. This secure and high-speed network is used by physicians on five continents to collaborate on time sensitive patient cases.

With API integration, more providers will have the ability to tap into the network by enabling their existing systems to securely share imaging information on demand. PACS, EMR, dictation and reporting, CD/DVD writer, visualization, or personal health record (PHR) application vendors can integrate with open APIs to give their end-users the added benefit of a simple workflow for sharing patients’ imaging history.

“Our CD burning systems that have been in place for several years at an academic medical center in the Washington D.C., in addition to other customer sites, are used to publish imaging results to other providers outside their network using the lifeIMAGE cloud service,” said Cyrus Samari, a co-founder of Sorna. “When our customers have an exam that needs to be sent to an outside referring physician, or to the patient, with a single click, they have the option of burning a disc or sending it electronically on the lifeIMAGE network, all from the same interface - automatically.”

Norman Young, President & CEO of ClearCanvas, said “We were founded on the simple belief that medical imaging informatics should be accessible to all.  Now, using a lifeIMAGE open API, users of our FDA-cleared diagnostic viewer will be able to instantaneously share images that are in front of them with any one.”

“Whether it’s a simple CT or a complicated cardiology exam, whether it’s arriving through the door on a CD with a patient or arriving via the cloud, open and secure exchange of patients’ imaging history is key to improving patient care and driving down our country’s healthcare costs, said Hamid Tabatabaie, President & CEO of lifeIMAGE.   “We are eliminating the technological barriers to timely access to information by making our API available to all developers of related software. Now, HIT companies can use the open API to differentiate their services and ensure their users have the power to exchange information on demand.”

“lifeIMAGE recently delivered an API to a large academic medical center to enable their Epic users to upload or view images directly from the applications they use to check patients in or when accessing medical records of patients,” Tabatabaie added.  “A separate API is being used to provide access to employees who use WebMD’s PHR. Employees are able to share imaging content with any physician directly from their PHR, where other important medical history may also be available. ”

Companies that want to use the API can visit lifeIMAGE at the annual SIIM conference in booth #426, or request more information at
Since I won't make it to SCAR SiiM this year, I'll request more information. Does it work with IMPAX?

Which brings us to the "for worse"...

I've heard nothing from Agfa about Western Australia, and I would really like to know their take on the situation. Have I been fed incorrect information? Is the system working perfectly? Or is it such a disaster that no one wants to talk about it? As always, I will gladly post any official (or semi-official) statement from Agfa.

And worse yet, an email trail has been released, courtesy of the GOP, rather clearly outlining the level of Thugocracy under which we must live and function. Did you think the authors of the Affordable Care Act really had your best interest at heart? Ha. The ACA was gleefully crammed down this nation's collective (pun intended) throat by the Obama/Pelosi/Reid axis of evil, and there were any number of back-alley deals, in truth, threats and bribes, to assure the lock-step (goose-step?) cooperation of the drug and insurance industries. Read this from the (Republican-chaired, thank Heaven) House Energy and Commerce Committee:
WASHINGTON, DC – The House Energy and Commerce Oversight and Investigations Subcommittee, chaired by Rep. Cliff Stearns (R-FL), today released a memo and supporting documentation outlining a series of intricate policy negotiations used to craft the health care law, the full details of which have never been released to the public. The memo is part on an ongoing investigation the committee launched more than a year ago to shine light on a process that excluded both the American people and many of their elected representatives. Despite the White House’s unwillingness to make these negotiations transparent, even after the fact, the investigation has uncovered a series of emails and internal documents that paint a much clearer picture of the tools and tactics used by the Obama administration to secure a narrow, partisan victory and see PPACA signed into law...

Documents released by the committee today show major negotiation milestones throughout 2009 as the White House attempted to secure a deal with the interest groups who had been invited to the bargaining table. The materials reflect negotiating tactics used by top White House personnel including threats of public criticism and policy declarations. They also show that PhRMA was assured a “direct line of communication” with the White House, and that the organization was offered private reassurances about the deal remaining intact in spite of congressional concerns.
From the Washington Times:
Top administration officials cut backroom deals with the nation’s top drug companies to win support for President Obama’s health care overhaul, threatening them with steeper taxes if they resisted and promising a better financial deal for the industry if they acquiesced, according to internal documents released Thursday by House Republicans.

In some of the key deals, Mr. Obama agreed to drop his long-standing support for letting Americans buy cheaper foreign prescription drugs — something the pharmaceutical industry vehemently opposed — and the drugmakers promised to mount a public campaign to sell the public on the health care legislation...

The material released by House GOP members provides a rare insider look at the wheeling and dealing on Capitol Hill as Mr. Obama tried to shepherd his bill through Congress, in the face of near-unanimous GOP opposition.

The details emerged as House Republicans released emails it obtained during a yearlong investigation into the closed-door negotiations between the White House and lobbyists for drug companies. House Republicans said those negotiations violated the promises of transparency Mr. Obama made during his 2008 campaign.

“We really have now been able to build a case that there was a sequential, planned, organized strategy for the White House to trade policy for politics, if you will,” said Rep. Michael C. Burgess, Texas Republican. “They were willing to give up on things they thought were sound principles.”

The documents show that former White House Chief of Staff Jim Messina and health care reform point woman Nancy-Ann DeParle told drug company representatives in June 2009 that if they didn’t cooperate on the initiative, Mr. Obama would demand a 15 percent rebate on Medicare drugs and push to remove the tax deduction for direct consumer advertising — items that could cost the industry $100 billion over the next decade.

The threats appeared to work, and the parties met the next month to hammer out a final deal. The drug companies agreed to pay higher Medicaid rebates and a new health care reform fee to raise $80 billion for the legislation, and promised to run positive television ads about it.

In exchange, the White House gave them direct input into the new policies and promised to let them continue to set their own drug prices. Ms. DeParle threw in an extra prize to reward pharmaceutical companies for their cooperation, saying she and other officials decided to reverse the administration’s position on drug importation, which Mr. Obama supported while running for president.

“I made [the] decision, based on how constructive you guys have been, to oppose importation on this bill,” she wrote to Bryant Hall, chief lobbyist for the Pharmaceutical Research and Manufacturers of America(PhRMA).

Administration officials have denied that they negotiated directly with PhRMA, instead saying it was Senate Democrats who brokered the agreement.

But Republicans said their findings contradict the White House and confirm what the GOP has long contended: that the White Housebypassed members of its own party to iron out specific details with the drug companies.

The White House didn’t respond to requests for comment, but congressional Democrats defended the deal-making, saying it was no different from what had been done for major legislation under previous presidents...

PhRMA said the industry’s negotiations with the White House were a normal part of doing business...

Republicans said the investigation punctured a hole in Mr. Obama’s pledges of transparency during the 2008 campaign — including a vow to televise all of the health care negotiations so Americans could see who was lobbying for the drug companies and other big players in the debate.

“When you are supposedly acting in the public’s behalf, when you have promised that this is going to be the central feature of your administration, you darned well better behave that way,” Mr. Burgess said...
Yes, yes, I know. Business as usual in D.C. Except this piece of garbage gives the Socialists Democrats control over our very lives.

I'm presently in a nation with Socialized Medicine, and I've asked around about it. Everyone in Costa Rica pays a 9% tax for their "free" healthcare. However, if you need something beyond the basic, you have to wait (sometimes a year or two) for an appointment, or pay $30 for a primary-care visit outside the "free" system, or have your employer dock you for more insurance, which is a big hardship on most. As my guide Juan Carlo put it, "you might not think $30 is a lot, but for me and my friends, it's impossible."

Americans who believe in the increasingly mis-named Affordable Care Act would do well to heed the examples of the rest of the world. Governmental CONTROL (as opposed to Regulation) does not work very well for any prolonged period of time. Don't even bother to tell me of the few anecdotes you've heard about wonderful "free" care your cousin's friend's uncle received in England. The majority of the care isn't wonderful, and it certainly isn't free. Someone is paying for it, rest assured.

I don't think anyone is particularly surprised by this latest revelation of corruption by our illustrious leaders, both in the Administration and the Pharmaceutical industry. But it should certainly give us pause. The whole welfare state in America, and with that I include Medicare, Medicaid, and Social Security, are little more than governmental thuggery, redistributing wealth in a very small part to those who are truly in need, but also to the cronies of those in power, and to many (the looters or moochers, as Ayn Rand calls them in Atlas Shrugged) who don't need it at all.

Medicine in particular has been corrupted by the unholy alliance of Left-Leaning (and sometimes Right-Leaning too) Government, Big Pharmacy, Big Insurance, and not a few thieving physicians. It has become all about the money, and only tangentially about the health of the patient. Personally, I blame Government most of all (what a surprise...) It has set the rules, and the rest of the louts simply follow them or skirt them in the most barely legal manner possible to their own benefit. Nothing personal, of course.

I've got the answer, but if I told you how to fix this, too many of the above would be on the next flight down to Costa Rica with the express purpose of dropping me into the active C-Crater of Arenal.

In the meantime, I'll be on my porch, appreciating the beauty of Arenal and the flora and fauna around her, sipping on yet another Imperial.

Pura Vida!