Imablog

Somewhere in the back of my head, I’ve been pondering the idea of learning how to write some image processing routines. It’s one of those things that I think about every now and then. I’ve always wanted to write some image reconstruction routines to do some filtered backprojection. Sure, I could probably find some library routines out there that do it already, but you always learn more about a subject when you do it yourself. I’m already familiar with the concept, and it’s not all that difficult. I can use my FORTRAN again! Or maybe I could do something cool on the web! Then I also think about learning how to do other image processing algorithms, like filtering, warping, mapping, transforms. I could do all sorts of cool things to images that I acquire for some of my research.

Other projects come to mind, then I remember all the half finished projects that I’ve got sitting on the backburner waiting for me to get back to them. I’m still trying to learn enough about Visual Basic and using ADO to get my spreadsheets and databases interacting with each other. And then there are the web pages for work I’m maintaining, the web interfaces for my databases that I want to rework, the research projects to do, etc etc.

When I have some spare moments, I’ll sit down and work on some of the programming related projects on my list. Then after working on them for a few days, I remember just how much I hate programming. I really do. I mean, it’s something I can do, and I’ve had plenty of exposure to different programming languages: Applesoft BASIC, Fortran, C, Objective C, a touch of Pascal, and more recently PHP. Maybe it’s just because I’m not proficient enough at programming. I haven’t had much in the way of formal programming courses other than two Fortran courses during my undergrad. Most of my programming knowledge I’ve acquired as I needed it. Most of the programs I end up writing are usually functional, but hardly pretty or elegant. So after a while of pondering how to write something, I’ll get tired and put it away again. Occasionally I’ll get a flash of insight on how to accomplish some task.

hat’s always a good feeling.

But, I’ve decided I just don’t like programming, and any programming I have to do is just a necessary evil. As long as my programs spit out the right results, I’m happy.

The other day, I was listening to a news story about how there are more people in healthcare working in billing and administration than there are doctors and nurses combined. And for the most part, largely brought on by managed care, the HMOs. So much for the premise that they were supposed to be saving money and reducing health care costs. Imagine that, there are more people working to figure out how much to charge you for your hospital stay than there are people taking care of you while you’re in the hospital.

Actually, after having worked in US hospitals for the past few years, it’s not all that hard to imagine. I noticed shortly after moving to the US that healthcare was definitely much more business oriented than it is in Canada. One of the first things I noted was that I saw a lot more administrative and non-patient care people than I did doctors, nurses or techs while I was walking along the corridors.

Healthcare billing is big business. There are companies that don’t do anything except handle billing and coding for doctors’ offices and hospitals. There are graduate programs in medical billing. The CPT code books are thicker than most unabridged dictionaries.

And the billing process is convoluted. I haven’t seen the entire billing process from start to finish, but this is what I’ve encountered of it. After the doctor sees you, he might check off a few diagnosis codes on a form. Then there might be a dictated report, which is listened to and transcribed by a transcriptionist. From the form and transcripted report, a CPT coder (hopefully a properly trained and certified one) will select the appropriate codes to be billed for, which would then be sent to the billing group (internally or external). So between the doctor and your bill, there are several layers of people (at least 3) with minimal medical training deciding how much it’s going to cost you.

Where am I going with this? Oh, nowhere in particular. Just that getting sick in the US is expensive, and staying healthy in the US is almost as expensive.

UPDATE: And to top it off, who knows where your medical records end up. An article in SFGate (via slashdot) talks about how dictated reports from UCSF Medical Center ended up in a transcriptionist’s hands in Pakistan, apparently through several levels of subcontracted transcription services. So hospitals contract out transcription services to a company, who in turn subcontracts out excess work, which gets subcontracted out to some other company, ad infinitum.

Oh, the insanity…