Right livelihood

Last week I suggested to my teen that she apply for an internship with a local arts organization. “What do you think I’d be doing there?” was her response. When I told her I thought she’d likely be “administrative help,” that was the end of our conversation. After all, she wants to be a professional musician, no office skills required.
So how do I guide my daughter in preparing for her life’s work — do I caution her to develop skills to ensure a paycheck, or help her express her inner artist?
In Ashland we know many creative folk who seem to be thriving, but Ashland is a rare spot – an oasis of culture in our gorgeous rural Oregon countyside. After all, that’s why we moved here! Growing up next door to a cellist who retired from a major symphony orchestra, or an actress who makes weekly flights to Burbank to film the next episode in a sit-com might make one think such success is “normal.” A score of Ashland five year olds take up the violin each year, and practice their way up through the chairs in the local youth orchestra, only to find there are many wonderful violinists competing for first place at the state high school solo competition. Becoming a successful artist requires talent/charisma, determination, and a bit of luck.
The world of artists is competitive, but perhaps that is as it should be — who wants to watch a so-so performance? The cream rises to the top, and we like our cream.

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Snow Day in Ashland

Alison's chilly friend

Alison’s chilly friend

Defying gravity?

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Groundhog day

Out of doors today we’ve got fog, pockets of ice in the lawn, and fruit trees ripe for pruning — that’s right, it must be ‘Superbowl weekend’ here in southern Oregon, though our TV is dark now that we turned off the cable. My family’s off for the day at rehearsals for the high school Honor Band; my dog and kitty sleep beside me on the couch; I need to complete an online class on ICD-10 coding. These seemingly mundane details sound like a re-run of last year on this date, but I want to make note: for they are all temporary. In ten years the daughter will be launched; the job and hour-long commute likely gone; the house, with its peeling paint, sold? With luck I’ll be looking back without regret, though some details will doubtless remain: the knee I sprained a week ago will still cause me pain, my ’98 Toyota will still smell like bananas, the walnut seedlings I planted will be mature trees, perhaps I’ll see them from the street when I walk by, in Ashland on a visit.

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Documentation Improvement Specialists

Here’s a simplified description of what I do as a Clinical Documentation Improvement Specialist.  I review patient charts for completeness and accuracy, and then work with physicians to describe their care in terms that CMS (Medicare) and the hospital coding staff can understand.

Medicare is a complicated system– that means lots of paperwork and a numeric coding system that assigns numbers to medical conditions and the treatments that patients receive from their doctors.  Medicare decides how much to pay for a patient’s hospital stay based on how sick a patient is, and thus how many resources are expected to be required to care for him or her. Unfortunately, the language that Medicare is looking for to describe an illness or condition does not always match the complicated language that doctors learn in medical school.

Documentation Specialists help physicians use the language of Medicare so everyone can understand what happened: for example, they may need  say that a patient has “…Received 3 units of blood for Acute Blood Loss Anemia from Pelvis Fracture sustained at home when she fell after tripping over her dog” rather than a shorthand physician note like “Hip fracture; H&H 7.8 and 18.5; Transfused 3 units PRBC.” Another health care professional might understand the second description, but the accounting department has to translate those details into a code. The Documentation Specialist helps the physician describe things in English, e.g. “Is there acute blood loss anemia?”

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