The totally off-topic thread

[Pushka]

My great grandma was born in 1899 and made it to 99.

Great. I think that means I am old enough to be your Grandma? Maybe, I hated Anthropology at Uni.

MrP's great Aunt lived to be 105. And had every single brain cell in tact. He used to say she was the most forward thinking relative he had. He didn't think much of his grandies.

 

[serfty]

And I was last to be seen. :mrgreen: You'd think there was a conspiracy against me!

Now waiting for blood test while I'm here. What does "Out to lunch back at 1:35" mean? Back at 1:41? I love waiting. It's fun. And haven't been to work yet.
...

I ALWAYS try to book the first appointment of the day - even doing that I have been known to walk out after waiting for 30 minutes. I do generally make another apopintment on the way out though; although once I went back to my GP after two such events from the one practitioner and asked to be referred to someone else ...

 

[medhead]

I ALWAYS try to book the first appointment of the day - even doing that I have been known to walk out after waiting for 30 minutes. I do generally make another apopintment on the way out though; although once I went back to my GP after two such events from the one practitioner and asked to be referred to someone else ...

I assumed he was at a hospital clinic. In which case there are no such things as appointments. People just sit around all day waiting to see someone. Heard some interesting discussion around this situation during a Lean Healthcare course.

 

[tuapekastar]

Re: Best Status Run Options - A quick overview!

totally OT but when did you become a Mod Jess?

and congratulations

Ah, yes, mods. Somewhat O/T, I know, but that term always reminds me of mods and rockers.


Mods and rockers From Wikipedia:

mods and rockers were two conflicting British youth subcultures of the early to mid-1960s. Media coverage of mods and rockers fighting in 1964 sparked a moral panic about British youths, and the two groups became labelled as folk devils.

https://www.youtube.com/watch?v=begMgjEBdAw

 

[blackcat20]

Re: Best Status Run Options - A quick overview!

Great. I think that means I am old enough to be your Grandma? Maybe, I hated Anthropology at Uni.

MrP's great Aunt lived to be 105. And had every single brain cell in tact. He used to say she was the most forward thinking relative he had. He didn't think much of his grandies.

my grandma is 90 so I doubt it

 

[anat0l]

I hate public transport....

Easy - don't use it! However, airline travel is public transport too.

Public transport is a way of life for many Europeans. Switzerland is no exception to that at all.

Probably one of the worst experiences in Swiss public transport is getting onto an InterCity train and there's nary any space left. No seats (including those who have been told to take their bags off the seats), mostly standing room only or people sit on the stairs or against the walls on the floors. Even the restaurant car is full. Having a seat reservation is usually of little effect. But what can you do? Someone said that if 2nd class is this full you are entitled to sit in 1st class even without a relevant 1st class fare, but I doubt the inspectors will buy that.

I remember having to catch the RER in Paris for only 3 stops but at about 1730h. We had to wait for the third train (yes, they arrive almost every 3-5 minutes) to arrive before we had a chance to get on, because the platforms were burgeoning and the trains were arriving practically full. I don't know why it seems easier or more civilised in Tokyo, but the whole pushing in until you are a sardine in a can doesn't seem as refined in Paris. And I had to hold up a bouquet of flowers I was taking for my aunt, which meant when the train rocked forward, my elbow was essentially pressing into someone.

 

[medhead]

Not sure about Switzerland. But I had a chat with a German/Austrian guy on the train from Salzberg to Munich who was standing in first class. (Being Auslanders we had reservations.) I invited him to have a seat and he explained that as he was on a second class ticket he couldn't sit down as that would get him in trouble. But he could stand in first class, I think he was actually leaning on a shelf or something.

 

[JohnK]

I ALWAYS try to book the first appointment of the day - even doing that I have been known to walk out after waiting for 30 minutes. I do generally make another apopintment on the way out though; although once I went back to my GP after two such events from the one practitioner and asked to be referred to someone else ...

Not in this hospital. Apparently appointments are too difficult to handle so have to processed randomly on a Cray 1 supercomputer after hours and a letter sent out. You can change a date but not the time.

Wasted 2.5 hours of my life waiting today which I will have to make up tomorrow night at work. Next time I have a 10:45am appointment at this clinic I will know I am in the last batch of appointments for the morning and better off turning up 11:30am-11:45am.

 

[anat0l]

Not sure about Switzerland. But I had a chat with a German/Austrian guy on the train from Salzberg to Munich who was standing in first class. (Being Auslanders we had reservations.) I invited him to have a seat and he explained that as he was on a second class ticket he couldn't sit down as that would get him in trouble. But he could stand in first class, I think he was actually leaning on a shelf or something.

I could see that passing off (standing, not sitting) if second class is absolutely packed, and you could convince the controller of this fact. I wouldn't say it would be easy, though, and for those controllers who are not easily convinced, there is (99% of the time) no "first warning" before you get fined, even if you are an Auslander. (Thankfully, plenty of the SBB CFF FFS controllers are able to speak English).

It has happened that 1st class cars have been opened to 2nd class passengers when the controllers think that the overflow is required. Sucks a little bit if you just paid for a 1st class ticket, and the fact is often unannounced, just relying on word of mouth or when someone who boards at a station down the line sees the temporary sign pasted on the door.

 

[straitman]

I hate banks :!:

 

[NFF]

The world's largest cave (may be).
https://vimeo.com/121736043

 

[medhead]

Not in this hospital. Apparently appointments are too difficult to handle so have to processed randomly on a Cray 1 supercomputer after hours and a letter sent out. You can change a date but not the time.

Wasted 2.5 hours of my life waiting today which I will have to make up tomorrow night at work. Next time I have a 10:45am appointment at this clinic I will know I am in the last batch of appointments for the morning and better off turning up 11:30am-11:45am.

One of the reasons against appointments offered during my training course is that patients just turn up at the start of the day anyway. It certainly is a waste of time and the hospital would be vastly more efficient if they had appointments.

I could see that passing off (standing, not sitting) if second class is absolutely packed, and you could convince the controller of this fact. I wouldn't say it would be easy, though, and for those controllers who are not easily convinced, there is (99% of the time) no "first warning" before you get fined, even if you are an Auslander. (Thankfully, plenty of the SBB CFF FFS controllers are able to speak English).

It has happened that 1st class cars have been opened to 2nd class passengers when the controllers think that the overflow is required. Sucks a little bit if you just paid for a 1st class ticket, and the fact is often unannounced, just relying on word of mouth or when someone who boards at a station down the line sees the temporary sign pasted on the door.

I'm hearing you about the conductors. We had a very interesting experience in Italy when my brother forgot to validate when leaving Venice. This involves having a machine stamp the date on the ticket. A real mistake since there was no way he was going back to venice. Anyway, the italian conductor basically demanded a bribe. But all resolved when the date was written on the ticket with a biro. Anyway, it was an interesting solution by the german guy, the carriage wasn't that full and was also a mixed class carriage. I assumed that he would actually sit down if there was any risk of getting fined.

 

[Hvr]

I hate banks :!:

I've lost interest in them as well.

 

[anat0l]

One of the reasons against appointments offered during my training course is that patients just turn up at the start of the day anyway. It certainly is a waste of time and the hospital would be vastly more efficient if they had appointments.

Yes, appointments are probably a good idea...
[video=youtube;OFj2qpIA_M0]https://www.youtube.com/watch?v=OFj2qpIA_M0[/video]

More seriously, I guess the reasons why there are no appointments (and these are just guesses) are:

• The powers that be could then start putting quotas on doctors in hospitals which forces them to basically send people on their way as fast as possible no matter what, so save their job will be done for. If the powers that be see that the appointment system is breaking down, the next one will abolish it saying it was a stupid idea at the risk of people's health and jobs.
• Do you have a few doctors then specifically set aside for only periodic appointments or to handle A&E?
• There is already an appointment system (e.g. my mum receives a letter saying to turn up at the hospital at this time for her whatnot checkup); the reliability of getting seen on time at your appointment time is just really low.

I'm hearing you about the conductors. We had a very interesting experience in Italy when my brother forgot to validate when leaving Venice. This involves having a machine stamp the date on the ticket. A real mistake since there was no way he was going back to venice. Anyway, the italian conductor basically demanded a bribe. But all resolved when the date was written on the ticket with a biro. Anyway, it was an interesting solution by the german guy, the carriage wasn't that full and was also a mixed class carriage. I assumed that he would actually sit down if there was any risk of getting fined.

In Switzerland, for tickets that have no specific date on them, they need to be validated before travel. At a train station, there is a validator machine but in other places (e.g. bus stops), there isn't, so one of the accepted workarounds is to just write the date on it with a pen.

The mixed class carriage probably makes his argument easier, especially if second class is full (because the controller could then clearly see that second class is full).

Funny enough, with people standing in the aisles, it does make life harder for the controllers and - without surprise - it is possible to take that ride without being controlled. (Most train rides of at least half an hour will almost guarantee your being controlled). Of course, no one ever (or should ever) ride the train without a valid ticket just to play the probabilities of not being controlled - and I've had my train rides, even late at night with not many passengers, of about an hour on the main line without a control of my CHF 13 fare - but suffice to say I've heard that having the speedy-efficient open gate system in Australia would lead to massive (and near unenforceable) fare evasion.

 

[TheRealTMA]

I hate banks :!:

Well, don't use them!
Just buy their shares.

 

[medhead]

More seriously, I guess the reasons why there are no appointments (and these are just guesses) are:

• The powers that be could then start putting quotas on doctors in hospitals which forces them to basically send people on their way as fast as possible no matter what, so save their job will be done for. If the powers that be see that the appointment system is breaking down, the next one will abolish it saying it was a stupid idea at the risk of people's health and jobs.
• Do you have a few doctors then specifically set aside for only periodic appointments or to handle A&E?
• There is already an appointment system (e.g. my mum receives a letter saying to turn up at the hospital at this time for her whatnot checkup); the reliability of getting seen on time at your appointment time is just really low.

I can't really answer your questions in detail. I just observe one clinic where patients seem to sit around all day. The big point about appointments is that it helps the patients. If they have an appointment for 3pm then they can turn up at 2pm, providing the timing is relatively reliable. Without appointments I see them standing around the closed clinic waiting area at 7am. I can't see any risk of a quota system. At the moment there is X patients and the clinic is open from 8am to 3 pm. They still have to treat X patients. I couldn't really see that demand changing. Apparently this clinic tried appointments and the patients still just turned up at 7 am; another factor.

A&E is completely separate, being there is an emergency department. Triage and treatment according to need. A different model to a follow up clinic. I also gather that some of the other clinics, e.g. dental, is better than others.

In Switzerland, for tickets that have no specific date on them, they need to be validated before travel. At a train station, there is a validator machine but in other places (e.g. bus stops), there isn't, so one of the accepted workarounds is to just write the date on it with a pen.

The mixed class carriage probably makes his argument easier, especially if second class is full (because the controller could then clearly see that second class is full).

Funny enough, with people standing in the aisles, it does make life harder for the controllers and - without surprise - it is possible to take that ride without being controlled. (Most train rides of at least half an hour will almost guarantee your being controlled). Of course, no one ever (or should ever) ride the train without a valid ticket just to play the probabilities of not being controlled - and I've had my train rides, even late at night with not many passengers, of about an hour on the main line without a control of my CHF 13 fare - but suffice to say I've heard that having the speedy-efficient open gate system in Australia would lead to massive (and near unenforceable) fare evasion.

I think open gates would be ok. Munich has little old ladies doing their knitting who check tickets. There are also ways to scam the validation system, at least in Munich where tickets are supposed to be validated in a fix location. Just validate on the wrong side. If caught - whoops my mistake but it is validated. Can then reuse the ticket by validating in the correct spot.

As I said, the venice thing was an honest mistake. Mum was anxious about missing the train being as we had 8 minutes before departure. That was distracting.

 

[drross]

I hate public transport....

maybe it's just the public you hate JohnK

 

[drron]

As far as Outpatient clinics go I can assure you that most hospitals are different.My experience is with rural and regional hospitals.
There are some that do not even have an Outpatient department.Some just have follow up clinics for those who have been discharged.
Some use appointment times,some just block bookings.

When I first became a specialist at my first outpatient clinic the nurse in charge told me in no uncertain terms how many patients I was allowed to see and the time the clinic doors closed no matter what.
At others if I decide a test-eg a stress test or echo-is needed I am not allowed to get that done on the same day as I see the patient even if the patient has travelled a 100 plus kms to be seen.
There are some that are very good.One QLD hospital I have worked at used me as an extra just to do outpatient clinics so as to reduce the waiting list for outpatients-I would do 9 sessions a week and no limits were placed on me.Unfortunately I ended up doing myself out of a job.
Most patients booked into see me do get in on time.One of the reasons for that though is that quite often 1 in 3 patients do not turn up and have not cancelled.

 

[medhead]

As far as Outpatient clinics go I can assure you that most hospitals are different.My experience is with rural and regional hospitals.
There are some that do not even have an Outpatient department.Some just have follow up clinics for those who have been discharged.
Some use appointment times,some just block bookings.

When I first became a specialist at my first outpatient clinic the nurse in charge told me in no uncertain terms how many patients I was allowed to see and the time the clinic doors closed no matter what.
At others if I decide a test-eg a stress test or echo-is needed I am not allowed to get that done on the same day as I see the patient even if the patient has travelled a 100 plus kms to be seen.
There are some that are very good.One QLD hospital I have worked at used me as an extra just to do outpatient clinics so as to reduce the waiting list for outpatients-I would do 9 sessions a week and no limits were placed on me.Unfortunately I ended up doing myself out of a job.
Most patients booked into see me do get in on time.One of the reasons for that though is that quite often 1 in 3 patients do not turn up and have not cancelled.

Another classic is sending patients away to return another day because they've had the stress test and someone doing another test doesn't want the very small amount radiation exposure from the patient. :evil: But it might be hard to do a stress test on the same day as the radioisotope may not have been ordered or the radiopharmaceutical may not have been prepared for that day. Of course, they might also have extra going to waste.

You've reminded me of overbooked because of the cancellation rate. Book more patents that can be served because they don't turn up. In terms of efficient use of resources/Lean thinking there seems to be a lot of scope for improvement.

 

[medhead]

This Yank on lateline is great. Flat tax on net sales. Flat tax on gross income. No deductions, no exemptions. That's it. No waste on tax returns, not waste on cycling money around, no tax loopholes. Shame about the accountants and financial advisors....