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Thursday, August 11, 2011

Risk Assessment

Over a couple of beers last night, my paramedic buddy mentioned how humans are pretty bad at risk assessment. People think that they’ll be safe in some isolated zombie proof fortress on an island somewhere. You’ve got to ask yourself: how many people have ever died from a zombie apocalypse? On the the other hand, how many people die every day from heart attacks? Someone in a remote isolated area is more likely to die from a medical emergency than someone in the city.

My home area is rural, but not necessarily what I’d call really isolated. There is a paved door that runs past my house. (a narrow, rutted and pot holed road, but a road none the less.) It’s even plowed by the town in the winter. A couple years ago there was bad car accident about 2/10 of a mile from my house. A state trooper happened on the scene soon after and radioed for an ambulance. The local volunteer ambulance crew could not be mustered. I think they may have already been on a call and didn’t have the resources to respond to a second call. The professional crew one town over was also maxed out due to a combination of out of state transfers and local emergencies. Eventually the town after them was able to must their volunteer crew and respond to the emergency. That accident victim survived, but suffered a lot longer than she would have in a city.

This is not a criticism of volunteer crews. They donate a lot of time and energy to provide a public service. I salute them. They get the same basic training as an EMT who works for a professional company. However, they don’t get nearly the same number of calls. An EMS crew in a busy professional company may go on more calls in month than a volunteer will go on in 5 years. Practice does make perfect.

Another buddy of mine is making the quality of medical care a big part of his relocation plan. He and his wife are actively looking at rural property but never too far from a very good regional hospital. It’s small, but well equipped and staffed with top notch people. This couple doesn’t’t have any major health problems, but they do recognize that being in their 50s, they aren’t kids anymore. They want the self reliant, low crime, rural lifestyle, but have calculated the likelihood of needing good medical care.

Medical emergencies is one major risk people underrate. I’ve done it myself. Only in the last few years have I made a point to travel with basic medical kits. When in my twenties, I’d go bushwacking through untracked wilderness without even a band-aid. I had a lot of faith my invulnerability. I’d like to think my risk assessment has gotten better over the years.



  1. The biggest risk is going to a doctor. . .

  2. I live in rural Nova Scotia. In Canada we have single-payer state financed health care.

    On Tuesday I called my doctor's office and asked to see him some time this week. A recurrence of a small infection in important glands. The nurse said how about 5:15 this afternoon?

    I went in 8 minutes early and the waiting room was empty as he books long appointments. I got examined and prescribed, we talked about interesting matters (obesity in the young, etc) and I was out the door and up the street to the drugstore. I gave them my prescription for antibiotics and at 5:30 I was on the street headed for home. Cash cost to me was about $30 for my pills. Blue Cross for my wife and I costs $525 per quarter. (Blue Cross for us is about prescription medicine costs. Doctor visits and hospital procedures are covered by basic healthcare.)

    Two years ago I was in to see about a lump on my knee. Arrived a few minutes early for my 2:15 appointment, was taken right in, examined and diagnosed (a bursa) but just to be sure he said I should have an X-ray. He said to slip right up to the hospital as Eileen the X-ray tech goes off at 2:45; he would call to tell her I was coming. I was x-rayed, we both reviewed the screen, Eileen said that Dr X would review the display when he came that afternoon to do rounds, and the radiologist in the central hospital would review the scan the next morning. I was out the door to home before 3:00 pm. Cash cost was zero. My taxes are low as I live low.

    Access to good affordable healthcare is so important. anyone planning to move needs to pay attention to that one.

    . . . Alan

  3. My ancestors made the mistake of leaving Canada a couple generations ago. Of course, at the time, it was that or starve to death. Times were rough on the old potato farm. Go ahead, rub it in.

  4. My ancestors were driven out of America about 6 generations ago. Those were ugly times. . . . Alan

  5. Hi amigo. Maybe this and your next blog [priorities and risk assessment] are all of a single piece.

    I've never been good at acting on statistics in my life, but maybe it would have been easier if I had. I quit going to doctors 25 years ago when I got bored with hearing the same thing from them about the likelihood of me dying from a particularly pesky type of carcinoma my congenital medical condition leans to. Went in every six months so they could knock me out and run a snake with a camera on it down my throat to see if what they couldn't do anything about was happening yet. Wouldn't give me a prescription to keep me from bleeding to death from my regular condition if I wouldn't let them check to see whether I was already dying.

    That's when I decided to buy my drugs in Mexico and cut out the middle man. They can take their risk assessment to someone wants to hear it.

    Thanks for sharing your thoughts. J