Sliding scale insulin


  One of the most important reason why we see so much corruption in our government, small or large, is because our government has no written policy that encourages whistle-blowers to stab the back of corruptors who work in that agency. For example, I am not aware that the DOJ has any policy that encourages its employees to blow the whistle when they see or hear something wrong that is going on at the management level. Backstabbers, or whistle-blowers, are an important integral part of any government agency, and not only in private businesses. They are needed to assure transparency, and to prevent collusion and consolidation among some politically motivated corrupt people to hurt the public who trusted them; just like those crooked and money hungry doctors who are in cahoot with other doctors and medical providers, such as physician assistants, to rob Medicare, Medicaid, and other insurers. They normally do this by ordering unnecessary test, routinely referring patients to their specialist doctor friends, and prescribing new drugs without a follow up visit, unless the patient is a wealthy patient.

How could this all occur? Because no one is watching them. Medical doctors who are supposed to supervise their physician assistants are not checking the work of their assistants. For example, an x-ray technician who recently took his physician assistant training at a community college wrote a sliding scale insulin prescription for his patient like this, "inject 14 units subcutaneously three times daily before meals." A true sample of a "sliding scale insulin" looks like this, 

In practice, different amounts of insulin is given depending on the premeal blood sugar level and the amount of carbohydrate that the patient plans to eat at each meal. "14 units" before each meal assumes that the patient has a stable premeal blood sugar level and eats the same amount of carbohydrate at each meal. This patient has had diabetes for over 40 years, and doesn't always cook her own food. She can't, and she cannot afford Jenny Craig food.

I believe we need whistle blowers/backstabbers policy in private businesses and government agencies as well. I hope President Donald Trump will soon issue a decree establishing a whistle-blower policy in every important government agency. Or ask Congress to make such law.