By James Lovegrove
Lex Dove notion he was once performed with the killing video game. Then a decision comes. One final challenge: to steer a black ops staff right into a disused chilly conflict bunker on a distant island. 100 ft less than floor they face the culmination of an scan in technology and voodoo witchcraft long gone mistaken. as though slightly human monsters weren’t undesirable sufficient, a clock is ticking. Little do they recognize that deeper within the bowels of the earth, a god is waiting.
Lex Dove notion he was once performed with the killing online game. A retired British wetwork professional, he’s dwelling the quiet lifestyles within the Caribbean, minding his personal enterprise.
Then a decision comes. One final venture: to steer an American black ops group right into a disused chilly warfare bunker on a distant island. The money’s strong, this means that the dangers are excessive.
How excessive, Dove doesn’t detect until eventually he and his group are 100 toes lower than flooring, dealing with the end result of an scan in technological know-how and voodoo witchcraft long past mistaken. as though slightly human monsters weren’t undesirable sufficient, a clock is ticking. Deep within the bowels of the earth, a god is ready. And his anger, if roused, might be fearsome certainly.
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Extra info for Age of Voodoo
And it usually happens for me right when I am about to put my hand on that doorknob to turn it and get out of there. ” And I’ll cringe sometimes because I don’t know what’s coming and I’ve got a couple other patients sitting in other rooms waiting to see me. (Wilma, family physician) . . More than 50 percent of my practice now is kids who come in with some physical or surface complaint, like stomach pain or headaches, and the end result will be some behavioral issue that is the thing affecting them.
Now, the pressures of production have forced an acknowledgment by PCPs that NPs and PAs can do a fair number of routine things in primary care, and that using them produces more proﬁt for the practice as a whole. But as the pressure to see more patients continues in primary care, will that acknowledgment be broadened to include previously “too complex” areas of primary care medicine? If so, how would we begin to look at primary care? In the short-term solution of using cheaper, less-skilled labor to meet production demand, the ﬁeld of primary care risks its image as something only MDs and their traditional primary care practices can do best.
If patients have multiple issues, which many do, often the PCP cannot bill for treating both diagnoses in the same encounter but instead must bring the patient back for separate visits to address each of the issues in a way that provides adequate reimbursement. This emphasis on both speed and numbers raises tensions in the practice of today’s primary care medicine; tensions that never existed for the generalist of 1970. For example, as greater numbers of patients with behavioral health issues present in the PCP’s ofﬁce, and the PCP’s reimbursement system is not set up to pay them adequately for this type of care, PCPs have four suboptimal 18 Practice Under Pressure choices before them: either attempt to provide appropriate care by spending time with the patient, thereby sacriﬁcing other ofﬁce visits and earning less money for the practice; attempt to provide more complex behavioral medicine within the conﬁnes of ﬁfteen- or twenty-minute visits that may produce lowquality care; offer “quick-and-dirty” prescription therapies to patients; or refer patients to behavioral health specialists who are in short supply causing delays of weeks or months before they are seen.
Age of Voodoo by James Lovegrove