May 25, 2012

Now I’ve seen everything. I’m outraged and disgusted by the unscrupulous marketers that prey on my elderly and the unsuspecting patients who seek health in a bottle and instead pay good money for snake oil.

I’m equally frustrated by the fact that these same patients either shun conventional medicine or can’t afford the pills that have been proven to improve or even save lives. Recently, I’ve written about the harm done by Pharma’s TV advertisement of their merchandise. You’ve all seen the commercials proclaiming that product “X” can save your sex life, helping you be ready at a moment’s notice while warning of the dangers of a four hour erection, loss of vision, back pain, or worse.

The purveyors of snake oil have no such restrictions and make no mention of any negative associated with their products. Today, my patient brought in the “dietary supplement” her father purchased at the cost ...

May 24, 2012

“Could” is a word I would do without if I had my way!  Unfortunately, my patients love it!

“Doc, could my headache be from stress?”

“Doc, could my husband be suffering from depression?”

“Doc, could my son have ADD?”

“Doc, could …?”  is a question I hear multiple times a day. The funny thing is the answer is always the same. Realistically, anything “could” be true. So every time a patient asks the question, “could,” the answer is yes.

“Yes, your headache could be from stress.”

“Yes, your husband could be suffering from depression.”

“Yes, your son could have ADD.”

Unfortunately, ...

May 23, 2012

This article was originally published in December of 2010. Unfortunately, I continue to meet gamblers and continue to see the high rollers lose (their lives or their health). Don’t gamble with your health!

Today was a stressful day. When “high rollers” come into the office to be seen, my day is more stressful than usual. Today, I saw an unusually large number of “high rollers”.

“High rollers are those patients who bet their lives on the premise that they “know their bodies” or they are “healthy”. Their bet is a real one; and, when they lose, they either lose their lives or suffer major losses to health and dignity. No matter what I say or do, “high rollers” insist they understand the risks involved and will live with the consequences of their decisions if they are wrong. The problem is that they really can’t imagine what the consequences of having a stroke or heart attack are until ...

May 22, 2012

Oh, my aching back!  Yes, for those of you who don’t know me, my youthful indiscretions have left me with a lousy back. Fifteen years after my first back surgery, I had my second. That was fourteen years ago!  Now my back is flaring again.

I wake up every morning feeling stiff and old. A hot shower and some stretching make me young again. I can conquer the world, at least until 4 pm. After 4 pm, I start to age again. It’s 6:30 and I’m 75 years old. I am not complaining!  It’s a fact of life. Most days, no one notices how I feel.

When my staff starts telling my wife, “He’s Grumpy,” I know my back pain is showing. I haven’t heard the “grumpy” word in a while so I guess I’m doing pretty well. I’m sharing my personal story in hopes of helping others who live with ...

May 21, 2012

Fifty Shades of Grey is the name of the book all of my female patients are reading. It is also an appropriate description of the practice of medicine. In my world, there is very little that is black and white. Even death is no longer permanent!

Over the last few years, I have published articles dealing with the words “Necessary” and “Unnecessary.” Patients, insurers, Medicare, and doctors can’t quite reach an accord on what is truly necessary. Why?  The answer is simple. There are very few things in the medical world that are truly definitive, black and white.

I hospitalize a patient for chest pain and fever. The radiologist reads his chest x-ray as a probable pneumonia. The pulmonologist (lung specialist) does not believe that my patient has pneumonia. He thinks my patient needs a cardiologist. The cardiologist (heart specialist) is pretty sure my patient’s heart ...

May 20, 2012

Yesterday, KevinMD published an article entitled, Necessary is a word best defined when looking back in time,  I wrote the article early in the month in response to a comment made on KevinMD by an angry reader. The comment had to do with doctors ordering unnecessary tests. In response to my article, a reader posted, “Another post suggesting that a doctor must care about you to give good treatment. What do you do with those patients you don't like, give them lousy medical treatment?”

The answer is NO!  However, often I have to work six times as hard to give them excellent care. Yes, just as patients have the right to dislike their doctors; doctors have the right to dislike their patients. When a patient is unhappy with, or dislikes his doc, he simply transfers his care to another doc in the community until he finds a medical home he can be comfortable in.

May 19, 2019

After watching T.V. tonight, I’m amazed my patients are willing to take the medications I prescribe. I’ve watched four commercials extolling the benefits of four different prescription medications. At the end of each commercial, the commentator listed a litany of horrible sounding possible side effects and warnings. It appears that the same medication that can save you from the problems associated with asthma can also kill you. What’s a patient to do?

The problem with T.V. commercials and package inserts warning about possible side effects and risks of taking prescription medications is that they do not come with any comparators. Without establishing a frame of reference, a life saving medication sounds horrible and people who would benefit from its use often are too afraid to use it!

Now imagine that a medication, we’ll call Agent X, was developed that prevented you from getting cancer. Research showed that the twice daily ingestion of one pill would prevent you from ever having a cancer. What a great T.V. commercial that would be!  Oops, I forgot the ...

May 18, 2012

The following was handed to me by one of my patients today. I love it!  Setting realistic goals and then working to accomplish those goals is the formula this patient used to achieve success!  I hope you appreciate this list as much as I do. I also hope you will make your own list and work to be a better you.

2012 Goals / Concerns

To continue to improve my physical, mental, & spiritual conditions.

What needs to be done?

I need discipline, discipline, & discipline to follow my doctor’s directions and for me to do what I know needs to be done.

What I am ...

May 17, 2012

Oh, by the way . . .

are four simple words that cause most docs to shudder. Yes, shudder!  Your patient signed in for a sore throat, congestion, and cough. The nurse did her job. She’s recorded the patient’s chief complaints. She’s taken the patient’s vital signs and readied the patient to see me, the doc.

I take a history, asking questions about the problems that brought the patient to the office. I ask pertinent questions about the patient’s health history, medications he takes, allergies he has. I order appropriate tests, make a diagnosis, and discuss treatment options. I write prescriptions and give the patient a print out summarizing the finds and plan as well as follow up instructions. I ask the patient if he has any questions. I say good bye and end with “be happy, be healthy,” my wish for all of my patients.