Here’s another ZdoggMD that, while it is hard to watch, should definitely be watched and discussed widely! “Ain’t The Way To Die” is an everyday story for docs and patients across our nation.
I love this guy. This video clip sums up what Docs feel about the great and mighty electronic medical record (EHR). Unfortunately, our government has won in its attempt to enslave and control the medical professionals who have worked so hard, for so many years, to protect your health.
During your next visit, please forgive me for standing at my computer and inputting data. No matter how hard I try, I can’t get the EHR out of your life and mind!
October 23, 2015
Yesterday, one of my octogenarians stated that the “Itis” family was a problematic bunch and Arthur Itis (arthritis) was the worst of the bunch. After I stopped laughing and regained my composure, I realized that he was right and that I should share her wisdom with you.
The Itises are many. This time of year we see rhinitis, sinusitis, and bronchitis just to name a few. Of course, my patient’s arthritis is seen year round and tends to become more problematic with age. Frankly, all of the Itis family can be nasty and most need to be dealt with sooner rather than later.
Unfortunately, most of my patients put up with the Itises too long and allow them to entrenched themselves in the body where many of them proceed in wreaking havoc. If you are plagued by Arthur or any of his extended family, see your doc and learn how to get rid of them and stop them from coming back. Arthur Itis indeed may be the nastiest of the bunch, and, while we may not be able remove him, at least we can contain him and limit the damage he is likely to cause.
Out of the mouth of octogenarians comes great wisdom.
September 18, 2015
Do you remember the story about Chicken Little? Chicken Little ran around yelling, “The sky is falling, the sky is falling.” Welcome to the modern day version of this story. I am cast in the role of Chicken Little and I am quite sure that on the first of October the sky will collapse on top of all of us!
On October 1, 2015, every doctor’s office in this country will be forced to change their coding system over to the “ICD 10” codes designed to capture more information and data points for Medicare and the insurers of the world. The new system transitions from 14,000 codes to 64,000 codes and is radically different from anything we have dealt with in the past. Every code I have used for the last 20 years will be obsolete. Every description of illness I have used to search for diagnostic codes will be thrown in the garbage. Every physician in our country will be forced to learn a new system while actively caring for their patients.
PLEASE BE PATIENT WITH US. OUR OFFICE FLOW WILL SIGNIFICANTLY SLOW DOWN AS WILL THE FLOW OF PATIENTS IN EVERY OFFICE ACROSS THE COUNTRY. WE HAVE BEEN PREPARING FOR THIS EVENT FOR THE LAST YEAR. THIS CHANGEOVER MAY BE MORE SIGNIFICANT THAN THE FEARED “MILLENIUM” CHANGE. I HOPE NOT!
On the bright side, if you are bitten by a Beluga Whale in Lake Zurich, I will be able to appropriately code your visit so that Medicare will be able to track the incidence and importance of whale attacks in our village. Equally important, if you are sucked into a jet engine at the airport, the emergency room will be able to code for that as well. Of major significance is the fact that there is a code for the second episode of being sucked into a jet engine! I am sure you understand the importance of such advances in medical coding and will not mind the prolonged wait to be seen.
September 17, 2015
Last week was a great week. Two patients came in for their annual physicals. Both of these “Wellthy” individuals brought their “Wellthy” plan summaries with them. Below is an example:
- I’m worst at some things:
- I haven’t been able to get out on my fishing boat like I used to.
- I haven’t been able to hit the driver like I used to.
- My overall golf is not as good as it used to be
All of the above are minor things!
- I’m about the same with some things
- Things that don’t concern me of affect me bother me.
- I’m always analyzing things that don’t concern me.
- I hate waste and incompetence.
- I still profile people and that bothers me. I make quick judgments about people.
- I’m better at some things (no particular order)
- I’m a better father.
- I like my grandkids better, I have always loved them.
- I think I have gotten better at managing & directing things I get involved in.
- I think my ego has gotten larger. (don’t know if that is good)
- My health is better & is a top priority of mine.
- My lower back is much better.
- I’m stronger.
- I eat better & I know when I don’t and it bothers me.
- 40 years ago I absolutely could not get up in front of people. Now I can.
- I think I’m a very proud person.
- I love getting up in the morning.
For the coming year:
- I want to reduce #1 (I’m worst at some things)
- I want to reduce #2 and make sure they don’t become #1 (I’m about the same
- I want to expand #3 (better at some things)
Last, but not least, my 10 favorite:
- Fall down six times, get up 7
- It is much easier to stay well than to get well
- There is never a wrong time to do the right thing
- When all else fails read the instructions … THE BIBLE
- The trouble with doing nothing is that you never know when you are done
- True success is overcoming the fear of being unsuccessful
- There are no bad soldiers under a good general
- Whether you think you can’t or you think you can, YOU’RE RIGHT
- We cannot direct the wind but we can adjust the sails
- Lord, keep your arm around my shoulder & your hand over my mouth
- PRAYER…….. The world’s best wireless service
Editor’s note: Living Wellthy means doing regular self assessments taking into account weaknesses and strength and then actively working on your weakness and building new strengths. When was the last time you did a self assessment? Why not start now?
September 3, 2015
Sometimes, I just don’t get it! Let me give you an example. My patient is 60 years old. He lives in an older section of Lake Zurich in a house that is 50 years old. His lawn is beautifully manicured and landscaped. His house is freshly painted. The roof has recently been upgraded, the windows caulked.
The inside of his house is immaculate. Anything that breaks gets immediately repaired or replaced. The 50+ year-old kitchen functions just as good today as it did when it was new. The plumbing was updated two years ago.
In his two car garage sits two beautiful cars. The 1998 Oldsmobile is in pristine shape. The 2006 Ford still purrs. Oil changes are done on a regular basis. Brakes and tires are checked on a schedule. As you can see, my patient believes in keeping his belongings in tip top shape.
So why am I confused? What’s not to understand? Let me share some more facts with you. My patient is in lousy shape! His frame has spread in all directions and he weighs in at 240 pounds. His chassis (back) is full of arthritis and the muscles that are supposed to support it have been neglected for decades.
He has heart disease (plumbing), diabetes, high blood pressure and high cholesterol. He has an irregular heart rate called atrial fibrillation (electrical system) caused by his alcohol intake. While he puts only the best gas in his cars, he puts fast food crap in his belly.
I get that it is important to take good care of your house. You live in it! I get that it makes good sense to take care of your car. You drive around in it. What I don’t get is how you can totally ignore and abuse your body. After all, your soul lives in it!
Unfortunately, my patients don’t get it. One day, my patient’s beautiful home will have a hospital bed in it. One day his family will wheel him in a wheelchair to the kitchen to eat. One day, his family will mourn his loss in an immaculate, well kept, old house.
Take better care of yourself than you take of your property or pay the price! By the way, this patient profile is all too common in my practice!
I’m always amazed by Jordan Grumet’s ability to read my mind and put it on paper. His articles portray the joy and the agony of practicing medicine in our country. Pay particular attention to the last line of his article. It’s a really good synopsis of my daily existence.
July 18, 2015
In a well written article entitled, “A patient is angry with her emergency care bill,” published on KevinMD and written by Whitecoat, MD, the author writes:
“Unfortunately, in the world of $20 copays and government-mandated free birth control pills, there seems to be a pervasive belief that medical care should cost less than an appointment at a hairstylist and should definitely cost less than the newest iPhone.”
I couldn’t agree more. Recently a middle aged man who was successfully being treated for diabetes, high blood pressure, high cholesterol and obesity demanded that I change his medications. His insurance company had informed him that changing his medications that “preferred” status generics would result in a $385 a year savings. I explained that his medications were doing their job. His blood pressure and lab values were in excellent ranges and that changing his medication would be potentially risky. I also explained that losing weight and exercising would go a long way towards getting him off of his medication.
My patient persisted in his demands and I stood my ground, refusing to make those changes. Before you judge me too harshly, let me at one more fact to this story. My patient had pulled into the parking lot at the same time I did that day. He was driving a brand new S series Mercedes. Wow, what a car! I would venture to guess that the price tag on that vehicle exceeded $100,000.
Yes, “there seems to be a pervasive belief that medical care should cost less than an appointment at a hairstylist and should definitely cost less than the newest iPhone,” or even a $100,000 Mercedes.
I really do wonder what this world is coming to.
YES, A PICTURE IS WORTH A THOUSAND WORDS AND THE GRAFT AT THE TOP OF THIS ARTICLE JUST BLEW ME AWAY.
IS IT ANY WONDER THAT THE COST OF MEDICAL CARE IN OUR COUNTRY HAS SKYROCKECTED?
June 25, 2015
I really feel old. I find myself reminiscing about the “good old days” a lot recently. I’m afraid that modern medicine has become way too automated and impersonal! The computer seems to run everything and it is a poor substitute for human judgment, contact and empathy.
Yesterday, I had a patient who was in trouble. His doctor was a University professor and expert in his illness. In the “good old days,” I would call his doc to confer on the best course of action and my call would be taken by a human. Yesterday, I got:
“Push one for English and two for Spanish.” This, in itself, bothered me. I was calling a university in Chicago, not Mexico.
“Push 1 if you are a physician or calling from a physician’s office.” I pushed 1 again.
“Our operators are busy, we value your services, please hold.” I heard the same message for the next 10 minutes. There was no option to leave a message for the doc. My phone tracts how long I am on a call and I’m not exaggerating. My patient needed help so I stayed on the line.
The doctor’s secretary answered and would not get the doc. “She’s in clinic. I’ll have her call you.” Four and a half hours later the doc calls; and, unfortunately, I missed the call. The doc left her office number leaving me no choice but to call back the same number I had such a bad experience with earlier.
Guess what happened. Yep, I was placed on eternal hold and waited 15 minutes until the doc finally answered. The pity is that this super specialist knows her phone system sucks but can’t do anything about it and frankly sounded like she could give a crap about it. Apparently, she is employed by the university and takes no responsibility for the negative effects on patient care her phone system causes.
I miss the “good old days” when docs were employed by their patients and could be reached by “dialing” a rotary phone and took responsibility for their offices and patient care.
On a side note, when I bought my phone system, the vendor told me I was nuts for not buying an automated attendant with my system. I’m glad I didn’t listen! A human answers my phones and always will!