As a writer, it’s often difficult to put down in words exactly what your brain wants to say in such a way that you cannot be misunderstood.  Sometimes, what you say is not what you meant.  Sometimes, what you say is what you meant but your reader interprets what you say in a way you did not anticipate.  Sometimes, you mean to provoke thought and action, and you fail.  Sometimes, you provoke thoughts and action you did not mean to provoke.

Writing is tricky.  Yesterday’s article upset one of my readers.  In retrospect, she was right.  The article appears to disrespect and demean some members of the service industry.  I assure you; I meant no disrespect.  I’ve taken down the article and want to apologize to anyone who felt slighted.

In 1976 I worked for Carol’s Hamburger, a forerunner of McDonalds.  I made $1.40 an hour and came home at the end of an 8-hour shift covered in sweat and oil from the fryers.  During college I bussed, waited tables and short order cooked at Barnaby’s.  I understand, firsthand, the plight of those individuals who work in the service industry.

As a waiter, I was at the mercy of the kitchen staff.  If they messed up, I caught flax.  At the time, it seemed as if I caught flax for anything that went wrong, whether it was a long waits getting seated when we were mobbed, or an order misplace.  A good tip saved the day (and helped pay for college.)  A bad tip or no tip at all ruined the day.  You would be surprised at how many customers left without a thank you and a tip.

In looking back at the years I practiced medicine, I smile when I think of those occasions when someone “tipped” my staff or I.  The rum cake that misses “P” brought or the lunch that Mr. “C” sponsored at Christmas every year will not be forgotten.  These “tips” were a nice way of saying, “You’re truly appreciated.”

You’d be surprised at how many people never said thanks for the care.  You’d also be surprised to know that pharma and the insurers were not my friend. That quite the contrary, they created long waits (or denials of care) for procedures or medications.  They controlled prices and much more.  In return, my staff and I caught flax.

My intent in writing yesterday’s article was to remind you, the reader and patients of America, to say thanks to your physician and his staff.  They are service providers also and a “tip” for excellent services rendered, is an American tradition.

Over the years, many patients have asked how I would change the healthcare industry in the US if I was in charge.  My first thought is I’d shoot myself.  Lately, I’ve been thinking about how a sane person would tackle such a Herculean task.  In the next few weeks, I’ll try to answer that question.

Here’s your music for the day and a joke.

Morris, an 82 year-old man, went to the doctor to get a physical.

A few days later, the doctor saw Morris walking down the street with a gorgeous young woman on his arm.

A couple of days later, the doctor spoke to Morris and said: “You’re really doing great, aren’t you?”

Morris replied: “Just doing what you said, Doc. Get a hot mamma and be cheerful.”

The doctor said: “I didn’t say that. I said, “You’ve got a heart murmur – be careful.”

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