A RESPONSIBLE PATIENT

The following document speaks for itself.  Hopefully, you have already covered items 1-27.  If not, it is time to become a responsible patient so, sign up and get started.

I AM A RESPONSIBLE PATIENT

I, ______________, am a responsible patient.  As such, I take full responsibility for my health and my healthcare.  My responsibilities include but are not limited to:

  1. Learning how to promote my own health and wellness.
  2. Learning how to deal with illness, both acute and chronic.
  3. Actively working to eliminate those unhealthy habits I have acquired over my lifetime.
  4. Eating properly, exercising, and striving to eliminate those stressors within my control.
  5. Seeking medical advice when appropriate.
  6. Understanding the medical advice I receive.
  7. Asking questions when I do not understand the advice offered.
  8. Following the medical advice when mutually agreed upon by my doctor and me.
  9. Taking my medications as prescribed.
  10. Notifying my doctor prior to stopping my medication.
  11. Notifying my doctor should I have any adverse reaction from my prescribed treatments.
  12. Keeping a list of all medications, both prescription and non-prescription (including herbals, homeopathic, and nutraceuticals), that I take and who prescribed them.
  13. Bringing my medication list to the office at every visit.
  14. Knowing when I will need refills and not running out of pills.
  15. Completing diagnostic tests (lab, x-ray, EKG, etc.) in a timely fashion.
  16. Keeping my follow up appointments.
  17. Seeing consultants when necessary.
  18. Understanding my diagnosis, learning about its effects on my body and how I can help manage it.
  19. Studying and learning about my diagnosis.
  20. Being an active partner in my medical care.
  21. Notifying my doctor when I have added other professionals to my healthcare team.
  22. Being honest about what I am doing, taking, and who I am seeing.
  23. Paying the bill on time.
  24. Setting up a payment schedule when I cannot pay the bill and following that schedule.
  25. Know the rules of my insurance policy, what benefits are covered and what are not.
  26. Notifying the office if any contact information changes occur.
  27. Having an emergency contact listed should critical information need to be relayed to me.

My health is important to me, my family, and loved ones.  I will work hard to care for myself.  I understand that my doctor cannot help me if I will not help myself.  I expect my doctor to offer me his/her best advice based on his/her medical training.  I understand that, without my active participation, my doctor’s ability to help me is limited.  I understand that my doctor is the consulting partner, I am the working partner.  Working together, we can accomplish great things.

Signature____________________       Date___________

Here’s your joke for the day:

Arthur Davidson, of the Harley Davidson Motorcycle Corporation, died and went to heaven.

At the gates, St. Peter told Arthur, “Since you’ve been such a good man and your motorcycles have changed the world, your reward is, you can hang out with anyone you want in Heaven.”

Arthur thought about it for a minute and then said, “I want to hang out with God.”

St. Peter took Arthur to the Throne and introduced him to God.

Arthur then asked God, “Hey, aren’t you the inventor of women?”

God said, “Ah, yes.”

“Well,” said Arthur, “professional to professional, you have some major design flaws in your invention.”

   1. There’s too much inconsistency in the front-end protrusions.

   2. It chatters constantly at high speeds.

   3. Most of the rear ends are too soft and wobble too much.

   4. The intake is placed way too close to the exhaust.

and finally,

   5. Maintenance costs are outrageous.

“Hmmmm, you may have some good points there,” replied God, “hold on.”

God went to his Celestial supercomputer, typed in a few words and waited for the results.  The computer printed out a slip of paper and God read it.

“Well, it may be true that my invention is flawed,” God said to Arthur, “but according to these numbers, more men are riding my invention than yours.”

OMG AND PRIDE

OMG!  “Oh my God” used to be what you would say when something dramatic happened in life.  Now OMG is loosely used, on a daily basis, in response to a myriad of subjects, some good and some bad.  In the last few weeks, I’ve had two OMG events and I would like to share them with you.

First, a little background information.  In building and furnishing my new home, I’ve come to expect mediocrity as a standard of American craftmanship.  Yes, the builders who mass produced the houses on my block showed very little care/pride in the work they did.  They literally cut corners so poorly that they applied puddy to the gaps rather than properly miter the joints.  Like many companies, their mission statement sounds great but, in reality, is meaningless.

As to the furniture I purchased, almost every piece arrived defective and had to be replaced.  Some of the furniture was built in America, some overseas.  Regardless, name brand furniture was again built by individuals who obviously took no pride in their work.  I live in North Carolina, the furniture capital of America, and I can’t find a quality manufacturer.

I was taught to do my best at whatever I did.  I took pride in my work effort and the results of my care.  Seeing the lack of pride the builders of my house and furniture put forth was disheartening.  Lucky for me, my neighbors sent me two very talented and proud individuals.

I’ve had two OMG interactions in the last few weeks that have restored my faith in American workers.  Recently, I’ve written about sex in an attempt to increase my readership (and address topics most readers are hesitant to discuss).  Both my garden consultant and painter talked about their services in loving terms that were almost orgasmic in intensity.

My garden consultant loves growing food.  She designed and built elevated gardens for me.  When the gardens were finished and filled with dirt and mulch, she ran her fingers through the soil and, had I filmed the look on her face and her body language, you might believe you were watching a sex act in progress.  Seeing someone who truly loves her work was fantastic.  Being the recipient of a job well done is marvelous.  She is teaching me about growing food in NC and I’m currently growing all sorts of greens, carrots, onions and parsnip.  Tomatoes, peppers and cucumbers for gazpacho and salads galore.

Last night, the painter stopped in to discuss cost and colors.  It was the first time we had met him and it was the most amazing OMG experience.  His energy was evident.  He looked at our house through the eyes of a young artist (even though he is in his 60s) and was excited at the potential he saw in the walls.  At one point, his excitement was such that I was sure he was going to have the big “O”.  Again, meeting a true craftsman who loves his trade and loves sharing it with others was excitement. 

These two individuals share a common sense of pride in what they do.  Being proud of your work and lot in life should be routine, not rare/infrequent.  Loving what you do is important but being able to share that love with others is amazing.

Certainly, my builder and furniture manufacturers could learn much from these seemingly unique individuals.  I was not looking forward to living through the hassles of painting a house. Now, Renee and I are excited about painting the house. Working with our painter and garden consultant is going to be fun.  I can’t wait.

Here’s your jokes:

What do a penis and a Rubik’s Cubes have in common?

The more you play with it, the harder it gets.

What does one saggy boob say to the other saggy boob?

If we don’t get some support, people will think we’re nuts.

What’s the best part about gardening?

Getting down and dirty with your hoes.

How is a girlfriend like a laxative?

They both irritate the shit out of you.

RETURNING TO NORMAL

What’s up?  Renee and I have spent the morning looking for things to do.  We’ve had Covid and we’ve had the first vaccine.  We continue to wear masks in public.  While we are no longer scared of dying from Covid, we are being extra careful about the venues we frequent.

Eating is a large part of our lives.  We look for restaurants that are essentially empty or that have open air facilities.  Having had Covid once is enough to convince me I never want it again.  We do, however, want to go back to living.

We want to learn about our new home state.  It’s time to take a few road trips.  I’ve heard Ashville is gorgeous.  We want to see the mountains and the coast.  We get our second shot next week.  Two weeks after that, still wearing our masks, we should be good to go.

We will have taken every precaution possible.  If God calls, we’ll go no matter what we do.  If he does call us home, I hope he has a good sense of humor.  I have a host of new jokes.  Sitting around doing nothing but getting fat is a joke all by itself.

I very much want to travel back to Lake Zurich this summer.  I want to spend a week seeing all my old friends.  I hope to eat lunch at the Score-board Bar and Grill in LZ.  I’ll publish the date and hope many of you will come to lunch with Renee and me.

If I found a genie in a bottle, I would wish to restore my health and open a treatment center at 504 S Rand Rd.  I miss LZFTC.  I’m not waiting until I find the genie.  I’m exercising more and working on my diet.  I’m laughing out loud daily as I work on being better. I’m enjoying my neighbors.

Of course, everything depends on how I do with DBS.  Oh yes, everything depends on what Covid does as well. In the meantime, don’t let your guard down.  Get vaccinated and wear a mask.  Most of all, be happy with what you have.  And don’t forget to laugh.

Here’s a joke:

I once saw a one-handed man in a second-hand store. I told him, “I don’t think they have what you’re looking for, sir.”

NARRATIVE MEDICINE

Published on KevinMD on April 16, 2021, “Difficult” patients: Is it them or is it us?” by Laila Kind should be mandatory reading for medical personnel and patients alike.  Dr. Kind is studying a new field of medicine called Narrative Medicine.

What I used to call “taking a good history” is now referred to as Narrative Medicine.  A primary tenant of Narrative Medicine is listening to the patient and recording the history of why they are in the office in their own words, letting the story unfold on its own.

The author states, “Patients’ feelings of dismissal by providers is a rapidly growing problem. A 2019 study found that patients were interrupted after a median of 11 seconds, about as long as it takes to sing Happy Birthday, once.”  Despite the fact that this information is not new, the behavior is almost impossible to extinct.  I have witnessed it myself since becoming a patient and have been guilty of it as a physician.

My profession has ruined itself with the insertion of the EMR (electronic medical record) into every facet of medicine.  The EMR has a workflow that demands patient and physician input in a fixed way.  Patients, who tell their stories in highly personalized and often random ways, create havoc in an EMR atmosphere.  One of the reasons physician interrupt us so early into our conversations is to force us into divulging what the EMR wants in the order the computer program wants it.

Another reason why it takes only 11 seconds for a physician or his staff to interrupt our story has to do with time management.  As physicians sold to large corporations, their role changed from doctor to provider.  The MD’s time was always limited by patients in the waiting room who needed to be seen.  The provider’s time is managed by an employer who pressures the provider to see large numbers of customers efficiently and expeditiously.

In the last paragraph of this excellent paper, Dr Kind suggests a solution to today’s problems that, unfortunately, I think are unachievable.  As patients, we need to take control of the narrative in our physicians’ offices.  My suggestion is that, in advance of your visit, you should outline what information you want to relay. The whys, hows, whats, whens and wheres of your ailment so that you can succinctly deliver the information your physician will need to understand what you are experiencing and how to help you.

While you are writing out your summary, also make a list of the medications you are taking and how you are taking them.  A list of allergies and a family history will be helpful as well.  Take copies of everything to give to the doctor.

I have written about the art of listening in the past.  If you notice that your physician is not listening, you must point that out to him or her!  I know that is difficult but two-way communication with your MD is critical.

Now for a couple of jokes:

They say sex is a killer…

Do you want to die happy?

 A judge was interviewing a woman regarding her pending divorce and asked, “What are the grounds for your divorce?”

She replied, “About four acres and a nice little home in the middle of the

property with a stream running by.”

“No,” he said, “I mean, what is the foundation of this case?”

“It is made of concrete, brick and mortar,” she responded.

“I mean,” he continued, “What are your relations like?”

The woman replied, “I have an aunt and uncle living here in town, and so does my husband’s parents.”

He said, “Do you have a real grudge?”

“No,” she replied, “We have a two-car carport and have never really needed one.”

“Please,” he tried again, “Is there any infidelity in your marriage?”

“Yes, both my son and daughter have stereo sets. We don’t necessarily like the music, but the answer to your questions is yes.”

The judge tries again, “Ma’am, does your husband ever beat you up?”

“Yes,” she responded, “About twice a week he gets up earlier than I do.”

Finally, in frustration, the judge asked, “Lady, why do you want a divorce?”

“Oh, I don’t want a divorce,” she replied. “I’ve never wanted a divorce. My

husband does. He said he can’t communicate with me.”

FEAR

Life is getting scary.  It’s Parkinson’s Awareness Month and we are trying our best to make the general public aware of how prevalent and devastating Parkinson’s can be.  We are also trying to show that there are things patients with Parkinson’s can do to improve their lives. Rock Steady is a program developed to improve Parkinson’s patients’ balance, endurance and outlook.  Channel 3’s report in which I am shown punching the crap out of a dummy got rave reviews.  The fund-raising event I’m participating in, Move It Walk 2021-Charlotte, is not doing as well as I had hoped.  If you click on the underlined words above you should find the donation page.  Under the amount donated is a box where you can type my name.  Thanks in advance.

Now, back to today’s topic.  I’m on the same medications my father was on 30 years ago.  Advances in treatment are around the corner but I can’t wait for them.  I’m taking the next step and, frankly, I’m scared.  I’m being evaluated for Deep Brain Stimulation (DBS).  In other words, a neurosurgeon will bore holes in my skull and implant electrical wires into the part of my brain that is misbehaving.  DBS was just starting to become recognized as a safe and effective treatment for Parkinson’s at the time of my father’s death.  While it has come a long way since then, it’s still scary as hell.  The risk of intraoperative stroke is low but still significant.

It’s really strange, but I can’t remember a single patient ever talking to me about fear.  I saw the whole gamut of illnesses, yet I don’t recall anyone using the words scary or fear.  I remember patients discussing doubts about surgery and procedures.  I remember treating anxiety associated with treatments but never FEAR!  Was I that good that my care allayed all fear? I seriously doubt it.  Conversely, was I that bad that people were afraid to share their fears with me?  I don’t think so either.  Maybe it’s just a case of CRS.

Maybe, it’s a case of selective memory.  Maybe my brain is trying to protect me by remembering only the good outcomes.  My most vivid memories are of the miracles I witnessed.  I vividly remember my first miracle patient.  He came into the ER with a massive brain bleed.  The neurosurgeon took him to the OR and worked for hours trying to save him but failed.  He returned to the ICU in a vegetative state.  The family was told he was essentially brain dead.  Two days later his right toe started to move.  The next day, he was found on the floor.  No one knew how it happened, but it did.  The next day, he was found on the floor again.  Again, it seemed impossible; but, some way, he rolled out of bed.  The next day, he woke up and started talking.  One week later, he went to rehab.  Eventually, he went back to work.

He was not the only “brain dead” patient of mine to be discharged home and return to a normal life.  Miracles do happen!  So, why am I scared?  I don’t need a miracle.  All I need is to be one of the many successes.  Perhaps I’m worried because I’ve always looked at statistics from a different frame of mind.

If the odds of something bad happening are 1%, is it really only one in one hundred or is it really 50/50?  I’ve always told my patients that, in the individual, it’s 50/50.  Either it is going to happen to you or not.  In the early years of my practice, I assisted the neurosurgeon several times.  Boring holes in a person’s skull was always freaky.  Having them bored in my skull is scary!

If you are scared about your health/a procedure/a loved one, share your fears with your doc.  He/she may not be able to fully allay them but knowing they exist will help your doc understand you better.

Here’s your joke for the day:

A man is sitting at the bar, his head in his hands.

“Bartender: What’s the matter, buddy?

Man: It’s the worst thing ever. I caught my wife in bed with my best friend.

Bartender: Oh man, that really sucks! What did you do?

Man: I told her to pack her shit and get the hell out!

Bartender: What about your best friend?

Man: I looked him straight in the eyes and said BAD DOG!”

INFLAMMATORY FOOD?

I’ve always told my patients that when your doctor believes he knows more than the authorities, it’s probably time to find a new doc.  I was wrong.  Age and a lifetime of experience teaches you that, in the medical field, what is gospel today is heresy tomorrow.  If you google inflammatory foods, you’ll find hundreds of articles on foods you shouldn’t eat if you have an inflammatory illness.  You’ll also find multiple diets all claiming to be your savior, as well as a number of miracle pills to swallow.

Are there really inflammatory foods?  I’m not convinced.  If they exist, is there a safe quantity that can be consumed?  Does going on an elimination diet work?  Is there a placebo effect of significance when you radically modify your diet?

The following is a partial list of “inflammatory” foods:

  1. Processed meats
  2. Refined sugars
  3. Saturated fats
  4. Artificial preservatives and additives
  5. Gluten
  6. Artificial trans fats
  7. Vegetable oils
  8. Alcohol

Let’s assume that these items really do cause inflammation in the human body.  Does everybody react the same?  Is one bite enough to push you over the cliff into the land of inflammation or does it take large quantities to make you sick?

If you feed a rat poison that makes him sick but does not kill him, he’ll never eat it again.  My patients do the same.  They’ll freely tell you what foods they don’t tolerate.  “Doc, I can’t eat spinach, it gives me horrible gas!” If inflammatory foods negatively impacted your health, you’d know it.  You would tell me, “Doc, I just don’t like tomatoes!  I never eat them,” despite not consciously being able to identify a worsening of your inherent inflammatory state.

Over the years, I’ve had patients who have gone on highly restrictive diets because Google or a friend sold them on the idea that many foods were bad for them.  In some cases, their restrictive diets were nutritionally deficient.  If you are worried about the potential negative effects of some food groups, do an elimination diet in which you eliminate one item at a time and judge its effect on your health.  To be complete, add the food back into your diet after you have assessed the effects of removing it and see how you do.  REMEMBER, THE PLACEBO EFFECT CAN BE AS HIGH AS 30% IN MANY INSTANCES.

During the early days of my practice, before the world became so politically correct and uptight, I prescribed placebos for viruses and other diagnoses with great results.  I loved prescribing placebos.  I treated them as if they were real medications.  “Mr. J, take one pill 3 times a day.  It can cause nausea so take it with food.  It has a mild stimulant effect so you’ll probably be more energetic.”  Mr. J called back the next day complaining that the pill kept him up all night.  I reduced the dose and had him take his last pill a little earlier.  That night, he slept like a baby.

Placebos were particularly helpful in college students who wanted speed to help them study.  “J, be careful with these pills.  Do not leave them where someone can steal them and don’t tell anyone I gave them to you.  Take two pills an hour before you eat and drop it to 1 pill if you get over stimulated.  The power of suggestion strengthens placebos.

One last story.  Mrs. X called complaining that her husband wouldn’t leave her alone!  She demanded that I stop giving him the little blue pill (placebo) as he was getting erections 2-3 times a day.  Mr. X hadn’t been so virile in years and fought hard to keep his hard.  The Xs took the problem in hand and worked it out in the end.

Here are your jokes for the day:

A family’s driving behind a garbage truck when a dildo flies out and thumps against the windshield. Embarrassed, and trying to spare her young son’s innocence, the mother turns around and says, “Don’t worry, dear. That was just an insect.” “Wow,” the boy replies. “I’m surprised it could get off the ground with a cock like that!

What’s the difference between a G-spot and a golf ball? A guy will actually search for a golf ball!

COMPANIONSHIP

One of my readers commented on my last article, “My Neighborhood.”  She suggested that I read, ‘The Turquoise Table: Finding Community and Connection in Your Own Front Yard” by Kristin Schell.  I just read the publisher’s summary on Amazon and ordered the book.

“My Neighborhood” provoked a flurry of comments, all good.  While I presumed that my new neighborhood was exceptional, apparently it is not.  I was glad to find that others were lucky enough to find companionship and friends in their yards.  Particularly in older folks, companionship is critical.

Over the years I practiced, I watched my elders deteriorate physically and mentally as they refused to abandon the homes they raised their families in.  Their families grew older and moved away.  The neighbors they once knew moved, as well.  They became socially isolated.

Despite their children’s pleas for them to move to a senior community, they were steadfast in holding onto the past.  Their children enlisted me in a further effort to talk sense into their parents.  I told them being in a community of retirees their own age, who understood their lot in life, would be beneficial in a multitude of ways.  They ignored me.

My mother and Renee’s father moved in with us. They no longer could live on their own. It was great having them with us for a while, then it wasn’t.  They did not understand our lifestyle and we didn’t truly understand theirs.  We literally ran out of things to talk about.  I tried to convince my mother that she would be better in a senior community to no avail.  As you know, I’ve been playing the “would have, could have, should have” game.

I’ve looked back in time and realized the mistakes I’ve made.  Moving into a over 55 retirement community and finding the companionship and newfound friendships with couples my own age has proven that my advice to my elders was right.

If you are dealing with stubborn parents or loved ones who refuse to give up their empty aging homes, give them this article.  Have them call me.  I hated leaving Briarcrest.  I had a big empty house that was too much to maintain. I had neighborhood friends that were aging and moving.  My family moved out of state, as well.

Moving was scary but necessary.  It turned out to be one of the best things I could do!  My new house is handicapped equipped.  My neighbors have CRS and joke about it.  They are going through the same problems Renee and I are going through.  Even more importantly, they laugh at my jokes.  I’m a lucky man.

Here’s today’s joke:

A farmer drove to a neighbour’s farmhouse and knocked at the door.

A boy, about 9, opened the door.

“Is your dad or mom home?” said the farmer.

“No, they went to town.”

“How about your brother, Howard? Is he here?”

“No, he went with Mom and Dad.”

The farmer stood there for a few minutes, shifting from one foot to the other, mumbling to himself, when the young boy says, “I know where all the tools are if you want to borrow one, or I can give Dad a message.”

“Well,” said the farmer uncomfortably, “No, I really want to talk to your Dad, about your brother Howard getting my daughter Suzy pregnant!”.

The boy thought for a moment, hen says, “You’ll have to talk to my Dad about that. I know he charges $50 for the bulls and $15 for the pigs, but I have no idea how much he charges for Howard.

MY NEIGHBORHOOD

My neighborhood is approaching its 1 year anniversary.  I live in an over 55 development in North Carolina. It truly is a special place, populated by special people.  Apparently, Southerners sit on their front porches or, in the case of my neighborhood, on their driveways in the late afternoon.

Tonight, I was sitting in front of my neighbor’s house with “C “and his wife. I was enjoying a Pacifico and we were talking about the blog, telling jokes and remembering days long gone.  I mentioned that I was having a writer’s block and asked if there was a topic he or his wife would want me to write about.

“C” immediately responded, “Write about the health benefits of sitting outside with your neighbors and forming new friendships.” “C’s” idea is brilliant.  In Illinois, I had friends in the neighborhood, but I never remember sitting on the front porch in the evening greeting my neighbors.  In my Illinois community, all the action occurred in the back yard and was inherently a more private affair.

In my neighborhood in North Carolina, a group of six neighbors started sitting in front of one of their houses. Their laughter could be heard from one end of Manor Stone Way to the other.  Their openness was amazing, welcoming anyone walking by.  Typically, everyone introduces themselves, the host offers a chair, a drink and we talk as if we had known each other for years.  If this is the highly touted southern hospitality, I love it.

First of all, an hour in the front yard welcoming relative strangers and turning them into friends is much better than living mostly in the backyard.  The second health benefit is derived from getting old people (the guys are old, the women appear much younger) out of the house, into the afternoon sun and being more active. The benefits of laughter are well documented, and we laugh a lot.  If I’m there, our laughter involves the topic of sex.  Some of my neighbors initially were taken aback by my lewd jokes but they have loosened up and are, themselves, becoming lewd.

Hmm, loose women and lewd men could be interesting.  The list of health benefits goes on and on.   Lisa was right. I’m a lucky man!  So far, I haven’t met a person I couldn’t call friend.

Here’s your joke:

What’s the difference between an oral and a rectal thermometer? The taste!

PLEASE DONATE

April is Parkinson’s Awareness Month and I’m fund raising for our local Parkinson’s chapter. On May 22, 2021, I will be participating in the Move It Walk for Parkinson’s and I’m hoping that my readers will support this worthy cause.  I’ve set my goal at $500 and you can donate on my walk page by clicking on the underlined link and typing in my name.  Of course, I’ll be happy if we surpass my goal.

I am currently on the same medications my father was on 50 years ago.  Support Parkinson’s researchers today.  We need a breakthrough soon.

PATIENTS AND DOCS FLEE

On April 4,2021, KevinMD published, “No wonder patients detest our health care system, and doctors are leaving medicine in droves,” an article by Dr C Fratila.  Dr. Fratilia addressed an issue that I have been writing about for years, the insurance companies ever-present quest for profits at everyone’s expense.  In particular, her article deals with the ever-present demand for “PRIOR AUTHORIZATION” and its burden on the physician’s staff and resources.

Her solution is novel and something I tried many years ago.  She has her patients become “voluntary” staff and has them deal with the insurance company’s outrageous demands.  Who better to sit on hold for hours, listening to the insurers’ propaganda than the patient whose medication is not on formulary?  Who better to plead the patient’s case than the patient?  After all, the patient knows his/her history better than anyone.  The patient knows the impact of not having his/her meds better than anyone, as well.

So, what’s the problem?  Letting the patient deal with his/her insurer seems logical, right? The problem is that it doesn’t work.  The patient eventually feels put upon and gets angry.  Rather than venting his/her anger at the insurer, he/she vents it at the doc and the doc’s staff.

I’ve written about it before.  Docs have been under fire for years.  The ground they stand on has been undermined by the insurers.  They have been demoted from the MD status of the past to their current position as providers, buried in regulations and paper work.  Their journey into the pits has forced them into contracts they never wanted and employed positions in which they have ceded control of their practice to a cadre of administrators.

Despite all of the changes, they have persisted in their roles as patient defender and advocate.  I know some of you are thinking that I’m out of touch with reality.  Let me assure you, I am not.  The reality is that docs try to defend you but can no longer do so.  The insurers have won and docs are retiring at an alarming rate.  Doctor suicide is at an all-time high! I loved my profession and miss it. 

In actuality, my profession left me long before I retired.  I maintained the position of doc with my long-term patients but was seen as provider to the newcomers.  I fought with insurers daily.  The fights were expensive both financially and emotionally.  Ultimately, the insurers put me out of business.  I became an employed provider.  Amita was good to me.  They gave me time to see my patients.  Eventually, that would have changed.  To earn a living wage, I would have needed to increase the number of patients seen per hour.

What can you do to help your new doc?  Unfortunately, nothing!  They are stuck in their role and you, in yours.  I envision today’s medical complex as a puppet show: we are the puppets and the great puppeteer in the sky is the insurer.

One last thought.  Concierge medicine is a way out for some of you.  Unfortunately, many see it as the rich man’s escape.  In reality, many of my concierge patients were middle income individuals who placed their health above all.  I sure loved taking care of them. Their commitment to being healthy was admirable.

The long and the short of it is that I wish I could be back in LZFTC, seeing patients and fighting the good fight.

Here’s your jokes for the day:

They say that during sex you burn off as many calories as running eight miles. Who the hell runs eight miles in 30 seconds?

“Give it to me! Give it to me!” she yelled. “I’m so wet, give it to me now!” She could scream all she wanted, but I was keeping the umbrella.

“I bet you can’t tell me something that will make me both happy and sad at the same time,” a husband says to his wife. She thinks about it for a moment and then responds, “Your penis is bigger than your brother’s.”