FORD CRESTLINER

I once saw an amazing sight:  a 1951 Ford Crestliner.  It’s amazing, in pristine condition and must be worth a fortune.  Can you imagine owning a piece of history?  I bet every head turns when it goes cruising by, proud owner at the wheel.

This particular Crestliner was all original, having been meticulously cared for over the last 69 years.  I imagine that the owner took it into the shop for regular tune-ups and preventative servicing.  When a part broke, he would do his best to repair it, resorting to using all original replacements only when necessary.

Ford sold a lot of Crestliners in 1951.  Have you ever seen one?  I doubt it.  Unlike the owner of the above-mentioned antique, most owners of cars do minimal maintenance, junking them when they age.  Junk yards across this country are full of rusting heaps of vehicles that once gleamed brilliantly.  A few will be meticulously restored.  Most will be turned into scrap metal and parts.

So, what’s all of this have to do with medical care?  I’ll tell you.  I’m a 1951 model that is currently being restored.  Unfortunately, I had neglected to take proper care of my body, making lots of excuses about why there was no time for diet and exercise, no time to take my body out on the road and run it.  I’ve got to confess, restoring one’s health takes a lot more effort than just preserving.What model year are you?  DO OTHERS ADMIRE YOUR BOD WHEN YOU TAKE IT OUT OF THE HOUSE OR DO THEY SNICKER?  Are you showroom ready or heading for the junk yard?  Whatever shape you are in, start working on restoring your vitality.  Stop making excuses for not eating right and not exercising.  Trim down and take pride in what you have.  I guarantee you, it will be worth the effort!

DON’T TAKE YOUR HEALTHY FOR GRANTED

What’s easier: caulking and painting your house’s exterior or letting it rot and eventually replacing it? The answer is simple, isn’t it?

What’s easier: checking and replacing the brakes on your car when they are worn or dealing with the carnage when the brakes fail? Again, the answer is obvious!

So, what makes sense: taking care of your body by eating the right foods, exercising and seeing your doc for yearly physicals and routine maintenance or letting your body go to fat, your belly sag over your belt and your muscles atrophy from disuse. The answer should be obvious, shouldn’t it? Unfortunately, it’s not!

Many of my patients take their health for granted! They feel well! They’ve never been sick a day of their lives. They work hard at making a living but invest little in staying healthy. Then catastrophe hits and they are sick! Their blood pressure is elevated. They are diabetic or worse; they have a heart attack or stroke. Recovery is a bitch!

It’s no secret. It’s easier to maintain your health than to restore it once you’ve lost it. So, this year, work hard at maintaining your health. Make sure your fall-cleaning list entails cleaning up your diet, tightening up your waistline and exercising. And, for God’s sake, wear your masks and keep your distance.  

The life you save may be your own or mine is a statement I’ve ended many of the 1700 articles I’ve written with. The reality is that you can save your life by the simple means described above.  The question is, will you do it?  Will you take a few minutes everyday to work on a healthy meal plan?  Will you take a long walk, ride your bike or work out in a gym five days a week?  Will you tell a joke a day? LOL? Hug a loved one?   Wish someone a happy new day?  If the answer to any of these questions is “no,” you need to figure out what you really want out of life and realize that you are not likely to realize your goals if you are not healthy. 

May you be so blessed as to never know the disease you prevented and “may your troubles be less, your blessings be more and nothing but happiness come through your door. (Old Irish Blessing) 

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

The only reason I would take up jogging is so I could hear heavy breathing again.
– Erma Bombeck

Doctor to patient: “What fits your busy schedule better, exercising one hour a day or being dead 24 hours a day?”
– Randy Glasbergen

BLESSINGS LIST

Do you ever feel overwhelmed? Do you have too much on your plate? Your husband is out of work. You have a full-time job during the day and you are mom at night. Your parents are getting old. Your house needs work. You have too many bills and your children are needy, whiny and unappreciative. Dinner conversations are all about “needs,” that four-letter word. Life needs balance!

Often, we are so focused on our curses and problems that we can’t see our blessings. By adjusting your viewpoint, you can reduce your stresses and better address your problems. Try this exercise:

  1. Your husband is out of work; you are blessed to have a husband.
  2. You have too much on your plate; you have a table to put your plate on and food to put on that plate.
  3. You have a full-time job during the day and are a mom at night; you are lucky to have a job and blessed with children.
  4. Your parents are getting old; your parents are alive.
  5. Your house needs work; you have a roof over your head.
  6. You have too many bills; I can spend less and live with less as long as I have a roof over my head, food on the table to feed the children and a husband I love.
  7. My children are too needy; they will learn the difference between wants and needs and learn to be appreciative of what they have.
  8. Whiny kids are healthy enough to whine and they will grow up eventually.  

So, make a blessings list. Include everything you are lucky enough to have, everything that makes you smile. Place that list on your bathroom mirror and every morning and night, brush your teeth for two minutes. While you brush your teeth, count your blessings. If you start the day blessed and end the day blessed, whatever happens during the day won’t be too bad. By the way, count the fact that you have teeth to brush as a blessing!

Here’s your music and a joke.

How can you tell if being a suicide bomber really guarantees you blessings in the afterlife?

You have to C4 yourself

LIFE IS LIKE AN ONION

Often, I used the analogy of peeling an onion to help my patients visualize their illnesses and health.  An onion has many layers, each unique yet looking similar to the ones next to it.  Each layer of an onion affects all the other layers.  

When you buy an onion at your local supermarket, the outside layer is often thickened and discolored.  In order to assess the quality of an onion, you often have to peel away the outside layers until you reach the healthy core. 

When dealing with humans, physicians often have to get past the thickened, discolored outside layers of a person’s life in order to reach the healthy, vital core of their patient’s existence.  

“Doc, I don’t feel good.  Do you think it’s stress related?”

“Doc, I’m having problems maintaining an erection.  Do you think I have low T?”

“Doc, I have . . .  Do you think it’s  .  . .?”

Solving my patient’s problems often meant peeling back the layers of his life, carefully, one at a time.  Rarely is there a simple cause for human suffering.  Most of the time, the bad layers adversely affect the good layers; and, sometimes, it is impossible to discern which layer is the culprit.

When something is bothering you or making you sick, carefully peel back the onion and explore what is under the surface.  Share your findings with your doc/psychologist/counselor; it will help him/her help you.  

In my case, at the core of my existence is the memories of my grandfather and father, both of whom had Parkinson’s.  Those memories haunt me and are closely tied to the negative/depressing attitudes that bleed through to every layer of my being.  No matter how many times I tell myself that I’m not my father, that life is good, that I am lucky, I see my ancestors in their final stages of Parkinson’s, I freak out and want to puke.

So, I do.  I puke out all of the negative emotions onto these pages.  Then I re-read the positive articles again and again until the sun comes up and I can celebrate a Happy New Day.  Those of you who suffer with a chronic illness or simply a few rotten layers in your “onion” may want to consider writing/talking about them in an attempt to peel them away, leaving the healthy layers in their place and, if you’ve found any solace in the ramblings of an old family doc, may want to re-read some of the positive articles on this blog until you to can have a Happy New Day.

Here is your music for today and a joke.  

A man goes to a $10 sex worker and contracts crabs. When he goes back to complain, the sex worker laughs and says, “What do you expect for ten dollars? Lobster?”

OUR HOUSE

Crosby, Stills, Nash and Young sang “Our house is a very, very fine house” in 1970.  I fell in love with the song then and still love it today.  This morning I woke up with “Our House” playing in my mind.  Yes, our house is a very fine house and the reason is that it’s where Renee lives.

Home is wherever Renee is! Currently, home is in North Carolina, in a 55 and older community, surrounded by construction, noise, red dirt and pollen.  Despite the mess, I love it because its where Renee and I live.  Those of you who know me well are probably thinking that I’m brown nosing Renee in an attempt to get lucky.  

I got lucky when, ions ago, I went over to Renee’s mother’s house to

visit Cynthia (Renee’s mother) and found that Renee had just moved back to Norfolk from Chicago.  I got lucky when, later that year, Renee said yes to my proposal.  I got lucky when Renee moved back to Chicago as my wife.  I got lucky when she gave me three beautiful children.  I’m already a very lucky man.

Now, 42 years later, I’m lucky Renee puts up with me.  I’m sure it’s not easy watching the one you love slowly degenerate. It’s not easy for her when I insist on doing things myself (while I can) despite her desire to lighten my load by doing for me.  I am sure I’m not easy to live with at times.  My daughter recently pointed out that my less than rosy attitude was all too apparent.  I try not to be a pessimist.  I work at seeing the good in life and ignoring the bad that I know, from experience and training, is just around the corner.

 What’s really bad is seeing the worry on Renee’s face every time my legs don’t work or when I nap all day.  Even worse, is when she tries to hide her fears of what the future holds from me and the rest of the world.  I can see it on her face but, when I ask her, she always responds, “everything is ok.”  In a sense, everything is ok as long as we are together.  Our house is, in fact, a very, very fine house.  

At this point in life, I have a very important task to accomplish.  I have to remember that I am not the only one living with Parkinson’s.  I have to remember that Renee and the children live with the effects of Parkinson’s on a daily basis and, as I have bad days and worse days, so do they.  I have to help them survive the changes occurring in me.  

I have to make the most out of the future and continue to make our house a very fine place to be. I have to remember how lucky I am.  And yes. I’m not above a little brown nosing to get “lucky,” if you catch my drift. 

There is a moral to this story.  Those who suffer with chronic illness often lose track of the fact that their loved ones suffer the effects of the same illness they have, as if they actually were diagnosed with it.  Chronically ill patients often become self-centered and selfish as they deal with their disability/pain.  Their job is to never lose sight of the suffering of their loved ones caused by whatever illness they are suffering with. Caregivers need care!  If you are chronically ill  or suffering from a disability, con’t forget to care for your caregiver.  

Here’s your music and a joke.  

What do you do if your wife starts smoking?

“Slow down and possibly use some lubricant.” 

TIME FOR WELLNESS CARE

It’s the time of year I liked to start my wellness drive.  I would talk to patients about yearly physicals, influenza vaccine and a host of other preventive measures they should utilize. The following article has been published several times over the past few years.  It is even more appropriate today than it has been in the past.

Originally published on March 5, 2011, this article ranks in my all-time top five viewed publications.  Covid has changed our world.  It’s our new number one enemy.  The healthier you are the better you’ll do if you get Covid or any other illness.

As insurance and Medicare become more restrictive, medical luxuries become more important.  With the recent move to brand many tests and interventions as unnecessary, what was once cutting edge and “necessary” now falls into the realm of luxury.  The statisticians look at what is “enough lives saved” in their quest to define “necessary”.  PSA screening is one example.  Initially, PSA testing was considered “unnecessary” as not enough lives were saved for the cost of the test.  Frankly, I’ve been away from the office for 18 months and I’m uncertain of PSA’s current status. However, my own opinion, if I save one life, that should be enough to justify the test.  “Medical Luxuries” addresses the word “need.” 

The word “need” means different things to different people.  In an earlier article, I referred to “need” as the new four letter word.  People overuse and abuse the word “need”.  In my practice of medicine, I defined three levels of need. 

A level one need is critical and worth fighting over.  I saw level one needs two to three times a week.  Level one needs are exemplified by the 60-year-old hypertensive male who has chest pain.  He needs to be in the hospital now!  He needs to go by ambulance now!  His life depends on it.  When he refuses to follow my advice, I dial 911.  When he is at home and refuses to heed my advice, I call 911 and his wife.  Level one needs are absolute! 

Level two is where I spent the majority of my time.  My job was to inform you why you needed whatever it was you needed, what the benefits and risks were, what the expense was and how soon I think you should get it done.  I then left it up to you to decide if and when you were going to do it.  I might disagree with your decision but respected it.  A routine colonoscopy is the standard of care at the age of 50.  It is a level two need.  (If you have a family history of colon cancer, it is a level one need.) 

Level three needs are luxuries and the topic of tonight’s article.  Luxuries are needs you can do without but can do better with!  In medicine, a luxury is anything that is either unproven (but promising), not standard of care, or not covered by insurance.  We live in a peculiar world.  I have patients who won’t get a chest x-ray ($200) because their insurance won’t cover it.  They drive to the office in a BMW but won’t spend $200 on their own health.  I have patients who eat at expensive restaurants every weekend ($75 per person) yet want an inferior generic because the branded cost is $100 per month.  The insurance world has convinced us that if, they won’t pay for it, either you don’t need it or it is too expensive to afford.  

Luxuries can save you money and your life.  Several years ago, I was called in to the hospital to see a very sick patient at 5 a.m.  I dressed quickly, jumped into my car, backed out of the garage and slammed into my daughter’s car.  I had not spent the extra money to buy back up sensors when I purchased my car.  My decision had consequences.   I had to tell my daughter I smashed her car.  I had to pay for her repairs, as well as mine.  What seemed like a luxury item at the time turned out to be more of a necessity than I had anticipated and a costly error in judgment as well.  Luckily, the patient did fine. 

So, what are luxury medical items?  Cardiac Scoring is a good example.  It measures the calcium load in your coronary arteries and predicts coronary artery disease.  A healthy 50-year-old male with no family history of heart disease is buying a luxury when he gets one.  Insurance won’t pay for it and technically he doesn’t need it.  So why get it?  Most of us are healthy until we are not.  If his results are normal, he gets peace of mind.  If his test is strongly positive (it happens to the healthiest of us), he may well have saved his life. 

Every year there are unexpected deaths in our community.  Could the purchase of a healthcare luxury, an annual physical, an EKG, blood test or x-ray, have saved their lives?   I would like to think so.  The next time your doc asks you to get a test or buy a medication that is not a covered benefit, think twice before you dismiss the idea.  Times are tough and money is tight; but, if your roof was leaking, you would find a way to get it repaired.  I often use analogies to make a point and my favorite has to do with your house.  Your house is very important; and, when it needs repairs, we find the means to do so.  Your house shelters your body; your body houses your soul.  Do everything you can to protect your body and keep it fit for many years to come. 

Here is your music for today and a joke. 

A 90-year-old man goes for a physical and all of his tests come back normal. The doctor says, “Larry, everything looks great. How are you doing mentally and emotionally? Are you at peace with God?”

Larry replies, “God and I are tight. He knows I have poor eyesight, so He’s fixed it so when I get up in the middle of the night to go to the bathroom, poof! The light goes on. When I’m done, poof! The light goes off.”

“Wow, that’s incredible,” the doctor says.

A little later in the day, the doctor calls Larry’s wife.

“Bonnie,” he says, “Larry is doing fine! But I had to call you because I’m in awe of his relationship with God. Is it true that he gets up during the night, and poof, the light goes on in the bathroom, and when he’s done, poof, the light goes off?”

“Oh sweet Jesus”, exclaims Bonnie. “He’s peeing in the refrigerator again!”

HAPPY NEW DAY

We are just a month away from the beginning of the Jewish New Year. This past year has been pretty rough for most of us.  Covid has changed our lives in so many ways that it’s hard to imagine a happy future.  Anxiety and depression are just two of the negative effects of Covid and is worsened by “Breaking News” segments burning the daily death counts into our brains and promising more bad news to come.  Something needs to change. Perhaps part of the answer can be found in an article I wrote in 2011:

I’ve always loved New Years!  New Years is a celebration of life.  New Years is full of hope with everyone wishing each other a happy, healthy, and prosperous year.  New Years is a time of reflection, looking back at the time that was, assessing what was good, what was bad, and what you wished you had done. 

New Years marks a new beginning as you look forward to what you pledge to accomplish, the things you want to set right, and the things you failed to do in the preceding year.

Why can’t everyday be New Years?  Why not start every day off by wishing each other a happy, healthy and prosperous day?  Why can’t everyday be a reflection of the past and a renewed pledge to do better in the future?

Think how much we could accomplish if each and every day we awakened by celebrating today as if it was the onset of the New Year.  I think I’ll try to follow my own advice.  I will proclaim a new holiday called, “Happy New Day”!  May today and every day bring you health, happiness, and prosperity.  May every morning you awaken and be blessed with hope and the knowledge that each day is a blessing.

Sometimes it’s easy to lose sight of the fact that each day you walk the earth is a blessing.  As many of you are aware, my own attitude has been quite negative lately.  As I stated yesterday, it’s time for me to go to work and improve my health and attitude.  It’s time to post my Blessing’s List on my mirror and count my blessings every morning and night.  Perhaps it’s time for you to do the same.

I wish you could hear my 3 year old granddaughter singing, “It’s a Beautiful Day in the neighborhood” as I finish this article.  Time to go play.

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

A biker walks into a bar and sits down on a bar stool near the end of the bar.

He takes a look at the menu and it reads as follows:

Hamburger – 2.99

Cheeseburger – 3.99

Chicken Sandwich – 4.99

Hand Jobs – 19.99

The crusty old biker waves the bartender down, and up walks this tall, busty, beautiful redhead in her mid-twenties. She smiles at the biker coyly, and he asks in a quiet voice “Are you the one who gives the hand jobs?” The bartender blushes slightly and says “Yes, I am” with a sexy little smile. The biker grins and says, “Well wash your hands, because I want a cheeseburger.”

TRY OR WORK

Over the past 30 years, I’ve written many articles vilifying the word “try.”  When my patients, children or friends used the word “try,” I would pounce on them.  Try is a word that almost always is accompanied by the word “but.”  People who try to lose weight fail.  An employee who promises to try to finish a project by Friday is not likely to finish it.  

“I tried to get it done but my wife got sick and I had to pick up the kids,” is a great excuse, isn’t it? 

“I’ll tried to take the garbage out, but I had to go to a study group for my math exam.” Another great excuse, isn’t it?

Yes, when you accept the word try from another person, you should expect that they will disappoint you.  You can bet there is a “but” coming your way.  I never accepted the word try.  Instead, I would explain the difference between trying to do something and working at doing something.  When you use the word “work,” there is an expectation that you will finish the job.  Work is usually hard; but, when the work is assigned to you, no matter how hard, you are obliged to finish it.  People who work are expected to make mistakes from time to time.  They are also expected to fix and learn from those mistakes.  When you have a job, you are expected to show up for work everyday until you have finished it.  

Yes, there is a big difference between “trying and working.”  Today, while looking for something to write about, I came across several old articles I’ve written on this subject.  I also recognized that I’ve been trying to lose weight and get healthy/wellthy.  I realized that “do what I say, not as I do, is stupid.  So, it’s time to come out of retirement and go to work at getting healthy and wellthy.   Working on being healthy means walking/biking every day, no excuses.  Working at losing weight means eating healthy no matter how good the Krispy Kremes smell.  Working at being healthy means no ifs ands and buts!  I will finish this job.  The job is going to take a year to complete so accepting the job is a long-term commitment. I’ll make that commitment.

How are you doing?  Are you working on being healthy and wellthy or are you trying to be healthy and wellthy?  If you are sitting on your butt rather than doing what you should be doing, throw out the “but” and work hard at fulfilling your obligations to yourself an others.

Here is your song for the day and a joke.

Teamwork is important.  It helps to put the blame on someone else!

DON’T PUT OFF THE HAPPY!

As a family doc, I am acutely aware of the stages of life each of us eventually go through.  I counselled young sleep deprived parents of a colicky baby.  I reassured the parents of teens pointing out that their irresponsible child will go to college, go to work and become a success.  I helped 50-year-olds survive their mid-life crisis.  I also worked with the elderly helping them through an assortment of losses and eventually death.

Knowing what’s coming really doesn’t help. I really expected that I would skip this stage of life. Instead, I become more like my father every day.  My dad started life as an optimist and ended life as the world’s greatest pessimist. I think Parkinson’s and the unavoidable, degrading losses of motor function does that to you.  At least I haven’t started reading the obituaries yet.  He started his day looking at who died.  Of course, the internet and Facebook bring that info to your desktop in real time.

Yes, I’m in the “Golden Years.”  I’ll share a little secret with you.  They are golden years because you need gold reserves to pay for your medications, nursing home and funeral.  Are you depressed yet?  Are you ready to exit my blog and do something else?  Read on.  I promise it will be worth it!

Here’s my gift.  I’ve often told my patients that the devil exists, and his greatest accomplishment is the concept of tomorrow.  By giving us tomorrow to worry about, save and plan for, the devil ruins today.  Today is the only thing we really have.  Don’t waste it.

They say, “No one knows what the future holds.”  I do.  For most of my patients, it holds regrets.  Most of my patients put off happiness and work their lives away so that “one day” they will be secure and realize their dreams.  Don’t wait for “one day!”  It may not come.

I am amazed at how bright I was in 2011.  It’s as if I could predict the future and left myself notes in the form of my blog to help guide me through rough times.  Below is an article published August 26, 2011.

Last night, I watched “The Big C”, a TV show about a woman diagnosed with an advanced stage of melanoma, a nasty skin cancer.  The show follows Cathy, the main character, through the various stages of dealing with a life-threatening disease.  The show is funny and sad, uplifting and depressing.  Living with and dying from cancer is often a rollercoaster ride.

In last night’s episode, Cathy, while counseling a friend, remarked, “Don’t delay the happiness!”  Too often, we delay the happiness while dealing with today’s stressors and tasks.  We promise to get together with friends and family.  We promise to call mom and dad.  We plan to run away from it all and be selfish.  We will do it all, one day.

Sometimes, there are no more “one days.”  I have seen patients die for no reason.  One day they are here, the next day they are forever gone.  “Don’t delay the happiness” is sagely advice.  One thing is for sure: today is your day to find happiness.  Today is a good day to make that call, see that friend, and make definitive plans for your runaway vacation.

Yes, you have to work, to make a living, and provide for yourself and your family.  Yes, you are a responsible individual who others rely on.  Yes, you have a list of problems a mile long.  You also have time to count your blessings and you need to make time to do something nice for you and your special ones.  Recently, I wrote about regrets.  Don’t set yourself up for regrets.

Most of my patients are so focused on retirement that they forget to live.  Don’t live to work; work to live.  Your job tomorrow, and every day, is to find happiness.  Happiness is best when it happens spontaneously, but life’s complexities means that finding happiness often requires some work.  Work hard to be happy and then share it with others.  “Wellthy” is not just about being physically healthy; it is also about being emotionally happy.

Horace wrote, Carpe diem, quam minimum credula postero – “Seize the Day, putting as little trust as possible in the future.”   Yes, you have to plan for the future, but not at the cost of the here and now.  

I wish you many years of happiness and no regrets. Here’s your music and a joke.

Rodney Dangerfield – “I told my doc I didn’t want to get older.  He gave me a gun.”

Carrie Fisher – “as you get older the pickings get slimmer, but he people sure don’t.”

Joan Rivers – “You know you’re getting older when you buy a sexy sheer nightgown but don’t know anybody who can see through it.”

FINDING A NEW DOC

I did it!  I had my first visit with a geriatrician (specialist in taking care of of people).  Yep, I’m old so since I needed to find a new doc. I thought I might as well look for a doc who focuses on taking care of the aged.  I was impressed(she didn’t even wince when she saw my lengthy list of complaints)! 

Her office staff was very welcoming despite the fact that we were late. I hate being late, but being new to the area, Renee and I had to rely on the GPS.  I think the GPS is doing drugs.  It took us to the wrong office, the long way.  Eventually, we found the right office.  

They assigned me a patient counselor who took Renee and I back to the exam room and reviewed my medical history, meds and allergies.  She took my vital signs (her technique was excellent).  After introducing me to her various functions (scribe, diet advice, communicator), she brought the doc in.

Dr. Rosen is young (she wasn’t born when I got my MD).  While I’m the first to tell you that 35 years of experience is invaluable, I’m also a realist.  My cronies are retiring.  I wanted a young physician who would outlast me.  She is also a good communicator who proudly points out the benefits of her practice style.  I was pleased to find that her practice is run very much like mine was.  While she is a specialist by training, her philosophy appears to be more in line with that of a generalist.  She has same day availability.  She encourages her patients to call after hours when they need care, avoiding urgent care centers and ERs. Her skill set allows her to meet the majority of your needs in her office without being referred out to other specialists.

Following my own advice, I brought her a chart summary, med list, review of systems and the names of the docs on my prior care team.  I strongly recommend that, if you are seeing a new doc, you compile the above-mentioned documents and bring them with you to your visit.  If you are like me and have CRS, the chart summary and med list will help you avoid forgetting essential facts (and bring your spouse with, as well).  She certainly appreciated the written info I had for her and listened to Renee when she related the things that only a wife would note.

She ordered lab and her lab tech drew my blood.  She was extremely personable, and her technique was perfect.  Her office promised to post the results on the patient portal and call me with them.

As a physician, I was nervous about seeing a new doc.  When you are used to being in charge, giving up control is difficult.  Dr. Rosen made it easy.  She was accepting of my advice and answered all of my questions.  I was particularly pleased to find that she could inject my trigger finger rather than send me to an orthopedist.

I know many of you still haven’t found a new doc.  I recommend looking for a young doc, specialty trained, down to earth who is an excellent communicator, appears to enjoy being a doc, and welcomes you to their practice.  You also need to find a one-stop-shop with same day availability and an on-call doc who will actually respond to your call.

Good luck!  Finding the perfect doc is not easy but can be done.  When you do find that special doc, go to the internet rating sites and give the doc a five star review.  If the doc is only 4 stars, keep looking.

Next on my list is a dentist.  Now that’s really scary. 

Here’s your music.  It’s a parody and hits close to home.  Residency at Lutheran General was a bitch.  Below is an article I published in the past which is worth reading.

In 1980, I was an ER doc at a local hospital.  I was so amazed at how many non-emergency patients came to the ER that I started asking every patient that I saw one of ten questions as to why they were there.  I took the top 5 reasons, found the solution to each, and opened the Lake Zurich Family Treatment Center. Searching for my patients’ medical needs and finding solutions for them proved to be one of my best things I ever did.  Forty years later, I’m on the other side of the fence looking in.  What I see is not pretty.  The medical world I grew up in is extinct and the new world (and those who inhabit it) are radically different.

Below is a checklist created to enhance your next patient visit.  It was created by Dr. Segal, the physician, and will help you interface with your doctor and his/her staff more effectively.  Now that I’ve transitioned to a patient role, I feel that it’s time to make a list of things I need from my doctor.  What do you need from your doctor?  If you will include your answers in the comment box, I will collate and publish the responses.

The better prepared you are for an office visit, the more you will get out of it.  The following are my top recommendations:

  1. Come prepared with clear objectives.  Define your first and second most important problems by going through the: who, what, when, why and how of your issues and know what you want.  If you are having chest pain or breathing problems, that is number one!
  2. Stay on track.  So many of my patients come in for one specific problem and then do the “Oh, by the way, while I’m here” spewing forth six other problems.  It is hard to do justice handling seven chronic medical problems during the course of an office visit.  Attend to your top two and set up time to do the next two and so on until the list is empty.
  3. Prioritize your list.  It is important to know what the top two are.  Your doc needs to know everything that is on the list.  Sometimes, what you think is the most important problem really isn’t.  Sometimes the doc will re-prioritize your list.  Use an “A” next to a problem to delineate a current/active problem.  Use a “P” to delineate an past/old/resolved problem.
  4. If you are seeing other doctors, tell the nurse who you are seeing and tell her what you are seeing the doctor(s) for.
  5. Bring your medications with you.  “I’m on a blue oval pill, two yellow ones and a green one” is not only worthless, it is dangerous.  Keep the pills in their original bottles.  Make sure you bring all of them, even if someone else prescribed them.
  6. Bring your supplements and vitamins.  They may impact your treatment.
  7. Wear appropriate clothes.  If you are modest, wear your bathing suit under your clothes.  If your knee is killing you, don’t wear tight jeans.
  8. Don’t forget to ask questions.  If you don’t understand what the doctor is telling you, ask for clarification.
  9. Ask for a written set of instructions if they are not provided.
  10. Know which pharmacy you want your prescription sent to.  In the world of electronic medical records, prescriptions are sent over the internet.
  11. Have a written list of your known allergies.
  12. Bring your insurance cards.  Different plans have different rules and panels.  Also, bring your driver’s license and co-pay.  Don’t be angry at the front desk when you are asked to present these at each visit. 
  13. Bring your old labs and x-rays if they were done elsewhere and they are available.

What I need from my doc:

  1.  Listen to and address my objectives.
  2. Re-prioritize my list when necessary to address more threatening problems as rapidly as possible.
  3. Tell me what you think I have and what you need to do about it.
  4. Tell me what I need to do about it.
  5. If you need to do tests, tell me which ones you are ordering and why.  Let me know how I get my results.
  6. If I need meds, which ones do I need and why.  How should I take them?  What are the risks?
  7. When do you want to see me again?
  8. What warning signs, if any, do I need to watch for?    When should I call you or your nurse if any warning signs show up?

We know these simple tips will help make your office visit a more fulfilling experience.