As a physician i have struggled for years on how to bring the compassion and enthusiasm back into the practice of medicine. I have watched as my colleagues, myself, and almost all other health care associates become more frustrated with the red tape and loss of control over our professions that we worked so hard to get. We all made huge sacrifices and continue to make sacrifices to get to engage in the practice of health care, no matter what level you yourself may be engaged in.
What is the payoff? Occasionally an opportunity to really help another human being with their medical problems and improve their quality of life or minimize their suffering from disease. But all to often it is internal frustration and even grief about what the quality of life is for health care providers in today's workplace.
Was there ever really a Marcus Welby environment to practice in? In talking to my older colleagues i truly believe there was. Was it perfect? Certainly not! The vision of sitting down with a patient and calmly listening to their problems or complaints, then examining them, then returning to a consult room or office to work together on a plan to treat an illness or work up the problem sounds pretty good to me. It would certainly sound good to me if i was the patient as well.
The one place i have personally been a patient that practices following this protocol is The Mayo Clinic in Rochester, Mn. That is there protocol and they send out a wonderful summary letter to the patient and the referring physician after the consult or continuing care to keep everyone updated on the recommendations or progress of the treatment. My point is that it does still exist. The real irony here is the bills from Mayo that i receive and my insurance company receive are much lower than equivalent treatment in my own major treatment center nearby. In spite of this Mayo Clinic is rated number one in many categories of medicine across the US.
What is their secret? Maybe they have endowment funds that other facilities don't that allow them to practice that way. But i know if you read about the founders of the Mayo Clinic they were primary care doctors who never wanted to compromise this caring empathetic bond with the patients they served and have never fallen short of this goal.
My point here is not to give kudos to Mayo Clinic alone as there are other treatment centers that are just as compassionate, i am sure, i just don't have personal experience with them.
How did things get so bad? It all started with the Medicare act in 1964 unfortunately. As soon as patients were no longer responsible for their bills and a government entity took over setting prices and imposing regulations it has gradually come down to where we are today. In the mid 1980'3 the DRG's started to curb run away hospital and doctor costs by limiting what Medicare would pay for a given diagnosis or procedure to a hospital. This is when all the other insurance companies started tying their reimbursement rates to a percentage of what medicare would pay. So as medicare payed less and restricted assess to certain procedures so do the insurance companies.
Then along came HMO'S to save money and make primary care doctors the gatekeepers of health care to protect their patients rights. The problem is they dictated to us what was medically necessary and what was not and also what they would pay for these services. The other major twist was that they didn't tell primary care doctors that they were NOT going to be paid for this added level of responsibility. In effect it put another wedge between the patient and the doctor. It made us look like the bad guy by requiring us to give them a referral to see a specialist and many times telling them they could not see the doctor they had seen for 10 years because he wasn't on their preferred provider list.
Little did they know that the preferred provider list had nothing to do with the quality of the care they gave, just the price they were willing to do a service for and bill the HMO accordingly.
The bottom line is this. We cannot look to government to fix whats wrong with medicine today. One of the simplest solutions is for the patient to take back control of how they spend their health care dollars in the free marketplace. One of the presidential candidates running for the Republican nomination has always been an advocate for this structure in health care insurance as I have for over 10 years. Its called a medical savings accounts where your employer or the government puts money into an account tax free for you to spend on whatever health care you decide to. If you didn't spend much money on health care for a few years the balances carry over year to year so you could end up with a larger account later when you might need the extra money.
You would need a policy to provide catastrophic coverage in the event you were ill with an injury or costly illness but it would put the free capitalistic market back to work in health care and take it out of the hands of the insurance companies and the federal government.
If you found a doctor that treated you like Marcus Welby and took exceptional care of you you would be willing to spend a little extra money for that i bet. This is no different than where you choose to shop for groceries or have your car worked on. If they consistently do a good job and are fair and honest and charge a fair price you will likely go back to them again.
Why do we think our medical care should be free or almost free? It is by far the most important thing you will ever spend your money on. Shouldn't you be willing to except that it is going to cost more than it has the last 10 years but have the quality improve 100%!! I dont know about you but the next time i need to go to the dr i dont wanr him/her to be rushed and to sit down and really talk with me and 'LISTEN' to what i have to say. Then explain what my treatment plan should be or what the next step might be and then make that descion together as a team.
Joke for today: Doctor Doctor I keep thinking i am a $10 bill!
( Thats ok go shopping the change will do you good!)
Resting Beauty
Be at peace with your inner self.
Friday, December 30, 2011
Tuesday, December 27, 2011
Where is the New Thing in Medicine Going to Come From?
The list of new technology on the horizon is really staggering. i will list a few and some of the smaller cos that are doing amazing research. Most of these you have never heard of "yet!
1. Stem cell research A. OSIRIS Theraputics
B. Neostem INC
C. FIBROCELL SCIENCE
D. CYTORI THERAPUTICS
E. CELGENE CORPORATION
F. AASTROM BIO INC
G. ADVANCED CELL TECHNOLOGY
2. Molecular Biology A. NEURALSTEM
3. Immunotherapy A. CELLDEX THERAPUTICS
for Cancer B. IMMUNOCELLULAR THERAPUTICS
4. Genetic Research A. COMPLETE GENOMICS
These are just examples of some of the companies in each category, as there are many more. The point is that we are moving away from the 'chemical model' of treating disease and moving light years ahead to targeting specific cells or repairing damaged cells or growing new cells to help cure or reduce the symptoms of a disease.
Genetics is moving so fast that before long you will know how likely you are to come down with a particular diease or condition and at what age. They will also be able to possible slow aging as they discover what cellular changes occur to make cells age and why some people die so much younger than others do. They can already tell if you have abnormal genes that may make you eliminate drugs slower than another person or transmit serotonin slower in your brain possibly putting you at greater risk of depression etc.
Much of the mystery of the human body and our own thoughts and feelings may someday be shown to be the result of a different set of chemical and molecular processes that we have very little control over.
Joke for the Day!!!! Why did the ham go to see the doctor???
( To see if he could be cured!!!!!!!!!!!)
1. Stem cell research A. OSIRIS Theraputics
B. Neostem INC
C. FIBROCELL SCIENCE
D. CYTORI THERAPUTICS
E. CELGENE CORPORATION
F. AASTROM BIO INC
G. ADVANCED CELL TECHNOLOGY
2. Molecular Biology A. NEURALSTEM
3. Immunotherapy A. CELLDEX THERAPUTICS
for Cancer B. IMMUNOCELLULAR THERAPUTICS
4. Genetic Research A. COMPLETE GENOMICS
These are just examples of some of the companies in each category, as there are many more. The point is that we are moving away from the 'chemical model' of treating disease and moving light years ahead to targeting specific cells or repairing damaged cells or growing new cells to help cure or reduce the symptoms of a disease.
Genetics is moving so fast that before long you will know how likely you are to come down with a particular diease or condition and at what age. They will also be able to possible slow aging as they discover what cellular changes occur to make cells age and why some people die so much younger than others do. They can already tell if you have abnormal genes that may make you eliminate drugs slower than another person or transmit serotonin slower in your brain possibly putting you at greater risk of depression etc.
Much of the mystery of the human body and our own thoughts and feelings may someday be shown to be the result of a different set of chemical and molecular processes that we have very little control over.
Joke for the Day!!!! Why did the ham go to see the doctor???
( To see if he could be cured!!!!!!!!!!!)
What Will 2012 Bring?
Its always exciting to think what breakthroughs are coming for the next year in medicine. New treatments or medications will come forward to help pain and suffering and hopefully heal and reverse disease. The really exciting thing about research in medicine today is we are embarking on new territory. We are entering the era of molecular biology and medicine with means we are looking at structures and chemicals and naturally occurring elements on their simplist level. This may lead to major breakthroughs in how we apply their properties to the healing and reversal of disease.
Between stem cells derived from our own progenitor cells (not embryos), molecular biology, immunotherapy targeted at specific cancer cells in our body and continued unraveling of the genomes of humans and cancer cells we truely are embarking on on a new frontier in medicine in the next decade. In ten years we will look back on how we treated disease and illness much like the physicians did after the advent of immunizations and antibiotics and wonder how we did any good at all.
The important thing to remember is that no matter how technological we get our patients are still human beings from all walks of life and not numbers or study subjects. We can never lose sight of that fact and must continue to treat each and everyone of them with the respect and kindness they may not find anywhere else but form us!
Joke for the Day!!! What did one elevator say to the other one?
( I think i am coming down with something!!)
Between stem cells derived from our own progenitor cells (not embryos), molecular biology, immunotherapy targeted at specific cancer cells in our body and continued unraveling of the genomes of humans and cancer cells we truely are embarking on on a new frontier in medicine in the next decade. In ten years we will look back on how we treated disease and illness much like the physicians did after the advent of immunizations and antibiotics and wonder how we did any good at all.
The important thing to remember is that no matter how technological we get our patients are still human beings from all walks of life and not numbers or study subjects. We can never lose sight of that fact and must continue to treat each and everyone of them with the respect and kindness they may not find anywhere else but form us!
Joke for the Day!!! What did one elevator say to the other one?
( I think i am coming down with something!!)
Saturday, December 10, 2011
The Future of Medicine
"The Doctor of the future will give no medicine
but will interest his or her patients in the care of the human frame,
in a proper diet, and in the cause and prevention of disease."
Thomas A. Edison
Inventor / Scientist
"This one sentence killed more people than all the wars in American History";
"You get all the nutrition you need from the four food groups."
Joel D. Wallach
B.S. D.V.M. N.D.
This is amazing as these quotes were written 100 years apart! What has really changed? With the explosion in the consumption of fast food and frozen foods over the last 25 years we are in worse shape than ever nutritionally! Combine this with the fact the are soils are depleted of vital minerals and vitamins and contaminated with chemicals and metals. Our waterways seafood and fish have unsafe levels of mercury and other chemicals and heavy metals as well in many parts of the world. Is it any wonder that diabetes, cancer, and a multitude of autoimmune diseases are epidemic?
As humans we are much more concerned about the content of facebook, you tube or television than we are about the content of the foods we consume daily! You have heard the expression "to get quality you have to pay for it!" or "junk in = junk out!" What do we really expect to feel like if we continue to show such blatant disregard to how we eat, what we eat, how much rest we get, and the nutritional content of our food.
Everyday we are bombarded by ads for nutritional supplements, vitamins, and minerals from literally hundreds of companies. Which products do we really need? Many people want to take supplements and keep eating an unhealthy, high fat, fast food diet! Which companies are reliable and trustworthy. Several years ago I read about a company in Minnesota that was growing a natural herb that got caught spraying their fields with a highly toxic pesticide when they were suppose to be organic and a pesticide and chemical free farm!
I also read an interesting article about consuming a large amount of food bought from local farmers markets. This is a huge growing industry in our country and some of the larger produce growers have not missed this. They are starting to develop distribution chains through smaller farms to get their products to market through the back door.
The more pertinent fact about the local farmers market is that as farmers with farms, generally under 40 acres, they are not nearly as concerned about how much fertilizer or pesticide they use per acre like the farms with thousands of acres. This ironically leads to the use of larger amounts of chemicals per acre to maximize the output. So you may actually be getting more chemical exposure in these "natural locally grown foods" than those at the supermarket.
To me the message to us as health care providers is to become as educated as possible in the area of nutrition and diet so we can share what we learn with our family and our patients. We must all become more aware of what we are consuming and how it may be affecting our health and well being. We can then help to protect our families and patients from medical problems caused by poor nutrition and to help them keep from wasting money on unnecessary ,expensive supplements if they are not needed and to increase our intake of wholesome foods.
The bottom line 1. eat more vegetables fruits and lean meats. 2.eat smaller meals and more often 3. drink more water. 4. eat and cook with healthy fats and oils. 5.eat out rarely. 6 consider taking a basic multivitamin and fish oil daily. 7. learn what a Mediterranean diet is and start implementing it at home and teach your patients what one is. 8 consider growing some of your own fruits and vegetables. if you don't have the space see if one of your friends that does would be interested in doing with you or offer to share part of your crop with them as rent!!
MAKE THESE CHANGES NOW DON'T PUT IT OFF ANY LONGER!!
JOKE FOR TODAY; Why did the mother always put her helmet on before she
used her computer?
http://www.freedigitalphotos.net/images/Pills_and_Drugs_g279-Spoon_With_Colorful_Vitamin_Medicine_Pills_p36718.html
( because she was afraid it would crash!!!!!!!!!!!!)
but will interest his or her patients in the care of the human frame,
in a proper diet, and in the cause and prevention of disease."
Thomas A. Edison
Inventor / Scientist
"This one sentence killed more people than all the wars in American History";
"You get all the nutrition you need from the four food groups."
Joel D. Wallach
B.S. D.V.M. N.D.
This is amazing as these quotes were written 100 years apart! What has really changed? With the explosion in the consumption of fast food and frozen foods over the last 25 years we are in worse shape than ever nutritionally! Combine this with the fact the are soils are depleted of vital minerals and vitamins and contaminated with chemicals and metals. Our waterways seafood and fish have unsafe levels of mercury and other chemicals and heavy metals as well in many parts of the world. Is it any wonder that diabetes, cancer, and a multitude of autoimmune diseases are epidemic?
As humans we are much more concerned about the content of facebook, you tube or television than we are about the content of the foods we consume daily! You have heard the expression "to get quality you have to pay for it!" or "junk in = junk out!" What do we really expect to feel like if we continue to show such blatant disregard to how we eat, what we eat, how much rest we get, and the nutritional content of our food.
Everyday we are bombarded by ads for nutritional supplements, vitamins, and minerals from literally hundreds of companies. Which products do we really need? Many people want to take supplements and keep eating an unhealthy, high fat, fast food diet! Which companies are reliable and trustworthy. Several years ago I read about a company in Minnesota that was growing a natural herb that got caught spraying their fields with a highly toxic pesticide when they were suppose to be organic and a pesticide and chemical free farm!
I also read an interesting article about consuming a large amount of food bought from local farmers markets. This is a huge growing industry in our country and some of the larger produce growers have not missed this. They are starting to develop distribution chains through smaller farms to get their products to market through the back door.
The more pertinent fact about the local farmers market is that as farmers with farms, generally under 40 acres, they are not nearly as concerned about how much fertilizer or pesticide they use per acre like the farms with thousands of acres. This ironically leads to the use of larger amounts of chemicals per acre to maximize the output. So you may actually be getting more chemical exposure in these "natural locally grown foods" than those at the supermarket.
To me the message to us as health care providers is to become as educated as possible in the area of nutrition and diet so we can share what we learn with our family and our patients. We must all become more aware of what we are consuming and how it may be affecting our health and well being. We can then help to protect our families and patients from medical problems caused by poor nutrition and to help them keep from wasting money on unnecessary ,expensive supplements if they are not needed and to increase our intake of wholesome foods.
The bottom line 1. eat more vegetables fruits and lean meats. 2.eat smaller meals and more often 3. drink more water. 4. eat and cook with healthy fats and oils. 5.eat out rarely. 6 consider taking a basic multivitamin and fish oil daily. 7. learn what a Mediterranean diet is and start implementing it at home and teach your patients what one is. 8 consider growing some of your own fruits and vegetables. if you don't have the space see if one of your friends that does would be interested in doing with you or offer to share part of your crop with them as rent!!
MAKE THESE CHANGES NOW DON'T PUT IT OFF ANY LONGER!!
JOKE FOR TODAY; Why did the mother always put her helmet on before she
used her computer?
http://www.freedigitalphotos.net/images/Pills_and_Drugs_g279-Spoon_With_Colorful_Vitamin_Medicine_Pills_p36718.html
Wednesday, December 7, 2011
Taking a History.
In my opinion the single most important element in any patients evaluation is their history. This applies to accident victims where the EMT's and Paramedics must determine with rapidity and accuracy just what happened to a patient at the scene of an illness or accident. As well as any significant allergies or medical problems from family or friends if the patients cannot speak. If multiple victims they need to know where they together in the same vehicle or place or does it just appear that way. Just as in law enforcement circumstances can be very misleading.
There are many other examples of accurate history taking I could give but the points are the same.
1. What is the patients medical history?
2. What are their current medications? and have they recently stopped any medications?
3. What medical procedure, surgeries,treatments, accidents have they had in the past?
4. What is their family history? does it relate to their current illness or complaint?
5. Is their a history of drug, alcohol,tobacco use?
6. The list could go on but you get the idea.
Now maybe the most important one. What are they reporting as their main problem or complaint?
This is where I see so many mistakes made in the evaluation of a patient. Sometimes we come to a conclusion too quickly due to input from family or other heath providors. Or maybe we forget or are too rushed to ask a few more questions.One more question might allow the patient to open up and share what is really on their mind. Sometimes i think they want to see how interested we are in them and their problem. If we rush them in and out they lose their respect for us or assume they are not really important. Sometimes the patient does not even give us all the information they could because they are afraid of the outcome or their family members don't know that many of their symptoms have been going on for some time.
Each situation and patient is a unique case and must be handled that way. When we sign off on the evaluation as a EMT, medical assistant, physical therapist,respiratory therapist,nurse,nurse practitioner,physician assistant, physician, or consultant we have essentially passed the patient on to the next level of care.We must make sure we have done the job to the best of our ability and training. If we do not then we risk harming that patient and changing the outcome of their treatment. Sometimes in a way that can change that patients life forever.
I hear all to often of incomplete workups blamed on this or that factor that result in the patient being misdiagnosed and suffering needlessly. Many patients will go to the doctor once for a problem(especially men) and if they are told it is nothing serious they may not return until it is too late. The reason for this is because "the doctor told me there was nothing wrong with me." Many patients put way too much confidence in one doctor and don't know to seek second opinions when symptoms persist or increase.
We all need to do our jobs to the best of our ability even with the most difficult patients. Sometimes those patients are actually hiding behind their behavior. I like to think of them as my biggest challenge and never take their problems for granted or dismiss any new symptoms they are telling me about as just more attention seeking behavior until i have fully evaluated them to 'MY' satisfaction.
To make an analogy to a car: If you take your car to the mechanic and try to describe to him what the problem is you want him to find the problem and fix it if possible as soon as possible so it wont cost you more or do more damage later if not properly taken care of now!!!! Everyone can relate to that. Patients are no different than a car really except that they can talk and try to mislead us or lie to us about heir history or symptoms. That is what makes the job as a health care provider so interesting. It really is alot like being a detective, and your job is to get as much evidence as possible to catch the culprit that is making them sick!!!!
Joke for the Day: Why did the watch go on vacation?
(to unwind!!!!!!!!!!!)
There are many other examples of accurate history taking I could give but the points are the same.
1. What is the patients medical history?
2. What are their current medications? and have they recently stopped any medications?
3. What medical procedure, surgeries,treatments, accidents have they had in the past?
4. What is their family history? does it relate to their current illness or complaint?
5. Is their a history of drug, alcohol,tobacco use?
6. The list could go on but you get the idea.
Now maybe the most important one. What are they reporting as their main problem or complaint?
This is where I see so many mistakes made in the evaluation of a patient. Sometimes we come to a conclusion too quickly due to input from family or other heath providors. Or maybe we forget or are too rushed to ask a few more questions.One more question might allow the patient to open up and share what is really on their mind. Sometimes i think they want to see how interested we are in them and their problem. If we rush them in and out they lose their respect for us or assume they are not really important. Sometimes the patient does not even give us all the information they could because they are afraid of the outcome or their family members don't know that many of their symptoms have been going on for some time.
Each situation and patient is a unique case and must be handled that way. When we sign off on the evaluation as a EMT, medical assistant, physical therapist,respiratory therapist,nurse,nurse practitioner,physician assistant, physician, or consultant we have essentially passed the patient on to the next level of care.We must make sure we have done the job to the best of our ability and training. If we do not then we risk harming that patient and changing the outcome of their treatment. Sometimes in a way that can change that patients life forever.
I hear all to often of incomplete workups blamed on this or that factor that result in the patient being misdiagnosed and suffering needlessly. Many patients will go to the doctor once for a problem(especially men) and if they are told it is nothing serious they may not return until it is too late. The reason for this is because "the doctor told me there was nothing wrong with me." Many patients put way too much confidence in one doctor and don't know to seek second opinions when symptoms persist or increase.
We all need to do our jobs to the best of our ability even with the most difficult patients. Sometimes those patients are actually hiding behind their behavior. I like to think of them as my biggest challenge and never take their problems for granted or dismiss any new symptoms they are telling me about as just more attention seeking behavior until i have fully evaluated them to 'MY' satisfaction.
To make an analogy to a car: If you take your car to the mechanic and try to describe to him what the problem is you want him to find the problem and fix it if possible as soon as possible so it wont cost you more or do more damage later if not properly taken care of now!!!! Everyone can relate to that. Patients are no different than a car really except that they can talk and try to mislead us or lie to us about heir history or symptoms. That is what makes the job as a health care provider so interesting. It really is alot like being a detective, and your job is to get as much evidence as possible to catch the culprit that is making them sick!!!!
Joke for the Day: Why did the watch go on vacation?
(to unwind!!!!!!!!!!!)
Sunday, December 4, 2011
Sacrifice.
When I look back on all the personal sacrifices i had to made becoming a doctor and practicing for 25 years I sometimes feel cheated on a numer of levels. The public and patients think because you make a better than average income its all so wonderful. They also assume that because doctors do usually get respect from the public (especially when they need you), that that is one more of the fringe benefits of being a health care provider. They also tend to think all doctors have a similar income and lifestyle for some unclear reason. As we know that couldn't be farthter from the truth.
What they don't see is the string of sleepless nights, 10-12 hour work days, concern over the outcome of a patients episode of illness and loss of personal and family time over many years. Then there is the ever present threat of potential or actual complaints of malpractice, insurance company control over your practice and income etc etc.
It is only when you take a step back and clear your head can you really see the how lucky you have been to be in this role after all. Just like everything in life, no one else will ever understand what seems so clear to you when you try to explain the reality of your personal experiences. This applies to professional and personal events. Just like I may see the life of an actor as glamorous and so much better than mine or the life of a big politician or CEO as being so much more lucrative and influential!
But unless I have actually lived in their shoes or with them as a family member i really don't have any concept for what the quality of their life is really like. It may be wonderful to play golf three times a week or travel the world making movies or business decisions or it may be just as difficult on a personal
level for reasons i don't even comprehend.
What i do know that there are very few professions like health care, where you get the opportunity to really help people and change lives and relieve suffering on a daily basis if you put your heart and soul into your work! So you didn't get home till 8 pm because you were in the emergency room with a child that was very ill. What did you really miss? A television show, a football game?
When you look back on your life years from now and think what did I really accomplish with my life? The answer is likely to be flooded with memories of very intensely happy and sad moments but they will represent real life events that changed you and possibly someone else's life forever! Contrast that with trying to remember what your best day of fishing or golf was, or what was the most memorable vacation you ever took, or who won the superbowl 5 years ago?
The real secret is striking a balance between your private and personal life. It is vitally important for health care providers to try to achieve this balance early in their career to avoid burnout. This can easily be done if you are aware of the warning signs. When they occur consider a change in working hours, practice type or location. The best way to keep this opportunity open to you is to live within your means and not get overextended financially so you will have this flexibility if that time ever comes that you want to make a change.
When things are going well it is easy to get a little to confident in the future and lock yourself into obligations that may be hard to fulfill of your situation changes personally or professionally. The good news is that most health care jobs are much more transferable to another location within the same city or to just about any state in the USA.
So realize what you do is important, valuable and irreplaceable. Relish in those facts and enjoy yourself, just keeps the doors open to making changes when necessary to keep yourself and your family as your primary focus. If you or your family are not happy you cannot be the best at what you do!!!
12-4-11
joke for today: What kind of music do they play at the playground?
(Swing!!!!!!)
What they don't see is the string of sleepless nights, 10-12 hour work days, concern over the outcome of a patients episode of illness and loss of personal and family time over many years. Then there is the ever present threat of potential or actual complaints of malpractice, insurance company control over your practice and income etc etc.
It is only when you take a step back and clear your head can you really see the how lucky you have been to be in this role after all. Just like everything in life, no one else will ever understand what seems so clear to you when you try to explain the reality of your personal experiences. This applies to professional and personal events. Just like I may see the life of an actor as glamorous and so much better than mine or the life of a big politician or CEO as being so much more lucrative and influential!
But unless I have actually lived in their shoes or with them as a family member i really don't have any concept for what the quality of their life is really like. It may be wonderful to play golf three times a week or travel the world making movies or business decisions or it may be just as difficult on a personal
level for reasons i don't even comprehend.
What i do know that there are very few professions like health care, where you get the opportunity to really help people and change lives and relieve suffering on a daily basis if you put your heart and soul into your work! So you didn't get home till 8 pm because you were in the emergency room with a child that was very ill. What did you really miss? A television show, a football game?
When you look back on your life years from now and think what did I really accomplish with my life? The answer is likely to be flooded with memories of very intensely happy and sad moments but they will represent real life events that changed you and possibly someone else's life forever! Contrast that with trying to remember what your best day of fishing or golf was, or what was the most memorable vacation you ever took, or who won the superbowl 5 years ago?
The real secret is striking a balance between your private and personal life. It is vitally important for health care providers to try to achieve this balance early in their career to avoid burnout. This can easily be done if you are aware of the warning signs. When they occur consider a change in working hours, practice type or location. The best way to keep this opportunity open to you is to live within your means and not get overextended financially so you will have this flexibility if that time ever comes that you want to make a change.
When things are going well it is easy to get a little to confident in the future and lock yourself into obligations that may be hard to fulfill of your situation changes personally or professionally. The good news is that most health care jobs are much more transferable to another location within the same city or to just about any state in the USA.
So realize what you do is important, valuable and irreplaceable. Relish in those facts and enjoy yourself, just keeps the doors open to making changes when necessary to keep yourself and your family as your primary focus. If you or your family are not happy you cannot be the best at what you do!!!
12-4-11
joke for today: What kind of music do they play at the playground?
(Swing!!!!!!)
Thursday, December 1, 2011
BUGS and SUCH!
The following is a true account of an experience I had in a childrens ER as a resident.
What brings you here today? I said to the childs mother.
He got a bug in his ear. She responded.
He has what? I asked.
A bug crawled right in his ear at home and now he wont quit the crying!!
So I examined the childs ear with two nurses assistance. Sure enough he had a cockroach in his right ear. I proceeded to use forceps to remove the dead bug. After I was done he was much relieved as i am sure it was putting pressure on his eardrum. The mother and child walked out of the ER much happier. I felt like an exterminator at that moment more than a doctor, but I realized how much that simple procedure had helped the child. It is the little things we do for others as people or healthcare providers that sometimes mean the most to to our friends, patients and people we meet each day.
Tip: should you or anyone you know ever have an insect crawl in your ear it will drive you crazy, especially if they have wings. To remove it take a flashlight and go into the darkest room in the house, a closet or a bathroom and hold the flashlight up to the ear. The insect will come out to the light and everything will be better!!!
Joke for today; Why was the saucepan always getting in trouble?
( He was too hot to handle!!!!!)
12-1-11
What brings you here today? I said to the childs mother.
He got a bug in his ear. She responded.
He has what? I asked.
A bug crawled right in his ear at home and now he wont quit the crying!!
So I examined the childs ear with two nurses assistance. Sure enough he had a cockroach in his right ear. I proceeded to use forceps to remove the dead bug. After I was done he was much relieved as i am sure it was putting pressure on his eardrum. The mother and child walked out of the ER much happier. I felt like an exterminator at that moment more than a doctor, but I realized how much that simple procedure had helped the child. It is the little things we do for others as people or healthcare providers that sometimes mean the most to to our friends, patients and people we meet each day.
Tip: should you or anyone you know ever have an insect crawl in your ear it will drive you crazy, especially if they have wings. To remove it take a flashlight and go into the darkest room in the house, a closet or a bathroom and hold the flashlight up to the ear. The insect will come out to the light and everything will be better!!!
Joke for today; Why was the saucepan always getting in trouble?
( He was too hot to handle!!!!!)
12-1-11
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