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True Confessions

by Rob on June 5, 2009 · Comments

in Personal Musings

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I have to get some things off of my chest.  A guilty conscience is something that can cause lots of problems, both emotional and physical.  As David said in Psalm 32:

For when I kept silent, my bones wasted away
through my groaning all day long.
For day and night your hand was heavy upon me;
my strength was dried up as by the heat of summer.

Sounds like David lived in Georgia.

So here are my confessions:

I stole a bagel yesterday. I went to Pannera Bread Company yesterday and ordered a blueberry bagel (toasted and sliced).  I have a cup that allows me to get free coffee, so when the woman at the counter was slicing and toasting I went got myself some dark roast.  I chatted there with a woman about the fact that light roast actually has more caffeine than dark roast.  As I went to the counter I saw someone I recognized, said “hi,” grabbed my bag and headed out the door.  It was half-way to work when I realized I was now a criminal.

This morning I went back and tried to pay for yesterday’s bagel but she wouldn’t let me.  I think she wanted me to live with my shame.  I put the appropriate change into a can collecting money for a kids cancer camp.

I watch American Idol. Yes, I watched most every episode this year.  Those who think I am all counter-culture can express their shock and disgust.  I enjoy hearing them perform – they were especially talented this year – and we watch as a family.  You must remember that I started college as a voice major, so I do like to hear good singing.

I was kind of pulling for Adam (his last name is almost the same as mine), but I thought Chris and Danny were worthy as well.

Sorry to those who now think less of me.

Our office allows drug reps to visit and give samples.  We even have them give us lunch. I know there are some who think that this is the hight of immorality, but I have found them to be quite valuable.  We have done our best to keep a limit on their access to us – they are not allowed to detail us in the hallway, only when they bring us lunch.  Only 1 rep at a time and no more than 6/day (never more than one from one company).

We have a person on staff who is dedicated to getting patients medications when they can’t afford them.  She will work with the reps to find a program for them and will give samples when possible.

Why do we do lunch?  One main reason: for our staff.  I actually skip it often because I get fat if I eat too much at lunch.  Their finances are tight and so supplying them with lunch saves them money.  The docs will generally tell the flat truth to the reps (“I dont prescribe your drug very much”).  I do find that they have brought me good information at times.

Our practice has always been a lower utilizer of brand drugs when we have been measured (mainly United Healthcare), so I don’t think this has had an undue effect on us.  Still, the conscience nags when others feel that pharma is the spawn of satan.

I have checked my blog in a patient room. During the more acute compulsive blogging phases, I have checked traffic during a lul in the exam room.  I do actually feel guilty about this and have stopped doing it.  I have NEVER twittered in the exam room, however. 

 

There.  I hope my bones don’t waste away now.

What do you feel guilty about?

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  • bill
    "ask your local farmers markets to provide regular deliveries and presentations to your practice which include fresh in-season fruits, vegetables, & protein source"

    Sounds grabby. Whats in it for them?
  • perishedcore
    customers and locavore voters *g*

    PS on the poll: Where's the "lying about how often I floss" guilt option? In theory only - I swe....
  • Ken O
    If you brush properly, you don't actually need to floss!
  • perishedcore
    Here's how to get rid 'o the reps, but keep and improve the bennies:

    Does your practice send out a patient newsletter with health education and self management strategies?

    If so, form a Meetup-type patient-led advocacy group. Charge it with providing your practice with feedback about your practice: satisfiers, desires, performance improvement, recommendations. Empower your patients.

    Ask them to form a drug rep liaison committee (or tap an informed patient volunteer or group) to learn how to take over the functions of connecting patients in need with pharma drug subsidies and need-based programs.

    Instead of pharma provided lunches, ask your local farmers markets to provide regular deliveries and presentations to your practice which include fresh in-season fruits, vegetables, & protein sources. Sponsor brown bag locavore tastings cum lunch and learns or after work hours grazers for your staff and patients (and if on friendly turf, staff from other medical practices) to work in some hands on experimental nutrition, health and fitness (include topics such as container gardening, beginning vegetable gardening, incrementally increasing walking, using a pedometer, adding plant-based high quality protein to the diet, strategies to improve sleep/sleep hygeine, preventing communicable disease, bicycling safety, how to choose walking/running/sports shoes, falls prevention, etc.

    One strategy that should be imported from the practice of community mental health is that of peer support. It works, it's low or no cost, and it builds commitment - to your practice, to your patients' own health, and to empowerment and advocacy. A side benefit is that you and your staff should receive some well-earned good will and satisfaction, too. {;^}

    You may never again need to see a drug rep except as a patient or attendee at one of your popular events!
  • I think it's great that you allow drug reps in and help people with their meds. You're right - so many people cannot afford them and not all meds have generic equivalents.

    What would you do if a patients tweeted when you were in the exam room with them?!
  • Ken O
    Things I have actively enjoyed recently:-

    "The Matrix", with Keanu Plank, Carrie-Ann Moss, and Llama Fishburne! Keep an eye on the randon humourous pictures folks!
  • Ken O
    I have no idea what the RDA of Thiamine actually is, so I'm sure I must eat less than that much sometimes!

    Oh and good way of benefitting staff morale, at least as long as you don't make lunch semi-compulsory even for people who want to be somewhere else.
  • Amanda B
    I yell too. I also threaten to sell them to the gypsies occasionally. Our ENT Doc. said I couldn't because the children are too active and the gypsies, being rather lazy, would want their money back.
  • GeoerdieKin
    Hmmm my son would be an excellent gypsy then...any caravans in the area? Anyway don't feel too guilty about it, I ran a school health office for a few years...450 students ages 3/4 (pre-k) and 9/10 (fouth & fifth grades) yelling was the only way to be heard most of the time...but I did sleep very good at night those years.
  • Sara
    I clicked the colonic one for fun.
  • Rob
    Do you feel guilty about it?
  • bill
    I go to a dental surgeon who I think makes way big bucks (that's an economic term, no need to be alarmed). I mentioned to him that I think his staff does a great job, and he agreed, by which I conclude that he pays them well. Nevertheless, I bought them lunch once (some pizzas). Turns out this is fairly common -- they were mildly pleased, but not surprised. Does this happen to you?
  • Rob
    Yes, our office does get stuff brought in by patients. It's not real common, but it happens with reasonable regularity. It means a TON to the staff when it does happen.
  • yay
    In year 8 I got 100% in a maths test. When I got home and flipped through the paper I realised that there was a CROSS instead of a TICK next to a little bit of working out. Obviously my teacher had missed that bit... but I did not report this the next morning. I had reported other such errors in the past, but 100%!!!!

    What if I'd reported that 99%, been kicked out of the top maths class, turned into a second-top maths class delinquent, not made it into my undergrad uni course or honours stream and hence not had a high enough GPA to be accepted into med.

    I still have dreams that there was a big mistake in year 12 and I have to go back and repeat the year so that my pharmacy degree is valid. Without a legit pharmacy degree I am not eligible for my medical degree.. but the university allows me to study year 12 and final year med at the same time. Man it sucks to wear school uniform again.
  • Rob
    You are a haunted soul, it seems.
  • "Why do we do lunch? One main reason: for our staff... Their finances are tight and so supplying them with lunch saves them money."

    Pay your staff more!

    And yes, I would crack up if you were examining me and Twittering at the same time.
    A sudden change of heart, I am paying you to do your job... so DO YOUR JOB!
  • Rob
    We pay them fine. Morale is lifted by food. It really is.
  • That poll would be much more fun if it was multiple choice. I had to pick & choose. Confess to yelling at the kids, or to plans for world domination? Decisions, decisions...
  • Rob
    It is supposed to let me do multiple choice, but for some reason it doesn't.
  • I think you SHOULD twitter while you are examining a patient. Twitter is frequently boring, and that would spice it up a bit. I can see it now: Checking patient's prostate, seems ok.
  • Rob
    So you don't think my regular twitter is exciting enough?
  • I have to admit I wasn't following you. But now I am. So I'll let you know.
  • Frank Drackman
    Ever helped yourself to any samples???

    Not even the Cialis???

    Nuthin???

    I getta kick out of eatin their food and prescribin generics...

    Frank
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