Comments for Musings of a Distractible Mind

Comment on Working by Dr. Rob

Dr. Rob — Thu, 23 May 2013 01:28:00 +0000

I think you don’t realize that the 300 I have so far were not hand-picked well people. I have not filtered out anyone. I have 5 patients on insulin pumps, one child with type 1 diabetes, and new onset type 2 diabetic, people with COPD, on oxygen, CHF, and other severe chronic problems. There’s also a whole lot of folks with anxiety and depression seeking my help, and they’ve required a good amount of communication.

I will say that all patients are motivated to stay away from the doctor’s office in that I believe that (nearly) all patients want to be well. What I do, however is to let them call me or message me before they get sick enough to go to the ER or even to need an office visit. This makes their problems not become catastrophic, instead keeping it small. It’s just better management of disease to give people access to care.

Please understand that I am motivated to keep people healthy, while the rest of the system is motivated to keep them sick. Do you really think I have a worse system?

By the way, even in my old practice with 4000 patients, I’ve seldom had patients who go to the ER 2-3 times per month. If they are doing that, there usually is a non-medical issue.

Comment on Working by Frank

Frank — Thu, 23 May 2013 01:01:00 +0000

So at 300 patients….if they are paying you 30 bucks per month you are taking in 9000/month. Your motivation to make the most money you can and do the least would be to see no one and talk to a few people on the phone.

Your goal would also be to sign up 300 healthy patients with very little medical problems so your work is easy

and they do not bother you.

What happens when you accpt patients with pre-existing conditions or brittle diabetics- the people that have 2 or 3 office visits per month and possibly 2 or 3 ER visits per month???

What I see in your practice would be a motivation to only sign up healthy patients trying to avoid the “high problem” patients and you are motivated more NOT to see the patient in an appointment.

What do you think???

Comment on Working by greg30808

greg30808 — Thu, 23 May 2013 00:45:00 +0000

When I forget to login first, it throws away my comments when I do login. Not a good design, I think.

Comment on A Letter to Patients With Chronic Disease by Kathy Brady

Kathy Brady — Wed, 22 May 2013 12:44:00 +0000

I have a corn allergy. It is infuriating to me that most doctors I have encountered a) have never heard of it’ b) are very resistant to learning that virtually everything they use in their practice (prescription and OTC drugs, IVs, inhalers, band-aids, stored blood product) — all have corn in them. Drs get frustrated at me. Imagine how I feel! And denying that corn isn’t in these products doesn’t help.And yes, I need to know more about corn than drs do to keep them from killing me.

Comment on A Letter to Patients With Chronic Disease by Lahoma Howard

Lahoma Howard — Wed, 22 May 2013 01:10:00 +0000

Thank you doctor Rob. That was a nice thing to read. I have several autoimmune conditions and finally feel like I have a doctor who although he is not perfect, he cares and he listens. I try not to overwhelm him as it was SO hard to find him in the first place. It has helped to ease the suckishness…ever so slightly

Comment on Catching Some Z’s by Sue

Sue — Mon, 20 May 2013 15:09:00 +0000

I, too, was diagnosed with bronchitis and given a Z-pak. It was usless. Went back to the doctor and was given ciprofloxacn. Today is the 10 day taking it and I am going back to the doctor AGAIN! STILL coughing up hockers and blowing my nose for the first 1/2 of the day. The only thing gone is the terrible cough that I am sure would be gone even if I didn’t take antibiotics. Won’t take yet another antibiotic! I am convinced that this article is right is saying “bronchitis” does NOT respond to antibiotics. Maybe an inhailer to open up sinuses. I went to the store this a.m. and going to take garlic capsules 4 times a day. Antibiotics are too overused in this country.

Comment on A Letter to Patients With Chronic Disease by Hubby's Pain

Hubby's Pain — Sun, 19 May 2013 16:58:00 +0000

Thank you so much for this! It is so affirming for chronic pain patients and their families who must advocate for themselves. The sad thing about this is that due to the “cognitive impairment” (brain fog or as my husband calls it “feeling drunk and out of it”) that many pain sufferers experience, this may come across as a patient either appearing to seek drugs or , despite making it to the office despite all odds, can not eloquently speak nor stand up for themselves. They really want the doctor just to make them feel better, to make the pain go away or give them a diagnosis to hang on to.

I have shared this letter with pain groups and organizations, members of government, media and anyone who I think will listen here in Canada!

My husband has been living with Chronic Pain for 26 years. It is at a 10/10 24/7, 365 days a year. Pain does not take a holiday.

I admire the honesty in your letter. Thank you so much.

Comment on A Letter to Patients With Chronic Disease by Vickie Isaac

Vickie Isaac — Sun, 19 May 2013 14:46:00 +0000

After taking 3 generations of chronically ill family members to dozens of doctors, and reading forums for several different chronic illnesses, I think the problem is that Western medicine has very little to offer chronically ill patients. In fact it makes them sicker.
The only thing that improves chronic illness is being open minded enough to study alternative healing. Integrative medicine and chiropractic and Chinese medicine seem to be much more effective. The things that seem to be helping the most are essential oils, NAET allergy desensitization, nutrition, balancing gut flora, of course as much exercise as they can tolerate without over-exercising. My daughter’s chronic illness appears to have been caused, at least, in part, by black mold, so her healing will involve some detoxing

Comment on A Letter to Patients With Chronic Disease by Veronica

Veronica — Sun, 19 May 2013 14:43:00 +0000

I’m in a unique position of being chronically, critically ill with a sister-in-law that treats similar diseases in kids. I’ve known her for many years prior to my illness and learned many aspects of being a doctor as a result. Her pager/cell phone has gone off during Thanksgiving dinner and family birthdays. During vacations, she is rarely able to make it a day without a call from someone in her medical group contacting her about a patient. She is always a doctor, always a wife, mom, daughter and sister. As a patient, I try to remember that my doctors are all people and that is helpful. I want them to be super-human and I want them to know everything and fix everything but some things can’t be fixed. We all just have to work together to make the best of a difficult situation. Thanks to all my wonderful doctors for continuing to try.

Comment on Failure by PiperAfloat

PiperAfloat — Sat, 18 May 2013 07:14:00 +0000

“you don’t always have to fix things to make them better. You don’t always have to relieve suffering to give care. It’s great when you do, but in the end the most important thing is to be there”

As we say in rural Mass., “Ah, yu’.” Translation: you got it.

The question in my eyes, which looks like guarded hope when I meet a new doc, is not “can you fix me?” but “will you not abandon me? Will you treat me like the decent, well-informed person I am? Will you be honest with me?”

I’ve got a few who seem to have the right answer. I’m lucky!