random thoughts

When your Doctor Srews Up

Bad things happen. many times they are outside our control. Often patients ask me, “Why did this happen to me?”. Many times the answer is quite simple. Bad luck.

Unfortunately for many patients that bad luck continues when they step into their doctor’s office. Many of us have long held to the notion that all doctors are created equal and that the profession is filled with many competent and intelligent people who are all equally qualified. Not true. Unfortunately many doctors do not all practice the same level of care. There are many very competent and thought leading physicians and there are many who are not. How do know which one you have. You don’t. And you almost never will until it is too late. Checking their credentials will not help. Checking their academic background or board certification will not help. Checking to see if they have ever been sued will not help. Asking your neighbors will certainly not help. Nothing will help. It is really just luck.

When a doctor screws up, bad things happen. Just ask Stephanie. Her true story blog appeared earlier on these pages. Stephanie had all the classic signs and symptoms of Bipolar Disorder. But her doctor missed it. Missing bipolar disorder can be catastrophic and I am certain that in this situation it directly lead to Stephanie becoming an addict. If it had been recognized earlier I firmly believe that Stephanie’s life would have been drastically different in a very powerful way.

Don’t be afraid to challenge your doctor and ask questions. The smart and confident ones will welcome the questions and answer them thoroughly. the bad ones will be insulted and will blow off your questions.

A good doctor will save your life. A bad one may destroy it.

I Choose Happiness!

WE really do have a choice that we can make. I choose happiness. Unfortunately many do not. We are bombarded by pessimism everyday. Negative thinkers who often say that they have no control over the “basd luck” that dominates their lives. However i believe that bad luck is often the by-product of poor decision making and negative thinking that creates negative action and outcomes in our daily lives.

Positive thinkers are happier people and happier people live longer and healthier lives.

So I choose happiness. It is a conscious decision that all of us can make. No matter what the circumstances are there is still a choice. We live currently in the most challenging socio-economic era since the Great Depression. Financial uncertainty is the rule, not the exception for most Americans. And yet we still have a choice. You can still by the TV watching news shows and following the daily turmoil of the stock market or you can choose to worry only about the things that we can control and take everyday for what it has to offer us. To laugh with your children; to enjoy the wonders of nature as a new spring comes to full bloom; to hold your wife; to cherish your friends; to read a book; to do anything at all that brings us peace and serenity and happiness.

It all sounds so simplistic and I am not suggesting that it will pay the bills. But neither will worry. As I write this blog my 4 year old is running in the back yard with her friends. Her world is small and concentric. her needs are few. Perhaps we need to shrink our world. To think and laugh and play like a child.

It is possible. We can choose happiness. Think about those around you who do make that choice and those around you who don’t. Who would you rather be with?

It’s just my Opinion

Everyone has an opinion. The problem is quite simply this; most are not qualified to share that opinion. Medicine, unlike virtually any other field, draws opinion like ants to a picnic. Many doctors don’t even have the opportunity to stay as current as they should when it comes to the overwhelming body of medical information available. A mountainous swell of information is released on almost a daily basis. Yet, as difficult as it is to stay current at least doctors have 8 years or more of medical training to fall back on. So today when one patient told me that they disagreed with my diagnosis and another told me that they know more about what they needed than I did, well you will just have to forgive me if I disagree with them.

Nothing gets in the way of treatment more than the uneducated and unfounded opinions of patients. Why is it that a patient with absolutely no training or experience feels that they have all the answers while at the same time their board certified physician just simply does not know what they are talking about? I have no answer to that question.

Now I will admit that doctors are often inappropriately paternalistic. And there are clearly times in which the doctor/patient relationship should be a partnership. but more and more patients are trying to take control of their healthcare and they are suffering dearly for that decision.

do yourself a favor and defer to an expert if indeed you have faith in your doctor to be that expert. If you have no confidence in your doctor then get a new doctor. Just don’t be that doctor.

Double Standards

Several years ago during an episode of the hit show “Ally McBeal”, Ally is running through a litany of problems she is having and extolling the severity of each problem. Her colleague looks at her and asks, “What makes you think that your problems are more important than my problems?” Ally looks her colleague straight in the eye and says, “Because they are MY problems!”

This sort of parochial view of our world is what often leads to double standards and having double standards, while being uniquely human, leads to all sorts of problems. Everyone openly admits that insurance fraud is wrong and leads to a global inflation of rates, yet at the same time doesn’t everyone ask the local auto repair shop to find a way to “cover my deductible”. People think that our country is too litigious until they slip in WalMart.

Double standards exist in the world of addiction as well. We judge people who are ticketed for DUI as evil,careless, and reckless individuals. yet at the same time we have all driven under the influence. We have all at some point in our lives gotten behind the wheel when we should have called a cab. What is the difference between us and those who have a DUI on their record? Luck. Obviously that is not true for someone who just got their third DUI. They are evil, careless, and reckless.

How about how we treat those who are famous when they fall under the spell of addiction or alcohol. Some how this seems to only serve as boost to their celebrity while the rest of us are demonized for our behavior.

Perhaps the simplest solution is simply to “do unto others…. It is perhaps too simplistic and even a bit naive to a assume that one would step back from a situation and say “what if?” before they judge. If they could the world would a different place. More tolerance. More patience. More understanding.

Sounds nice.

Insurance Reform; The Time is Now

What is the real purpose of health insurance? Who is the one who should benefit the most? Isn’t the purpose of health insurance to ensure that a patient is cared for in the most complete and thorough way? But insurance companies clearly get in the way of everyone’s health. The problem lies in the fact that insurance companies are in it for the money. Doctors have always been accused of allowing money to cloud their decision making when it comes to patient care. I will be the first to admit that that has been and occasionally continues to be true. However, the one thing you can say about that situation is that the patient always benefits. The doctor makes money by providing services that improves their health care. That is not the case with insurance companies. Insurance companies make money by not spending that money on patient care. If they spend money on patients that simple make less. That situation never benefits the patient. It is impossible to provide good healthcare and save money at the same time.

health insurance companies not only block our access to healthcare, they also block our access to insurance and inhibit our utilization of our benefits. It has happened over and over when a patient is seeking health or life insurance and a company simply says no for no good reason. They tell us that there is too much risk. That we are too unhealthy. Insurance companies are notorious for taking a condition that is not pathologic and telling you that this condition prevents you from getting coverage. They want to ensure that the population that they are insuring are not the neediest but the healthiest. The same is true of life insurance.

Heaven forbid that you should accurately try to use your insurance. You will be branded with all sorts of labels that you will never walk away from. Try to use your addiction benefits and tell some insurance company 10 years for now that you are in recovery and in perfect health. They will make you pay, literally and figuratively.

We need health reform in the US. The first step is to take the power away from insurance companies. Make them not for profit. the only person who should profit is the patient.

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