Pages

Tuesday, February 11, 2014

Hiring and Firing Doctors




In the last several years we’ve hired and fired quite a few doctors. C. J. and I have primary care doctors, and every body part has it's own specialist. Not just eyes and teeth, but we have ones like the toe guy, the cancer guy, and "Gastro Man." He laughs when I call him that.  Getting good ones doesn’t come easy; you have to kiss a lot of frogs to find a prince. Here are some hints on finding your prince(s).

WAITING ROOM
Is it clean? One of CJ’s specialists had peeling linoluem on the floor, stained walls and woodwork, and no sink in the exam room so you could see if the doctor washes up. Even if it’s clean, is it crowded? Does he expect you to spend a lot of time there with patients who are coughing and snorting and screaming kids? An hour is too much, and it shows the doctor doesn’t respect you or your time. The receptionist has your phone number, and could call if an emergency affects the schedule. Greed leads to overbooking, which leads to long waits for you.

COMMUNICATION
If you call the office and get a busy signal, this doctor is living in the dark ages. He or she doesn’t trust voicemail, e-mail, or fax messages. Odds are they are using paper files instead of a computer, and get all information by pony express. Your appointment time is spent digging through paperwork instead of looking down your throat or up your wazoo, which should be more interesting. Odds are good that they are not sharing information with your other doctors or the pharmacy, as they should.

COURTESY
We have had doctors who will not shake our hand without rubber gloves. We had one who wouldn’t let patients use the rest room, sending them upstairs and down a hall, some trailing tubes or tanks. Most do not visit hospitals at all, or even make a phone call. One asked me how my surgery had gone, after I dragged my sorry body to the office for a follow-up visit. I told her I had no idea, because I slept through the whole thing. That question told me she hadn't even checked with the hospital or the surgeon.

FIRING
This is easier than breaking up with a boyfriend or firing your yard man. No need to say good-bye, no need to ask for records, no reason to tell them why. Just hire a new doctor. We like new doctors, not just as in different, but newly graduated. This includes those with a dozen or more years or so under their white coat. They know the new tricks, are not burnt out, and don’t seem so arrogant. Maybe they run them through a charm school course. Or they may just appreciate your business.

Wednesday, January 1, 2014

Storming the Castle

Something triggered memories of our last European trip, probably pictures posted by friends. It was 1976, a milestone in several ways. It was the Bicentennial, it was the year before CJ's stroke, but is best remembered as the year we stormed the castle.

We took Doug and June, who were about 12 and 16 at the time, to see Europe by train. We carried only hand luggage so we could be spontaneous, sleeping by night and jumping off in the morning when we saw an interesting place. No reservations, just a vague plan to visit friends in the Netherlands, mosey up to Copenhagen, then down through Germany. The only Must Do was to spend the night in a castle on the Rhine, selected and booked ahead because it looked like a true castle, turrets and all.

The Netherlands trip included a bike ride in the Haag up to the North Sea beach to see the German bunkers, which were accessible by hiking through a nude beach. It also included a day trip to Gouda for the cheese festival, with music, dancing, and lots of cheese. We picked out a lovely ball of Gouda, sealed in wax, as a snackable souvenir.

Traveling by train in the summer sometimes included open cars, sometimes shared with livestock in the rear seats, and sometimes quite warm. After a night sleeping head to toe in our compartment, just the four of us and the cheese, we began to regret the cheese  We checked into a hotel in Copenhagen, all took showers, and ditched the cheese. However,  as we toured Tivoli Gardens, we still reeked of Gouda. We could part a crowd, which was a good thing.

At our next stop we found a laundromat, where we washed and dried the clothes in our satchels, put them on, and then washed and dried the clothes we had been wearing. No more Gouda cloud around us! {We told CJ we thought it was his socks anyway.}

We changed from train to bus to boat as we neared the Rhine, courtesy of Eurailpass. In less than an hour we spotted the turrets on top of a hill, and told the pilot to let us off at the castle. Sure enough, there was a dock with the right name on it, so we hopped off with our satchels and headed up the mountain.

After a hundred feet or so, the path gave out, and we stashed out satchels and began to climb.  Even as we are parting vines and helping one another over boulders and ravines, it never occurred to us to turn back. We finally reached a wall about ten feet tall. It had some slits, probably for pouring hot oil on the enemy, that gave  us a bit of a toe hold. Looking over the top, we saw a large courtyard with several tables of well-dressed people having tea and cookies. They looked at us with astonishment.

The waiters, however, brought over chairs to help our descent, led us to a table, and took our orders, oblivious to the fact that we were sweaty and trailing vines. Soon a manager arrived, confirmed our reservations, and asked about our luggage. He said he would send a car for it, and that is when we noticed a parking lot around the corner. Yes, there was a paved road that most people used, a few yards south of the dock. We used it the next day, after a lovely night at the castle.

Monday, December 16, 2013

Joyous Festivus

I was going to write a sweet Christmas spirit kind of entry today, but it just isn't happening. Some years I'm overwhelmed by comfort and joy. This is not one of them. If I go to Hell when I die (If?) there will be a choir of nitwits singing "Little Drummer Boy." Another group will follow with "The 27 Days of Christmas" or whatever number it is. For the solo, I want a lounge singer with a boozy version of "Have Yourself a Merry Little Whatever."

Our newspaper gives a "Sour Orange" award for the worst scoundrels of the year. Sort of like hoping Santa reads the Times and will bring them a lump of coal. Instead, their misdeeds are richly rewarded. The runner-up was Duke Energy, who has collected billions in advance to build a nuclear power plant that they have decided not to build after all. They not only get to keep the billions they collected but never spent, we are also going to spend billions more to decommission their old, broken plant. They will just keep on burning oil, thank you anyway.

The winner was Congress, who is refusing to reconsider a bill passed in haste last year that blows the lid off flood insurance. They were assuming that the "subsidies" being given to owners of homes in flood zones were rewarding rich people with waterfront mansions. Actually, the average homes affected in our area are about 1500 square feet, are not on the water or even in view of the water, and met all building codes when built. Their flood rates are going up from $2,000 to $40,000 a year, but they don't know for sure until the bills come in. The required affordability study was never done, and they voted with erroneous data, but they shrugged it off.

The third pisser of the week was Texas Governor Rick Perry getting a bill passed making it legal to say "Merry Christmas." This has people surprised and angry that it was illegal (it wasn't) and makes Perry a hero. Brilliant! I wish everyone Happy Hanukkah, Joyous Festivus, and Good Ramadan, just to make a point.

Saturday, November 16, 2013

A Christmas Trip

Started playing around with "Tell us 10 things about yourself that we may not know," and anyone that comments is supposed to add their own. I remembered a train trip I took, quite by accident, when I was six.

The train trip was only an accident because I did it alone. Mama was going to take me to New York to see the Christmas lights and windows. We were living in Princeton, N. J. for a few months in 1943 while Daddy was in training with the Navy before going off to war. The train pulled in to the station, the doors opened, so I got on. I didn't notice that Mama wasn't with me until the doors closed and we were off and going. I figured she was in another car or maybe the bathroom, but it was no big deal. I wasn't worried, because we were both going to New York, and I'd just find her there.

It didn't seem like long before we pulled into a tunnel. It wasn't scary because there were lights. No one got off at the first few stops, so I didn't either. Then, it seemed like everyone got off, so I did too. There was a big sign that said "MACY'S'"with more toys and Christmas trees and music than you could ever imagine. This must be Heaven! You just walked across the platform and right in the door and it went on forever. There were big moving elves and snowmen and deer and Santas of all sizes. I picked up a baby doll and decided to keep that for my own. I danced to the music, climbed up to a big tree, and sang along.

It was wonderful until I heard loud screaming. Mama came running in with a couple of policemen and a little Santa guy I had seen by the door. A policeman picked me up and asked me if I was alright. He tried to take my doll so I kicked him. He held me way out in front of himself when he carried me over to Mama. She was really crying and I didn't know why. It wasn't a sad thing, because we were just where we had planned to be. I guess she was sad because she missed the train. She told me not to tell Daddy, but I did. And I got to keep the doll. Her name was Barbara.

Saturday, October 19, 2013

Opinions, Mistakes, Lies

I got the same e-mail from two friends, listing facts I don't know. For instance, I never knew how many ridges are on a dime, or that butterflies taste with their feet. Now I believe these facts, because these friends wouldn't just make them up. What's the point? But the main reason I believe things they tell me is that, as far as I know, they have never lied to me before.

There are others that I would go outside and check if they told me it was raining. They are the "friends" in Facebook terms, that send me bogus e-mails. There are lots of ways to check a story to find out if it's true or a big lie. Call your library, ask the nice lady in the reference department. Call your Congressman's office. But if you send me a story, you are telling me that you believe it's true.

Instead, you tell me you got it from Rush, or Sean, or Glen, or somebody else you're on a first-name basis with. If I listened to your guys, I would know the truth about the government coming for your guns, your home, your horses. They would tell me about how our leaders are violating the (non-existent) 28th amendment, or the dreaded Agenda 27 of the U. N., whatever that is. 

The problem is that once you send me a lie and expect me to believe it, I can't believe anything else you say. I'm not talking about mistakes. God knows, I may tell you it's Tuesday when it's Wednesday, just because my pill dispenser got off on a wrong start this week. I forgive your mistakes as much as I hope you forgive mine. But don't lie to me. 

OK, you can tell me I look like I've lost weight. That's an opinion, based on a mistake, and I really appreciate it. You can say that you truly believe Obama is a Muslim. I will chalk you up as a racist, but that's your opinion. Tell me he created this gazillion dollar deficit since he took office, and that 's a lie, not an opinion. Tell me he has to follow the 28th amendment, and it's a mistake, unless you know better, then it's a lie.

By the way, I'm very glad we don't taste with our feet. It would make for a disgusting dinner party. And do you know where those feet have been?

Monday, October 7, 2013

Too much Anger


I don't understand where all this anger is coming from. I've lived through some decades of election year vitriol, and we expect that and shrug it off. Or we used to. Then we'd all cool off, have a beer, and plan how to change the world next time. Not now.

If you can't figure it out, I'm talking about the shutdown of the federal government. Don't tell me both sides are to blame. When I hear that, I know which TV network you watch. I'm worried that the inmates have taken over the asylum, the bonafide crazies are claiming victory over putting hundreds of thousands of people out of work, turning little children out of day care, and they're dancing around giving each other high-fives.

There are some people ignorant enough to think this is about health care. It's not. we already pay for health care for everyone who needs it, just not very well and not at all efficiently. I'm not insulting you if you are among these ignorant, which just means you are not well informed. If you want to be better informed, read more than one newspaper, listen to more than one radio or TV station, and ignore any of them that claim to be telling you The Truth. It's about a bunch of prima donnas who got elected in gerrymandered safe districts and are preaching to their little choirs that they know what's best for the country, not the rest of us who form the majority.

Notice I have not called you poor deluded souls dumb, just ignorant. Ignorant can be fixed with leaning. There ain't no cure for dumb. Dumb is voluntary, and is best pictured as the monkey sitting there with his hands over his ears, saying "Don't confuse me with the facts." If we want to let the crazies wreck the economy, put millions out of work, and change the way this country works, cheer 'em on. Otherwise, scratch your head and say "What would Reagan do?"

Sunday, September 22, 2013

The Real Malpractice Problem

Had an occasion recently to talk to a bright young doctor about malpractice. He didn't know, for one thing, that it's harder to sue doctors than most anyone else. You have to hire your own expert witnesses, as though you are going to trial, who will testify in your favor, and have a mediation session where they will lay out your case. Local doctors aren't eager to do this, so you may have to go out-of-state. All told, the cost estimate for pre-suit activity was around $50,000, and that was twenty years ago.

That's when CJ fell and broke his hip. When he got to the emergency room they whisked him away for X-rays, told us nothing was broken and we should take him home. Well, this was a problem because he couldn't stand up, much less walk. They reluctantly admitted him, put him in a room on the stroke patients' hall. Well, yes he had had a stroke 15 years before that kept him from talking much, but he had been walking with just a bit of a limp. He walked the dogs until they were exhausted, morning and evening. Well, the doctor thought that some physical therapy would help.

After a couple of days I went in during his therapy session, and they were trying to get him to walk between parallel bars. He couldn't take a step. As I watched, the therapist poked him with a stick, and his leg twitched. CJ was crying, so I told them to put him back to bed. I asked the therapist about the stick, and was told it was an electric stimulator. A cattle prod!

I found the doctor in charge and told him that this was cruel and unacceptable. He replied that they had run out of options, that CJ was not cooperative, and we should just take him home or to a nursing home. Our daughter, June, suggested they call a meeting with the doctors, nurses, and staff who had been working with him, and they did. She asked where the orthopedic doctor was, and they replied that he hadn't needed one because no bones were broken. Well, they did call one, who found that his hip was snapped in two. The only X-rays taken in the emergency room were of the chest.

After getting a new hip and months of physical therapy, CJ was walking slowly, now with a cane. I worked part-time for months, son Jason took a semester off from college, but things would never be the same. We visited several lawyers we knew who were specialists in medical malpractice. Each of them declined to take the case. The reason? Negligence was clear, but it was "garden variety negligence," meaning that it happens so often as to be predictable. Also, he was already disabled, so we couldn't sue for lost income. My lost income, our son's lost semester, CJ's lost ability to do things like walking the dogs, all fell under the "too bad" rule. Even if a jury felt especially generous, it was unlikely that an award would reach the $50,000 it would cost to file suit, much less the costs to go to trial.

So the next time you hear that medical costs are soaring because of greedy lawyers, put on your skeptical hat. The next time you see glossy ads for doctors or medicines, do not get sucked in. The next time you hear that doctors are leaving their practice for fear of lawsuits, get the facts. Just don't depend on your insurance salesman to give you the straight stuff. He makes a living off scaring doctors.